Self-harm
self; harm; self-harm; cutting; burning; cut; burn; suicide; razor; pills;
Contents
If you are close to people who choose to cut or burn themselves, it can be really tough to cope with, and hard to understand.
The reasons people harm themselves are complicated. Self-harming usually does not mean that a person wants to commit suicide or that they are looking for attention. Usually when people harm themselves, they are suffering a great deal inside.
What is self-harming?
Self-harming is when people cause themselves physical pain that alters their mood state (how they feel inside). Some people harm themselves because they feel disconnected and isolated from everybody, and hurting themselves is the only way they feel real or connected.
Self-harming behaviours can include:
- cutting their skin with knives or any sharp object
- burning their skin
- hitting their body with an object or fists (like punching the wall)
- deliberately falling when doing something like extreme sports
- picking at their skin
- swallowing pills or sharp objects
- pulling at their hair (hair pulling can also be a habit).
Eating disorders, alcohol and drug addiction are other ways that people harm themselves physically and mentally.
Why do people start harming themselves?
Self-harming can be a way that people deal with feelings of:
- helplessness, despair and low self-esteem
- anger, loneliness, shame and guilt
- not having control over their life
- being 'out of it' – so the only way to feel 'real' is to cause physical pain to themselves.
Some self-harm is related to severe emotional pain. When people have experienced abuse or violence, it often re-appears as emotional pain in later life. Some people have said that:
- When they hurt themselves physically, it helps take away the emotional pain.
- Self-harm makes internal pain visible on the surface. It is showing that there is a problem that needs to be addressed.
- Self-harm is a way that people punish themselves for something.
People who harm themselves...
- may have difficulty expressing their feelings verbally
- may dislike themselves and their bodies
- may do it because of difficulties with relationships
- may do it because of mental health issues such as depression, anxiety or stress.
It is important to understand that whatever the reason for self-harming behaviour, there are more positive ways of dealing with the troubling feelings.
Why do people keep harming themselves?
Some people say that self-harming is an addictive behaviour.
- Behaviours, when they become addictive, can be just as hard to give up as an addictive drug.
- When people get into a cycle of self-harming behaviour, it can become their main way of dealing with problems, and can start to have very negative impacts on their lives.
Myths about self harm
One myth is that people who self harm do it for attention. Research suggests that about two thirds of young people who self harm don't even tell anyone, so they can't be looking for attention.
Another myth is that people who self harm do it because they have a mental illness. Some do have a mental illness like depression, but again about two thirds of young people who self harm do not.
One more myth is that people who self harm do it because they want to commit suicide. This is also false as most self-harmers do not attempt suicide. In fact many feel that it protects them from suicide.
The risks of self-harm
- By expressing themselves in this way, they may not be dealing with the underlying issues, such as depression or emotional pain.
- People usually do it when they are on their own, and this can be a really isolating experience – they may not get the support they need to work it out.
- There is a risk that one day, without meaning to, they may go too far, and die.
- If they don't feel that people would understand, they may have to lie and cover up their cuts or burns. A lot of young people find this secrecy really difficult to maintain and stressful to deal with.
- Cuts can become infected if not looked after, and can cause permanent scars.
It is important to recognise that self-harming is not well understood in society, and is not seen as an acceptable way of coping with problems.
- This could make things more complicated, as they may have to lie and cover their cuts up.
- They will also have to deal with the disapproval of other people who don't understand what they are going through, and who make hurtful comments like, "Pull yourself together", or "Ignore her, she's only doing it for attention."
- We are often judged by the way we look, and others may not understand why some people have cuts or scars on their body.
How can I help my friend?
Finding out that someone you care about is deliberately hurting themself can be very distressing. It is hard to understand why someone would want to hurt themself in this way. Don't take it personally – your friend is not doing it to make you feel bad or guilty. Even if it feels like your friend is trying to manipulate you into feeling a certain way, it may not be the reason he or she hurts themself.
- Educate yourself – find out as much information as you can, and talk to a professional about what you can do to support the person.
- Be supportive without reinforcing the behaviour – let your friend know that you are there if he or she wants to talk. Make the initial approach, but don't push your friend to disclose information.
- Take care of yourself – recognise that this is a difficult situation, and you need time to adjust and make sure you are taking care of your own needs as well as the person you care about. Everyone has to make their own choices, you can't make choices for your friend you can only help them to find ways to make better choices.
- Be clear about what your limits are – if you feel uncomfortable with the self-harming behaviour, be clear with your friend and come to an agreement about what you can and can't cope with.
