Self Harm (or Self Injury or Self Mutilation)

Many people, when distressed, turn to a coping mechanism which has been well established in their lives. Some of these coping mechanisms could be described as positive, for instance talking to friends or taking a bath to relax. Others may be described as negative or self-destructive, which may include abusing alcohol, taking drugs, or self-harming.

However it is rarely this clear cut. What may seem like a negative or destructive coping mechanism to one person could in fact prevent more harm than it causes for another. If we take alcohol as an example, for some people a glass of wine after a hard day relaxes them, they enjoy it, and they feel better for it. However for someone who has struggled with alcoholism, one glass of wine could lead to alcohol binges, feelings of failure and despair.

It is easy to see, therefore, how many of the strategies which we employ to cope with our everyday lives or to cheer ourselves up can have both positive and negative implications. However when people talk about self-harm it is almost always in a negative way - i.e. that self harm is a destructive force which must be stopped.

I will explain what I mean by self harm. Self harm or self injury are terms used to describe the actions of someone who deliberately and intentionally hurts themself. There are many ways that people do this: cutting their body with knives, razor blades or glass; burning their body; biting their body; hitting themself against things; hair pulling; eating foods they are allergic to; starving themselves; ingesting objects or substances; deliberately depriving themselves of sleep. The list could go on and on. Some people believe that there is a spectrum of self harm according to which many of the population could be described to some extent as self harming, including things like smoking or getting drunk.

All kinds of people self harm. Below I will explain some of the groups of people who are more likely to, but this is not to exclude those who self harm who do not fit into any of those categories.

Studies show that more women than men self harm. Research suggests that this is because society dictates that women turn their feelings, especially feelings of anger, inwards whereas men are encouraged to turn their anger outwards, e.g. in aggression. This could be why men may be more likely to get into a fight than women, and women are more likely to hurt themselves than men.

Research also suggests that young lesbians, gay men and bisexual women and men are more likely to self harm than the heterosexual population. This is likely to be due to living in a heterosexist society, which leads to feelings of low self worth and even self hatred. Obviously many lesbians, gay men and bisexuals face prejudice and discrimination on a day to day basis. This makes life very difficult to tolerate and self harm may feel like an outlet to cope with the pain of living this way.

Young Asian women in Britain have also been found to have a higher incidence of self harm. It is likely that for many young Asian women this is because of (1) living in a racist society and (2) living with the dual identity of being both Asian and British. Within both British and Asian cultures there is a certain pressure to conform to cultural ideals. The struggle for young Asian women to find an acceptable place in each of these cultures, to please both family and friends while fitting in, can be an unbearable pressure, and self harm is one outlet which for some, brings relief.

However like I said above, people from all walks of life, all ages, all social classes self-harm. Just because you or someone you know do not fit into the above groups does not mean you / they are not going to self harm.

There are probably as many reasons for self-harming as there are self-harmers.

Some people find that when they self-harm they experience a "release" which they cannot achieve in any other way. This can be a huge relief if feelings of depression, anger, self-hatred, fear or anxiety are becoming overwhelming.

Others find that when emotional pain becomes unbearable, if they hurt themselves in some way it transfers the pain to physical pain on the body. For many, physical pain (e.g. from a cut or a burn) is much easier to deal with than deep emotional pain.

On a similar note, some people find that hurting themselves physically gives them more control over their pain and their lives. Whereas it is difficult to control the emotional pain you may feel, if you then take charge of the pain and are in control of it, this can seem easier to deal with.

On the surface it could appear that self harming is similar to suicidal behaviour, especially if people are cutting their wrists, or overdosing. However for an awful lot of people, self harm is known to prevent suicide. By the means I mentioned above, self harm can take the edge off overwhelming feelings, and thus make someone less likely to attempt or commit suicide.

Some people self harm as a way of punishing themselves. If they feel guilty for something they have done, said or thought, they may then cut or burn or otherwise harm themselves because it is what they feel they deserve. Often the "punishment" is much more severe than is warranted, for example someone slashing their wrists because they overslept.

Self harm can also be anger turned inwards. For women in today's society, showing outward signs of anger is a socially unacceptable behaviour so if someone angers them, instead of shouting at them or taking their anger out in other ways, they may self harm to get rid of the supposedly unacceptable angry feelings.

