Self harm - Anglicare Southern Queensland

Self harm is not an unusual or abnormal issue. About 25,000 Australians are admitted to hospital each year due to self harm. That’s around 118 people per 100,000 in Australia. That’s not an insignificant number, particularly considering that these are only the cases serious enough to warrant immediate medical attention.

Adults who self harm are 100 times more likely to suicide. Despite this, around 50% of people who use self harm report that they are not thinking about suicide, and many people who use self harm describe it as a way to avoid suicide.

There are many reasons people turn to self harm, although it’s usually linked to depression and anxiety. Some people report that it helps them to feel more in control. Others report they see it as a release, or as a way to feel something besides the numbness that often accompanies depression. Self harming does not always mean that you want to commit suicide, that you are “looking for attention,” or that you are being manipulative. In fact, it’s common for people who use self harm to not want to worry their loved ones, to go to great lengths to hide it, or to feel shame about it.

Often people who self harm do so as a way to cope with emotions and situations that seem otherwise too complex or difficult to deal with. Self harm is, therefore, seen as a coping strategy, one that’s used by someone who doesn’t know any more effective tools to cope with their pain, to put it into words, or to show express how deeply they hurt inside.

For someone to intentionally hurt themselves, regardless of the method, they must be suffering very deeply.

What is self harming?

There is no universal definition of self harm, as it’s a complex issue and one that affects everyone differently. One very simple way of defining it is:

A person deliberately causing him or herself physical pain as a means of managing difficult or painful emotions, or as a way of communicating their distress to others.

Most people think of cutting when they think of self harming. In reality, there are lots of behaviours that can be considered as self harm. Some of these are:

Cutting with razors, knives or sharp objects.
Purposely overdosing on medication or alcohol, or consuming a toxic substance.
Burning or branding.
Scratching which results in bleeding or welts.
Picking at skin.
Pulling hair.
Hitting yourself with your fists, or a blunt object, hard enough to cause bruising.
Punching walls or objects to hurt yourself.
Engaging in risky behaviour likely to cause injury, such as dangerous driving.

If you’re not sure whether you’re self harming, or if you are worried about someone else’s behaviour, here are some questions you might want to ask:

Do you deliberately hurt yourself in a way which breaks the skin, leaves marks that last for a while, or scars you?
Do you deliberately do things to yourself for which you should go see your doctor?
Do you hurt yourself as a way of getting rid of painful feelings, dealing with difficult situations, or because you feel numb?

These are questions you might like to think about. If you find yourself unsure or concerned about your responses to these questions, the best thing to do is talk to a health professional or someone you trust.

Why do people self harm?

People hurt themselves because it’s the only thing they can think of doing to cope. Self harming can be a way of dealing with feelings of deep sadness, loss, depression, guilt, anger, hate, worthlessness, loss of control, fear, anxiety, low self esteem, loneliness, shame, and numbness – just to name a few.

Some reasons people self harm include:

Feeling upset, angry or scared to a degree that seems unbearable.
Having the sense that painful thoughts or feelings are building up inside and cutting is the only way to let them out.
Feeling alone and isolated from everybody, and that hurting themselves is the only way they feel ‘real’ or ‘connected.’
Feeling out of control; that hurting themselves is the only way they can regain a sense of control.
Feeling overburdened, or responsible for everything and everyone.
Feeling numb, like the only thing they can feel is physical pain.
It can make the pain they feel inside visible, and when it is visible, it seems easier to understand.
Feeling like others only care about them if something bad happens.
Feeling like everything is hopeless.
Feeling worthless or deserving of punishment. Self harm can be a way of punishing themselves, and sometimes others.
Feeling like there is no other option for dealing with everything
Isolation and loneliness. Feeling alone, like they have no one to talk to, or not knowing how to talk, or safe to talk about it.

People hurt themselves because it is the only thing they can think of doing to cope.

