I have a microsecond in which to emotionally brace myself before she tentatively pulls up her sleeves… I hold my breath, whilst trying very hard not to give away any indication that I am anxious about what I could potentially be confronted with.
I force myself not to visibly react as I see the marks on her pale skin, I exhale slowly and then I manage to meet her eye without flinching. I clean the cuts with wipes and bandage up her arm, whilst breathing a sigh of relief that she trusts me enough to now start talking…
Self harm amongst young people (under 25) is still one of our society’s greatest taboos. And yet it is far more common than any of us could imagine. The Mental Health Foundation report “Truth Hurts” states that 1 in 15 young people have self-harmed although the figure is now believed to be even higher, and the UK is said to have higher rates than anywhere else in Europe. The average age of starting is now just 12 years old.
More and more children and young people are using self harm as a mechanism to cope with the pressures of life. Very often it will be dismissed as simply attention seeking behaviour, but actually it’s because they have no other way of coping with the emotional distress or pain from a wide range of factors: Peer pressure, exam pressure, low self-esteem, feeling isolated, family breakdown and bullying can all contribute to the need to let out all the hurt, anger, pain, sadness or pain that they re feeling inside.
However, it is very unlikely that anyone else will know that it is happening, no matter how close a family unit or friendship. Very often it is done in secret and concealed since there is a huge amount of guilt associated with it and there are concerns about how someone else will react.
Self harm is generally defined as “the act of deliberately causing harm to oneself either by causing a physical injury, by putting oneself in dangerous situations and/or self neglect.” It can therefore take on many different forms, many of which are not easily identified.
Cutting is often seen to be the most apparent and visibly identifiable form of physical injury, however there are other types, including hair pulling, picking and scratching, burning, biting, head banging etc.
Eating disorders are another method of self harming and controlling emotions – gorging and binge eating can often be used to relieve feelings of emptiness and low self worth, vomiting is seen to be both the punishment and the release.
There are also very common forms, which are generally not labelled as self harm, but which still induce harm upon one’s body and these include general risk taking behaviour, violence, breaking the law, sexual encounters and promiscuity, excessive exercise, multiple piercings and tattoos, and simply neglecting general hygiene etc.
One of the most dismissed forms is that of general alcohol and substance misuse. Very often excessive consumption of alcohol or drugs of any kind (including legal prescription or over the counter medicine) is a symptom of low self worth, and a way of blocking out emotional distress or painful memories.
It is worth remembering that there is no ‘typical’ person who self harms and I urge you to keep an open mind about the fact that ANYONE you know could find themselves at an emotionally distressing time in their life when it’s just too difficult to talk to anyone else.
Look out for the signs and remember that it is a form of communication about unhappiness. Self harm gives a sense of control that is missing elsewhere in life and if you react negatively then the damage might just be irreversible.
If you are self harming, or you know someone who is, then there are organisations out there who can help. People who understand why someone self harms. People who can help work through the complexities including triggers and distractions whilst counselling for the underlying issues.