6) When I feel the need to self-harm I can’t stop myself. Is there anything I can do?

7) Is self-harm just about cutting?

8) Is self-harm a mental illness?

9) Is there a lot of stigma attached to self-harm?

10) Where can I get help?

1) What is self-harm?   ( Back To Top )

Self-harm is generally a way of dealing with emotions or trauma that involves the idea of punishing the body. It is more often than not a coping mechanism to react to past or present situations of distress.

Acts of self-harm include:

• Cutting

• Eating disorders

• Stabbing sharp objects into the skin or body

• Burning skin (fire or chemical)

• Picking at old or open wounds

• Hair pulling

• Severe skin scratching

• Gnawing or biting flesh (including inside of the mouth).

• Any act that induces the sight of blood/ bruising.

We may also include: alcohol/ drug abuse, death defying stunts, or tattoos and piercings. Please be aware that as far as the latter two are concerned, it may be damaging if they are on a huge scale, but remember that they are also statements of fashion or religious and cultural preferences – there may therefore be no underlying issues.

2) Why do people self-harm?   ( Back To Top )

Tough question. Reasons for self-harming vary from person to person. It can involve the individual wanting to punish his or her body as a result of intensely negative emotions. It can be an act of re-gaining power and control over the body at a period during which the mind itself is causing a great deal of pain and anguish; this therefore is an act of defiance against emotional pain evoked.

There is no single reason as to why people may self-harm. It may be a response to feelings of self-hatred and failure, resulting from a wide range of life-events. We have met people who injure themselves as a means of coping with abuse, of feelings of failure; a means of responding to a traumatic or distressing situation that is beyond his or her control.

Note that self-harm is not necessarily link to mental illness. It may indeed accompany symptoms of depression or other mental illnesses, but is, as I have stated above, a method of coping with an intensely distressing situation or highly negative emotions.

3) Is self-harm attempted suicide?   ( Back To Top )

No, although the two can be closely connected.

Self-harm is instead a survival technique, a means perhaps of representing the avoidance of suicide. People experiencing the desire to self-harm instead treat it as a coping mechanism, a method instead of getting by and surviving.

Though some acts may be para-suicidal (a suicidal attempt may enacted without the fatal consequences), many of the fatalities or near-fatalities have been caused by the accidental cutting of a vein or artery.   

Paradoxically, for many, self-injury may instead be a method of affirming the fact that they are alive when feelings of numbness prevail, when they feel ‘dead’ inside.

4) What should I do if someone I know self-harms?   ( Back To Top )

It is advisable not to approach the person and ask them directly about it – this may cause further distress and further self-harm as s/he feels that you have been let down by them.

 If possible you should wait until they approach you for your support. However, do not be afraid to seek help about it yourself as this is also very traumatic for you. When the individual knows that you are truly concerned (this may be difficult for them to comprehend at first), they may be encouraged to talk to you or to seek help for themselves.

You cannot and should not stop them from self-harming. If, for example, you remove the knife they cut with, they may look for other, more dangerous methods of self-injuring. Try to remember that, for them, self-injury is a coping mechanism, and they may feel totally deprived of any power and coping strategies if this is taken away from them.

Perhaps you might encourage them to self-harm safely: leave a first-aid kit around for them, or ensure that there is a clean supply of sharp objects. This sounds awful, but it actually demonstrates that you are aware of what they are doing, and, instead of punishing them for it, you are concerned for their welfare and want them to be as safe as possible. It is a sign of you understanding, or attempting to understand, and may subsequently encourage them to approach you or to seek help for themselves.

Whatever you do, try to ensure that you do not appear to be punishing the individual for self-harming, as this will cause more harm than good (pun intended). Be sensitive to their delicate thoughts of low esteem, and their desire or even need to punish themselves, without adding further to them.

5) Can you self-harm safely?   ( Back To Top )

There is never a truly safe way to self-harm. But you can minimise the risks by following some of these suggestions;

• Ensure that you have a clean, hygienic implement with which to harm. This can reduce the risk of infection.

• Try to have a first-aid kit on hand to clean and dress the wound.

