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Self harm

Self harm is any behavior that causes immediate physical damage to your body. It can take many forms and includes cutting, head banging, putting objects in your body, taking too many tablets, burning, throwing your body against something hard, punching yourself and swallowing harmful objects.

Some people understand self harm as belonging on a spectrum of behaviors. Using the idea of a spectrum can be useful in trying to understand why someone might self harm as we all sit somewhere on the spectrum. What do you do when life gets tough? Maybe you drink or drive too fast or eat too little. We all have things we do when life feels too difficult and many of these things provide immediate relief but are perhaps not the healthiest things to be doing.

Who self harms

Well, absolutely anyone. While there are sub groups in which self harm is more common (e.g. young people, prisoners, asylum seekers) it would be misleading to give a profile of your average self harmer. With self harm there simply is no average, it transgresses age, gender, ethnicity, employment status, any group you can think of will almost definitely include people who self harm. What these people will all have in common is they will all be doing their very best to deal with intolerable emotions or life situations. Many people who self harm have experienced childhood abuse but this is not always the case.

Why do people self harm?

Every person who self harms will have their own unique set of circumstances. Self harm fulfills many functions. It can be a way of communicating deep seated distress. This could be a personal communication to the self, a way of tangibly seeing an inner turmoil that can’t be understood with words.

 It could be a way of communicating to others. Experiencing distress can be very lonely when you don't have the words to share it with others. Physical injury is a concrete visible way of showing someone the hurt inside. 

It can be a way of taking control over your own body. If you have been abused your sense of ownership of your own body has probably been totally violated. Taking the choice to be the one causing the pain can feel liberating. It can also be a way of taking control of feelings that feel uncontrollable.

Some people harm as a way of punishing themselves. They perhaps feel inadequate or like they have failed. Perhaps they blame themselves for the difficult situation they find themselves in or for things that have happened in their past.

Some may find self harm a useful way of cleansing themselves from feelings of “badness”, “poison”, “feeling dirty inside”. There can be great relief in seeing and feeling the blood flowing out.

It can simply be a way of taking a break, providing a different focus. Self harm is very immediate, bringing us back into the present. It can be a way of “coming back” when dissociating. 

Conversely, self harm provides a reason to provide self care. It can be a whole ritual of harming followed by treating any injuries, cleaning and applying dressings.

Is it a suicide attempt?

No. Self harm is very much about surviving in intolerable situations. Suicide is about ending life, self harm is someone doing their best to find a way of preserving life.

Is it attention seeking?

Good question! I have two answers...

  1. It is rarely attention seeking. Self harm is notoriously a  hidden and secretive act. People often go to great lengths to conceal wounds.
  2. If someone is behaving in a way that you might label attention seeking, chances are they could do with some really good attention! “Attention seeking” has really negative connotations but think about it, we all seek attention, we need it to live. As babies if we didn’t get attention we would have died. Sometimes people grow up in an environment where they don't learn healthy ways to seek attention, it’s not their fault if the ways they learned make you feel uncomfortable.

Harm minimisation

Harm minimisation means accepting that for a while you may need to rely on self harm to get you through a difficult period and finding way of doing it that reduces the damage.

  • Finding a sympathetic GP can be invaluable. They can provide you with dressings and keep an eye on any wounds that are not healing. 
  • Wash your hands before harming yourself.
  • Always use a clean blade.
  • Sharp blades can be safer than blunt ones as you can use less pressure.
  • Have a first aid kit (see below for what you should have in a first aid kit).
  • Pull wounds together with steri strips. This will reduce scarring and minimise the risk of infection.

Have a basic understanding of anatomy and physiology (Ro... can we work with Heidi Hi on this? a diagram showing layers of skin, soft tissue, muscle, tendons, arteries etc). You do not want to be cutting into tendons, if you do you will need surgery and you may well restrict your mobility. 

If you have cut and it doesn’t stop bleeding or it looks like it is pumping out go to A and E.

Harm minimisation only applies to external injuries. If you have swallowed too many tablets or harmful substances you cannot asses the internal damage yourself, please seek medical attention as soon as possible.

There is still a lot of stigma surrounding self harm and you will get mixed responses from professionals. Taking a sympathetic friend with you to A and E can be really useful.

The National Self Harm Network have created a “self harm report card” which can be downloaded and filled in. You can give this to staff at A and E and it will tell them what your injury is, where the injury is and any treatment you would/would not like to receive. This can be really helpful if you find it embarrassing or difficult to talk about what happened.

If you want to stop self harming...

Don’t give yourself a hard time. You have been harming yourself for a reason and giving up can be tough. Trust that you will give up when the time is right.

Some people find a support group or self help group useful. Meeting other people who also harm themselves can help you feel more normal and no one understand self harm like a self harmer.

Counselling can be a space for you to work through the reasons you are harming yourself and/or find different ways of coping with your life and expressing what’s going on inside. Do your research. Some counsellors still use “self harm contracts”, meaning they will want you to agree to refrain from harming yourself while in counselling. You may find having an explicit agreement helpful. Personally I think it’s a bit like saying “we will help you... as soon as you are feeling better!”

The ice method!

I have never tried this one myself but know people who have found it helpful. Instead of cutting, take some ice and hold it in your hand, make a fist. This is painful but won’t cause injury. Apparantly as the ice melts and drips down your arm it feels similar to blood.

Get creative

Finding creative outlets for your emotions may reduce your need to harm yourself. Paint, draw, take photos, write, play an instrument, whatever does it for you.  The hi team have developed a photography work shop to get you started on the creative journey.  This is not super advanced, nor will you need a sexy camera... just time and a little motivation to get out there and take some photos. You can access the workshop here http://www.flickr.com/photos/hiwecanhelp/

Get active

There is loads of research suggesting physical activity boosts your mood. Go for a run, walk the dog, swim. Find an exercise class, take up a martial art, kick a football around with your mates. Find something you will enjoy.

Don’t give up giving up! It takes time, learning new ways to cope is really hard work. Every day you manage without self harm is something to be celebrated. If you slip up just let it go, know you did it for a reason and start over.

Please take some time to review the supporting documents and links here for more information. 

 

 

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Roweena Russell, E: roweena@hiwecanhelp.com , T: 079 57 57 6305
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