Louise, who is herself an ex self-harmer, gave us a clear insight into what it is like to self-harm, why it happens, the way outsiders react, and how our Practitioners can help those who self-harm.
Self-harm is often caused by depression and lack of self-worth, and many have suffered either mental or sexual abuse as children. There are a variety of ways we all use to cope with stress or depression such as alcohol or drugs that are reasonably socially acceptable, but not self-harm.
Louise explained that to a self-harmer the physical pain they cause themselves is a way of shutting out the mental anguish they suffer every day – the physical pain is preferable to the mental pain.
It is hard for non self-harmers to understand and accept how someone can continually hurt himself or herself to the point where they could even lose a limb through repeatedly cutting the same area. To the self-harmer, however, it is a means of survival, a way of preserving themselves from suicide, although sadly too many do eventually do so.
Many also manage to hide their habit and their scars for years, even from family and friends, by never wearing short sleeves or short skirts and wearing wristbands.
Both men and women and even young children can be victims of this terrible self- affliction and the Self-Harm Network receive many letters every week from distressed self-harmers.
In Louise's long experience over many years she has found that the medical profession have little sympathy for self-harmers. A&E is usually the first place that a self-harmer comes into contact with medical staff, and if they receive poor physical or mental treatment on the first occasion then they will never return to seek further help. Louise mentioned cases where the patient had been shouted at or shaken. In some cases anaesthetics had been withheld in order to bully patients to stop self-harming but this sort of attitude just makes the patient learn not to show pain and never to ask for help again. The staff had called them 'cutters' and attention seekers and sometimes placed them in secure units or give them drugs to keep them quiet.
The result of such treatment was for the self-harmer to pretend they were ready to face the outside world by false cheerfulness and taking great trouble with their appearance, as they soon learned that this would facilitate their discharge.
Louise went on to say that attitudes are gradually changing and that there is more real help and sympathy today for self-harmers, which is good to hear.
As SCN Practitioners Louise said we can help when self-harmers come to us by firstly just talking to the patient in the first place and listening carefully and with interest to everything they say. Some will be willing to show their scars, as after all that is why you think they came to see you, but whether or not they volunteer to show them to you, we should simply talk in a friendly manner and never ask about the scars or ask to see them. Sympathy is needed but should not be seen as patronising. Kindness and understanding will go a long way to helping these patients recover.
Read the new Self Harm article from the 2007 Study Day