Understanding Self Harm 

Self-harm is a physical response to an emotional pain and can affect males and females of all ages. Self-harm is defined as any deliberate behaviour, action or habit that is of intentional detriment to our short or long term health. It's often assumed to be about cutting, when in fact it can involve a whole range of behaviours including bruising, scratching, eating disorders, self-poisoning and illicit drug use. In reality, it's not about the behaviour rather than the underlying distress.

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 to harming themselves? Why can it be so hard to stop once you start? And how do you get on the road to recovery?

Self harm usually develops as a strategy for dealing with difficult feelings or emotions. It has a variety of causes and triggers. It's important someone's self-harm isn't measured by the severity of their injury but more by the degree of underlying emotional distress. Self harm often accompanies other emotional and mental health problems such as depression and eating disorders. 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 (i.e to say that they understand and that it is okay 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.

Can it be treated?

Treatment will vary according to individual need. Some people will benefit from psychological interventions such as counselling or Cognitive Behavioural Therapy, whereas others may require medication to treat any underlying depression. In-patient treatment isn't common but may be an option. In most cases, what people benefit from most is the opportunity to talk about how they're feeling and why self-harm seems to help before exploring alternative coping mechanisms. A supportive network of family and friends can make a real difference.

Breaking the cycle

Whatever the nature of someone's self harm, it's important to remember 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 willpower, is unlikely to be successful 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. 

What about my faith?

Phillip Yancey writes that "there's nothing we can do to make God love us more, and there's nothing we can do to make God love us less." This is very helpful when we think about self-harm - the act of harming ourselves does not change God's view of us. The Bible says that we're "fearfully and wonderfully made" and that our bodies are "temple(s) of the Holy Spirit", but for self-harmers these verses can be difficult to read. Perhaps more helpfully the Bible says that God's love isn't conditional upon who we are and what we do (Romans 5 v 8), and that "perfect love casts out fear" (1 John 4 v 18).

God doesn't ask us to be perfect - He frequently uses people with different struggles and 'limps' to achieve his purposes (see the list of flawed 'heroes of the faith' in Hebrews 11). Self-harm is just one part of who we are, but it's our faith in God that defines us.

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

Alumnia is is a free, online 7 week course for young people struggling with self-harm. Each course has up to 14 young people, all accessing the sessions from their own phones, tablets or laptops across the UK. The courses take place on different evenings of the week and are run by friendly, trained counsellors and volunteer youth workers. You don’t need an adult to refer you or sign you up, and no-one will see or hear you during the sessions – you’ll just join in via the chatbox.

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