March 1st marks ‘self-injury awareness day’, a global movement signified by the wearing of an orange ribbon, which aims to increase the awareness of self-injury and challenge many of the misconceptions surrounding this.
What is self-injury? Self-injury, also known as ‘self-harm’ or ‘cutting’, describes how someone intentionally inflicts physical injury to their own body without any suicidal intent. It can take on any form, whether it is cutting, head banging, hair pulling, burning, recreational drug or alcohol abuse, non-lethal drug overdoses or taking excessive risks to personal safety. It affects people regardless of age, gender or ethnicity, although it is known to be particularly common in younger people. Due to the shame and self-hatred often associated with self-harm, many sufferers will go to great lengths to hide scars, making it difficult to identify those needing help, and also to estimate how prevalent this is. Research suggests that at least ten percent of 15-16 year olds have self-harmed at some point in their lives.
Why do people self-injure? Self-injury is recognised as a coping mechanism for overwhelming emotional distress relating to current traumas or difficulties from the past. The distress might be grief, anger, loneliness, emptiness, anxiety or self-hatred and sufferers may describe how the ‘real pain’ of self-harm numbs their emotional turmoil, and in some cases acts as a way of avoiding attempting suicide. Over time self-injury might become a person’s ordinary response to everyday stressors, sometimes increasing the frequency and severity of injury.
What to do if you are self-harming? GPs are well placed to provide confidential advice and support, put you in touch with local and national self- injury organisations (see below) and check for any underlying depression/ anxiety or eating disorder symptoms. The Student Counselling Service is also somewhere safe and non judgmental to go to.
Is there treatment for self-harm? Yes there can be, and the aim of treatment may be to both minimise harm from acts of self-injury and to help the sufferer find new coping mechanisms and develop problem-solving skills. Strategies to minimise harm include recognising triggers for self-injury, learning less dangerous ways/locations for cutting, carrying dressings and understanding the dangers associated with certain medications. However, stopping the self harm is not necessarily the aim of treatment, which may be more directed towards underlying issues.
Talking therapy (e.g. cognitive behavioural therapy/ dialectical behavioural therapy), creative therapy, support networks and the promotion of the development of self-help skills all help in supporting a sufferer to learn new coping mechanisms. If self-harm is part of an underlying mental health illness, specific treatment for that condition may be warranted.
I am worried that my friend is self-harming? It is upsetting to discover a friend is self-harming but it is important to provide non-judgmental support and acceptance, acknowledging that they are distressed. Encouraging them to talk to health care professionals or contact a local support group will show them that you care. Asking a person to stop self-harming will not help the situation as you are asking them to take away their coping strategy.
Will I/my friend get better? There are no quick fixes for self-harm, but by getting a person the right support and treatment, they will start to learn new ways to deal with their emotional distress.
References/ literature available:
- Life Signs Self-Injury Fact Sheet for Health Care Workers- www.lifesigns.org.uk
- Information resource pack- Bristol Crisis Service for Women –www.selfinjurysupport.org.uk
- NHS self injury fact sheet- http://www.nhs.uk/conditions/self-injury/pages/introduction.aspx
- MIND- ‘understanding self-harm’- http://www.mind.org.uk
Self Injury Self Help- support groups for women and men who self-injure in the Bristol area. www.sishbristol.org.uk
TESS- Bristol Crisis Support for Women, text or email support service for girls and women who self-injure- up to age 25. www.selfinjurysupport.org.uk, or text 07800472908
MIND- for information sheets/ advice about local resources- www.mind.org.uk