I have struggled with self harm since I was 13 years old. I started out as a cutter, using just small razors and other household things, added burning a few years later, and eventually started punching things to try and break my hand a few years ago. I do it because I’m in pain, and I am far from alone.
In 2013, about 3.3 million cases of self-harm occurred globally. Self-harm is most common between the ages of 12 and 24. Self-harm is more common in females than males with this risk being fives times greater in the 12-15 age group.
Self harm is a false friend. It provides temporary relief and permanent scars. It is something many of us obsess about, for different reasons each, and the act of self harming becomes compulsive. There are a variety of precursors to self harm.
The basic cycle of self harm goes like this:
And there are many precursors.
When I am struggling, I end up self harming for a variety of reasons. The first is usually that I’ve been having a hard time emotionally, so I get overwhelmed and suddenly don’t know how to cope with all the feelings that I have. The thing I know will help for at least a while is the self harm. At least the pain will be real instead of in my head. The pain will be visible to me and others (though I try to hide as much as I can). The physical pain distracts me from the emotional pain. Second, sometimes I am so dissociated that I cannot bring myself back down to the ground so I want something physical to shock me out of the fog, to ground me. It usually helps for a while, but then I just feel that shame/guilt/grief about giving in. Third, I use it as punishment. When I feel badly about myself, I feel like I deserve the pain. I deserve the scars. I deserve the shame associated with it because I’ve done something wrong or bad.
What my therapist and I discovered recently is that I have some form of OCD, which I think plays into this cycle quite a bit. Below is an OCD cycle but it is very, very applicable for me with my self harm.
I obsess and obsess and obsess about self harm, day in and day out. Some days are easier than others but man, sometimes it’s literally the only thing on my mind and I sit here in agony hoping my valium will take me to a different plane of existence. These are my obsessive unpleasant thoughts, usually following some kind of other emotional turmoil. So then I turn to the self harm and I act on it compulsively, hurting myself often on and off for hours at a time, to the point where I desperately want to stop but I can’t or don’t know how. This compulsion and action gets the obsession out of my head for a while, providing some kind of relief. That is, until the emotions build again and I become obsessed, ruminating about it for the better part of each day, and I need to give in to the compulsions.
What constitutes self harm?
People self harm in an almost infinite number of ways, though there are some common forms that are found through the world.
Eighty percent of self-harm involves stabbing or cutting the skin with a sharp object. However, the number of self-harm methods are only limited by an individual’s inventiveness and their determination to harm themselves; this includes burning, self-poisoning, alcohol abuse, self-embedding of objects, hair pulling, bruising/hitting one’s self, scratching to hurt one’s self, knowingly abusing over the counter or prescription drugs, and forms of self-harm related to anorexia and bulimia. The locations of self-harm are often areas of the body that are easily hidden and concealed from the detection of others. As well as defining self-harm in terms of the act of damaging the body, it may be more accurate to define self-harm in terms of the intent, and the emotional distress that the person is attempting to deal with.
The thing about self harm that many people don’t understand is that self harm, though often related to suicidal thoughts, is not about being suicidal. It is about all of the reasons mentioned above and more, but it’s not an act of suicidality. It is harmful but not deadly unless you make a really big mistake. However all the people I’ve met don’t do it as a means to kill themselves, just to provide relief. Wikipedia has this to say:
Self-harm, also known as self-injury, is defined as the intentional, direct injuring of body tissue, done without suicidal intentions.
I have been held in hospitals for chronic self harm, the worst experience at 14, when I was pulled out AMA because they wanted to keep me just because I was finding ways to cut, though I was stable and no longer suicidal. For me, self harm has never been related to suicide.
Who suffers from self harm?
I have borderline personality disorder, and one of the hallmark symptoms of BPD is self harm. In fact, even I always suspect BPD in someone who mentions self harm but hasn’t been diagnosed. If you’re interested in some scholarly reading about BPD and self harm, check out this article. It is common amongst many other mental illnesses and even in some individuals who do not have underlying mental health issues. It is a flawed coping mechanism often used by people who have experienced abuse or emotional/physical trauma in their earlier life, as well as people dealing with grief or other major emotional upheavals.
How do you cope with self harm?
It’s not easy to live with self harm. For me it rules a great proportion of my life, filling my days with rumination and my mornings and nights with compulsive release. I can go for days, weeks at a time, but lately not more than that. What I have figured out along the way are a few positive coping mechanisms.
For me, cold showers and standing out in the cold are the most effective ways to jar myself back into reality and out of the compulsions, though it doesn’t always help, I’ll be honest. I used to hold ice cubes but it’s not the same. I do like drawing on myself with red sharpies. For whatever reason that really helps. What I have learned to do is to put my weapons out of reach because I get attached to particular items. Currently, I have something frozen in ice in my freezer so that I have to melt it to get at it to hurt myself. I think for me the key has been to build in barriers for myself when I’m feeling better, so that when I don’t feel great or I feel impulsive, I cannot immediately reach for something sharp or on fire. I would recommend this to anyone in the same position.
Crisis Text Line : Text 741741 anywhere in the US
*1-800-DON’T-CUT – More info on self-injury
*http://www.selfinjury.com – Referrals for therapists and tips for how to stop.
*1-800-273-TALK – A 24-hour crisis hotline if you’re about to self-harm or are in an emergency situation.
*To Write Love On Her Arms (http://www.TWLOHA.com) – A non-profit movement dedicated to presenting hope and finding help for people struggling with depression, addiction, self-injury, and suicide.
*1-800-SUICIDE – Hotline for people contemplating suicide.
*1-800-334-HELP – Self Injury Foundation’s 24-hour national crisis line.
*1-800-799-SAFE – Domestic violence hotline.
*1-877-332-7333 – Real Help For Teens’ help line.