Understanding self harm
This week, an article in the Lancet was aimed at understanding why people hurt themselves, but stated “why people self-harm is poorly understood”. I disagree with this – I think the reasons can be quite straightforward. My comments are based on my own experience of self-harm but also from supporting friends and understanding where they are coming from.
Taking self-injury in its most obvious sense, and in the experience of both myself and my peers, it is about turning a mental pain into a physical one. Depression leads to agonising internal pain, at best chugging along without truly coping, but at worst tearing yourself apart with torment over every action in life. This of course leads the sufferer to stop coping with life, and from there it is a small step to self-harm or indeed to anything which can offer relief.
If you cut yourself, you are now distracted by the sharpness of the physical pain. It is easy for anyone to comprehend why a wound hurts – your body is torn open, it’s bleeding, and so the pain is understandable. In contrast to this, many people don’t understand why, when your heart is torn open and you are bleeding inside, you may be suffering a huge and intolerable pain, either physical or mental in nature.
Self-harm is also about taking control. By holding the knife, you are responsible for your own pain – when you will feel it and how it will be caused. For victims of abuse this is particularly powerful – including those who didn’t realise that being squashed by other people every day is a form of abuse – but in all cases, self-harm is often about taking control of your own pain and wanting to understand and be in charge of what happens to your body. Somehow it isn’t as bad if you are choosing to inflict it, rather than being an unwilling participant.
Also, once someone has self-harmed for the first time and realises what a focus it was for them – a way that they can take back power while managing the very real pain they are experiencing – then it can become compulsive. I will not say that self-harm is actually appealing as that would not be accurate, but it can seem alluring as a method of regaining control over emotions and experiences which have been dominated by parents or other adults until this point.
There is a final related issue in that self-harm can replace the focus of someone’s attentions, and after the first time people may concern themself with when they will do it again, which implement they will choose, whether the marks would be visible when clothed, or even if wounds need to go somewhere which would not be noticed by a boyfriend, making sure that any cuts were not too deep. This sounds terribly obsessive but it is a safe time – a half hour or so when you are considering this and nothing else, so you do not have to confront the demons in your head. Self-harm is a great distraction.
When I was a very unhappy person in my early twenties, I used to self harm, but always as inconspicuously as possible. I wanted the pain to be an outlet for my mental anguish, without attracting the concerns of those around me. I had a boyfriend who was flummoxed by my distress and unhappiness, but he had another friend who was experiencing similar problems. Therefore, he invited both of us to visit in the hope that we would be comfort for each other. His actions were well meaning, but self-harmers understand each other and within minutes of saying hello for the first time, his friend and I had discussed where in the bathroom we were keeping our tools (part of an essential toiletry bag for a weekend away) and had even offered to share items with each other if necessary. My boyfriend despaired.
How do you stop? Initially I tried to prevent myself from self injury by willpower, because a new squeeze admitted that he didn’t like or understand the scratches on my arm, and I didn’t want to upset him. This man mattered to me, so I tried to ensure that I cut myself as little as possible, but I also felt that if I had to cut, it must be in a hidden area, and I could not be honest about what had happened. There is always the feeling that self harm – which can relieve and be liberating – must be kept hidden.
Things progressed well in our new relationship and I learned to cope and believe in myself, but every time our romance hit a hiccup I reached for a knife – perhaps in the same way that some ex-smokers relapse in times of stress – although I knew my new squeeze didn’t like it. In the end things settled with my partner – now, a decade later, my wonderful husband Mike – and I no longer felt the need to let out pain from my body in that way. I was able to contain and process any mental distress I experienced. Slowly, I moved on without realising that it was happening.
It took me many months to stop self-harming after years of relying upon it, and I think that as time went on I was lucky enough to find myself in a secure environment where I could flourish without needing a crutch to fall back on, and where I could rely on my partner for support. Unfortunately I think that for others, finding a way past their anxiety or depression may be the only way forward, and this may ultimately need counselling or proper psychiatric care for people who rely on self-harming to keep themselves balanced.
I hope everyone else is as fortunate as I was in finding a long term solution – in my case a relationship where I learnt to feel valued and secure. For those who don’t have the support they need to stop self-harming, I hope they find confidence within themselves and manage to reach a point where self-injury is not the only or most obvious coping strategy. Self harm may be easy, and widespread, but that doesn’t mean it is healthy.