Inside The Mind Of A Self Harmer And How You Can Help One

When I wrote a piece of self injury a few months I wrote it for others who self harmed. It was to show that even people who seem relatively strong and sure of themselves on the outside aren’t always feeling that way on the inside. It was also to act to reduce some of the stigma about the issue and the belief it isn’t something that should be spoken about.

And in part the email responses I got from it showed that it had acted to have some impact with self harmers. However what surprised me more was the amount of response I had not from self harmers, but from people who had relatives or friends who had self harmed filled with questions about how, what and why.

Up until now I’ve tried my best to answer the questions on an individual basis but now I think it’s time to answer these questions more publicly and form some kind of resource that  people with questions about self injury that they don’t feel comfortable asking the person can refer to.

So let’s start at the beginning. You’ve been told by someone they self harm. Your head is now fill of questions and fear of what you should be doing.  Why would anyone act to intentionally hurt themselves? Is it all some big cry for help? Are they on the brink of something worse like committing suicide?

They’re all questions that you really going to want to ask but don’t know how or even if you should. The reality is you should. If someone has built up the courage to talk to you then they’re likely to be at the stage where they will not only answer the questions, but want to answer them, but if  you really aren’t comfortable doing that then let me, a confessed self harmer, try and do it for you, starting with the most important question of all.

Is someone who self injuries leading up to a suicide attempt?

No. Whilst they might seem closely related to the non self harmer, for somone self harms the two things are at complete opposite ends of the spectrum. Suicide is about bringing things to an end. If you’re choosing to  self injury, it’s not about ending your life. Self harm is a life saving reaction. It’s a way to gain control over the negative elements in your life and steer you away from things such as suicide.

Is it all a big cry for help?

I lot of people see self injury as attention seeking behaviour. Believe me it isn’t. Having spent many a Summer boiling to death because I need to cover up evidence of my self harming this is quite the opposite of what it is all about. Self harming is a very private and very personal way of dealing with negative situations and if someone is talking to you about it, it’s not because they’re after attention it’s because they need help.

Why would anyone intentionally hurt themselves?

If you’re someone who self injuries the reasons act to make perfect sense. It may not in reality be THE solution to the problems you’re facing, but it is a solution that works, if only in the short term.

If you’re looking at the act of self harm from the outside it’s a whole lot harder to comprehend how someone can seem fine one minute and is self injurying themselves the next. And there’s a reason why. This isn’t really what is happening.

Each case is an individual one, but for most people who self harm it follows a very strong cycle of events, something described very succintly by  Jan Sutton, author of the book Healing The Hurt Within, who breaks it down into six stages – Mental Anguish, Emotional Engulfment, Panic Stations, Action Stations, Feeling Better and Grief.

As words on their own they probably don’t make much sense so let me try and explain it with how it feels for me.

1. Mental Anguish

At this point in the cycle, self harm isn’t really a thought. Instead my mind gets stuck replaying negative thoughts and images with certain things keep replaying themselves again and again in my head.

As Sutton describes it, a  fire starts smouldering.

2. Emotional Engulfment

I’ll have been fighting with these negative thoughts for a while now and I won’t have been winning. This leads these negative thoughts to trigger more powerful emotions. For some people this will be a real feeling of dissociation from everything, for others it will be anger or fear.

Personally this stage manifests itself in a couple of different ways for me. If it’s been building for a while then I can start to feel in fear of my own thoughts. If however it’s been triggered by a certain situation it feels more like my whole body, including my blood, has solidified into one tense lump and is about to explode.

At this stage it is described as the smouldering fire turning into a raging inferno.

3. Panic Stations

Whilst at the Mental Anguish stage there is an opportunity to turn things around,but now it feels like it’s gone too far. The raging inferno of emotion is getting out of hand. For some that manifests itself in feeling totally out of control, for others it’s feeling extremely numb and detached.

For me it’s both. I feel like the situation and my thoughts are now totally out of control and on top of that I’m totally detached from everyone around me. They’re just a blur.

This is the point where self harmers feel a compelling urge to self harm.

4. Action Stations

Now we’re at the point where the self harming takes place because it feels there’s no other way to get rid of the fear, anger or detachment. For some people this will be done in a state of full awareness where the pain is felt or alternatively as with me, one where the harmer is in a dissociative state and feels nothing at all.

