Self- harm can be anything from banging your head against the wall, to cutting yourself with a blade. It is a way of expressing deep depression and distress. People who self-harm don't always understand why they do so, but they use it as a method of communication, telling people things that they cannot put into words. It is sometimes described as an inner scream or cry for help. After harming themselves, people will feel better and feel that they are able to cope with life again, for a while.
Self-harm is a very broad term, people can harm themselves in many different ways including:
- Poisoning themselves.
- Overdosing on drugs.
- Cutting, scratching or burning of the skin.
- Swallowing or putting objects inside of them.
- Putting themselves at unnecessary risks.
- Remaining in an abusive relationship.
- Developing an eating disorder, for example anorexia or bulimia.
- Developing drug or alcohol addictions.
- Neglecting their own physical and emotional needs.
The response of self-harm helps some people to cope with any feeling that they find threatening or overwhelming. These could be painful emotions, such as rage, sadness, emptiness, grief, self-hatred, fear, loneliness or guilt.
Self-harm may serve different purposes for different people, it can be a method of getting the pain out, of being distracted from the pain, of communicating feelings to someone else, or of finding comfort. It can also be a method of punishment or an attempt to gain control over life. This could be because they feel ashamed, afraid or worried about other people's reactions, people who self-harm usually conceal what they are doing rather than draw attention to it.
Most people behave self-destructively at times, even if they don't realise it. Perfectly ordinary behaviour, such as smoking, eating and drinking too much or working long hours, day after day, can all be helping people to numb or distract themselves and avoid being left with their own thoughts and feelings.
By clicking the headings below, you can find out more about a particular aspect of self-harm.
People self-harm because of experiences they have been through, these are usually traumatic and painful and have usually happened when they were a child or young adult. When they were going through these painful experiences, they most likely had no one to confide in, and therefore needed to find other ways to deal with the pain they were feeling. They could have experienced things such as:
- Physical violence,
- Emotional abuse,
- Sexual abuse.
They may have been:
- Separated from loved ones
- Put under pressure
- Made homeless
- Sent into care, hospital or to other institutions.
Experiences like these can break down your self-esteem, these feelings may be kept locked up and blocked out of awareness. If a trusted adult abuses a child, with no other witnesses present, then the children will often blame themselves. They turn their anger and upset onto themselves, and by the time they grow up, they discover self-injury as a method of expressing their pain, punishing themselves and keeping their own memories at bay.
There have been research studies in the past that have suggested that 10% of 16 year olds have self-harmed, and this is usually by cutting themselves. These studies have also shows that girls are far more likely to self-harm than boys. Young people are quite often put under a lot of pressure, from their families, school and peers, and many young people report having peers who self-harm.
Research also suggests that young people who self harm are highly likely to have low self-esteem, depression or anxiety. They seem to face more problems in day-to-day life, and may not be as good at coping with these as others. They may retreat into themselves, feeling angry or blaming themselves. They may find themselves drinking, smoking or using recreational drugs too much. They will find it harder to confide in friends and parents or other adults, and they may even be too worried about asking for help that they need.
Women tend to find themselves in a caring role, and seem to put their own needs last. This can affect their sense of worth, opinions and strengths. Over time, a woman may start to feel that she is unimportant, she may also start to lose her sense of identity, power and rights. To survive, she may cut herself off from he real needs, for example if a woman is focusing on the size of her body then she may drastically restrict what she eats.
If men stick to the stereotype of being "macho" and that expressing any type of emotion is a weakness, it can leave them unable to experience their feelings, and they may become detached from that side of themselves. They may have less difficulty showing anger than women, but if they are in prison where these feelings can't be released they may turn to self-harm, especially if they have been abused.
Self-harm isn't always about suicide, sometimes it can be about trying to stay alive. Self-harm can be a coping mechanism for survival, and to escape from emotional pain. The majority of people who self-harm are not suicidal, but a small minority will intentionally attempt suicide. Some suicides resulting from self-harming behaviour may be accidental, occurring when someone has hurt themselves more than they originally intended too.
Because self-harm is difficult to understand, healthcare professionals, friends and relatives sometimes mix up the signals and see self-harm as attention seeking or manipulative when they should be regarded as someone with mistrust or fear. If someone you know self-harms, you may feel helpless when faced with their wounds. Your feelings and fears of the situation may lead you to blame them instead of support them. Sometimes self-harm can be the only way that they can communicate to get the care and attention that they need. However upsetting it may be for you, it doesn't mean that it was their intention.
Whether people have deep wounds or slight injuries, each problem they represent should be taken very seriously. The size of the external wounds don't always match the size of the external wounds.
What help can I get?
If you find that you are self-harming because you are struggling to cope with or control your emotions, you may now start doubting whether there are other ways to deal with them. But, people do move forwards, to grieve over past events or a lost childhood and work through the fear and confusion surrounding them. With plenty of support, they learn that they can cope with the pain, anger and rage which need to surface.
The important thing is, is to find ways to talk to someone that you trust, this could be a friend, family member, doctor, professional counsellor, psychologist or psychotherapist.
A professional should have the training to listen to you and help you reach your feelings and manage them in other ways. All problems, whether they are past or present need to be addressed. If you can, aim to find someone who specialises in treating people who self-harm, who have eating problems or who have been abused.
Talking to your GP
It is recommended that you should be offered a full assessment of your physical, psychological and social needs, by a professional who has been trained in the treatment of people who harm themselves, in an atmosphere of respect and understanding. If your GP is dismissive or unhelpful, then you can contact the Patient Advice and Liaison Services (PALS), and you have the right to change your GP is this is necessary.
Your GP may offer various treatment options, including various forms of counselling or therapy. One option might be cognitive behaviour therapy (CBT), which is practical treatment that involved looking at what happens just before you self-harm, encouraging you to keep a diary of self-harming episodes and finding other ways to channel your emotions. CBT does not usually explore any underlying causes of self-harming.
If your self-harm is severe, you may be referred to Psychiatric services for further assessment, treatment and support. In an emergency, it is possible that you may be taken into hospital, and peoples experiences of these services are variable. Even though there are guidelines in place that are designed to improve the treatment people receive, when there is limited time and resources it may be easier for staff to make snap judgements, use diagnostic labels and offer medication.
The most important thing to remember is that you have choices, and that stopping self-harm can begin now!
Knowledge is power. Try to gather information about your own behaviour, keep diaries and notes of what is happening and how you feel when you are about to, or when you are self-harming. Over a period of time, patterns will start to emerge and you will be able to focus on the single points that are affecting your self-harming.
Aim to talk more. Try talking to someone you trust about how you feel, even though you may feel alone there are people who understand you pain and can help to boost your strength! Many people find that support groups with people who share the same problems can be helpful and an important step forward.
Work on your self-esteem. Remember that you are not to blame for how you feel, your self-injury is an expression of powerful negative feelings. It's not your fault! Make lists of your feelings and then write positive thoughts and feelings about yourself. If you can think of any then get family, friends or teachers to come up with some for you!
Reduce stress. Try to give yourself occasional treats and find time to relax, healthy eating, fresh air and healthy sleeping habits are known to help boost self-esteem.
Have your friends' phone numbers handy, as well as phone numbers of national helplines. Try to keep them somewhere that you can find them and are easily accessible and make sure that you use them when you need too!
If you feel like you need to self-harm, focus on staying safe! A supportive GP will be able to give you good advice on minimising and caring for injuries, they may even be able to find you further help.