Even if the thought of your friend self-harming causes you to feel uncomfortable, try to understand what the issues behind the feelings may be, and how you can support your friend to find more positive ways of coping with the pain.
What your friend could try
It is very difficult to stop self-harming without having other ways of coping to replace it. Changing any kind of behaviour is difficult, and deciding to change is a decision that only they can make for themselves.
As with any kind of addiction, they must be kind to themselves and understand that they may fall back into old patterns of behaviour from time to time – but this does not mean they have failed or that they should give up trying. 'Yet' is a very important word. They could try saying "I haven't managed to give up YET." Then try again!
What is important is that they do keep trying, and that they get the support they need to get through it. Some of the things that might help them are:
- taking themselves away from risky situations - something as simple as removing themselves from the presence of knives and razors works for some people.
- trying to focus on something around them, rather than the pain they may be feeling.
- making a list of supportive people that they can talk to, who understand their situation - people like parents, other relatives, teachers, friends of the family and close friends who know them and their situation well.
- if they are not getting the help they need and nothing is changing, then talking to a professional – eg. a counsellor, doctor, psychologist, psychiatrist.
- thinking about their alcohol and drug use - is it too much? Are they more likely to hurt themselves if they've been drinking or using drugs?
- trying deep breathing and relaxation - see Stress – learning to relax.
- writing in a journal – recording how they feel and the reasons why they might want to harm themselves.
- looking at the reasons why they harm themselves and asking themselves the question, "Can I do something about this or does something else need to change?"
- remembering that self-harming is something a person chooses to do, but it is not an effective way of dealing with a problem - the problem will stay until it is dealt with once and for all.
- trying something like holding ice cubes in their hand – cold causes pain but is not dangerous to their health.
- wearing a rubber band on their wrist and snapping it when they feel the need.
- using a red pen to draw on the areas they might normally cut.
- working it off with exercise.
- learning to confront others, making their feelings known. - check out our topics Assertiveness – what it means, and Assertiveness – stick up for yourself.
- making a list of reasons why they are going to stop cutting, and set themselves some realistic goals to help stop it.
- calling a crisis line if they feel that their behaviour is becoming dangerous - see our list of numbers at the end of this topic.
Looking forward
When everything seems too big to handle and you can't see any way out, it can be hard to think about the future. When you or your friend feels this way, there are some things you can try to concentrate on.
- Problems that seem unsolvable will change. Life is always changing and nothing lasts for ever, neither good nor bad.
- You do have choices about what happens and how you react to your surroundings.
There are people who can help, who want to hear what you and your friend have to say. Self-harming is destructive and stops people dealing with their pain. There are better ways to deal with the way you feel, and the first step is to reach out and talk to someone and see the future you have ahead.
Resources
South Australia
- The Second Story Youth Health Service (TSS)
- Central: 57 Hyde St, Adelaide
- South: 50a Beach Rd, Christies Beach
- North: 6 Gillingham Rd, Elizabeth
- West: 51 Bower St, Woodville
- Youth Healthline 1300 13 17 19 9am to 5pm weekdays
- Crisis care 131611
- Kids Helpline 1800 551 800
- School, college or university counsellor
- Local community health service
- The doctor
- Child and Adolescent Mental Health Service (CAMHS) (for people under 18 years)
- Northern Region: 8252 0133
- Eastern Region: 8207 8999
- Western Region: 8341 1222
- Noarlunga Region: 8326 1234
- Marion Region: 8298 7744
- Mental health emergency support line (ACIS) 131465 (24 hours, every day for people over 18)
- The emergency department of your local hospital.
General
Sinclair, J. & Green, J. 'Understanding resolution of deliberate self harm: qualitative interview study of patients' experiences'. British Medical Journal, May 2005; 330: 1112. Online (cited 11/7/05):
http://www.bmj.com/cgi/content/full/330/7500/1112
Solomon, Y. & Farrand, J. '"Why Don't You Do It Properly?" young women who self injure'. Journal of Adolescence, 1996; 19: 111-119.
Santa, N., Eliane, E. & Gallop, R. 'Childhood sexual and physical abuse and adult self harm and suicidal behaviour: a literature review'. Canadian Journal of Psychiatry, 1998; 43: 793-800.
Self Harm - recovery, advice and support
http://www.thesite.org/healthandwellbeing/mentalhealth/selfharm
The information on this site should not be used as an alternative to professional care. If you have a particular problem, see a doctor, or ring the Youth Healthline on 1300 13 17 19 (local call cost from anywhere in South Australia).