mental health · mental wellness · Self-harm

Your words cut deeper than a knife

Self-injury or self-harm, or cutting, is such a complex topic to discuss. It’s confusing if you don’t engage in it but you find out that your friends, or children, or loved ones engage in the act. Is it a suicide attempt? Is it attention seeking? Are they trying to follow some trend from social media? Why would anyone want to harm themselves?

And the simple answer is that self-harm is a way of releasing overwhelming emotion or a way of feeling something in the absence of emotion.

bandaged wrists, pulling sleeves down to hide

What is self-harm?

In moments of deep distress or emotional pain, some people engage in an act of self-injury. The type of act varies, and it can be cutting themselves, scratching at skin, burning skin, preventing an old injury from healing, hitting themselves against walls, pulling hair, getting into fights knowing they’ll get hurt, or any manner of causing harm to themselves. Any act, in fact that causes some sort of physical harm, it can even include the misuse of alcohol and drugs and unsafe sexual behaviour, or overeating and undereating.

Self-injury isn’t in and of itself a mental illness, but it is usually a behaviour resulting from depression, anxiety, or trauma, which would need professional help. And because there is a lot of shame and guilt and embarrassment in the act of self-injury, the person might not be able to open up at all about the behaviour out of fear of judgement or angering or disappointing family and friends, but in fact they may need to so that they can get the help they need.

Why do people self-harm?

One of the most common reasons for engaging in self-injury is deal with difficult emotions like guilt, self-hatred or emptiness. Related to this, people engage in self-harm to express feelings that cannot be put into words or to release pain or tension.

Sometimes, this is an act to feel something, anything, when the person is struggling with emotional numbness, or is feeling derealization (which is a feeling disconnected from the world), or feelings of dissociation (feeling disconnected from themself).

Other reasons are for a person to distract themselves from challenging life circumstances, or to prevent themselves from doing something that is more damaging. It’s also a way for them to feel in control of out-of-control life circumstances. Another reason can be a way for people to punish themselves.

Whatever the reason for a person wanting to harm themselves, we need to validate these feelings, and learn what is the reason for self-injury, and understand what is causing them to engage in this behaviour. Ultimately whether it is to feel control, to communicate emotion, to punish or to feel something, we need to help them feel seen, and understood. It’s important for them to have someone they can turn to because then next time, maybe they won’t need to engage in self-harm to release the pain, maybe they can speak to someone to address what is at the core of the need to hurt themselves, or to get professional help.

There are a number of difficult experiences that can result in a person using self-injury to manage their emotional distress. For example, work or school pressures, bullying, low self-esteem, financial difficulties, abuse (physical, emotional, sexual), bereavement, homophobia or transphobia, relationship difficulties, loss of a job, stress etc.

Myths debunked

Myth: It’s attention-seeking

Fact: While the area of self-injury may be visible to others, the act itself causes a lot of shame and embarrassment, so no it’s not attention-seeking. No one who engages in self-harm actually wants you to notice. That being said, what I have come to realise in my therapeutic journey, is that yes, maybe the person is “seeking attention”, but not in the negative connotated way we understand. When someone engages in self-harm, there is trauma there, or some kind of emotional distress, and maybe they don’t have the words to say I need help, and this act is all they can do to say, please see that I am hurting and in need of help.

Myth: They want to kill themselves

Fact: Usually the injury is too minor to actually cause any mortal harm, and the reason for self-injury is to release emotional pain, or address emotional numbing, or punishment, not a desire for suicide. Although that being said, it is important to note that this act is usually related to trauma, or depression, or anxiety, or other mental illneses, and the person could be experiencing serious emotional hurt that they may be suicidal, but the act of self-injury itself is not necessarily a suicide attempt.

Myth: They are crazy or dangerous

Fact: Not crazy, but yes, most likely suffering with a mental illness like depression or anxiety. Anyone engaging in self-injury is hurting more than anything, and struggling with life, or some kind of difficulty.

Myth: The wounds are not bad therefore it’s not that bad

Fact: Engaging in an act of purposefully hurting yourself is bad enough, whether or not that is a surface wound, or an injury that requires stitches. Most people who engage in self-injury will need to learn a healthier coping mechanism to deal with emotional overwhelm.

wrist with win no scars, and wrist with lose with self-harm scars

What to do if someone I know is self-harming

Deal with your own emotions first – you need to acknowledge your feelings which might include anger or disgust before you address the act of self-harm. There is a lot of guilt and shame surrounding self-harm, and the emotions related to why the person would self-harm, so do not approach them if you are feeling anger or disgust

Learn about the problem – it’s confusing and mysterious. So find out everything you can about self-harm before you speak to them. It will also help you deal with any feelings of discomfort if you have an understanding of self-injury

Don’t judge – try and avoid any type of judgment or criticism. This type of reaction will only make the situation worse, and create more guilt and shame which will start the self-injury cycle all over again.

Offer support, not ultimatums – If you want to help, be available as a person who is willing to listen to the persons’ problems, and who is willing to help them find solutions to their emotional distress. Express concern about what they are doing, but offer to help. And make sure that they know you are available whenever they need to talk. Self-harm can be a lonely and isolated road, and anyone would want to know that they have someone there for them

Encourage communication – Encourage them to express their feelings, that you are offering a safe space for them to share how they are feeling, so that they do not have to use self-injury to release those emotions.

