Self-harm: the taboo topic we need to talk about

One of the biggest problems about self-harm is its taboo status.

Very recently the tragedy of it hit the headlines. People, especially young people, were found to be searching on-line for information. Not for support. Not for self-help. But for information.

The ultimate tragedy of that was the way it highlighted the fact that they had no-one to turn to within their personal circle of family and friends.

So, what are the facts?

My qualification for writing this is that I am a self-harmer. Even though I haven’t hurt myself for a couple of years the thought of it as a default way of coping is still there. I have also run a self-help/support group for self-harmers as part of my work with an NHS Trust, and been interviewed by a local paper about my experience.

Number One – the facts can be subjective as well as objective, as individual as the people who do it. Very few can understand, and even then it’s from the viewpoint of their own experience.

Is it extremely lonely in the world of the self-harmer. It may be impossible to share feelings with those close to you, because they may not understand, they may worry or fear for your safety, they may even laugh or mock you. Comments such as “Why do you want to hurt yourself on such a lovely sunny day?” have been made.

Those outside this world can be very judgemental: it’s a cop-out, childish, attention-seeking; you’re pathetic, weak, lazy; you need to get out, get a job, think about others; you’re a drain on society, a drain on resources, a drain on everyone’s time.

Attitudes can vary enormously leading to confusion. Even in special units and hospitals, there may be some staff offering support, taking time to talk about what’s happening; others offering nothing but rejection, sanctions, even punishments.

It is a coping strategy that isn’t begun lightly. Too often it becomes the only means to take the mind away from the indescribable or unbearable pain it’s in. It doesn’t help to be told it’s maladaptive, inappropriate, manipulative. It is none of these things.

What may lead someone to self-harm?

Firstly, it is NOT learned behaviour, ‘copy cat’ behaviour, nor attention-seeking behaviour. It is more often deeply personal, private, and a means to self-punish for perceived wrong doing.

An inability to express powerful, distressing feelings and thoughts. A person may have excellent language and communication skills but not be able to verbalise how they are really feeling. This is often the case for those with ASD and Borderline Personality Disorder.

A strong and inexplicable urge to punish the self. Personality Disorders, especially Borderline, may lead to a conviction that the person is bad, evil, and deserve to be punished. There may also be an intense conviction that the evil inside must be let out.

A need to release overwhelming distress brought on by intense or sustained trauma, may lead those with PTSD and Anxiety Disorders to resort to self-harm as a means of releasing these feelings if only temporarily.

As a means of kick-starting oneself out of the profound low mood and all-pervasive sadness of Clinical Depression or the depressive facet of Bipolar.

This is not an exhaustive list, nor is it a complete explanation of reasons. It is based on my personal experience and on the experiences of those I have met. I cite these as examples and not as clinical descriptions of self-harm nor self-harmers.