There is also a scientific theory which could explain some people's self harming behaviours too. This is the theory that when we are in physical pain, endorphins ("happy" chemicals) are released into the body, leading to something resembling a "high". So when someone is feeling especially down or depressed, self harming could lead to a boost of endorphins which could make them feel better, albeit temporarily.

Self harm, self injury or self mutilation are coping strategies and it is important to remember this. For many people, especially those who know someone who is self harming, it seems to be a purely self destructive and very distressing behaviour, however an important point to remember is that if it didn't work, no-one would continue to do it!

Many people who self harm have reported negative experiences with health professionals to their self harming, particularly when going to get wounds treated. Some doctors have stitched up cuts without anaesthetic, others dismiss them as attention seeking, others force a psychiatric consultation on someone who has self harmed when all they want is physical treatment, while still others refuse to offer any kind of emotional support to someone who is self harming and wants help.

However it is important to point out that not all medical professionals react in an insensitive, caring way. In many ways it seems that attitudes are improving and people are receiving somewhat better services.

If you are reading this and need medical attention, do not avoid it because some professionals are insensitive. If you need to get a wound / burn looked at then do.

It is important that you try to understand their feelings, and do not criticise them for their behaviour. To find out that someone you care about is self harming can be very shocking and a lot of self harm can appear quite alarming. However it is important that you do not get hung up on the physical side of it. Self harm is a physical manifestation of genuine emotional distress, and this is where your friend / family member will need your support.

Talk to them, try to find out what is behind the self harming behaviour, and see if you can offer support to help them with their distressing feelings. Often just listening to what they have to say can be invaluable, especially if they feel they have never been listened to or taken seriously.

It is important that you do not criticise or judge someone who is self harming. Remember that for many people, self harm is about survival, and if you appreciate this then you will hopefully hold back on judgements.

Also, do not overreact to someone's self harm. Self harm can be quite shocking to see, but remember that it is an outward manifestation of interal turmoil.

If you feel like you want something practical to do to help, then if someone needs medical treatment as a result of their self harm, you could always offer to go with them while they get that help.

If you are unsure about how to support someone who is self harming, the way forward is to ask that person how they wish to be supported. They may want a hug, or physical treatment, they may want you to bring the topic up in conversation, or they may not want to discuss it if they bring it up. Ask them what they want, then you know you are doing the right thing.

If, as a result of supporting someone who self harms, you are feeling distressed and would like some support, as them if they would mind if you talked to someone else, without mentioning their name. If they don't want you to talk to a mutual friend, as if it would be okay if you phoned a helpline anonymously. Don't plough forwards and start talking to other friends about it without their permission.

There are many reasons people want to give up self harming, for example wanting to be able to wear short sleeves / shorts rather than cover their arms and legs up to stop people seeing their scars. They may also want to stop because they are treated badly by some medical professionals when they go for help with their injuries. Or because they are criticised by family and friends for what they are doing. Or because they are aware that their behaviour is causing pain to others and they don't want to do that. However, self harming can become a rather addictive behaviour which, once started, it is difficult to give up.

Giving up self harming is rarely easy. Until you try, you may believe that you could stop any time you want to, but when it comes to actually doing this, you may find it harder than you anticipated.

However, there are things you can do which will help you to give up.

The first thing is to remember that self harm is a coping mechanism, so in order to be able to get on with your life without self harm you will need to put in place some alternative coping mechanisms which can take its place. Think about different ways you can take extra care of yourself, and consider the different situations which can make you want to self harm, and see if you can think of any alternative coping strategies for those specific situations.

Although you can give up self harming on your own, it is often easier if you have the support of the people around you, or perhaps a professional. You could ask a few close friends, or family members to support you during this time. Or alternatively you could go to your GP and ask for a referral to a counsellor or someone who can support you. This could be a CPN (Community Psychiatric Nurse), mental health worker, OT (Occupational Therapist), or a support worker, amongst others.

If you do manage to go for a period of time without self harming, and then you go back to this behaviour, do not beat yourself up about it. You have been using this as a coping strategy, probably for some years, and it is not so straight forward to stop! Look on it as a setback not a failure, and start to work on stopping again when you feel ready.

by Philippa Willitts

Picture of my lego clone!

Name :
Philippa Willitts (Pippa)

Email :
purple_pippa@yahoo.com