5. Feel Better / Different

This stage is the reason why self harmers do what they do. With the act of self injury over there will be a feeling of relief. The negativity that has been replaying in their heads has stopped. Things feel clearer. The physical injury feels like a small price to pay for escaping those intense emotions described in stage two.

6. The Grief Reaction

However it’s important to realise this relief doesn’t last long.  These feelings will soon dissipate and now with the realisation of what you’ve just done leading to feelings of shame, guilt, self digust or self hate, it’s very easy for the cycle to start  all over again, which is why it is most important when dealing with a self harmer that the focus isn’t on the harming action but working on creating better alternative responses to the Mental Anguish state.

Is this “Mental Anguish” all down to some horrible childhood trauma?

No. It’s a common assumption self harm is related to childhood abuse, and whilst the relationship can’t be denied when research shows 50% – 60% of self harmers,  it is important to recognise that still leaves 40-50% who are doing it for different reasons.

This is the same for alexithymia, a personality trait that sees people have “difficulty identifying feelings and distinguishing between feelings and the bodily sensations of emotional arousal”. Whilst there will be a high number of self harmers who score highly in tests for this, it again isn’t exclusive. There are a whole host of different reasons why people self harm so don’t immediately assume why. Work with them, support them till they feel they can tell you.

What can you do?

Discovering someone has self harmed is likely to come as something of a shock, especially if you discover it rather than them telling you about. It is important to remember though, someone who self harms isn’t doing it for attention, it is someone who is hurting and self harming is currently the only way they are able to express this. You being angry or denying it (as the first person I told helpfully did) isn’t going to help matters. In fact it’s likely to make it worse.

So first bit of advice. If you’ve actually discovered them self harming then their wounds are your first priority. Tend to them calmly and in a way that shows you care about the person, not that you’re scared and fearful of what they’ve done.

After that’s done it’s time to appreciate there is no quick fix to self harming. You’re in for a long journey that is likely to have many ups and down that’s going to need you both going to be strong. For you that means you need to accept what they’re doing. That doesn’t mean encouraging them to continue but it does mean showing you’re not angry or upset with them for it being the best way they can cope at the moment. Doing this will act to give them the confidence to work with you to try and find different solutions to dealing with their issues.

So what about me personally?  Where am I as a self harmer on this journey?

Whilst I would like to be able to write here that I’m a past self harmer to do so would be a lie.

I made the decision to write this piece in response to people getting in touch wanting to understand more about self injury following an earlier piece. In one sense it was a very easy decision – there’s a lot of misunderstanding and stigma about self harming ,and just like I as a gay woman feel it’s my duty to do the little I can to make a positive difference for future LGBT generations, I as a self harmer feel it is my duty to do the same.  For me both issues are bigger than me and if I am made to feel a little vulnerable and uncomfortable to do it… well so be it.

However saying that is easier has been a lot harder than the reality. I can be quite blasé with my feelings of vulnerability concerning gay rights. If I feel vulnerable it makes me feel I’m doing something that could act to make a difference. Writing and researching this article however made me feel a very different vulnerable.

I’ve been thinking about writing this for a while, but have been putting it off for a few reasons.  The first if I’m honest is because it makes me uncomfortable. I like to be seen as the strong, funny one, not the weak, self harming one. The second is because there’s so much misunderstanding about self harming that I didn’t want to jot something down that diluted the issue. I wanted it to be something that really would help educate others and so I started spending lot of time reading around the issue.

In doing so I saw one line time and time again -  ”Be careful. As a self harmer you may find this triggering” a lot. Now be honest the first time I read it I thought it was slightly odd and little silly. How can reading academic discussion of self harming be triggering, surely this must only be for people caught in a very intense cycle of self harming.

A few hours into my reading and my opinion had changed. I was now feeling seriously uneasy. I may have been sitting in a room full of people but I was starting to feel seriously detached from everything else and was soon finding myself  focusing on negative elements of issues I’m currently dealing.

I was definitely teetering on the edge of the Mental Anguish stage. So can I in all honesty tell you I didn’t do anything? Yes, but what I can also tell you is it wasn’t easy at all and it wasn’t as simple as flicking a switch. This was a few minutes of wrestling with the issue. I have fought against myself for at least a week and whilst currently I winning, it has shown me that whilst I have come far in my own personal journey I still have a long long way to go.

Image by josh.liba.