There is no way I can cover all the types, and as a forum, we won’t put any specifics on here. Research has shown that this can ‘inspire’ others to copy techniques or words. It can also trigger others to self-harm.
Reasons for Self-Harm
Reasons for self-harm include:
- depression
- childhood abuse
- bullying
- high anxiety
- bereavement
- relationship difficulty
- the feeling of numbness to life
- physical health problems
- feeling suicidal
and many more.
A Physical Response to Emotional Pain
Self-harm is an aspect of emotional problems that often upsets and causes strong reactions in those who find out someone has or is doing it. This is understandable but with some insight, maybe this can be better understood. Self-harm is seen as a physical response to emotional pain.
People self-harm for myriad reasons and those reasons can change even in an individual from one bout of self-harm to another. Behind it is often desperation, an inner pain and turmoil which the person feels unable to manage and it works on the principle that a worse pain can settle a chronic one. Also, it can be done as punishment to the self for imagined unforgivable events in a person’s life. Remember, I said imagined or perceived, and not that these events really are unacceptable.
A History of Abuse
People who have been abused as children can be a group at high risk. Children, when abused, often blame themselves for the abuse since blaming the parent is unthinkable when most parents are seen as “god” to a child. So with that inner pain, that hurt child still dominates even into adulthood.
You could add in here addiction to street drugs, eating disorders, long term depression, guilt, phobias and fears, and many, many more.
Don’t Ignore the Physical Pain
When a person self-harms because they are feeling numb, it doesn’t mean that high tolerance to pain remains, and often that once the problem has been dealt with by the self-harm, the pain of what they have done can be excruciating. This needs to be remembered when the person seeks medical help and there are reports of doctors or nurses not giving pain relief before treatment!
Myths about Self-Harm
1. It’s attention seeking
Not so. In fact, most people who self-harm hide it from others and may harm in areas that won’t be seen. It’s not done to show people, it’s done to express inner pain.
2. The person is suicidal
A few people may self-harm before a suicide attempt, but the vast majority don’t feel suicidal. In fact, many find it a way to manage some emotions throughout their lives.
3. It’s a teenage thing
They will grow out of it: in fact, people who self-harm are of all ages. People who have used this coping mechanism can do so all their lives. Teenage children aren’t being silly or following a fashion. It is still an expression of inner pain.
4. The wound isn’t that bad, so they aren’t really that much in need
To harm yourself is a huge statement to yourself. The harm can be huge or small; it matters not. The inner emotional pain is still significant.
5. They are just manipulating others
Again, most self-harm is hidden. It is aimed at the Self, not others. If the aim was to manipulate, it’s not a very effective way to do that.
6. They like pain/don’t feel pain
No, the person may not like it. They do feel the pain and it’s not a pleasant thing to feel so much inner agony that self-harm is the only way to express it and feel better in the short term.
7. They could stop if they wanted to
Self-harm is very addictive as it does reduce pain and releases endorphins which are powerful hormones that relieve pain and have been described as the body’s own morphine. Sometimes, the addiction cycle can be broken once the emotional pain has been resolved.
8. They are mentally ill
In fact, many people with no other mental health problem can self-harm. It can be something that started when an event triggered a lot of pain and then became a strong habit.
What help is there?
To seek help, a person needs to recognise they need help.
How to Help a Person Who Self-Harms
It’s difficult for a relative or friend to realise that some people don’t want to stop, that they want to manage this way. Offering non-judgemental support, asking how they are feeling without bringing up the self-harm, might support a person far more.
Open-ended questions are better than closed questions. By that, I mean ones that can’t be answered with a simple yes/no. Keeping yourself calm when talking will be very helpful too. Reflect back on what they have said, not parroting it but saying, “I think you mean… Am I correct?” Then, pick out one or two words they have used that are significant and ask an open-ended question about that. But if the person is shutting down, there is no point continuing. But make it clear that they can talk to you without judgement.