Some people who self harm have experienced abuse or neglect from a young age. Others have experienced trauma, sexual abuse, or have repeatedly had their trust betrayed. Some have lost a loved family member, or have never felt loved in their lives. Many people who turn to self harm have never been taught helpful ways of coping, of trusting, or of how to connect with others, by those around them.

Everyone who uses self harm is experiencing a level of pain that seems unbearable. Sometimes this leads people to try to stop the emotional pain by hurting themselves physically.

However, not all people who self harm have been abused or experienced big losses. Some people hear that it has helped others, and turn to it themselves when they are at a loss for what else to do, and become caught in a cycle.

Usually, people who self harm have difficulty coping with and talking about their emotions. Sometimes they feel there is no one to talk to about these issues, that no one will listen or take them seriously, or that they will be judged or viewed as weak, crazy, or that they are just seeking attention. As a result, these emotions can build up to the point that they are simply too much to handle. Self harm can seem like the only thing that will relieve these feelings, even if it’s simply because you are then feeling something different. It’s important to understand that, whatever the reason you self harm, there are other ways of dealing with the way you feel. Support and other options are available, you are not alone, and you don’t need to go through this alone.

Why do people keep doing it?

Some people say that self harm helps takes away the emotional pain, and that this seems like the only way. The fact is, if something makes us feel better, then we tend to keep doing it. In this way, self harming is an addictive behaviour. Like a drug, self harming when you feel like you are not coping actually can make you feel better. It is a natural function of the human body to release pain relieving endorphins when physical pain is experienced, like dopamine. Many of the most addictive drugs simulate the effects of dopamine. The trouble is, we have a tolerance effect to dopamine: It can take more of the same behaviour to get the same result that we used to. This means that we not only continue the behaviour, we also need to increase the intensity of it to achieve the desired effects.

People understand that addictive drugs are extremely difficult to quit. However not many people understand that self harm acts in a similar way. If someone has been using self harm for a while, they experience the same very strong urges to use self harm that someone who is dependent on a drug experiences.

When people find hurting themselves brings relief, it can become their main coping strategy. Other strategies will not seem to work as well. The urge to self harm will still be there.

It is for these reasons that it is very important to remind yourself that self harming is just one way of dealing with things. When you are going through the process of trying to give it up, your mind may tell you that it is the only thing that it will help – because it wants that dopamine rush. However, just like giving up any addictive behaviour, if you can see that period of ‘withdrawal’ through, those urges will become less and less.

Some other reasons why people find it difficult to stop self harming include:

Wondering what they will do to cope instead of self harming.
Wondering whether people will still show they care if they don’t see the cuts and scars.
Wondering whether people will still know that they are hurting if they don’t see any injuries.
Letting go of self harming can be like letting go of a familiar part of yourself. It can become a part of you. The person may have thoughts like, “who will I be if I don’t have this?”
Worrying that they might get swallowed up by their feelings if they don’t self harm.
Concern that they might stay numb.

Some things to think about

You may be self harming and not be able to see the negative effects. Some consequences of self harming are:

You may accidentally or deliberately go too far one day and cause yourself a severe injury, or accidental suicide. Particularly if the self harm is escalating and you have to go further to feel the same relief.
Cuts often turn into scars. In some cases this may serve as an unhelpful reminder, or even a trigger, for many years.
People who self harm usually keep it a secret. This can be a very lonely experience. Dealing with feelings in this way means you are probably not getting the support you need and deserve.
You may be avoiding the issues that lead to you self harming. Expressing yourself in this way might not allow you to see the causes of your pain, and deal with them.
You may have to lie. You might feel the need to deceive your friends and others about your injuries in order to protect those you care about. This can be yet another heavy burden on you – the last thing you need.
You may feel guilty. People who self harm almost always feel guilt or shame about it. This means hiding the behaviour and blaming yourself for it. This creates yet more distress and pain, which leads to more self harm to cope.

How can I stop self harming?

Self harm is a way of trying to cope with inner pain. It is very difficult to stop self harming without having other ways to cope. Changing any behaviour is difficult. It is a decision ONLY YOU can make. Here are some different ways you can react when you feel like self harming. These won’t always be easy and will take lots of effort.

