Self-harmers in pyjamas
When I had my first client that had self harmed come into my office, I remember feeling shock and dismay and sick to my stomach. Now, I feel the same shock and dismay at how common self-harming is.
Self-harm, in the context of harming one’s self to alter emotion, escape from emotional distress or self-punish, must be separated from suicidal harm. Suicidal harm is when a person is harming themselves with the desire to end their life - and must be acted upon with urgency by contacting emergency mental health services. This article is for people who harm themselves without suicidal ideation, or who love someone that does.
I named this piece “self-harmers in pyjamas” not to make light of the subject - rather to acknowledge that we are currently in level 4 lockdown, and that there is a lot more time being spent in pyjamas. It is also to acknowledge that even in normal times, self-harming is done in the quiet, in the dark, hidden away with shame and secrecy - likely late at night when the house is asleep. In my experience so far, people who self-harm tend to be adolescent girls aged approximately 12-17, but of course there will be exceptions to this.
I have come to understand that for many who self-harm, it acts like a “scream into the skin”. Societal and family expectations make it difficult to do something loud or damaging like screaming a guttural scream so that the neighbours can hear, or throwing dinner plates at the wall. When emotions run rampant after a negative event or interaction, harming yourself is a way to change how you feel through pain, seeing the shock of blood, or even a way of punishing oneself if they perceive that they have done wrong. One thing I will not deny is that this can be an effective way to cope with strong emotions. However, there are thousands of other ways that can also help with strong emotions that do not involve harming your body.
If you love somebody that is self-harming, or if you suspect they are, it is important not to react angrily. Try to keep your own emotions in check - this is difficult I know, but you can absolutely be freaking out inside but act calm and accepting. You want the person to be able to come to you for help, not to run away and harm themselves even more. Your reaction is key here. Although it is a shocking thing to find out, remember that there is something going on for this person that is making them want to harm themselves. In other words, look at this big picture and try to understand what is happening that is sparking off the harming.
Teenagers in particular regularly take part in “discoverer” behaviour, that is, they are constantly trying out new and different things to solve problems and to feel good. Some of these are helpful behaviours like trying a new sport or making a new friend, and some are not - like harming themselves. They might need help to discover new behaviours that help them to keep emotions in check, and that is completely normal. I will now list some of the most common/effective strategies - remember that these will only help with the strong emotions at the time. For the root cause of the behaviour, you/they may have to seek professional help.
Popping bubble wrap, one bubble at a time
Take a hot shower
Wash your hands with scented soap, mindfully taking in each moment
Contact a friend via phone or social media
Drawing tiny designs on your skin where you normally harm
Drink a glass of ice and water
Put a very cold wet facecloth across your eyes
Colour in
Exercise - more difficult late at night but try something quiet like yoga
Focus on the breath for a full 2-3 minutes, taking longer to breathe out than in
STOP skill - Google “STOP skill DBT” for more information about this. Stop, Take a step back, Observe, Proceed mindfully.
Some other useful ways to frame self-harming to someone else or yourself:
Imagine that your body is your dream vehicle, whatever that may be. It takes you everywhere that you need and want to go in your life. When you use the right fuel it performs better, so taking care of it makes perfect sense. Now imagine that one day something upsets you so you stop your car and pick up a sharp rock. You scratch the paint work of your car right around the body. Would it have been better to have tried something else at that time, like using your car to get to somewhere to do something that matters to you?
Imagine that your best friend or someone you really care about is going through something really hard. You are there for her and would do anything to help and support her, including offering encouraging words. When she tells you that she is thinking of harming herself, what do you do? Would you hand her the blade? Of course not, you would comfort and support her to find another way. Now, turn those feelings back onto yourself. Listen to how you are feeling in that moment. What do you need to hear right now? Finally, know that others also suffer in this way. That is self-compassion and can be the key to reducing those strong negative emotions around yourself.
Self-harming can be very upsetting for those who partake and for those that love them. This information is intended to help you understand it a little more and how to help. Seek professional help if the harming continues - this will address the reason for the harming and how to cope with the behaviour.
Questions, comments? Email me, kathryn@kathrynwright.co.nz