Self-harm: an intentional action

There are many ways we might harm or damage ourselves, perhaps through accident or carelessness, perhaps through smoking or drinking too much or perhaps just working or playing too hard. The pressures of living and coping can sometimes prevent us from seeing the harm we’re doing to ourselves and those around us. For some, the gradual or even sudden moment of realisation of this harm can provide the impetus for change, the motivation to do something about it. The trigger may be a health-scare or a growing relationship problem, it may be recognition by our selves or from comments and observations by others; whichever it is, that may be enough. However, while it may have been harmful, it is not self-harm.

Self-harm involves far more intentional action; that of deliberate self-injury through cutting, burning, scalding, hitting, purging, poisoning and many more. The word deliberate is often used but, just for a moment, I’d like to consider its definition; “…to consider thoughtfully and carefully”. How does that fit with someone who feels so overwhelmed by what is going on in their mind that their only way to cope with it is to cause themselves real pain and risk serious harm?

There are many theories about why people self-harm yet it has to be acknowledged, people have been doing it in one form or another for thousands of years for a great variety of personal, cultural or spiritual reasons. Self-harm always has a reason and it is not always about wishing to die; more often than not it is about staying alive, about feeling alive. While suicide is an increased risk among many people who self-harm, there are also many who have self-harmed for years and have kept themselves safe, often keeping their self-harm a secret because of what they may have heard or experienced from the attitudes of both the general public and from those professionals who are there to help them;

“Over and over again, the young people we heard from told us that their experiences of asking for help often made their situation worse. Many of them have met with ridicule or hostility from the professionals they have turned to.”
Camelot Foundation & Mental Health Foundation, “the truth about self-harm”, 2006

However, as with the above quote and with the NHS NICE Guidelines for example, things are changing. Recognition of the damage that the wrong approach can do along with better understanding of the causes and thinking behind self-harm is creating more helpful and caring responses by health professionals. This is about helping to manage the self-harm more safely before perhaps finding a way to end the need. As such, a useful starting point may be The National Self-harm Network (www.nshn.co.uk) who provide detailed information and advice for individuals, families and professionals.