Decide that you want to stop self harming – making this decision is the first step.
Consider all the reasons that you do genuinely want to stop. Connect these with values that are important to you. Write them down. Remind yourself of these when you feel the urge.
Physical exercise can help – it is the best treatment for many mental health issues.
Remove yourself from the present situation. Something as simple as getting away from the environment, or the presence of whatever it is you use to self harm, works for some people.
Delay for 15 minutes. Do something to distract yourself from the urge. If this works, try another 15 minutes.
Have something to do. Keeping yourself occupied can keep your mind off stress and not leave you time to think about self harming. Plan things to do to occupy your free time. Develop structure or a routine.
Try to focus on something in the present moment rather than the pain you may be feeling. Do something that grounds you in the present moment and brings you out of your head. Go outside and look at the clouds, take a shower, watch some TV, read a book, go for a run, get on the internet, eat some food, drink a hot, fragrant drink.
Make a list of friends or support people you can talk to or call when you feel you need to. These people should understand your situation and what you’re going through. Not all friends will be able to do this – most people find it difficult to understand why someone self harms. If your friends are having trouble understanding, you may need to talk to a professional.
Try deep breathing and relaxation exercises. Deep breathing is a mindful activity, increases your oxygen supply, and can help you feel calm and relaxed. Deep breathing and relaxation exercises can also be good ways to stop you ruminating on unhelpful thoughts.
Write a diary. Describe in factual, nonjudgmental detail how you feel, and what might have triggered these feelings. In this way you can be aware of what causes feelings distressing enough to warrant self harm, and what you might be able to do before escalate to this level next time.
Make a list of alternative strategies that might help to express or ‘get the feelings out.’ Screaming into a pillow, flicking an elastic band on your wrist, drawing on your skin with a red pen, stream of consciousness writing, listening to music, expressing your feelings through art, yoga, going for a walk, and spending time with a pet are some examples.
Call a support or crisis line if you feel that your self harm is becoming dangerous. See the list of helpful numbers below.

If you’re trying to stop, it’s important to understand that you may do it again. Don’t get down on yourself about this. Lapsing once does not mean you have relapsed back into a pattern. It can be an opportunity to examine what happened, and prepare further for next time. What’s important is that you don’t give up trying to stop, and that you get the support you need to help you through.

Why is it so hard to talk about?

Talking to people that you are close to about self harm can be terribly difficult. Many people who self harm are deeply concerned about how their family and friends will react. Some of the ways that people fear their loved ones might respond are:

Becoming very worried about you and experiencing their own distress.
Not knowing what to do or say.
Questioning whether it is their fault and blaming themselves.
Telling you to stop, or making you promise you won’t do it again.
Dismissing it or trying to ignore it in the hope it will go away.
Getting frustrated or angry because they don’t understand.
Thinking that you are doing it for attention.
Judging you, thinking you are crazy.
Sending you away to a mental health facility.
Taking away your children.

Whatever you think the reaction might be, it is important you talk to someone about your self harming. Keeping it a secret will only serve to maintain the behaviour. There is then the risk of it escalating and leading to serious injury, infection, or worse.

Some ways of getting support from others:

When you talk to people about it, try to pick a place that is private where you can talk about it without additional pressures.
Make sure you and the other person have time to talk – try not to mention it on your way out the door.
Tell the person the things you are doing to try and stop harming yourself.
Be sensitive to those around you. Self harming may make sense to you but to the people around you it may seem frightening and difficult to understand.

Whatever you think the reaction might be, it is important you talk to someone about your self harming.

It is never going to be easy talking with other people about your self harm. Remember, you are in control of how and what they find out.

How can I help?

Finding out that someone you care about is hurting themself is tough. Many people can’t understand why someone would want to hurt themselves. It can be hard not to take it personally, and it’s a natural response to want to convince the person to stop.

