Self injury, or self harm, is a very taboo subject within society. More people are slowly beginning to talk about it, but it is still a very uncomfortable conversation. For someone who is faced with self harm pretty much every day at work, I find the conversation a little more comfortable than others. Why? Because I’m used to seeing it? Maybe, but I’ll never get fully used to seeing someone hurt their own body. I think I’m more comfortable with it because 1) I have to be to be able to talk to my patients about it, but 2) because I understand it. If everyone were to understand self harm to the level that they were comfortable enough to talk to their loved ones about it, then I believe we would see a decrease in the rates of self harm not only across the UK, but across the world. So it may only be a blog post, but reading this post this can be the start of your conversation about self harm.
A percentage of people within society believe that we shouldn’t talk about self-harm because it may “inspire someone to hurt themselves”. Sorry, but that’s total bollocks. That’s just another way to shy from the conversation that needs to be had. So this post may not be an easy read for some people – if anyone does find it triggering, just stop reading. I won’t take offence, I understand. If anyone finds it upsetting, once again just stop reading. However I must insist that self-harm is not an easy topic to read about, and without learning, you won’t understand. So whilst this post may not be comfortable or easy, it will be honest, and it will be truthful.
What is it?
The NHS defines self injury/self harm as when an individual intentionally physically harms their own body. It is known to be done for several reasons, and every single individual who suffers with self-harm is different, so this may be a very short list compared to the real truths:
- To cope with emotions
- To express emotions
- To relieve stress
- To punish themselves
- A symptom of psychosis – “the voices told me to”
- To help forget (in patients with PTSD)
Self harm is never a suicide attempt – however over half of people who die by suicide have a history of self harm, but we will come to this later.
Every individual is different. Their method is different, and the reason they do it is different. What is known, is that when the body experiences pain it lets out a hormone called endorphins. These are basically “feel good” hormones. They’re released when exercising, when eating well, and when having sex. They are released when the body is in pain to help numb that pain. So despite the pain (physical and psychological) the act of self-harm does not always necessarily feel bad. It can make an individual feel relieved, in control, and feel good about the fact that they have found a coping mechanism that helps them express their emotions – despite how unhealthy that coping mechanism may be.
How is it done?
Self harm can be carried out in an endless list of ways. As I said above, this is a truthful post. So here are some examples of how people may self-harm. I list these not just for the sake of it, but there may be some here that some of you would not think of, and knowing them may help you spot the signs of self harm in someone you know and love:
- Burning (with fire, matches, cigarettes, or burning the skin with plastic)
- Scratching (with their own nails, or with objects)
- Hitting themselves with their fists
- Head banging
- Punching/kicking walls
- Self-strangulation and ligatures (ligatures can also be used as a suicide attempt, but if they’re only slightly restricting the breathing then are seen as a self-harm method)
- Excessive alcohol intake, smoking and drug taking
- Risky/unprotected sex
- Restricting diet (can lead to an eating disorder but not necessarily)
- Biting (bite their own skin and/or through arteries/veins)
- Swallowing objects (baby wipes, tampons, batteries)
- Hair pulling.
There may be some methods up there that are surprising, such as smoking. Smoking, though it is habitual also, can be used as a self-harm method as it can be used to relieve stress and it physically harms the body. Unprotected sex is another perhaps surprising method – sometimes, I have seen it before, young girls meet strange men and let them do what they want to them as a way to punish themselves. They are putting their body in the way of physical danger, so is a form of self harm .
How common is it?
The Mental Health Foundation state that 4 in 1000 self harm in the UK. However, as a support worker in CAMHS (child and adolescent mental health services) I like to look at the facts specific to young people. 1 in 12 young people in the UK have self-harmed. In the last 2 years along ChildLine have seen a 167% increase in counselling requests surrounding the topic of self harm, and in 2012/13 self harm was in the top 5 life concerns for 13 year olds (Young Minds, 2017.)
What do I look out for?
If you are worried about a loved one self-harming, then look out for the following signs.
- Unexplained bruising, cuts, grazes, burns, bite marks, patches of hair missing or even clumps of hair on the floor (anything that looks like it could be caused by one of the methods listed above)
- Self loathing
- Withdrawn, not wishing to socialise
- Keeping their skin covered up, even in hot weather
- Signs of drug or alcohol abuse
- Changes in eating habits – over/under eating
- Lack of motivation
- Any talking of ‘not wanting to go on’, ‘wanting to end it’ or ‘not knowing how to cope.’
However, if that loved one trusts you, and you are close, then perhaps just asking would be the best way to find out. Self-harm, though not attention seeking, can be a cry out for help (this will be discussed later). Ignoring it would do more harm than asking outright about it. If it turns out they are not self-harming, then explain to them your concerns because there may be other issues underneath that they may feel the need to discuss which could explain their behaviours. The above signs are not just signs for self-harm, but also other mental health illnesses such as depression, anxiety and suicidal thoughts.