• Avoid cutting too deeply – also, if you can, avoid areas where you may nick a vein or artery if you do feel the need to cut deeply. The top of the arm, top of the legs or the stomach may be best places for these.

• Be aware that if the wound is severe, or becomes infected, medical attention may be needed. Do not be afraid to seek treatment for them. NHS workers now are on the whole trained to be sensitive and discreet; working in your best interests.

·     Do not be afraid to seek help about your self-harm if you have any concerns. Many people self-harm, and you are not alone in this although you may feel that you are. This website contains links to services that can help and support you, and can help advise you as to what steps to take to get help.

6) When I feel the need to self-harm I can’t stop myself. Is there anything I can do?   ( Back To Top )

Below are some distraction techniques that may help. You can adapt them to suit your own individual needs. They are based on the idea, as expressed by many who self-harm or have done so in the past, of being overcome by a sudden, unstoppable urge and desire to harm; these are some techniques that may distract you from that impulsive urge:

• Lock the tool you use to harm away in a box with tape around it in a drawer – this short delay may give you time between thinking about self-harm and actually doing it.

• Wrap your tool with several layers or paper, and, if possible, write messages to yourself with positive things about yourself; again, this provides a short delay between urge and action, and may distract you with statements that show that you don’t need to harm yourself.

• Avoid patterns that you have identified which may compel you to self-injure.

• The act of self-harm is often performed as a ritual or a routine. Do something that disrupts and breaks this ritual.

• Write yourself a list of why you want to self-harm, and then try to identify positive features about yourself and your life that betray these. Although this is a very difficult task, it can help you to realise why you don’t deserve and don’t need to harm yourself.

These are just some of many suggestions that you may find useful. Do not be afraid to try other things that are more appropriate to yourself. Base them around the idea of distracting yourself from your urges and desires to harm; watch a film you enjoy, exercise, go for a walk, stroke a pet. If possible, try to get out of the environment in which you self-harm, and perhaps try to meet up or telephone another person to keep you company.

7) Is self-harm just about cutting?   ( Back To Top )

No. Although much self-injury involves the individual cutting his or her arms or legs (it is easier to hide these wounds away from other eyes), there are many other acts that can be described as self-injury. These include; burning, pulling hair, biting or gnawing at flesh, pulling at finger- or toenails, picking at open or old wounds, drug or alcohol abuse, or any other acts that involve bleeding or marking the skin.

8) Is self-harm a mental illness?   ( Back To Top )

No. It may frequently accompany symptoms of mental illness such as depression or other conditions, but this is not necessarily the case for all those who experience self-harm. It can also be a response to one or several traumatic events, ranging from abuse to the failure of an exam or losing a job or a loved one, or the breakdown of a relationship.

It is a means of coping with such an event, or with feelings of low worth or self-esteem.

Do not be afraid or ashamed of seeking help for self-harm; if you are worried about being ‘mad’ or mentally ill this will not happen. People will instead help you to address why you harm and help you to deal with these issues, not as a symptom of mental illness, but instead as a way of supporting you and helping you (and others) to come to terms with your distress.

9) Is there a lot of stigma attached to self-harm?   ( Back To Top )

Unfortunately, I’d be lying if I said that there was none. In some rare cases people have experienced this and have been punished for what they are doing. But nowadays these are rare occurrences. Healthcare workers are instead very approachable on the subject, and more than ready to help you receive the treatment (if any) you need. This may involve counselling, other talking treatments on a group or one-to-one basis or other aspects of support and treatment, with healthcare professionals and other workers, many of whom have experienced self-harm themselves. You do, and please be aware of this, have a say in what treatment you receive, and can refuse it if you really want to.

Do not be ashamed in asking for help. You are not alone in this, and this is in fact a common experience shared amongst many.

You will find that you will be treated with respect and empathy, and will be supported in order to achieve the best level of treatment required, should you want it. You have a choice in the matter.

10) Where can I get help?   ( Back To Top )

This website provides links to organisations that can offer support and help. You can also get help from your GP surgery, NHS drop-in centre or the Samaritans. There are many other organisations that offer support; please get in touch for more information.