Here are some tips for helping someone who self harms:

Seek the support of a health professional – Self harm is a complex behaviour that may go on for a long time. It is important that you have the support and advice of a health professional.
Don’t take it personally – When people self harm, they don’t do it to intentionally make you feel bad or guilty. Even if it feels like they are trying to manipulate you, that may not be the reason they self harm.
Make a plan – If you’re able to, sit down with the person and figure out what can be done if they feel the urge to self harm, or if they have self harmed. This can make things feel safer for you both. It may also reduce the ‘secrecy’ around the self harming and make the person feel supported. If in doubt, talk to a health professional.
Be supportive and remain calm – Often, people react by making a big fuss about the self harm and become upset, angry or both. This can make the situation worse, as the person is already trying to cope with their own emotions. They may then self harm in secret because they fear your reaction. In a calm voice, ask the person if they want to talk – this leaves the control of this in their hands.
Make the initial approach but don’t push them.
Being supportive doesn’t mean you’re saying the behaviour is okay– it’s saying that you want to be there for the person to help them. You might start by saying, “People hurt themselves when they are feeling overwhelmed. Do you want to talk to me about it?”
While remaining calm, try to understand why the person is self harming. Some people feel sick at the thought that someone they know is hurting themselves. Try to understand what the issues behind the self harm are, and how you can support that person to find different ways of coping.
Don’t tell them not to do it. A normal reaction to self harm is to tell the person not to do it, or that it makes you feel bad. This often leads to the person feeling shame or guilt. A likely response to this is that they then start to hide their self harming behaviours from you.
Take care of yourself. This is really difficult! You will need time to adjust. Make sure you are taking care of your own needs, as well as those of the person you care about. The more you are able to relax, the easier it will be to deal with everything else.
Be clear about what your limits are. Most people feel completely out of their depth when it comes to self harm. It’s okay if you feel uncomfortable with it, and it’s okay if you don’t feel able to talk about it. Let the person know this, and together seek out the assistance of a health professional such as a psychologist, psychiatrist or counsellor.

Looking forward

When everything seems too big to handle and you can’t see a way out, it can be hard to think about your future. When you feel this way there are some things you can think about:

The people that you most look up to have probably gone through a really difficult time in their life – it does end.
The problems that seem unsolvable will change.
Life is always changing.
Feeling bad doesn’t last forever – it only lasts as long as we think about it.
If you went to live on another planet, there would be at least one person who would be sad to see you go.
There are people who want to hear what you’ve got to say. There are people who understand. There are people who want to help you stop self harming.

Self harming stops you from dealing with the reasons for your pain. There are other ways to deal with how you feel that don’t cause harm to yourself. The first step is to reach out and talk to someone and see the future you have ahead of you.

Resources

Lifeline Australia
Phone: 131 114
Live chat: https://www.lifeline.org.au/get-help/online-services/crisis-chat

Kids Helpline
Phone: 1800 551 800
Website: www.kidshelp.com.au

Your general practitioner (doctor)
Your local community or health service
The Emergency Department of your local hospital

SANE Australia
Helpline: 1800 187 263
Website: ~~https://www.sane.org/mental-health-and-illness/facts-and-guides/self-harm~~

Beyond Blue
Support line: 1300 224 636
Website: https://www.beyondblue.org.au/the-facts/self-harm-and-self-injury

A plan to stop self harming

Below is a plan that you can put together if you want to try to stop self harming. Write the following headings in a journal, and fill in your answers. Keep the journal somewhere safe.

Who are the people I can talk to if I feel like self harming?

What are the things that usually trigger self harm for me?
Think about the reasons you self harm or the things you have trouble coping with? This will help you to know when you are most likely to self harm and try to prevent yourself from doing so.

What can I do to try to stop self harming if I feel like doing it?

What are some other things I can do, if I feel like I’m not coping, instead of self harming?

Make sure you reward yourself for your efforts trying to stop self harming. Other people may not notice but it is important you do.

Changing is never easy, so be proud of the effort you make.

Adapted from Self Harm: An information booklet for young people who self harm & those who care for them. Text © The State of Queensland (Queensland Health) 2006