What’s real and what’s not?
So there’s the facts – what self harming is, what it entails, and how often it happens. But what’s true about it? There are so many myths floating around regarding mental health, but even more when you look at the ones about just self-harming. So I’m going to outline a few and give you the right facts:
"Only young teenage girls self harm"
This is a huge, and dangerous myth surrounding self-harm. It gives the impression that it is a teenage fashion icon, which is totally wrong. Yes, 1 in 12 young people in the UK self harm, but adults do too. Some teenagers never grow out of self-harming and carry the behaviour into their adult years. Some adults start self-harming when they’re older.
Also, this gives the impression that only females self harm. This is absolutely not true. Statistically, more females self-harm than males. But this may be because males are less likely to tell anyone about it. Males tend to have different methods of self-harm to females too.
Whilst were on the topic of demographics, self-harm is seen across cultures and races.
"Self harm leads to suicide!"
Definitely not true. Half of people who die of suicide have a history of self-harming, but it’s not the self-harming that led them to suicide. There are plenty of people who self-harm, but have no intention of killing themselves. Self-harming is a behaviour that can be used as a coping mechanism. If an individual is depressed and wants to kill themselves, it won’t be the self-harm that makes them want to kill themselves, it will be the depression. Yes, self harm and suicide are linked, but have more of a correlational relationship than a causal one. One does not cause the other, they are just related to one another.
"Self harm is just attention seeking!"
A survey of young people and their parents found that 39% of parents believed their children self harmed to seek attention. Now, compare that to when those young people were asked what was one thing they wished people understood about self harming, 80% of them said they wished people didn’t think it was attention seeking.
Individuals don’t just self harm in order to seek attention from others. However, if they are suffering, struggling, and don’t know how to talk about it, self-harm may well be a way to gain the attention they need in order to let people know that they’re not okay. I see it at work, often a young person may head bang in order to get the attention of a staff member because they don’t know how to ask for help. Nothing wrong with this – it only proves that the conversation of mental health and self harm needs to be spoken more so people find it easier to ask for help when they need it.
"People who self harm just like pain."
Would you say that to someone who does kick-boxing? Or who exercises and their muscles ache the next day? Or who gets tattoos? No, you wouldn’t. Self harm isn’t about the physical pain. There is a sense of adrenaline when carrying out the behaviour, but this isn’t the same as doing it because you like the pain. It’s more of a relief, rather than liking it.
"Self harming is a manipulative behaviour."
People may self-harm as a reaction to something that’s happened to them. If someone has upset them in a severe way they may self harm. This can be seen as manipulative, because the individual may not have gotten what they wanted so they self-harmed as a reaction. This is not necessarily true. The individual may have instead self-harmed because they didn’t know how to cope with the emotions they were feeling as a result of the situation they were in.
However, that being said, there are always exceptions. People may learn that their behaviour can be used to manipulate in situations. So, if someone threatens to self-harm because of a situation, then these threats should be ignored whilst support is still offered. You should never accept the blame for someone else self-harming behaviour as this is not helpful for the individual or supportive.
"Nobody understands - only other people who self harm understand."
No. That myth is the reason I am writing this blog post, to ensure it’s not true. That is the reason we have self-injury awareness day every year, to ensure it’s not true. And that is the reason why we need to talk about this more, and be open and receptive to anyone wanting to have that conversation, and learn how to respond to self-harm in an appropriate way – so that no one is left feeling like nobody understands and feeling they have no one to talk to.
Hopefully now you have a little more understanding into self harm. As much as I would love to write a blog post dedicated to why people self harm, that is merely impossible. Like I stated in the beginning, everyone does it for different reasons. However I hope you are now aware of the different methods of self-harm, what to look out for with your loved ones, and what the truths are behind the myths of self harm.
Below I will list references I have used for the statistics of the post, but also some websites and help lines that may be of use to you.
Thank you for reading, and remember; judge less, understand more.
NHS Choices – Self harm fact page:
Young Minds – Self Harm Awareness Day: www.youngminds.org.uk/about/our_campaigns/self-harm_awareness_day
Mental Health Foundation – Self harm information page: https://www.mentalhealth.org.uk/a-to-z/s/self-harm
Huffington Post – Why is my child hurting themselves: http://www.huffingtonpost.co.uk/entry/self-harm-injury-awareness-for-parents_uk_58b5a5f5e4b060480e0c26bc
Mind – Self Harm information:
Mind- Self harm support line: 0300 123 3393
LIFE SIGNS – Self injury Guidance & Support Network (supporters of self-injury awareness day):
Self Injury Support – supporting girls and women affected by self injury: http://www.selfinjurysupport.org.uk
Harmless – Self harm support, training, information and consultancy: