Six Questions You Might Be Scared To Ask Someone Who Self-Harms
Ah, self-harm. Not the first time I’ve written about it, certainly won’t be the last, but this might be the most important one so far. As with most mental health conditions and symptoms, it’s always tricky to ask people about their experiences. A lot of people - sometimes caused by the societal stigma - don’t want to talk about it, and are well within their rights to keep their privacy and not say anything they’re not comfortable with.
Well, that’s where I come in.
At this point, I’m an open book and pretty comfortable with answering any and all questions someone could throw at me. But most people aren’t like that, and usually for good reason. That’s why (and here we actually begin the post after that exceedingly long build-up) I thought I’d start a series of posts answering some fairly common questions about mental health topics I have experience with and understanding of, but that the average person might be scared of asking. Whether that be because of the fear of upsetting someone, or because of an awkwardness around those topics, it doesn’t matter. This is a safe space where 6 initial questions will be asked, and then I’ll open up the comment section for any further questions you might have and will keep dipping back in to answer them.
First up: self-harm. I thought I’d start here because it’s been the topic of several of my posts lately, but I’ve never really gone into great detail. After this, it’ll really be shaped by what people want to see. If you have any burning questions about any particular aspect of mental health, either whack them in the comment box below, email me at email@example.com, or private message me on Twitter.
Q1: Why do you do it - is it for attention?
A: People self-harm for a multitude of different reasons. The majority of the time, it’s not because they are looking for attention. It tends to be an intensely private thing that happens as a result of serious mental turmoil. For me, it was a way of making myself feel something when I’d felt numb for days because the pain was a reminder I was still alive, or occasionally I used it as a punishment if I’d considered that I’d messed up. Sometimes, I just felt so much I didn’t know what else to do to express those feelings. I’d wager that my experiences with self-harm aren’t unique, and that many people do it as a way to express their feelings when they don’t have the words, or a way to feel something.
Other people might use it as a way to make their feelings visible on the outside, feel like they are in control of something, block out past traumatic experiences and focus on something else, or turn emotional pain into physical pain, because quite often that’s easier to deal with. I know I coped much better with the clean up from self-harm than I did trying to cope with my emotions.
Either way, the reasons why someone might self-harm vary from person to person, and no two people will do it for exactly the same reasons. And even if someone is doing it for attention - pretty rare, most people will do everything that they can so no-one finds out - that alone tells me that they’re in need of as much help and care as someone who isn’t doing it for attention, because they’re clearly in pain in some way.
Q2: Why can’t you just stop?
A: It’s just not that easy.
Self-harm can become a habit that is very easy to rely on for short term emotional release, and very hard to stop doing. For me, years after I’d started self-harming, I often found myself doing it because it was just an ingrained habit. Even if I wasn’t necessarily feeling that bad or overwhelmed, it was just part of my daily routine. Not a great part, but a part nonetheless. And the more I did it, the worse it got because I needed more to satisfy the craving.
For anyone reading this who hasn’t dealt with self-harm, it might be quite shocking to read it described as a craving. But that’s what it became, after a while. I won’t go into detail here because quite frankly no-one needs to hear those thought processes, but needless to say the action and the sight was something that I ended up needing to see and do. I knew that if the slightest thing had gone wrong during my day, I could come home to the release of self-harm and it would get me through to the end.
But self-harm is ultimately a choice. It might not feel like it’s a choice in the moment, and stopping is very, very difficult. But it is a behaviour, and therefore a choice. Self-harm needs to be replaced with other coping mechanisms, and people who are in active recovery need love and support and compassion and the knowledge that it’s okay to slip up. Just stopping cold turkey often isn’t an option.
Q3: But doesn’t it hurt?
A: Like a fucker.
Q4: Why don’t you just cover up?
A: Choosing whether or not to cover your scars is a personal decision. Some people will, some people won’t, but no-one should ever be made to feel like they have to cover their scars. I wrote about my personal reasons for not covering up here, and spoke about it to Refinery29 here.
But essentially - some people will feel more comfortable covered up, some people don’t want to have to think about dressing to cover scars. Some people will choose to cover in some situations and not others. Whatever someone chooses, they are often doing what is most comfortable for them and don’t need to have that decision questioned or challenged. The stigma of having self-inflicted scarring is hard enough without the stares and the questioning, and the common feeling of judgement if you have those scars on show in a professional environment or around children.
Personally, I often forget that I even have scars and dress however I want to dress in most situations. I do feel exposed on the beach in the summer, and that’s when I feel most aware of my scarring because it’s prominent on my left arm and both thighs. I also tend to cover up around children I don’t know if I also don’t know the parents, and when going for job interviews (although when I have the actual job, that’s a different story). That’s what makes me feel comfortable in most situations, and I’m at a point now where I am comfortable with my scars being visible to the world. They’re nothing to be ashamed of, and I have nothing to hide.
Q5: Is self-harm just cutting?
A: Short answer? Nope.
Self-harm encompasses a wide range of behaviours, but to qualify as self-harm it has to be an injury caused to your person deliberately by yourself. Follow me? Cutting is the most ‘popular’, if you will, and the one that tends to be most visible in the media - whether that be fictional media or news headlines.
Self-harm can be anything from burning yourself deliberately, poisoning yourself, positioning yourself in a fight so you know you will get hurt (this one is particularly common in boys, and often very misunderstood and rarely will the person receive the right treatment), over or under eating, picking or scratching at your skin, exercising to excessive amounts, hitting yourself - there are many, many different forms of self-harm. Unfortunately, the list really does go on and there are many forms of self-harm that people don’t recognise as self-harm. Often this means that the underlying causes for the behaviour go untreated.
But if the action somehow causes injury to your body, it’s a form of self-harm. My self-harm did take place in the form of cutting myself, and it’s those scars that are most prominent. But I also restricted my food intake, binge ate until I felt physical pain, and still now bite the inside of my lips and cheeks until they bleed and are painful for days. I would go as far as saying these more ‘invisible’ forms of self-harm are even more dangerous than the visible.
Q6: Does it mean you want to die?
A: A lot of the time, being suicidal and self-harming are two different acts. Many people who engage in self-injurious behaviour don’t want to die, they’re just expressing their pain in a way that perhaps isn’t the best. And while there are people who both self-harm and are suicidal - me included - the two behaviours are often separate. A lot of the time when I self-harmed, I wasn’t actively suicidal. I just wanted to release the pain that I felt at that moment etc etc. Other times, when I was experiencing intrusive suicidal thoughts, I wasn’t self-harming at all.
It is scary when you find out a loved one is hurting themselves in whatever form that takes. A lot of people, many who have never suffered themselves, panic and immediately assume that because their friend or family member is actively hurting themselves, that means they want to die. This is often where the overreaction stems from. But remember - stay calm. It’s more than likely that your loved one wants to live, but they don’t know how else to express their feelings.
Occasionally, however, the two can be interlinked. I have definitely engaged in self-harm in the past to quiet the suicidal thoughts - although I still wasn’t self-harming to actively commit suicide, it was more an action that in the moment kept me alive. Again - self-harm is a very personal thing. The reasons and the thought processes behind it are going to vary wildly from person to person, and what is true for someone won’t be true for someone else.
At the end of the day, all you can do as a bystander is listen to your loved one or the person who has opened up to you to understand their thought processes, stay as calm as possible, and try not to overreact and immediately panic. Self-harming is never a good behaviour, but forcing someone to stop immediately or destroying their trust in you isn’t going to make the situation any better.
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If you have any further questions about self-harm, or want clarification on anything I’ve discussed above - again contact me at firstname.lastname@example.org, comment below, or private message me on Twitter.