First and foremost, self-harm is a way of dealing with emotions that are too painful to express in any other way.
Self-harm has been described in various ways by different people – self-mutilation; self-injury; self-attack; para-suicide; deliberate non-fatal act; symbolic wounding, etc. However, we stick with the term self-harm, because it sounds less judgemental and presumptuous than terms like para-suicide.
Self-harm has been spoken and written about for centuries, but it is only recently that it was recognised as a condition in its own right. It has previously been listed as occurring in conjunction with conditions such as eating disorders and borderline personality disorder, which has left people without such a diagnosis feeling as if their experience isn’t valid.
However, the new edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-5), lists a condition called NSSI Disorder (‘Non-Suicidal Self Injury Disorder’), which describes how some people use physical sensation to deal with emotional pain. This has at least helped to give a voice to people who struggle solely with self-harm. NSSI disorder explains self-harm as an emotional coping mechanism rather than faulty brain wiring or evidence of psychosis.
Methods of self-harm…
People who self-harm have described a great many ways in which they have caused injury to their bodies, including:
- scraping/rubbing skin, causing friction burns
- placing sharp objects under skin or in body orifices
- picking at wounds
- burning skin by physical means using heat or chemicals, or aerosols (cold burns)
- pulling hair out (also called trichotillomania)
- hitting, sometimes hard enough to cause bruises or break bones, with fists or objects
- interfering with wounds
- ingesting small amounts of toxic substances (could be medication, such as aspirin, or household products, such as bleach) without intention of overdosing to die
Cutting is the most common form of self-harm, although burning (with cigarettes or lighters) comes a close second.
Most will hide their injuries under clothing, some purposely only self-harming where it can’t be seen e.g. on the abdomen. Forearms are the most common place for cutting, and are hidden with long sleeves. Nearly everyone who self harms will do so when alone, probably because most self-harmers see what they do as shameful.
Like so many people, self harmers cope with their own feelings privately, in the only way they know how, developing an apparently tough outer shell and driving the pain, anger and hurt, deep inside.
Myths and truths about self-harm…
- Self-harm is not a failed suicide attempt. It is a way of carrying on life, not dying.
- Self-harm is not just attention seeking. It is mainly about trying to cope with great pain. For some it is a desperate attempt to show that something is wrong, that they are very much in pain.
- Self-harm is not a sign of madness. It is a sign of distress; a sign of someone trying to cope with life as best they can.
- A person who self-harms is not a danger to others. They are directing their hurt and anger at themselves not at others. Most self-harmers would be appalled at the idea of hurting anyone else.