Self-harm

What is self-harm?
Self-harm is when you hurt yourself as a way of dealing with very difficult feelings, old memories, or overwhelming situations and experiences. The ways you hurt yourself can be physical, such as cutting yourself. They can also be less obvious, such as putting yourself in risky situations, or not looking after your own physical or emotional needs.

Ways of self-harming can include:
harm

  • Cutting yourself
  • Poisoning yourself
  • Over-eating or under-eating
  • Burning your skin
  • Inserting objects into your body
  • Hitting yourself or walls
  • Overdosing
  • Exercising excessively
  • Scratching and hair pulling

After self-harming, you might feel better and more able to cope for a while. However, self-harm can bring up very difficult feelings and could make you feel worse.

If you self-harm, you may feel embarrassed or ashamed about it. You might be worried that other people will judge you or pressurise you to stop if you tell them about it. This may mean that you keep your self-harming a secret. This is a very common reaction, although not everyone does this.

Why do people harm themselves?
There are no fixed rules about why people self-harm. For some people, it can be linked to specific experiences, and be a way of dealing with something that is happening now, or that happened in the past. For others, it is less clear. If you don’t understand the reasons for your self-harm, it’s important to remind yourself that this is OK, and you don’t need to know this in order to ask for help.

Any difficult experience can cause someone to self-harm. Common causes include:
harm-themselves

  • Pressures at school or work
  • Bullying
  • Money worries
  • Sexual, physical or emotional abuse
  • Bereavement
  • Confusion about your sexuality
  • Breakdown of relationships
  • An illness or health problem
  • Difficult feelings, such as depression, anxiety, anger or numbness, experienced as part of a mental health problem

Some people have also described self-harm as a way to:

  • Express something that is hard to put into words
  • Make experiences, thoughts or feelings that feel invisible into something visible
  • Change emotional pain into physical pain
  • Reduce overwhelming emotional feelings or thoughts
  • Have a sense of being in control
  • Escape traumatic memories
  • Stop feeling numb, disconnected or dissociated (see dissociative disorders)
  • Create a reason to physically care for yourself
  • Express suicidal feelings and thoughts without taking your own life
  • Communicate to other people that you are experiencing severe distress

I used to cut myself just so I could feel pain. [It] let me know I was real and I wasn’t in a dream.

I ‘needed’ to harm to punish myself for being what I believed then to be a terrible person and to clear the fog in my head. As soon as I did, I’d feel in control, calm and as though a reset button had been pressed in my head.

Sometimes people talk about self-harm as attention-seeking. If people make comments like this, it can leave you feeling judged and alienated. In reality, most people keep their self-harm private, and it can feel very painful to have your behaviour misunderstood in this way.

If you do self-harm as a way of bringing attention to yourself, remember that you deserve a respectful response from those around you, including from medical professionals.

I found that cleaning and dressing wounds or taking myself to A&E for sutures was the only time I was kind to myself.

What support and treatment is available at Empathy Counselling ?
You might believe that it is impossible to stop self-harming if you have been doing it for a while. This isn’t true. It can take time, effort and determination to stop, but lots of people have managed to do it.

Sometimes, you may need to get outside support to help you make positive changes. You may find that you need to try a few different things to find what works for you, and combine self-help techniques with professional support. There is light at the end of this tunnel. It’s possible to change certain thought processes and to learn how to deal with things in a different way. The most important thing is to have a strong support network in place for when you’re ready.

It takes courage to ask for support. It is understandable that you may have concerns that you won’t be understood or that you will be pressured to make changes faster than you want to. However, it’s important to remember you have the right to receive support that is both empowering and respectful. Our Counsellors will discuss all your options with you, and your views and preferences should be taken into account when making decisions about your treatment.

be-yourself

These say that:

  • Any health professionals should treat you in a way that is sensitive and non-judgemental
  • Ideally, health professionals should be trained in communicating sensitively with people who self-harm and be aware of potential stigma
  • Any treatment you are given should be tailored to your individual needs
  • Treatments offered may include structured sessions of talking treatments, such as cognitive behavioural therapy (CBT), psychodynamic therapy or problem-solving approaches

If you are concerned about your treatment or care, or find it hard to access the support you need, it may be helpful to get an advocate to support you. This could be a friend, family member or professional.

Talking treatments
Talking treatments can be short- or long-term and involve talking with someone who is trained to listen with empathy and acceptance – usually a counsellor or therapist. They do not aim to give advice, but offer you the chance to explore your feelings and find your own solutions to any difficulties you are having. Talking things through with another person can help you understand your feelings and behaviour, and start to make positive changes. It can also help you feel supported to have someone else accept and understand your experiences.

Talking treatments that might be useful include:

  • Psychodynamic therapy – This focuses on how past experiences contribute to current experiences and feelings. It can be short- or long-term. It can be more intensive than some other therapies, because it involves talking about your childhood, your relationships, and how these things might relate to your self-harm.
  • Cognitive behavioural therapy (CBT) – CBT aims to identify connections between thoughts, feelings and behaviour, and to help develop practical skills to manage them. A CBT therapist may support you to look at what happens just before you self-harm, to keep a diary of self-harming episodes and find other channels for your feelings. CBT does not usually explore the underlying causes of self-harming.
  • Dialectical behaviour therapy (DBT) – This therapy was designed for people with borderline personality disorder (BPD). It combines techniques from CBT that help to change thoughts and feelings, along with techniques that strengthen self-acceptance. If you have been diagnosed with BPD and your self-harm is part of this condition, DBT might be something that would help you.

Your relationship with your therapist
One of the most important things about talking treatments is the relationship you have with your therapist. You may not always agree with each other, but you must both be committed to working together in spite of any difficulties.

Sometimes a counsellor may ask you to commit to not self-harming during a course of counselling. It’s important that you don’t feel pressured into making decisions about this, and that anything you decide is realistic for you at the time. If your counsellor is not specifically trained in self-harm, it might be useful to ask them to find out more, for example by reading information, such as this booklet, or by talking to organisations for people that self-harm.

Support groups
In a support group, people with similar experiences meet to discuss their feelings and experiences, and share tips for coping. Support groups can be run by a group leader or by group members. They may focus on specific issues, such as self-harm, or be more general.