Self harm
What is self-harm?
Self-harm is a broad term often used to refer to acts which can involve self-poisoning and inflicting injuries upon one's own body.
Examples include:
- Cutting, often to the arms using razor blades or broken glass
- Burning using cigarettes or caustic agents
- Punching and bruising
- Inserting or swallowing objects
- Head banging
- Hair pulling
- Restrictive or binge eating
- overdosing
What is self-injury?
Self-injury is any act which involves inflicting injuries or pain on your own body but without the intention of suicide.
Self harm is often used to include thoughts of suicide and attemped suicide as well as self-injury
Who self-injures?
Self-injury normally starts in adolescence, but some people start to hurt themselves even in childhood.
Most adults who self-injure report childhood experiences which are unhappy or even highly traumatic.
Commonly reported childhood experiences:
- Sexual abuse
- Physical abuse
- Witness to domestic violence
- Parents with alcohol problems
- Parents with severe mental health problems
- Neglect
- Bereavement, often loss of a parent
- Serious illness or major surgery in childhood
- Being received into care
- Inconsistent parenting
- Extreme pressure to succeed
- Bullying and harassment (often related to body image, perceived physical difference such as disfigurement)
- Poverty/poor housing
Adult experiences
Not all self-injury starts in childhood; women in particular have reported starting to harm themselves in adult life after one or more of the following experiences:
- Rape
- Sexual abuse
- Sexual harassment
- Being mugged
- Miscarriage
- Loss of a child (through bereavement or separation)
- Finding out that you are unable to have children
- Personal serious illness
- Relationship breakdown
- Institutional stay in prison/psychiatric hospital
"The combination of feeling trapped, neglected and helpless is usually seen as likely to lead to self-injury. These factors may well be influenced by social disadvantage due to gender, race, sexuality or physical difference."
- Both men and women self-injure although it is more widespread amongst women.
- Men who self-injure may have had similar life experiences as women who self-injure.
- There may be higher incidence amongst black and minority ethnic groups. A study by Collins (1996) for example shows young Asian women are six times more likely than their white counterparts to self-injure.
- Greater incidence of self-injury amongst gay and lesbian young adults; five times more likely than their heterosexual counterparts.
- Greater incidence of self-injury amongst those with physical disabilities and epilepsy
Why do people self-injure?
- A person injures themselves in order to stay alive
- Self-injury can have many different meanings for the same person
- Service user-led research shows that people who self-injure are clear about why they do it; overwhelmingly it is seen by them as a way of coping - not seen as a problem in itself but as a means of expressing and dealing with problems.
Six major themes seem to cover the main reasons for self-injuring:
- Relief of feelings
- Self-punishment
- To gain control
- As a means of communication
- As a form of comfort
- In order to feel 'real' or alive
What can be done to treat self-injury?
If you suspect that some one you know may be self-harming, there are things that you can do to help them.
- Try and give them the chance to talk about how they are feeling.
- Treat their worries and concerns seriously
- Offer sympathy and understanding
- Where possible help them solve their problems, or support them if they can’t
- Try not to let the self-harm upset or repulse you
- Make them aware of the risks of self-harm behaviour and that they can learn more positive ways of coping with their problems.
- Encourage them to get professional help as soon as possible.
- Everyone who has taken an overdose needs an urgent assessment by a doctor as soon as possible, even if they look ok. Harmful effects can be delayed. Even small amounts of some medications, such as paracetamol can be fatal.
What can you do for yourself?
Self-injury can be seen as a “faulty” way of trying to solve problems in which case it is important to learn more positive ways of problem-solving. The key elements of problem- solving include:
- Clearly defining the problem you are trying to solve. State in specific and concrete terms what the problem actually is.
- If there are many problems, deal with one problem at a time.
- Think about what your desired outcome to the problem would be.
- Think about different solutions/options for resolving your problem. To generate possibilities it may help to “brainstorm”, naming any possible solution no matter how off the wall they might seem.
- Look at each possible solution and weigh up the pros and cons. Choose the one that seems to have more positive consequences than the others.
- Start putting this solution into place
- Measure up the outcome of this solution – did it have the desired effect? If not, go back and try and work out why, and repeat the whole problem-solving process again if necessary.
Specialist help
This is likely to consist of psychological treatments and medication. Psychological treatments will involve talking to the individual about their underlying problems. It may also involve talking to their family too.
If anxiety or depression is part of the problem, medication may be helpful too.
