- Mental Health
Be Well Informed on the Seriousness of Self-Harm
A Personalized Introduction
I've noticed that online, there is a lot of pseudo-glorification of self-harm (mostly in the form of cutting) circulating via Tumblr, Facebook, and other social media outlets. I don't think anyone should be okay with this, and I think it creates a "fad" and a stereotype that morph the intensity of these actions severely. I also think it creates the idea that cutting is the only form of self-harm. I get the sense that when cut marks are shown online, it gives someone the credit of being an emotionally deep and mysterious person (or something stupid like that).
As someone who does, in fact, participate in self-harm, I want to debunk all of the myths and "glorified" perceptions of self-harm that I've seen around.
My background is in biting (not cutting). Since I was a child, I bit the skin on my fingers. After a while it became a habit and for the longest time I had considered it a nervous habit -- but when I started to understand self-mutilation and self-harm, I began to think it was something more. After seeing a psychiatrist, I was informed that my habits were more than just habits, and that they were in fact obsessive compulsive tendencies that were also self-harming.
The big problem that I have with the "cutting sensation" is the fact that it is, well, sensationalized. On my Tumblr dashboard, on more than one occasion, I get more than one picture of a person's wrists/arms/legs or whatever with cut marks. The images are photoshopped, usually, to look more tragic, with an "emo" saying scrawled over the top of the entire image. And then I wonder: so if I were a cutter, I could post my image online and probably get a decent amount of reblogs and response -- but as a biter, if I post a picture of my fingers online, people will probably just scroll past it, thinking "that's disgusting, why would someone post that.". In reality, this thought process should be true for the posting of any pictures that allude to self-harm (unless they are appended to a story of some kind or an article on awareness or something relevant to the seriousness of the image shown).
I know there are probably a lot of flaws in how I've articulated myself here, so please don't pick this article apart sentence by sentence. However, feel free to discuss and disagree with any of my ideas as a whole.
I am not a medical professional, and I am only one person. Therefore, I am using outside sources to help explain myself. I don't know the exact medical terminology or technicality of these conditions, nor will I pretend to. This article was written more as an effort to give a general explanation grounded in fact and not so much as a detailed account of all of the separate elements of self-harm.
If you have personal stories to share, feel free to comment or leave me a personal/private message (can you do that?). There are a lot of stories that are untold and a lot of people out there who deal with these struggles every day, and you are not alone.
A Few Definitions
A lot of places have a lot of different ways of explaining what self-harm/self-mutilation is. Here are a few.
Self-harm (SH) or deliberate self-harm (DSH) includes self-injury (SI) and self-poisoning and is defined as the intentional, direct injuring of body tissue most often done without suicidal intentions. These terms are used in the more recent literature in an attempt to reach a more neutral terminology. The older literature, especially that which predates the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), almost exclusively refers to self-mutilation. The term is synonymous with "self-injury". The most common form of self-harm is skin-cutting but self-harm also covers a wide range of behaviors including, but not limited to, burning, scratching, banging or hitting body parts, interfering with wound healing, hair-pulling (trichotillomania) and the ingestion of toxic substances or objects.Behaviours associated withsubstance abuse and eating disorders are usually not considered self-harm because the resulting tissue damage is ordinarily an unintentional side effect.However, the boundaries are not always clearly defined and in some cases behaviours that usually fall outside the boundaries of self-harm may indeed represent self-harm if performed with explicit intent to cause tissue damage. Although suicide is not the intention of self-harm, the relationship between self-harm and suicide is complex, as self-harming behaviour may be potentially life-threatening. There is also an increased risk of suicide in individuals who self-harm to the extent that self-harm is found in 40–60% of suicides. However, generalizing self-harmers to be suicidal is, in the majority of cases, inaccurate.
MHA (Mental Health America)
Self-injury, also known as cutting or self-mutilation, occurs when someone intentionally and repeatedly harms herself/himself. The method most often used is cutting but other common behaviors include burning, punching, and drinking something harmful, like bleach or detergent.
Self-injury is the act of deliberately harming your own body, such as cutting or burning yourself. It's not meant as a suicide attempt. Rather, self-injury is an unhealthy way to cope with emotional pain, intense anger and frustration.
