Being a very misunderstood condition, even within the health care system, many people view this as attention seeking and therefore find it difficult to understand why anyone would want to injure themselves. But sadly, this is a real and dangerous place for the self-harmer to be and attention is the last thing they want. The scars and wounds are usually hidden as this is a very personal and private practice that is not shared with others.
Perhaps you have noticed unusual scars, scabs or bruising on someone’s arm, notice they always have long sleeved clothing on and are very unwilling to show off their arms or legs. If you do notice scars, fresh wounds on arms, stomach or thighs your first instinct may be to question this person but take a step back first and think before you act. Often gentle suggestions of visiting a GP or a counsellor to tackle the underlying problem will be more effective.
What is self-harm?
Under the umbrella term for any behaviour that can cause harm to your health, self-harm has a wide range of ways to assist someone who is deeply distressed. These range from cutting or poisoning to burning or swallowing. The most common form you will hear of is cutting. Tools for cutting may be glass, a knife, razor blade, compass or a needle, really anything that the self-harmer feels is suitable. Patients often describe the act of cutting as a release of inner pain which they feel can’t be voiced. If you think of an alcoholic or someone with an eating disorder you may have more empathy but it is still a form of self-harm.
In short, the term self-harm is the act of causing deliberate harm to your own body through physical abuse. Triggers can be anger, distress, fear, emotional worry, depression or low self-esteem and can be seen as a form of self-punishment.
Painful experiences which have no emotional outlet at the time are often blocked or buried until the patient can find another way to cope, turning the anger inwards towards themselves. They may feel a sense of frustration, guilt or anger and feel this is a controlled way to release these emotions. An individual may also find that violence towards themselves helps to cope with aggressive or angry emotions towards others. Many people don’t know why they do it, it is a very lonely place to be.
Often the injuries will be in an area of the body that is easily covered with clothing so you may be quite shocked to find out how long this has been going on. There could be scars, scabs or old burn marks which will confirm this is not attention seeking otherwise they would be in a place for all to see.
There will always be an underlying cause.
Research has shown that young adults are the most likely to self-harm, but anyone of any age could be affected. It doesn’t matter what age you are, what gender or where you live, just like depression, self-harming can creep into the life of anyone. Men may feel emotion is a weakness and by self-harming they believe they are controlling their feelings by choosing a time and place to suit them. Because this is a hidden behaviour, it is difficult to have an accurate idea of how many people actually self-harm but it is thought that around 10% of young adults may try and hurt themselves and 90% of young adults treated for self-harm in A & E will have taken an overdose even though the preferred method is to cut.
What can you do to help?
No-one will open up and reveal the scars unless they find someone they can trust, therefore counselling is an ideal place to start. Knowing the therapist is non-judgemental and that confidentiality will be held, therapy offers the perfect place to start when an individual is ready to share feelings and emotions.
It may be a long journey to recovery but having a trusted companion can have a great impact on the emotional healing process.
If you have a friend or relative who self-harms, try to encourage them to talk to their GP or a therapist about the underlying problem and perhaps ask for help with relevant advice and information.
Try to open up methods of communication but don’t force them to talk about it.
Each episode could be for a different reason, so be willing to be patient and understanding. If they say they have just self-harmed, calmly ask if they need any medical attention.
When they appear low, offer distractions, help and understanding.
If you yourself self-harm, try to keep wounds clean to avoid infection no matter how small while trying to focus on safe limits.
British Association for Counselling and Psychotherapy (BACP)
Tel: 01455 883300
National Self-harm Network
Tel: 0800 622 6000
Kaye Townsend (MBACP)