We Have to Talk About Self-Harm

Warning, if you are vulnerable to self-harm you may find that some of this post contains triggering material.

I have to include this warning because to be perfectly honest I don't know if this post does include triggers for self-harm.  Like most of the population, I am completely "blind" to these triggers, and could include them by accident.  The urge to self-harm is something I have never experienced.  Like a blind person trying to imagine colours, I can only guess at what this experience is like, using analogies.  This is despite living for some time with my daughter who has self-harmed repeatedly, and who with whom I (now) talk openly and frankly about it.

One of the resources I have found most useful in understanding self-harm was from the Instant Help series for teens - the one on self-harm is called "Stopping the Pain" and written by Lawrence Shapiro.  For those who have not met this series, they offer a useful mixture of information and exercises in an attractive workbook format.  Given the range of titles (on depression, eating disorders etc) they are never going to be high on anyone's Christmas list, but for parents whose teenagers are going through a tricky patch they offer a very practical approach, particularly if you are on hold waiting for your first CAMHS appointment.

"Stopping the Pain" suggests that in fact we all know experiences of self-inflicted pain that can feel good - they suggest scratching an itch, exercising until your muscles burn, or popping a pimple.  I can vividly remember the childhood pleasure of picking at a scabby knee - guaranteed to give pain, and to turn any adult in the vicinity apoplectic, but at the same time weirdly addictive.  It is this addictive property that drives a lot of Julie's self-harm - something that we have openly discussed many times.  It is one reason why we are all slightly edgy about the self-harm starting up again - like the recovering alcoholic who just has the one drink, it could so quickly develop into another full-blown episode.  But conversely, the longer she goes without self-harming - and we have now had a run of two months with no incidents - the better the chances of her continuing to avoid it.

Self-harm is difficult for people to accept, and often provokes reactions of fear, anger or disgust.  You can see some of the nurses in A&E, otherwise so kind, and sympathetic, struggling with their own reactions when they encounter self-harmers.  Sometimes they confront them angrily - why are they doing this, why should they be given help when A&E is for people who are "really sick"?  At other times they just become cold rather than angry - the self-harmer is put to the back of the queue, treated rather roughly, may not be given anaesthetic while they are being stitched up.  It is hard to endure as a parent, but easy to understand.  It takes a lot of exposure to self-harm before you start seeing past it to the frightened person behind.