There are many myths about self-harm and often the behaviour is misunderstood, even by medical professionals. The act of self-harming is when someone deliberately hurts or injures themselves. This includes physical harm, putting oneself in potentially dangerous situations and neglect of self-care, both physical and/or emotional needs. Common ways people self-harm are cutting, burning, scalding, hitting, scratching or inserting objects into their body, hair pulling or skin picking, poisoning including alcohol and drug abuse and eating disorders. Anyone at any age can be affected by self-harm, regardless of gender, social background or ethnicity. However, self-harm most commonly affects young people between the ages of 11 and 25 years, 1 in every 15 young people experience self-harm.

Self-harm is often used as a coping mechanism to deal with overwhelming emotional pain; the physical pain created serves as a short-term relief from the emotional pain being experienced. Sometimes the physical pain is used to break the feeling of numbness someone may be experiencing. Other reasons people self-harm is to communicate things that they are unable to express any other way e.g. that they are in distress. Sometimes if an individual feels they have no control over their life, self-harm can give them a sense of control. Often self-harm can be directly related to a particular experience either on-going or in the past, and some people are unaware of the reason they self-harm. Some individuals may only self-harm a few times or just when experiencing exceptional stress. Others may find that frequency and severity increases with time.

Events that commonly lead to self-harming behaviour are pressures at school/work, bullying, sexual, physical or emotional abuse, financial problems, relationship breakdown, bereavement, confusion about your sexuality, and ill health. Self-harm is not a mental illness, although it can indicate an underlying mental health issue. The causes, reasons and how people self-harm are unique to the individual, as is how to manage and achieve recovery. Recovery from self-harm is possible with the right support, understanding and motivation, however, it is finding out what works for the individual.

Often self-harming is seen as attention seeking or manipulative behaviour. However, most self-harming behaviour is very personal and private, often hidden for months or years before an individual is ‘found out’, or they find the courage to confide in someone. Individuals who self-harm do not necessarily have high pain thresholds or enjoy physical pain, but sometimes physical pain is preferable to the emotional pain being experienced. Self-harm is not a suicidal behaviour, they do not wish to kill themselves, however sometimes self-harm can result in accidental death. Self-harm is about expression, coping and surviving with life’s emotional difficulties.

Finding out someone you care about self-harms can be shocking news. You may experience varied emotions from anger to sadness, try to put aside your own feelings about self-harm when you are supporting this person. The best way to support someone who self-harms is to refrain from being angry or critical with them, be available if they want to talk. It may be best to ignore their method of self-harm initially, instead focus on their emotional experience. Try to be understanding and empathetic with them. Emphasise their positive qualities and things that are going well for them. Demanding that they stop self-harming or giving ultimatums do not work, instead they can make the behaviour worse and the person may become more secretive about it. Encourage the person to seek professional help, but let them remain in control of decisions, support and any plans to reduce or stop their self-harm. Let them know you love/care about them regardless of if they self-harm or not, and that you are there for them.

Try to learn as much about self-harm as you can to increase your understanding of the behaviour, for both yourself and your loved one. Finally, it is important to take care of yourself so that you can stay strong and healthy yourself. Take time for yourself and seek professional help or support for your own feelings. Help can be sought from GPs, mental health services, private psychologists and charities offering text/email and helpline support.

By Mia Ford, honorary psychology assistant

References:
www.selfharm.co.uk
www.mind.org.uk
www.rethink.org