Understanding Self Harm 

Rates of self harm seem to be rising - with research showing that teenagers in particular may be at risk. Whether you are struggling yourself with self harm or supporting someone else, often the biggest question is WHY? What is it that leads people struggling with emotional distress resort to harming themselves? Why can it be so hard to stop once you start? And how do you get on the road to recovery?

There are 4 main theories about why people self harm. For many sufferers, their experience would be a combination of some of these:

(1) Triggering endorphin release

Endorphins are chemicals released in the brain. They have many different effects but seem to help people relax and think clearly as well as diminishing the impact of negative emotions.  Interestingly they also seem to reduce pain, and have been called the body’s natural painkillers.  Physical injury triggers endorphin release, so it is possible that people who self harm are discovering the way that endorphins really do help to decrease their emotions, and help them to relax. 

(2) Releasing emotions

Emotions, much as they may be difficult, are a normal and vital part of the way our brains work. They are designed to grab our attention, and they need to be processed. If our experience of emotions is to find them very overwhelming, and we do not know how to deal with them, we can get into a cycle of trying to just suppress and push them down without ever dealing with them. If this is the only thing we know to do, emotions can build up much like air in a balloon - and as the pressure builds, it can feel like you might burst! Many who self harm talk about how it helps them ‘release’ those emotions so that they can get on with what they need to do in that moment, or face another day. Some emotions in particular, like anger or frustration, also trigger a strong desire to do something - hit out or fight. if these emotions are the ones building up, self harm can stem from pure frustration, hitting out and turning that emotion onto yourself rather than expressing it outwardly in other ways.

(3) Communication

Another theory of why people self harm focuses on the way it can help people communicate or validate powerful emotions - to others or to themselves.  For many of us emotions are not easy to describe or articulate.  This becomes even harder if they are extreme or very overwhelming because powerful emotions like these actually start to shut down our rational brain making it hard to think clearly. A physical wound can be a kind of visible illustration of that emotional pain – much easier than putting it into words.  however, It’s important to be clear – this does not mean that people deliberately and specifically wound themselves to illustrate what they are feeling.  Self harm can be more of an instinctive way of illustrating that emotional pain- a way of saying this is how bad I feel.  In fact, although very few people consciously aim to harm in order to communicate (for example, most self harmers actually hide wounds), the most common reason given for self harm is that the sufferer yearns to have people hear their pain, and to validate their distress (ie to say that they understand and that it is ok to feel that way).  

(4) Routines and self-nurturing

Some people who self harm do so in a very structured and considered way, with a very clear routine of how they harm and what they do afterwards.  Sometimes this pattern of self harming ‘allows’ them some time afterwards for self-nurturing behaviours which they might otherwise feel guilty for. This is combined with the relaxing impact of endorphin release, meaning that self harming can become part of a strategy to try to lift mood or cope with low feelings.

Breaking the cycle

Whatever the nature of someone's self harm, it's important to rememebr that this is a strategy they are using to cope with difficult and painful, often frightening, emotions. Simply asking them to stop, by a feat of sheer will-power, is unlikely to be succesful and may even mean that emotions build up and lead them to eventually harm more seriously. An important part of managing self harm is therefore about exploring other things you can do when you feel low, or sad, or angry - and gradually starting to use these more positive strategies to either delay or replace self harm. Breaking the cycle of self harm takes time - it is not something that generally happens overnight. But it is possible! 

Getting on the road to recovery

With so many young people now starting to use self harm as a way to manage their emotions another important question is what this means for them as they grow up and go into adult life. The good news is that it is possible to ‘recover’ from self harm - finding more positive ways to manage emotions, understanding better what emotions are and why they are troublesome and developing a better vocabulary to talk about emotions and share with friends what you are struggling with so that they do not build up so dramatically. However, most young people will need some help with this - particularly if they are struggling with really strong emotions. 

If you would like more information about self harm and recovery check out the following resources:

SelfharmUK are a national organisation supporting young people and adults struggling with self harm and those who are caring for them. Their website is a mine of useful information about self harm and they also run support groups and interventions for sufferers.

This article is adapted from the book ‘Self harm, the road to recovery’ which can be purchased from SelfHarmUk, or via any good bookstore (check it out on amazon). 

Kate Middleton, 19/10/2017
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