To Hurt to Heal

Self harm has never been a secret on this blog. I guess it’s just not been something I’ve felt like talking  or thinking about. I’ve made the odd reference here and there, but never anything in depth. So, I figured, as one of my pre planned Australia posts and with the inspiration from There and Back’s famous post, I’d focus the old floodlight to the age old taboo of DSH.

I gather, if you’re reading this, you most likely have suffered or are suffering from some form of mental illness. I’m hardly writing gripping music or book reviews, although there Heath and his beautiful films have been mentioned on occasion. If I’m wrong, which I have the tendency to be, I’ll recap and there’s going to be a few links dotted about I’m sure. I’m actually going to do some research for once. Shock horror.

So on the off chance you’ve been living under a rock for the past however many years, as it’s banded about in the media often enough, this is self harm, or at least my interpretation:

There will be a consummate list somewhere of every traditional, original and creative method to damage yourself. Even smoking, getting wrecked and jacking up once in a while will be up there. This said, the majority of people will harm themselves in someway at sometime in their life with or without intent. Maybe without even realising. Those who deliberately hurt themselves have, in essence, just stepped up this deleterious behaviour and made, whatever method intentionally harmful to themselves.

“Individuals intentionally damaging a part of his/her own body apparently without a conscious intent to die”

- Marc Feldman (1988 ) The Challenge of Self-Mutilation, A Review.  Comprehensive Psychiatry, 29, 252-269.

Unlike the ever populous clubs of binge drinking, eating and smoking, DSH is harmful pain rather than harmful pleasure. I can’t speak for everyone obviously, but to cut/burn/bruise/break etc, at least for me, wasn’t and isn’t for pleasure. There tends to be a far more negative motive under the plasters.

The act of self injury can provide numerous voices for innumerable emotions and feelings; holding many different meanings and functions for that self. As I saw it, there was no other way to describe or understand the unfathomable depths of what I was feeling. It was alien to me, it hurt desperately and without anything tangible to tackle I put my mind to my skin instead in a futile effort to express what I couldn’t say. Making my body become my voice. I didn’t bother or hurt anyone else. I was fixing it. Initially it was a long lasting quick fix that would get me through the night or day.

I think I was about 12 when I took to my arm with a pair of nail scissors. The cuts were superficial. A smattering of blood and a little stinging and it was done. A feeling of intense relief flushed through me. The preceding months had been calorie-counted and calculated. I’d starved to gain some control over a life that I thought was falling apart right under my feet. In the beginning the starvation was never about weight loss, it was about self destruction and the juxtaposed self preservation as I recklessly grabbed at anything that could “help”. I’d lost myself somewhere along the way. This blanket of depression had settled itself heavily on my shoulders without warning, or apparent trigger and little Miss A* student didn’t have a clever enough answer. She didn’t know how to fix it.

There are a number of different theories but two common themes are apparent. The first is the experience of intense and distressing emotions. These may be related to particular experiences, such as sexual or physical abuse.

The second factor is the absence of the right kind of emotional support. In other words, the child (or in some cases the adult) is not provided with the assistance to recognize and understand their responses to the events they are experiencing.

- Pain and Deliberate Self Harm

After a while, its enchanting efficiency makes it a wholly plausible act to indulge in. The feelings of guilt and the shame felt as you position your sleeve out of the blood stream dissipate quickly. Self harm is bittersweet. Perversely like a Swiss army knife, it’s multipurpose. At times I cut to ground myself. An effort to come back from whatever dissociative state I was lingering in. Sometimes it was about survival. Sometimes about purging my sins. At others, it was purely a release like the exhalation of breath, it became natural.

I remember past conversations with my GP when he was patching up my latest curative handiwork. In the end, he thought, in part, that I’d become addicted. Whether to the actual act, the rush, the result or what, I do not know, but I’ve since read about the endorphin argument.

When people SI they, of course, are hurting their bodies. The body responds to the injuries by working to minimize pain and damage and to heal the wound quickly. The brain releases substances called endorphins (has similar effects to morphine) that work as pain-killers when you hurt yourself. Endorphins can also cause a pleasant physical sensation and can become addictive. So, some people SI to produce feelings of euphoria.

- Self Injury: A Struggle

I guess in the end, self harm even becomes a reasonable response. If you forget what caused the bleeding, burns or broken bones for a moment, it becomes acceptable. A simple cut can be fixed with a plaster. It can be nursed. Tended. Cared for. All technically within the bounds of sane human understanding. If you cut yourself on the bread knife innocently when cooking, your mum will whip out their first aid kit and kiss it better, but if you cut yourself intentionally on that bread knife there’s confusion around whether it’s the first aid kit or the psychiatrist you need.

Something to point out about self harm, though I’m sure you know this already, is that it’s not a suicide attempt. In some ways, it’s an attempt to stop suicide or at least delay it. There are so many rumours and misconceptions surrounding this taboo subject. To turn on yourself, you seemingly need to be mad, dangerous, attention seeking, unfeeling and/or manipulative. I’m none of this things, but neither am I the odd ball exception.

More often than not, self harm will eventually land you a seat in A&E with all the caring doctors and nurses. (Apologies to any A&E staff etc, this is based on my own experiences and I appreciate, somewhat like self harmers, that you’re not all to be tarred with the same brush.) Medically trained and compassionate, you’d expect some warmth and understanding at least from here. You’d expect the same level of care as anyone else who passed through the red doors and through the cramped waiting room. All injuries that need treatment should be given the same quality of care, regardless of how the injury was sustained yet because we were the cause we should either “deal with it” ourselves or be subjected to sub-standard care and punishment resembling treatment. Would an obese, sedentary male suffering from a heart attack be turned away because they “did it themselves”?

I’ve heard stories of wounds being stitched minus the apparently optional anaesthetic because, we “don’t feel pain”. When I attempted suicide earlier in the year by overdose, my blood pressure was checked on arrival and I was shut in a room until the psych and my parents came to get me. The only contact I got was when my bed was pulled from the wall when I began to bang my head against it – resulting in concussion, and a rather hefty lump, which again wasn’t monitored, and the threat of security and police when I escaped into the outside road and was carried kicking and screaming back into my room. Appreciated is the fact that A&E staff are overworked and accepted is the fact that in the agitated depressive state I was in, further exacerbated by the tablets, I was p’raps deemed as a nuisance, but I was out of control. I was distressed and they shut me in a room for 2 hours.

My experience definitely wasn’t an isolated incident but neither was the genuinely compassionate and caring treatment I’d recieved at other times in other A&E departments. My GP for example has always closed and cleaned wounds when I haven’t been able to make it to A&E. He’s talked to me. He’s never judged me and while I do moan about some of the stuff he says, he’s been there throughout this whole sorry mess and has given up his own time to help me.

My self harm continued for 5years. I stopped in November 2007, just after my 17th birthday. In time, the rush had worn off, this admittedly crude tool had ceased to work and again, I was alone. Since then, my depressions have worsened. Everything’s worsened. Proof p’raps that painting over the cracks doesn’t repair the damage. Today I’m left with bad hypertrophic scarring that, I’m told, will need plastic surgery and even then I’ll still be scarred. That first, frenzied fix became my life for half a decade and even now I’ve given up my razors, I’m still suffering the after effects and am still considered one of those mad, dangerous, attention seeking, unfeeling manipulative folk that no one seems able to understand.