While self-injury may bring a momentary sense of calm and a release of tension, it's usually followed by guilt and shame and the return of painful emotions. And with self-injury comes the possibility of inflicting serious and even fatal injuries.
Because self-injury is often done on impulse, it may be considered an impulse-control behavior problem. Self-injury may accompany a variety of mental illnesses, such as depression, eating disorders and borderline personality disorder.
Different Types of Self-Harm
There is more to self-harm than cutting, despite the fact that many of the websites I was looking at found the two synonymous. Here is a list, compiled from a few sources, of different types of self-harm:
- Severe scratching (Wiki and Mayo)
- Skin-cutting (Wiki, Mayo, MHA)
- Burning (Wiki, Mayo, MHA)
- Banging/hitting body parts (Wiki, Mayo, MHA)
- Interfering with wound healing (Wiki, Mayo)
- Hair-pulling/Trichotillomania (Wiki, Mayo)
- Ingestion of toxic substances/poisoning (Wiki, Mayo, MHA)
- Carving words/symbols on skin (Mayo)
- Breaking bones (Mayo)
- Piercing skin with sharp objects (Mayo)
There are a lot of "sources" that would say self-harm has some sort of relatively simple, one-dimensional reasoning. That might be being "emo" or "hating life" or "wanting to feel alive by bleeding". There are, however, more reasons than just those (and sometimes more than one per person, imagine that), and some of them are not quite as melodramatic. Here are some examples.
Wikipedia (normally I don't use Wiki as a source, but this particular article exhibits extensive research with a vast amount of sources cited as well as detailed information. Please read more on Wiki as what I have copied here is only a minor portion of the pathophysiology section)
The motivations for self-harm vary as it may be used to fulfill a number of different functions. These functions include self-harm being used as a coping mechanism which provides temporary relief of intense feelings such as anxiety, depression, stress, emotional numbness and a sense of failure or self-loathing. There is also a positive statistical correlation between self-harm and emotional abuse. Self-harm may become a means of managing and controlling pain, in contrast to the pain experienced earlier in the sufferers life of which they had no control over (e. g. through abuse).
Other motives for self-harm do not fit into medicalised models of behaviour and may seem incomprehensible to others, as demonstrated by this quotation: "My motivations for self-harming were diverse, but included examining the interior of my arms for hydraulic lines. This may sound strange. "
- Often, people say they hurt themselves to express emotional pain or feelings they can’t put into words.
- It can be a way to have control over your body when you can’t control anything else in your life. A lot of people who cut themselves also have an eating disorder.
- Although they usually aren’t trying to kill themselves, sometimes they’re unable to control the injury and die accidentally.
There's no one single or simple cause that leads someone to self-injure. The mix of emotions that triggers self-injury is complex. In general, self-injury is usually the result of an inability to cope in healthy ways with deep psychological pain. For instance, you may have a hard time regulating, expressing or understanding your emotions. Physical injury distracts you from these painful emotions or helps you feel a sense of control over an otherwise uncontrollable situation.
When you feel emotionally empty, self-injury is a way to feel something, anything, even if it's physical pain. It also offers an external way to express internal feelings. You may also turn to self-injury as a way to punish yourself for perceived faults. Sometimes self-injury may be an attempt to seek attention or to manipulate others.
My own personal reasons
Like I said before, I always thought it was just a nervous habit. Like biting your fingernails, or something. I always noticed I did it more when I was anxious, etc etc. But it was impossible to stop, no matter what -- being able to do it became so important that there wasn't really an effective method of preventing it from happening. And again, like I said, my psychiatrist helped me to understand a little. He defined some of my habits as less habit-like and more OCD-like, which now makes more sense to me (I was the kid that didn't allow her food to touch, I ate food in a specific order, I was always on time to the minute, and the list goes on...). I discovered that I was doing it, yes, because I was nervous or anxious, but also because it was something I could do as a sort of distraction or something I could control. It's direct, it's simple, and there is no complication to my actions. I'm sure there's something emotional in there somewhere but it just feels like a habit to me still. I just have a better understanding of it.
What I do know, however, is that when I scratch my skin it is because of an emotional response. This doesn't happen very often (Maybe 5 times in my entire life), but it feels much more severe for me. I scratch on my wrist on my right hand (because I'm left-handed) when I am extremely, extremely upset and I feel so angry I have nothing I feel like I can do but let it out somehow.
