Self-harm: The secret battle

Many of us have heard of self-harm. An American study found that 1 in 5 males and 1 in 7 females are self-harming, and a UK study suggested that 13% of teens admitted to ‘intentional self-harm’, though these statistics very much depend on what you consider to fall under that heading. For many of us the immediate image that comes to mind is that of cutting, but there is far more to it than this. The following information is aimed at creating a better idea of what self-harm is, what it may mean and how we can approach it.

What is self-harm?

As mentioned above, the form of self-harm we are most familiar with is that of cutting the skin. We may have seen this in films, or from images in the media of blades or scissors. However, there are many others forms such as;

• Burning.
• Pulling out hair.
• Inserting objects under the skin.
• Hitting yourself.
• Poisoning or making yourself sick.
• Picking at wounds to stop them healing.
• Purposely breaking bones.

There may be elements that we don’t automatically put into the category of intentional self-harm, or we see as ‘normalised’, for example hitting walls. For many people, particularly males, hitting a wall is a form of lashing out and releasing anger but it may also cause damage to the body, often resulting in breaks to the skin, sometimes breaks to the bones and severe pain.  

Another behaviour to be aware of is eating disorders, not just making yourself sick but also depriving yourself of food. Even something that from the outside appears positive for your health could be considered to be self-harm, as in the case of excessive exercising.

It is also worth noting risk-taking behaviour; excessive drinking, drug use and putting yourself in risk of physical harm such as violence or unsafe sex. While these may not be as visible to us as cutting or burning, the principle can still be the same; causing possible external pain or damage as a reaction to internal suffering. 

Why do people self-harm?

There are many reasons why people self-harm, and it is impossible to cover them all as it is such a personal experience. Many report that it is a way of coping with something that is difficult to put into words. It may be that they have feelings that are painful inside but are unable to vocalise them. By changing emotional pain into physical pain it is easier to understand, and may even feel easier to control, after all physical pain is something that we are brought up to deal with and know how to ‘fix’.  We understand how to clean a wound and that in time it will heal, this is not the case with emotional pain. Things can build up so much that self-harm is often described as being a ‘release’ or bringing feelings of ‘relief’. In turn treating any physical damage done can help create a reason to look after ourselves and create a sense of care that could be missing from life.

For others, self-harm can be a way to deal with numbness or a feeling of being disconnected; when you don’t feel anything, even physical pain can be preferable. A way of feeling you still exist in the world.

It may be linked to past trauma; again gaining a sense of control over what you once had no say over.  It has been observed that survivors of abuse may repeatedly hurt themselves in a way that replicates the nature of the abuse they went through, so, for example, if somebody was frequently held down by their wrists this may become the focus for pain in future life. In this way someone can try and take ownership of their suffering.

Sadly the accusation of ‘just attention seeking’ is still all too common, as is the notion of ‘a cry for attention’. The truth is that self-harm can be a way of asking for help, but that is not to be treated in a negative way. Sometimes it is just too hard to be heard otherwise. It can be a way of letting others know we are suffering or even expressing dark or suicidal thoughts without going too far. If this is a way of at least reaching out, then it is important that we listen.

What can be done?

So, once we have received the message, what can be done? If you recognise that you are caught in a cycle of self-harm, then what is the next step?

First of all, understand that it is nothing to be ashamed of and that there are people who understand and can help. Stopping self-harming can be incredibly difficult so having support through your journey is important.

Look at patterns of self-harm and note them down; this can help you understand your triggers and urges. Triggers could be a person, a place, a word, a situation or any range of things. Urges could feel like a surge of emotion, a loss of emotion, a feeling of distance from the world or thoughts around hurting, for example.

Once you have a sense of what is going on then you are making steps towards change; learning how to vocalise your feelings, finding new ways to cope, expressing yourself and dealing with past trauma.  Counselling can be a great place to do all of these things. Once the physical side of harming has been worked through and alternatives found, in-depth work can begin around self-esteem, how you view yourself and what you need. 

For many people self-harm is done in private and kept secret due to the stigma of shame or judgement. Speaking out is the first step. Counselling can offer a space to talk about whatever is troubling you, with someone you can trust. The work may not be easy and there may be bumps along the way, but you don’t have to go it alone.