Distraction Techniques
When we talk about techniques to distract, it’s not necessarily a good idea to suggest ones that mimic self-harm. In the past, before I knew better, I have suggested using a rubber band on the wrist and twang it hard when the urge comes on, or draw in pen the colour of blood on the part of the body etc. In fact, these techniques can reinforce the idea of self-harm, not how to avoid it.
Chain Analysis
Instead, there is a technique called Chain Analysis which the person who self-harms might like to try. Just before you self harmed (or feel the urge), stop. Describe exactly where you are, what is happening, who is talking to you, what TV programme you are watching, if there is tension in your body and where and anything else you can think about. Look at any of these, ask yourself which one feels stronger than the others, then chase that down like a word association, only with feelings.
An Example of Chain Analysis
I’ll give you an example I have used on the forum. My husband died a year before this. I went to get some shoe racks in a bargain shop and taking them to the checkout. Suddenly, I was overwhelmed by emotions and wanted to cry a lot. I couldn’t understand it! All I wanted to do was self-harm. Standing still in that shop, I looked at the shoe racks, and a picture of my husband came to mind. I could hear him saying, “What a waste of money! They are cheap looking and won’t last long!”. Also, I noticed that there was music playing that he hated and that I was in a crowded area, which was making me nervous.
I watched my thoughts picking up tiny clues back and forwards. Then I remembered when he put up shelves, immaculately, giving them a fine finish. I realised that I had broken one that morning, cursing at my stupidity and putting the bits in the bin. It was a part of the grief I hadn’t handled very well so far.
So one event led to another to another, and I chased the cause of the emotion down. Many others might take far longer than that and will take many attempts to find the cause. In other cases, the event that triggered it is deeply traumatic, like sexual abuse, so it is not really likely to be faced on its own. A good therapist might be a much safer place to explore that. But writing a couple of words or notes to remind you might be a good idea. Stopping, looking, listening inwardly can give a clue.
What To Do If You Can’t Stop Self-Harming
If you don’t manage to stop for a while or do stop but relapse, it’s not the end of the world. I try hard to say to myself that I will wait 5 minutes and then do it. If possible, once the 5 minutes is up, I might try to delay by another 5 minutes. The first time I watched the clock all the way to the 5 minutes! But it’s important to start to create a challenge in the mind to the impulses, to create a new pathway for the mind to use.
Other Techniques
When you may feel the urge to self-harm, try deep breathing, distraction to something pleasant like eating chocolate, having a hot bath (but really noticing the effect of water on your body, the smell of soap, the feel of shampoo) or notice how tense you are and purposely struggle to relax different parts of your body. Smells are powerful, so carry a little bag of lavender with you and smell it when you feel the urge, deeply breathe it in.
All of this won’t work first time probably, but keep trying and over time you will train your brain to think in different ways. Our brains get into ruts of behaviour so we need to change the rut to a more positive one. It takes time and patience to break a habit or addiction if it has got that far. Be kind to yourself though throughout your journey with self harm.
Self-Harm in Children and Teens
I could go on and on. It is a huge subject. One last point though about the very young who self-harm: as adults, we tend to minimise the emotions of children and teenagers. A 13-year old whose girlfriend has dumped them can go through just as deep emotions as an adult. In fact, because they are so inexperienced, the emotion might be even more intense. This could be the trigger to start self-harm, but if caught at this young age, taken seriously, a lifetime of self-harm might be avoided.
Medical Emergencies
If you have harmed yourself badly, please seek medical help at A&E. Don’t be embarrassed. They have seen it before and will help you. Please don’t leave a wound unattended as something relatively easy to sort out can become something serious, with infection, if left. You might not care about the scarring now, but later on, you may well worry about it. Try to minimise the long-term effects.
Get Support
Come on the forum and find many people who will know all too well what you are going through and can support you:
Calypso
Useful Resources
- The Mix – Essential support for under 25s
- Mind – Information on self-harm
- NHS – Information on self-harm
About the Author
Calypso is a member of the Mental Health Forum Staff Team and a former Senior Nursing Sister for older people with complex needs.
Next review due: 24 June 2024