What is self-harm?
Self-harm is the term used when someone harms or hurts themselves on purpose.
This usually happens when someone is overwhelmed with feelings and emotions, and at times may find it difficult to express themselves.
Self-harming may also be a behavioural or physical response to stress.
People self-harm for a lot of different reasons. The act of hurting yourself can be planned in advance, or it can happen spontaneously as an immediate response to a specific trigger. Sometimes self-harm can also be linked to the risk of future suicide.
False beliefs about self-harming
False belief: “People who self-harm always have a mental health illness”
False belief: “People who self-harm harm themselves all the time”
Some people may only ever do it once or twice in their lifetime, but it can become very hard to stop especially if you do it regularly.
False belief: “People who self-harm are just seeking attention”
Comments like this will make those who self-harm feel more alone and misunderstood. The majority of the time, people who self-harm try to hide their wounds and it can be very hurtful to judge their behaviour.
What are the different types of self-harm?
Self-harm can present itself in different ways for different people.
Some people might self-harm in the same way all the time, or they might hurt themself in different ways and at different times.
Direct self-harm is when someone hurts themself to create an injury which you can see, for example:
The cuts might be anywhere on the body, at times in places where they might want people to notice, like on their arms. Sometimes people cut themselves behind their legs so they can easily hide the marks.
Some people might pick at scabs on wounds deliberately to prevent them from healing, or to create physical pain.
Some people scratch themselves to create damage to your skin, and to create physical pain to an area of their body.
This can be a behavioural response to stress resulting in forceful pulling of the hair, which can sometimes lead to patches of hair loss.
Self-harm can also be indirect. This can happen with various actions, for example:
Taking too many tablets
Although someone might normally take prescribed medication, it is considered self-harm when they take an excessive amount of medication in a short period of time. Alternatively, someone might plan to buy tablets and then take them all at once, which is also considered to be a form of self-harm.
Using drugs and alcohol in excess
This might be planned in advance, or it might happen because of a specific trigger or event.
Not taking your prescribed medication in order to purposely harm yourself is also considered to be a form of self-harm.
Not eating or drinking with the specific intent to hurt yourself, or as a means to get attention from others, is a form of self-harm.
This can be any form of risk-taking activity that you know will put you in danger, for example driving cars very fast, or jumping on train tracks.
Who is most at risk of self-harming?
Anyone can be at risk of self-harm.
People of all backgrounds and ages hurt themselves, but there are specific pressures that can make self-harm more likely.
Certain groups of people who have experienced traumatic events, or who have lived in stressful environments, can be more at risk of self-harm.
Young children who hurt themselves may be doing it because they do not know how to process their emotions and feelings. This can happen if they have not formed strong relationships with the people who care for them.
As the brain develops in a young child, the lack of these relationships can lead to issues with attachment and the way the child is able to control their emotions.
Examples of children who might self-harm include children who:
- Are neglected or abused by the people who look after them
- Have a background of behavioural problems and learning disabilities.
The reasons why adolescents self-harm are similar to that of young children. Many adolescents who self-harm have been victims of neglect and abuse when younger or even at present.
Other pressures affecting this group are:
- Bullying at school or on social media and the internet, which can have a serious effect on a person’s self esteem and confidence.
- Teenagers at school may self-harm because of the overwhelming academic pressure from parents or teachers, or if there is a family breakdown.
- Rejection from a partner or difficulties with your sexuality can also be stressful triggers that can lead to self-harm.
In general, adults tend to be at a lower risk of self-harm, but there are certain groups of adults who do have a higher risk, for example:
- Members of the LGBTIQ+ community who may have been discriminated against and experienced stigma because of their identity.
- Veterans of the armed forces who have experienced traumatic life events.
- Prisoners and people in the criminal justice system.
- Asylum seekers who are under constant stress regarding their general wellbeing.
Other triggers and potential risk factors for self-harm include:
- Being female
- Grief after the loss of a close friend or relative
- Background of mental illness
- A seriously debilitating physical illness such as HIV and epilepsy
- Financial difficulty
- Domestic violence
- Problems with culture, religion and ethnicity
Why do people self-harm?
There are many reasons why some people might self-harm. Most of the time, self-harming behaviour is very impulsive and occurs without much planning beforehand. This makes it difficult for others to intervene. However, the majority of the time, self-harm is also carried out privately and in secret, away from others.
Some people who self-harm do it in specific areas where they might have experienced trauma in the past, or sometimes at a specific time of the day like at night.
Others might also drink alcohol and take drugs before physically self-harming. This is extremely dangerous because it can lead to accidental suicide.
Reasons why some people self-harm
Some reasons why people might self-harm include the following:
- To escape a difficult or stressful situation
- To turn emotional suffering into physical pain
- To have power or control over their life
- To scare people
- To punish themselves
- To block sad or traumatic memories
- To get some attention from others
- To show others how desperate they are feeling
- To take their own life
Some feelings people may be experiencing can also lead to self-harm such as:
- Feeling misunderstood
- Feeling alone and isolated
- Feeling hopeless
What are the signs that suggest someone is self-harming?
It can sometimes be difficult to tell if someone close to you is self-harming, especially if they hide their wounds and show little change in their behaviour.
