Understanding mental ill-health

Self-Harm

What is it?

In its broadest sense, self-harm describes "a wide range of things that people do to themselves in a deliberate and usually hidden way, which are damaging."¹ It includes cutting, burning, scalding, banging heads and other body parts against walls, and hair-pulling, biting, and swallowing or inserting objects as well as self-poisoning.

Self-harm is always a sign of emotional distress and that something is seriously wrong. People self-harm for a number of reasons. For some people, self-harm provides the means to cope with overwhelming emotions- a way to control feelings of helplessness and powerlessness. For others, self-harm temporarily combats feelings of numbness to the world around them.

No single factor has been shown to predict self-harm. A combination of pressures in home and school life, such as being bullied at school, not getting on with parents, parental divorce, unwanted pregnancy, abuse, rape, bereavement, entering care and mental health problems such as depression, can all lead people to self-harm.

Reports show that 1 in 10 teenagers self-harm, but the true figure could be even higher as most incidents of self-harm are treated at home and will not reach the attention of services or professionals. Although some very young people and some adults do self-harm, rates are much higher in and young people.

It is important to bear in mind that everybody's experience is unique, and there are no universal rules or reasons for self-harm.

Self-harm is a deeply personal thing. Individuals are likely to have a preferred method and part of the body for self-harm. Because of the complex feelings involved, people often keep self-harm well hidden from friends and family and they may go to great lengths to avoid showing the area of the body that they harm.

Self-harm is not a reaction that switches on and off. Most people that self-harm go through periods where they feel more vulnerable to self-harm, and periods where they are able to cope with things that would normally make them self-harm.

Whilst self-harm is ultimately damaging and may be dangerous, for many people it provides a method of coping with life. It is important to remember the level of distress that has led to the self-harm. This is particularly important for friends, parents, teachers or youth workers who may become aware of the issue and wish to raise it with the individual. Taking away a person's means of self-harm can increase the emotional distress and make the situation worse.

Recovery

Giving-up self-harm can be a long and difficult process. It is not something a person can just stop doing overnight. No two individual journeys of recovery will be the same. Some people use self help groups or on-line support communities, others seek help from their GP who may refer a person for psychological therapies. These can help to build coping mechanisms to replace self-harm, and address the feelings that led to the self-harming to begin with. Sometimes medication might be used to treat depression or another mental health problem that may be present.

There are a number of self-help groups and voluntary sector self-harm projects that can help people work towards developing alternative coping mechanisms. Contact the specialist organisations below for details of self-help strategies.

Stigma and Self-Harm

People may notice visible scars, often on people's arms and stare, point or make comment. For many people the thought of someone wilfully hurting themselves is unsettling or even disgusting. The effect of this judgement and public disgust is further reduction of confidence and self-esteem, and may feed into the cycle that leads to self-harm in the first place.

Many people hide their scars obsessively to prevent them being seen. This leads to problems, for example, in school, or the workplace, where uniform might dictate short sleeves, or situations might lead to peers seeing a person changing clothes. People are sometimes excluded from jobs, or asked to wear different clothes because of scarring from self-harm (e.g customer services or teaching).

Sometimes people are stigmatised in buying goods, for example by being barred from purchasing painkillers, or a safety razor in a pharmacist, because their scars were showing. One of the most commonly reported areas where self-harm results in stigma is when people access medical help, both for self-harm, and for other complaints. This can often lead to people not staying to complete treatment or being deterred from seeking treatment in the future.

Myths and Misunderstandings

Myth1: Young people who self-harm are attempting suicide Fact1: Self-harm can help people who are experiencing emotional distress to go on living with the pain they feel, rather than trying to escape it through suicide.

Myth2: Young people who self-harm are just attention-seeking
Fact2: Young people tend to keep their self-harm secret often as a result of feelings of embarrassment, shame or guilt. It is not 'just attention-seeking' however sometimes it can be a cry for help.

Myth3: Don't approach a young person who self-harms, send them straight to the doctor
Fact3: Taking time to listen without judging encourages young people to get their problems out into the open- the first step along the road to recovery

Myth4: You will know if someone is self-harming if they have cuts on their arms
Fact 4: Cutting is one form of self-harm; others include burning, hitting, bruising or poisoning

Myth 5: Self- harm is just the latest fashion which young people will grow out of.
Fact 5: Self-harm is not a phase or a fashion. Listening to certain music, or dressing in certain ways does not lead to self-harm. People of all ages, backgrounds and of both genders self-harm. Self-harm is always a signal that something is seriously wrong.

Contacts

For further information about self-harm contact the following organisations:

Self-Harm and Young People: A National Enquiry
National Self-Harm Network
Young Minds Self-Harm Information
NCB Young People and Self-Harm Resource
Penumbra Young People and Self-Harm Information