Remember that self-harm is usually part of a larger condition, relating to the emotional distress, and it is a coping mechanism for extreme emotional distress, or feelings of emotional numbness. So, if you know someone who is engaging in self-injury, try and encourage them to seek professional help, and at the very least, offer them a safe space to talk about how the feel.

They need to be seen, and heard, not judged and hated.

Sources:

Nami.org

Mind.org

Helpguide.org

Uncategorized

A permanent solution to a temporary problem

TRIGGER WARNING: Suicide

It was the middle of the night. And the fourth night that week that I was up at 1am, unable to sleep. I was reading package inserts to see the dosage I would need for overdose. And bemoaning the fact that based on the number of tablets I had, I would only damage my internal organs, and be forced to face the world anyway.

I’m no stranger to suicidal thinking. I have never ever attempted suicide, but I know far too many people who have, and of too many people who have committed suicide.

Project Semicolon quote

When it comes to suicide, people are confused by the act, think that it’s selfish, question what would drive someone to take their own life? It’s considered an act of weakness for people who are not brave enough to face the trials of life.

And in contradiction, when we hear someone talk about how they want to die, or they want to commit suicide, we brush it off as attention-seeking behaviour. If nothing else, please give these people attention. Rather a few minutes of attention to hear what is bothering someone, than a lifetime of missing someone who saw no way out other than taking their own life. And we are always left wondering why a person would take such extreme measures to end emotional pain. So let’s have these conversations before we have to grieve a loss.

Some things to understand about suicide:

  • It’s not death that the person desires, but the end of deep emotional pain.
  • The pain from challenging life circumstances is ongoing and there seems to be no end in sight.
  • Deep feelings of hopelessness
  • A deep-seated sense of loneliness and feeling alone in the world.
  • Self-hatred so deep that the world would seemingly be better without them.
  • Having nothing to live for because of perceived failures.
  • A sense that death is the only escape.
  • Certain medications have been known to cause suicidal thinking.

What can we do if we sense our loved ones are feeling suicidal, or if someone we know expresses suicidal thinking:

Help them seek professional help. Either psychologists, psychiatrists, suicide helplines.

Listen to them. Without trying to give advice, just listen. Accept how they are feeling – it doesn’t mean you are condoning the act of suicide, but that you are condoning them having very difficult feelings.

Anyone suffering with suicidality needs to be seen and heard, and shown that they are valuable and that the world needs them. Someone considering suicide, might feel like there is no one in the world who cares about them, and it may take just that one person to listen to make a difference.

The conversation you have needs to be matter-of-fact. If you react with emotion, like daring them to do it in anger, or acting shocked, or being judgemental, it will create further distance and feelings of loneliness. At this stage, this person needs to feel connected, and not experience any further challenging emotions.

The person may experience shame for feeling this way, but don’t let them swear you to secrecy. You need to seek help from a professional. Ask them if you can contact a family member.

If someone has expressed suicidal ideation, do not leave them alone, and do not leave them with the means to commit suicide. In that moment, seek the help that they need, through a suicide hotline, contacting hospitals, psychiatric facilities.

Show them that they are not alone in the world, and that you are there to listen to them. Sometimes that’s all someone needs is one person who shows them that they are wanted and needed.

Risks and warning signs:

  • Talking about death or suicide
  • Giving away possessions
  • Change in behaviour
  • Feeling worthless/hopeless/helpless
  • Not experiencing belonging
  • Sleep disruption
  • Feeling trapped
  • Feeling like a burden
  • Isolating from friends and family and withdrawing from activities
  • Calling people to say Goodbye
Semi colon your story isn't over yet

If you are experiencing suicidal ideation, first and foremost, seek professional help, or contact a helpline. And, if you are prone to suicidal thinking, it’s a good idea to have a safety plan for yourself:

  1. Know the warning signs, of how your mood, thoughts and behaviours change
  2. Have a list of people you can turn to (in the depths of emotional pain and loneliness, we sometimes forget who those people are)
  3. Make a list of activities to distract yourself (if you are feeling hopeless you could struggle to think of anything other than suicide)
  4. Make sure that you don’t have anything that can be used to commit suicide
  5. Make a list of relaxation techniques (e.g yoga, meditation, deep breathing, dancing)
  6. Make a list of professionals, and helplines you can contact.
Semicolons bring hope to fight instead of ending it all

At the end of the day, suicide is preventable, and it is important to have transparent conversations with loved ones whom you think are at risk. And if you are someone experiencing suicidal ideation, know that there is help out there, and it’s not weak to feel suicidal, nor is it weak to seek help.

References/Resources:
www.sadag.org

https://www.psychologytoday.com/za/basics/suicide

https://www.psychologytoday.com/za/blog/the-mind-body-connection/202009/the-myths-and-warning-signs-suicide

https://www.psychologytoday.com/za/blog/the-savvy-psychologist/201909/how-help-loved-one-struggling-suicidal-thoughts

SADAG contact details:

0800 21 22 23 (8am-8pm)

0800 12 13 14 (8pm-8am)

SMS: 31393