If you are concerned that someone you care about is self-harming, you can try looking out for the following:
- New and unexplained cuts, bruising, scars or burns, especially to their wrists, forearms and sometimes thighs and legs
- Recurrent infections of their wounds
- Wearing long sleeve clothing or making an effort to cover up in warm weather
- Being uncomfortable changing in front of others
- Changes to their eating pattern
- Excessive exercising
- Signs of significant hair loss
- Unexplained changes to their behaviour and mood such as self neglect or a decline in school performance
The information in this article is written for general information purposes only, and is not a substitute for professional medical advice, treatment or care. It is incredibly important that you do not make decisions regarding any symptoms based on this information alone. If you are worried about any symptoms you may be having, or have any further questions about this condition, please speak to a qualified and trustworthy medical professional.
What are the treatments for self-harming?
If you find it difficult talking to those close to you about your feelings and self-harm, talking to an anonymous source like a professional about treatment and support may be more helpful.
If this is the case, there are trained individuals to help listen and guide you through this journey. They will be aware of the potential stigma linked with self-harm and will communicate with you in a non-judgmental way to make you feel as comfortable as possible.
There are various types of support and treatments available to you if you self-harm.
It can take some time to find the right plan for you, and recovery normally involves a range of self-help techniques alongside professional therapy.
The following types of talking therapies are available and may be recommended for you by your therapist:
Cognitive Behavioural Therapy (CBT)
This is a common type of talking therapy which focuses on exploring your feelings, thoughts and behaviours and how they interact with one another.
This is a longer-term therapy which also looks into your experiences in the past and focuses mainly on exploring patterns in your emotions.
Dialectical Behavioural Therapy (DBT)
This is a type of CBT which focuses on more extreme feelings and how to regulate your emotions and mindfulness in order to cope with distress.
This is a talking therapy held in small groups and led by a professional where members of the group can share their experiences and support one another.
This is held with a therapist and members of your family to allow for a discussion about your feelings and thoughts without conflict and stress. This may help family members understand your emotions, but it would not be suitable if there is a history of abuse from a family member.
Sometimes medication may be considered if you also suffer with anxiety and depression, or if you have problems with sleeping.
The medication itself will not directly stop you from self-harming but may reduce the risk. A doctor will discuss the medication with you in detail, and they may possibly only prescribe small amounts at a time.
If your injuries are severe and considered to be a significant threat to your life, you might benefit from a short stay in hospital.
You can also go directly to the emergency department at any time if you feel like you are overwhelmed with your feelings, or after you have self-harmed and you are worried about your wounds. There will always be someone there to help you.
Treating your wounds and disguising your scars can be an important part of your journey to recovery.
Your scars might be a constant reminder of negative or traumatic events, but you shouldn't feel embarrassed or ashamed about your scars. Various options are available to help with reducing the appearance of your scars, for example:
- Wearing long-sleeved clothing
- Dressings such as scar plasters and bandages which reduce the redness and swelling of scars
- Cover-up tattoos to camouflage your scars
- Laser scar removal can be useful if you have a light scar, but you will need to discuss this first with a medical professional
- Scar removal surgery using skin grafts. This is a surgical procedure, which means you have to first discuss this with a qualified medical professional.
What happens if I do nothing?
If you don’t want any treatment or support, it is important to note that people who self-harm very often relapse the following year if they don’t get any help.
Risk of suicide
It is also important to consider that there is an increased risk of suicide in people who self-harm.
Permanent damage & disability
Permanent damage such as weakness or numbness from damage to nerves and tendons from self-harming can cause a long-term disability in the future.
How can you avoid & prevent self-harming?
If you self-harm, you may find it very difficult to approach others to explain how you are feeling, but there are steps you can take to help yourself now:
Understand your triggers
Triggers are the situations that cause you distress and give you an urge to self-harm. Try to be aware of the triggers & urges that you experience as this can help you recognise them quickly, and reduce the risk of you self-harming. Sometimes making a note of these triggers & urges in a diary can help you notice any patterns.
Once you are able to identify your triggers & urges, you can then focus on doing something straight away to distract yourself. For example, having a distraction box filled with things you like and things that make you happy and feel safe. Alternatively, you can try turning your emotions towards being creative by drawing or playing an instrument.
Sometimes just waiting a few minutes for the urge to pass can also help. For example, give yourself a ‘15 minute rule’ to wait and distract yourself. Over time, you may be able to increase the time you wait, but this can be very difficult to do alone.
Find a healthy alternative to self-harming
Alternatives to self-harming can include:
- Doing things that interest you, like listening to music or exercising
- Physically removing yourself from an environment that could be a potential trigger
- Talking to someone you trust like a close friend or relative
What should you do if you self-harmed badly?
If you have self-harmed and you feel that your life is in danger, you need to call the emergency services as soon as possible.
The number for the ambulance service in Iraq is 122. You can also call 115 for emergency services.
What can you do to help someone who is self-harming?
If you think someone close to you may be self-harming, it can be very difficult to approach them and know what to say.
You might feel very upset about the situation, or you might even feel guilty. Despite how you are feeling, it is important for you not to panic or overreact.
Try to focus on them and their feelings, and as much as possible listen to them without any judgement. This can be difficult, but it will help them open up to you about their self-harm.
Things you should do:
- Allow them to talk freely about their feelings and emotions without criticizing their actions
- Be understanding and show empathy towards them
- Offer support by letting them know you are there for them
- Empower them with your support and guidance
- Reassure them and remind them of what they do well
- Find out more information about how to support them
Things that you should not do include:
- Dismiss their feelings and actions by labelling them as ‘attention-seekers’
- Be angry and upset with them
- Force them to stop self-harming
- Be overly controlling of the situation
- Threaten them
It can be difficult to help a friend or loved one going through this, and it is important that you also take care of yourself in the process too.
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