What is self-harm?
Self-harm can be any behaviour that can have a detrimental effect on a person’s physical and/or emotional well being. Examples of this can include smoking, using drugs, drinking excessively, overworking, and even staying up late! It is important to note that self-harming behaviours can be viewed as a continuum – so what may be considered harmful for one person may not be so for another.
There is a difference between ‘self-harm’ and ‘self-injury’. Self-injury is “any act that involves deliberately inflicting pain and/or injury to one’s own body not necessarily with suicidal intent” (Arnold and Magil 1996). This can include, but is not limited to hair pulling (trichotillomania), skin picking, cutting, swallowing harmful substances, and burning (with heat or chemicals).
It is often useful to consider “The 8 ‘C’s of Self Harm” when exploring the reasons why. These are:
1. Coping and Crisis intervention – self-harming can be seen as an escape from a stressful situation.
2. Calming and Comforting – the ritual of self-injury can create familiarity where chaos and unpredictability may be present.
3. Control – in a situation where a person has limited options, self-injury can be the only thing they can control.
4. Cleansing – for example with cutting, the sight of blood can be reassuring.
5. Confirmation of existence – feeling physical pain or seeing blood can sometimes be the only way that a person can feel alive.
6. Creating comfortable numbness – switching emotional pain for physical pain.
7. Chastisement – punishment for acting or feeling a certain way for example.
8. Communication – ‘I’m not ok, I need help’.
(Taken from “The 8 ‘C’s of Self harm” by Jan Sutton)
As a counsellor, I would never tell someone to not self-harm or self-injure. For many, this has been the only way they have learned to cope in stressful situations in what is known as a ‘creative adjustment’, and to challenge this behaviour would be equally as harmful. Instead, it is useful to explore why someone may choose to self-injure to begin with, and to focus on the person behind the behaviour rather than the act itself.
If a client discloses to me that they have self-injured, I am not obliged to disclose this to anyone unless the act of self-injury could be life-threatening. I may suggest that they keep a diary to try and highlight any patterns or triggers that may emerge. We might explore alternatives such as snapping an elastic band on the wrist instead of cutting. One creative suggestion that I have heard of is from a client who enjoyed the sight of his own blood, and decided instead to lie in a bath of water that had had red food colouring added!
What to do next
Talking about self-harming behaviours can be difficult, and may bring up feelings of anxiety, shame and fear. There are many agencies out there that can provide support over the phone, or online such as Samaritans, and ChildLine. Here at Derby Counselling Centre, our counsellors have experience of working with people who have self-injured, and offer a non-judgemental, safe space to talk.