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Hello. Since self-harm is extremely stigmatised and poorly understood. For the purpose of awareness, I thought to dissect it a little today. This is only scratching the surface but I hope it is helpful.
Self harm can often be a consequence of mental distress. It is not a diagnosis by itself. It includes activities done voluntarily. Scratching, cutting, biting, burning, overdosing on medication, substance misuse are some examples.
This is not an exhaustive list but they are more commonly seen. Not everyone who self harms has suicidal ideation or intent. However, some may be vulnerable to suicidality and/or serious injury.
Self harm is often a coping mechanism. There are specific triggers experienced that instigate behaviours of self harm. Individuals often describe a gain as a consequence of their activity.
For example, cutting small sequential lines on the arm can feel calming to someone or burning oneself with a cigarette can give the satisfaction of ‘feeling’ to someone who experiences numbness.
The ritual of self-harm can also be organised and the organised pattern can provide order to someone’s anxiety or meaning to the emotions experienced when a trauma survivor is triggered. For some, it provides relief.
Point is that there can be a purpose, a helpful one, that actually prevents an individual from taking severe action when their mental distress feels unmanageable. Self harm warrants empathy, love and care, not shame.
Self harm is often stigmatised. People are shamed for not being ‘strong enough’ or for ‘destroying their bodies’ and the shaming is only contributing to their distress and not helping in the resolution. Who gets to define what's 'enough' anyway?!
And who are we to prescribe specific ways of coping when we haven’t experienced their pain or do not feel debilitated by their triggers. Providing help and support to someone has to be in a way suited for them, not you.
However, self harming can also lead to long term damage. Vulnerability to infection, other diseases and severe injury being a few. It is a very plausible reality. Enter: harm reduction.
The harm reduction principle is a strategy for self harm. It works with the individual’s coping mechanisms and not against them. There should be no shame in how we cope. It took a long time for us to get here.
Now harm reduction strives to reduce the vulnerability to serious injury, during self harm. Depending on the behaviour, it creates strategies that will minimise harm while self harming.
It can work like a safety plan. For example, using a clean blade to cut, using an ointment and dressing the area after cutting, trying to have 12 drinks a day instead of 13. It collaboratively sets realistic expectations.
Noticing if the behaviour is leading to further injury, having strategies in place for addressing them.Who is a safe person to approach for help if there has been a loss of blood?if there’s incessant vomiting,unusual skin discolouration.Harm reduction works towards sustainability
Because you know what else harm reduction is attempting to do?Increase capacity for self-care. One is learning to take care of themselves and being more mindful of the behaviours they are engaging in. It increases feelings of self-worth & expands support systems, in the process.
It aids a healthy environment without shaming the person for doing something that they know is helpful. And that is the first step to discovering why those triggers are there in the first place - a healthy, sustainable environment.
It supports a process of discovery & increases safety. As the process continues and the bank of coping skills increases, maybe the self harm tendencies start reducing or maybe they don’t. Only one person decides. The agency should always remain with the person struggling & coping
In closing, I want to add that harm reduction and help for these stressors is available. Strategising without stigmatisation is the kind of quality care you deserve. It is your right. It is available.
Please know that if you have tendencies of self harm, clinicians are trained in harm reduction and should never tell you to ‘stop doing this’. If they do, they are canceled. Take care <3