Again, I am not a medical professional (nowhere close). This article is only meant to generally inform and hopefully advocate. If you feel as though you might be self-harming, please seek professional medical advice from your doctor/psychiatrist/therapist before assuming anything. Do not treat yourself; get the help you deserve.
I have never had to deal with approaching a friend about self-harm concerns, and so my experience level in this is relatively low. I did, however, experience wondering if I myself was a victim, and dealing with how to cope with that and what the next steps would be. Because this process is personal and different for everyone depending on their situations, I am going to offer you some advice from Mental Health America and Mayo Clinic on how to see signs and how to approach someone.
Keep in mind that this is a very serious, very personal, and very sensitive subject. Be sure of what you think it happening (sure enough that you want to go through approaching them), and be as gentle and understanding as possible (instead of pushy or insensitive).
Signs to Watch Out For (Mayo Clinic)
- Usually, scars/evidence of self-injury are well hidden. However, there are things that you should look out for:
- Burn/cut scars
- Fresh injuries
- Someone always keeps a razor/scissors/harmful object on their person.
- Struggling with relationships (sexual and platonic)
- Always wears long sleeves/pants despite the weather.
- Claims to always be clumsy and have frequent accidents.
What To Do If You See The Signs (MHA)
- First, ask (sensitively! and probably in private -- that's my opinion though). They might just have been waiting for someone to approach them and show that they care and are concerned, and they might really need someone to talk to (but were afraid of judgement, etc). There's no harm in asking: they won't start because you mentioned it.
- Give them options. It's important not to act like you know what's best for them (because their personal situations are different than yours and their decisions need to be their own, and be what's best for them and their mental health). Offer them ways out of isolation, like talking to teachers or parents or a therapist. Don't be pushy though -- they need to move at their own pace and feel in control of their decisions.
- Remember to take care of yourself! Seeing something like a friend that is in so much pain might be a struggle to deal with (it might be hard to understand how someone could do this, or you might be scared for your friend's safety or even life). Make sure that you have someone to talk to as well about how this is influencing you. Teachers, counselors, teachers, etc could be good outlets. While keeping their condition discreet is important, it is unfair for you to have this burden on your shoulders alone.
- You aren't the reason they're going to stop. There's no way that you can force someone to stop, no matter how much you try to how good your intentions are or how much you care. Self-harm is deeply personal and unique to every situation and every person: when they stop is always going to be up to them. It's when they feel comfortable with themselves, when they feel in control, etc. The only thing you can do, really, is be as supportive as possible and to always make sure you have an ear to lend and are someone they can trust and depend on as they go through this experience.
Have you dealt with having a friend you were concerned about/have you wondered whether or not you self-harmed? How did you deal with the situation? Comment below if there's anything you think is generally important that I missed.
Or comment if you've been the person who's had a friend help them through hard times, and comment on what worked and what didn't.
Some Interesting Facts
But by interesting, I don't mean "cool".
(all of these facts are from Wikipedia.)
- 4% of adults self-harm. 1% of the population engage in chronic/severe self-harm.
- The rate of self-harm is higher among younger people (14-24 years old).
- Earliest incidents are reported in children (5-7 years old).
- 9.8% of undergraduate US students surveyed reported cutting/burning at least once. 32% of that sample admitted to other forms of self-harm including head-banging, scratching, and hitting along with cutting/burning.
- The latest research doesn't find a different between self-harm in woman and men.
- However, past research indicates 4 times the amount of self-harm in women vs men.
- Motivation doesn't seem to change among men and women.
To Conclude On A Slightly Brighter Note...
I hope this was helpful in some way. I realize I didn't write a whole lot of it, but I did credit my sources. I wanted to make sure that nothing was misconstrued and that everything is there at your disposal. All of the sources used are websites that I hand-picked to go off of, and you can find them easily by googling the names.
Self-harm is serious, it's painful, and it's not something to be made into a pretty photoshopped image. It's not something to be sensationalized, and it's not something to be jealous of in any way. It's not something to stereotype a person by, and it's nothing something to be taken lightly. It's something that effects millions of people worldwide, and it's something that these people struggle with day in and day out.
You are not alone. And if you have a friend/someone you know who is struggling, letting them know that they are not alone is the best you can do.
Let's all work together to increase awareness and support.