Sunday, March 1st 2015 was be Self-harm Awareness Day. The one day a year when people spare a moment to pledge their support or share a post on social media.
The remaining 364 days of the year are spent by many feeling isolated and crippled by a stigma which prevents them from seeking help, and so, whilst I did mean to post this article on Sunday, I believe that it is just as relevant today.
I recently went to my local hospital to have a blood test. Whilst sterilising my skin, the nurse noticed the dulled, reddish scars on my upper arm and stopped in her tracks, gawping silently at them for roughly five seconds. Suffering from moderate depression co-morbid with an anxiety disorder, I tend to be hyper-attentive to body language, and so what may well have been mild uneasiness on her part appeared to me as revulsion and shame. I spent the rest of the day mulling over her reaction in my head, feeling utterly wretched.
The outcome of this incident was two-fold.
Firstly, it highlighted my (sometimes) irrational thought processes, a common feature of almost all mental illnesses. Whilst intellectually, I realised that what had happened was far from disastrous, emotionally I felt a lot less sure that this was true.
Secondly, and more importantly, I realised that, despite my catastrophizing, the nurse's response was clearly not a helpful one, especially from an employee of the NHS.
In my experience, self-harm has a huge impact on the day-to-day life of those who do it. Those affected will often go to extreme lengths to keep what they're doing a secret, and to hide their scars or bruises. But the burden of guilt, shame and secrecy is incredibly difficult to carry.
When someone reacts with aversion or embarrassment to large, disfiguring scars from a car accident, or a surgery, they might do so on a purely aesthetic basis. However, when someone reacts in this manner to the obvious patterns of self-injury, I struggle to believe that their discomfort is based on aesthetics alone. In my case, where the context is fairly self-evident, the non-verbal reproach to what are, essentially, a few strange lines on my skin that indicate my less-than-stable mental state, demonstrates a subtle, but unmistakable stigma.
This stigma regarding self-injury is highly dangerous. Many still view it as a manipulative act, worthy of anger, and therefore, as something that they are reluctant to assist with. Often, this leads to emotional reticence, preventing people with serious psychiatric illnesses from seeking the necessary treatment for recovery.
According to the latest figures, self-injury has risen by as much as 70% in the past two years among 10- to 14-year-olds. Many find it almost impossible to understand why people harm themselves, and how it could possibly help them to feel better. In order to break down the stigma surrounding the issue, we need. When asked why they self-harm, young people came up with these reasons:
- To calm down when feeling anxious, angry, overwhelmed, or tearful
- To replace emotional pain with something physical that they know how to deal with
- To release painful feelings or get in touch with their emotions
- To prevent themselves from taking their anger out on other people or hurting them
- To distract themselves from other problems in their lives
- To punish themselves when they feel guilty, ashamed or inadequate
- To feel something instead of being numb, to make themselves feel "alive"
- To give them an excuse take care of themselves by dressing the wounds or tending to the injuries afterwards
- To be in control of something in their lives, when everything else seems beyond their control
Although this list is by no means exhaustive, it illustrates that self-injury is the result of serious emotional distress, and should be treated with empathy and understanding, not condemnation.
Statistically, teenage girls are still more than twice as likely to self-harm as young males, leading to another gender-based stigma: that self-harming, emotionally distressed young girls are simply "attention-seeking." This damaging stereotype makes it even more difficult for girls to feel able to talk about how they are feeling, or to seek support. Equally, if a young girl (or boy) is self-harming for attention, it doesn't mean that they should be ignored. If someone is crying for help, they deserve to be helped without being judged for the way they are asking for it.
Fortunately, ridding ourselves, and our societies, from preconceptions about self-injury should not be difficult. Destroying the ridiculous, harmful stigma that surrounds it should, in theory, be straightforward. We just need familiarity.
We need to start talking about it.