Beyond 101: On Self Harm
This article is part of a series on going deeper into mental health and wellness.
I’ve had a few requests on Twitter to talk about self harm from a professional’s perspective here on the site. The fact is, self harm is hard to write about because it isn’t one big, scary thing. It’s a lot of things and very different for each person.
To clarify: What I don’t mean to talk about here is suicide. I am not talking about the kind of self harm that is intended to end someone’s life. That is a very different thing and involves very different interventions.
When I say self harm, most people imagine a teenager in their bedroom with a straight razor and some thrashy music on the radio. They make jokes about cutting to release the paaaaain. The truth is that’s only one picture of self harm. Self harm can take on many faces: Anything from cutting to hair pulling to skin picking to food restricting (oh, hello it me) to denying rest to substance abuse can be self harm, and more.
The reasons for self harm are just as varied and personal. Some people find it to be a helpful outlet for emotional pain. Others like the endorphin rush or sexual thrill; still others feel they deserve it for some reason. Often, there’s a mental illness at play that encourages the behavior component or can make it hard to stop once one has gotten started. People who self harm come from all backgrounds and are all ages. They may or may not name their own behavior as self harm.
I think the most important thing to know about self harm is that it isn’t necessarily Bad (capital B intended). In my experience, the worst thing that comes out of self harm is the shame around it. Self harm is hidden, criticized, asked about, and judged. People who’ve never felt the urge to engage in one of these behaviors have a difficult time understanding why someone might engage. In my experience, people sort of freak out when they discover a friend or loved one has been harming themselves in this way. I can understand that. We are usually afraid when someone we love is in pain, even if the pain is self inflicted.
Now, self harm can be dangerous. If someone is into a type of harm like cutting they can make a mistake or misjudge and hurt themselves or even end their life unintentionally. If someone is drinking or using drugs to excess, that can be dangerous both for the user and those around them. Damaged skin can become infected, and hair follicles can swell or become inflamed as well. If someone is seeking out pain for pleasure, they are at the mercy of those they trust with that act—and that person may or may not be knowledgeable and skilled. Self harm isn’t harmless, and if you’re afraid for yourself or someone you know, absolutely reach out with your concerns (and if you’re a parent, talk to your child’s doctor immediately about safety and referrals for treatment).
However, the psychological truth of self harm is so diverse that the act isn’t always cause for great concern. When I encounter this kind of thing, I usually start by asking questions: What is this behavior helping with? What is it not helping with? Are there any problems with this behavior? An automatic assumption that self harming is Bad can be very shaming, and we know for certain that shame does not help change behaviors. If, for example, you are concerned about your own self harming and wanting to look at changing that behavior, feeling shamed and embarrassed about it won’t help you change.
Many times, self harm is a way to distract from an emotional experience. The truth is, we all numb out our emotions at times. Some of us use Netflix, and some of us use pain (and countless other ways). A way to address self harm is to look at your tolerance for strong emotion. Often, we have grown wary of strong emotion and seek to avoid it. Sometimes we even assume that the strong feeling is wrong to have or shameful in itself. Self harm becomes a tool of coping with big feelings that are difficult.
To move away from self harm like this, we need to add more tools to our toolbox of coping. There are hundreds of ways to cope with emotion. My favorite one is, much to the annoyance of anyone I tell about this, feeling the feeling. Instead of decreasing tolerance by hiding, numbing, or Netflixing away feelings, I suggest we all try to feel our feelings more so our brains learn that emotions are just emotions. Sometimes they are related to external events, but sometimes they are related to nothing at all. Emotions aren’t thoughts, truths, or anything that necessarily needs to be acted upon. Emotions are chemical brain farts. I do believe that, as a society, we have become increasingly intolerant of the discomfort emotion causes us. To combat that, I suggest people slowly learn to tolerate feelings and even welcome them as part of our lives. Make friends with our demons, as it were.
Incidentally, I watch Netflix all the time. But when I’m watching it to avoid hard feelings, I try to allow myself to sit quietly with emotion for a while first. I’ve got to teach this brain that we will not die if we feel bad. We just feel bad. This kind of mindful practice can be built upon. Sometimes sitting for 60 seconds is enough at first, and we learn to increase tolerance over time.
It is important to remember that self harm relating to hard emotions is just another way we as human beings try to cope. It doesn’t mean someone is weak, or sick, or dangerous. It means they’re no different than anyone else. Basically, no one is immune to the struggle of emotion (a very few people are, but not most of us). We all experience pain, and we all try to transmute that pain into something more acceptable to us. Self harm is just another way to do that.
Pain is our shared language, and it is what connects us to each other. The next time you encounter someone self harming, or perhaps yourself are doing so, please do not shame. Offer kindness, understanding, and support. We all suffer. May we be kind to each other and ourselves.