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Self-harm is a surprisingly common problem, with many people suffering in silence due to the stigma attached. One of the most common myths surrounding self-harm is that it is something that only teenage girls do, and that it has become fashionable or the latest fad. This is simply not the case. Self-harm can be a problem for both sexes and can affect anyone, regardless of age. It is sometimes suggested that people who self-harm are attention-seekers. This is not true in the majority of cases. Most acts of self-harm are carried out in private and the many people who self-harm never seek help. They also go to great lengths to cover their bruises and scars.
A common misconception is that someone who self-harms doesn't feel the pain but this is simply not true. Any physical injury is going to cause pain, although in some people the initial sensation is blunted by the intensity of emotion. Some people might think that people who hurt themselves can stop if they choose but those who self-harm do so because they see no other way of dealing with unbearable feelings. They have not developed more appropriate coping strategies.
Self-harm is often confused with suicide attempts, but for the majority of self-harmers this is not the case. In fact, physically harming themselves helps many people avoid attempting suicide. It is a way of dealing with overwhelming emotions that they sometimes cannot express in any other way. The extent of distress felt cannot be measured by the seriousness of the damage caused, people who self-harm only slightly may be as distressed as those who create greater damage.
What is self-harm?
It can be defined as causing deliberate physical injury to yourself so that you are causing tissue damage, ie breaking the skin or leaving bruises or marks that last for more than a couple of hours. This can take a number of forms, the most common being:
- Hitting yourself
- Banging limbs against walls
- Scratching or picking at your skin
- Interfering with wound healing
- Pulling out hair or eyelashes
- Taking an overdose of tablets
Why do people self-harm?
There are a number of reasons people give for physically harming themselves. For some it is a way of coping with intense feelings that lead to overwhelming emotional distress. It can be a way of dealing with the problems and pressures of everyday life.
Some people injure themselves as a form of self-punishment, for having feelings they believe they shouldn't have or because they believe they are 'bad' or worthless. One common factor to many people who self-harm is they were taught at an early age that their feelings were bad and wrong. They learned that certain feelings were not allowed, therefore learning to suppress their feelings. At the same time many have not had any good role models in order to learn how to express and cope with their emotions.
People who self-harm sometimes feel they have no control in other parts of their lives and harming themselves gives them the feeling of being in control of something. For some it can be a way to feel something, to escape numbness and feel they are still alive. It can also be used to express feelings that cannot be put into words.
Self-harm often occurs in people who have low self-esteem, and is often associated with depression, anxiety, addictions and eating disorders. Many self-harmers do not have a good range of coping skills. They often have a poor image of themselves, dislike themselves and can be hypersensitive to rejection. Many have feelings of anger, usually directed at themselves. There are often feelings of deep shame and guilt.
In some cases there is a history of physical, sexual or emotional abuse, possibly combined with a lack of love and affection, or neglect stemming from childhood.
How can you stop?
If you self-harm what can you do to stop? The first step is to try to understand why you hurt yourself. You can start by asking questions, such as:
- What was going on in your life when you first began to harm yourself?
- How you feel just before you want to hurt yourself. Keeping a mood diary can be useful.
- Are you always in the same place or with a particular person?
- Do you have any bad memories or thoughts that you can't tell anyone?
To stop hurting yourself it is necessary to recognise that self-harm is an inappropriate and uncontrollable method of coping, and to learn new and healthier coping mechanisms in it's place. It can help to tell someone you trust in the first instance and let the secret out. There are many feelings of guilt and shame that accompany self-harm and this prevents a lot of people from asking for help. It is a good idea to visit your doctor to seek professional help.
The following is a list of possible distraction methods you could try when you feel the urge to hurt yourself.
- Phone a friend.
- Write down your feelings in a diary.
- Listen to music or sing.
- Draw or paint.
- Go for a walk.
- Take some exercise.
- Concentrate on something else – think of a film title for every letter of the alphabet, anything to occupy your mind.
- Concentrate on breathing slowly.
- Relaxation tapes can be very useful.
If you still want to hurt yourself, you could try some safe alternatives, such as:
- Find something safe to punch, like pillows or cushions.
- Put your hands into a bowl of ice-cold water for a short time, or rubbing ice on the part of your body you feel like injuring.
- Use a red felt tip pen or lipstick to mark your body instead of cutting.
- Putting a (loose) rubber band around your wrist and flicking it
- Use some sticking plasters on the parts of your body you want to injure.
Self-harm can be really hard to stop. It will take time and there are likely to be ups and downs along the way. Sometimes however hard you try, it is just too hard to cope with your feelings on your own. If you can't stop wanting to hurt yourself it is advisable to talk to someone you trust and who can give you practical help.
The first port of call is usually your GP, who can discuss with you the options for further treatment. These include:
Cognitive-Behaviour Treatment: This can help you to recognise triggering feelings and learn to address them in healthier ways. It can involve the use of contracts, journals and behavioural logs.
Interpersonal Therapy: This can help you to understand your destructive thoughts and behaviours and learn new, healthier ways of coping.
Hypnotherapy: Can be helpful to teach relaxation and in reducing the stress and tension that often precedes self-harm.
Medication: Antidepressant/anti-anxiety medication may be used to reduce the initial impulsive response to stress while other coping strategies are developed.
If you know someone who self-harms
It can be worrying if you know someone who self-harms but there are ways you can offer support.
Try to remember that they are probably feeling very distressed and that self-harm may be the only way they have of expressing their emotions. Allowing them to talk about how they feel is probably the most important thing you can do. Just knowing that someone is listening and that they are finally being heard can really help.
Don't blame them for hurting themselves, and try to avoid being critical even if you feel shocked by what they are saying. This may make them feel even more alone and prevent them from talking to anyone else. Acknowledge and take them seriously. Respect their feelings.
Be clear and honest about your feelings. Explain that their behaviour upsets and worries you, but let them know that you understand it helps them to cope.
It is not a good idea to ask them to promise never to self-harm again. They may well do it again and then feel guilty about breaking their promise.
http://www.youngminds.org.uk – specifically aimed at young people who self-harm
http://www.nshn.co.uk – support for those who self-harm and families of anyone who self-harms