Monday, December 10, 2007

1. What is self harm?
Medically the term self harm means to deliberately harm or injure oneself through any behaviour that causes detriment to your health, like over-eating or smoking. A more appropriate term to use is that of self injury or deliberate self harm.

In common conversation, the terms self harm and self injury are often used interchangeably.

2. Who self harms?
Young people have the highest rate of self harm, with approximately three teenagers (13-19) harming every hour in the UK. One in ten people have harmed by the age of sixteen. It is thought to be the second highest reason for Hospital Accident and Emergency admissions (with the top being 'accidents'). Figures suggest that four times more girls harm than boys.

Although these statistics are very up to date, it is very difficult to get a true figure as research definitions of self harm vary. Also the level of taboo around the subject is so high that most are very secret about it, and this normally omits them from any research.

3. How do people self harm?
There are countless ways that someone may self harm, with the most common being cutting, used by over two thirds of those who self harm.

Here are just a few examples: cutting, burning, punching, head banging, hair pulling (Trichotillomania), poisoning to cause discomfort or damage, insertion of foreign objects, excessive nail biting, scratching, bone breaking, gnawing at flesh, picking wounds, tying ligatures around the neck etc, medication abuse, alcohol abuse, illegal drug use, smoking - some are socially acceptable. starvation, binge-eating, vomiting. This list is endless - it's important to be aware that someone who stops self injuring may replace their harming behaviour with a different type.

4. Why do people self harm?
People often harm themselves because they can find no other way to relieve a feeling of being overwhelmed by intense emotions.

These emotions commonly fall into five groups:
Anger and frustration : Feeling so wound up and annoyed that you want to scream and shout. (in this case animals would claw at themselves).
Low self esteem (punishment) : Feeling so undervalued and low that you want to harm and feel you may even deserve it.
Dissociation : Feeling so overwhelmed by everything going on around, they want to escape or distract themselves by making a louder metaphorical noise.
Control and focus : Feeling that so much is out of your control that the only thing that you can control is the harm you inflict on yourself.
Self nurture : Feeling unreal and needing to harm to know you exist, or to help yourself heal.

Normally someone who is self harming will be able to identify at least one of these, if not more, as a reason for their behaviour.

5. Why do people continue self harming?
Once someone has found a way of coping, that both works and brings relief, it is a very daunting prospect to try relinquishing that way of coping in favour of another.

When someone cuts themselves, they send a rush of endorphins through the body, that travel to the wound sight to help heal it. The experience of this is described as being similar to being walked up on from behind and startled, and then taking a sudden intake of breath to recover from the fright: the relief of that breath feels similar to the buzz felt by harmers. This feeling is addictive and is considered as a chemical addiction, underlining why it can be difficult to stop harming.

6. How do you know if someone is self harming?
The short answer is you might not: it is a very secretive thing, and often purposefully hidden from others. A person is three times more likely to harm if they feel they lack emotional support, so those who are isolated, or feel isolated, may be more likely to harm. Those who find coping with the strains of life very difficult may also self harm.

7. What immediate risks are associated with self harming?
Someone who self harm's is a hundred times more likely to commit suicide, whether accidental or not. In other words, there is a risk of death, even though that is not the intention of the harming action.

Infection of wounds is also a significant risk. The cleanliness of implements used in cutting is a significant factor in whether infection occurs, as is treatment of wounds. Proper medical treatment for cuts and burns etc will give better healing prospects and reduced risk from infection.

8. What long term risks are associated with self harming?
If a person harms regularly over a period of time they are likely to weaken their body, depleting the essentials needed to maintain themselves. For example, the body's ability to clot blood may be reduced, immune systems could weaken and pulled hair may not grow back. These are but a few examples of many potential long-term effects on health. However the body is also surprisingly resilient, and is not impossible to have just scars as a indication of times spent harming.

9. What alternatives are there to self harming?
As a direct alternative to self harm, holding ice cubes in a hand and trying to crush them, has the same result, but without any long term physical effects. Another alternative can be having an elastic band on a wrist that is pinged onto the skin to give a short spurt of pain and a small rush - this however does need to be done in moderation, as overdoing it can bruise. One other form is to pluck hairs on legs or arms as a technique for weaning off cutting.

A lot of harming is done impulsively - so encouraging someone to wait five minutes each time they want to harm can help the urge to pass. If the person has identified the emotional groups they are harming out of, it can be very beneficial to explore different ways of expressing those feelings.

10. What support is available?
It is very important for a self harmer to have consistent emotional support, where they can feel safe and respected. In terms of professional support an initial visit to a doctor will often lead to a referral to relevant mental health support in the local area. In Luton CAMH (Child and Adolescent Mental Health Unit) is a long established and effective NHS resource, with access to a wide range of support, from counseling to art therapy.

If you or someone you know has issues with self-harm aka "cutting" please have the join us at Sober Teens You will meet people from all over the world just like you and you will get the support you need!