What Are The Scars All About?

CAUTION: This post contains details of self harm (although no images) which may be disturbing to some readers.  Please take care of yourself in reading.

The sad truth for many.

“Everywhere Peter turned, he felt bombarded by misconception about self-harm. Why couldn’t anyone understand what he was going through? It was as if he had awakened to find himself on a different planet, where everyone spoke another language.  It’s not that he didn’t understand that self-harm can be scary and confusing to people who don’t harm themselves.  He did.  But the thing he couldn’t understand was why they couldn’t get beyond their misconceptions and hear what he was saying.  Just last week, he had got into an argument with an ER nurse about why he’d cut himself.  No matter how much he insisted that he had no intention of killing himself, she kept telling the other staff that he’d attempted suicide, and paged the psychiatrist on call to get him hospitalized.  Then, to make matters worse, the next day his father accused him of cutting himself to get attention, even though he’d tried to hide it from everyone.  Why couldn’t anyone understand that he was just trying to relieve some of his pain and cope with his depression?”

 – Kim Gratz & Alexander Chapman, Freedom from Self-Harm (p. 23)

As part of Mental Health Awareness Week I want to talk about self harm, because I believe that it is one of the hardest things for people to understand and get their head around.  It’s not often talked about, especially in polite company, but it’s out there happening, and literally tearing lives apart.

Perhaps one of the biggest issues in terms of it getting understood in the wider community is the shame that people who self harm carry with them.  It’s incredibly hard to talk about openly, especially if you don’t fully understand the reasons why you do it.  It’s fairly hard to avoid judgement, and even if you can, you are so fearful of what reaction you might get, that it’s simply easier to pull down your sleeves and pretend it’s not there.

This is how my self harm began, recorded in my book, Infinite Sadness:

“That night I started scratching my arms raw with my fingernails.  I would scratch and scratch with no feeling of pain.  Eventually I would look down and see the red, raw and bleeding skin.  I would realise what I had done and be horrified.  It wasn’t until I looked down at it that I would finally feel the pain.  The pain was bad, like a friction burn.

 I was disgusted that I could do such a thing to myself.  I had never had an urge to do anything like it, but had now just found myself mutilating my arms.  How?  Why?  Questions flooded my mind.  What was happening to me?  But then how could I answer those questions, for that would entail admitting to another human being the horror of what I had done.

 By the next day, I knew I needed help.  I wondered about the 24 hour Surgery but couldn’t bear the thought of a strange doctor questioning me.  Eventually I decided I would tell my friend Amy.  I knew I had to tell someone, and I thought that through her friendship and her nursing training, she must surely know what I should do. 

 I went to Amy’s house.  We drank coffee.  We talked for an hour and a half, but I couldn’t find the words to pull up my sleeves and show her the damage of the night before.  I left having not told her.  I think that I was so disgusted by what I had done that I just could not bear to admit it.” (p. 106,7)

I was 30 years old, so note that self harm is not just a teenage fad.  It’s serious, and it affects people of all ages.  Scratching my arms was never going to be a suicide attempt.  I simply made one heck of a very painful mess.  As for attention?  That was the last thing on my mind, simply because I was so disgusted by what I had done.

I didn’t even know what self harm was.  I had never seen evidence of it on anyone else, nor had a read anything about it.  It was completely new to me.  And in case you’re wondering, by that time I had spent a lengthy time in a psychiatric hospital, and while I accept that I was very sick at the time so might not have been very observant, I didn’t notice any sign of self harm amongst other patients.  The reason I say that is because a myth that exists is that people ‘learn’ self harm behaviours from watching others.  I didn’t.

Back to the story though.  Several days later I finally plucked up the courage to confess what I had done to both my doctor (a very wise, and trusted General Practitioner) and my psychotherapist.  By that time I had also self harmed again, but still had little idea of why I was doing it, or what I was achieving.

Both these health professionals immediately (and quite separately) told me that my self harm was a good thing.  They were both pleased that I had done it because I was apparently expressing my feelings.  I admit that I had great difficulty up until this point in expressing my feelings.  I simply didn’t have the words, and expressing feelings was not something I  had ever been encouraged to do.  Tearing my arms to shreds was apparently a good thing.  Of course no one, including myself, knew what those feelings were that I had been expressing but that didn’t seem to matter.

Image credit: FB-A Mental Illness Is Hidden

Fast forward 15 years.  In that time I graduated onto more serious, and dangerous methods of self harm.  At times I was self harming while dissociated, and this was the case in the worst damage I ever did to myself.  Now though, I have fought back and found other, healthy ways to express myself (if that was what I was doing), and to reclaim control over my life.

Beyond what was suggested initially I worked out that I self harmed because I felt totally out of control, and if I cut myself then I would somehow bring everything back into control   I also self harmed sometimes because I needed to see physical blood, and experience physical pain to comprehend the emotional pain I was in.  I self harmed sometimes to punish myself.  In this respect, it was more a case of thinking that I didn’t deserve to not harm myself.

While I don’t believe this is the case for all people who self harm, the self harm became a kind of addiction for me.  It was something I needed to do, and I had to break that pattern so that I could recover.

I don’t accept that self harm is ever a good thing, and while I still have a lot of respect for those people who told me it was, I completely disagree with the stance they took.  Recently I read something (which of course I can’t find now) that suggested that self harm shouldn’t be seen as a bad thing.  The article I read suggested that by judging the behaviour of self harm as bad, then we are judging the person as bad.  I don’t agree with this either.  Anything that we do that harms us has to be a bad thing, but that is not a judgement on the person.

I also don’t accept that one form of self harm is better or worse than another.  Yes, some forms are more dangerous, and can have more lasting consequences, but any harm that we do to ourselves has to be bad.

There are a lot of myths relation to self harm, some of which include

  • it is the same as a suicide attempt
  • superficial self harm is fine, and is not dangerous
  • people use self harm behaviours to manipulate others. and to get attention
  • self harm is a female problem
  • if you self harm, you must have a mental illness (no doubt, Borderline Personality Disorder)
  • only teenagers self harm
  • self harm is a copy-cat behaviour
  • if you self harm you are a danger to others
  • self harm is a response to childhood abuse

Self harm is difficult to understand, if you’ve never felt the urge to do this.  If you haven’t, be very thankful because the fight that goes on internally is terrible.  It’s made more difficult because of the stigma related to self harm.  The inclination is to think that a person who engages in self harm is ‘completely screwed up’ and maybe even ‘beyond help’.  Nothing could be further from the truth.

There is hope.  Recovery is possible, but it takes a lot of work and unfortunately many of the people struggling with this don’t get the long term therapeutic help they need.  Because of some of the things I am involved in when I’m not blogging, I know many people (men and women) who are fighting this battle every day, and also many people who have won the battle.  It is possible.  It is a really hard battle to beat this, but it is possible.

Self harm is a dangerous activity but the people who use it in order to cope, are no different from anyone else who might use destructive behaviours.  They deserve compassion, acceptance and help… just like any other human being.

An interesting story to end with shows this isn’t always available.  It is my experience of seeking help after my worst self harm, about ten years ago.  I had cut myself badly while dissociated, so actually I felt nothing.  I went to the Accident and Emergency Department of my local hospital (it was after-hours) and the doctor who treated me refused to give me a local anaesthetic while he stitched the large wound.  He told me that I had done this to myself, so I could take a bit more pain.  And yes, it was very painful.  Whether he thought he was being smart, or teaching me a lesson, I don’t know; but there certainly wasn’t much compassion or acceptance of the struggle I was having that night.

“Do no harm & leave the world a better place than you found it.”

―    Patricia Cornwell

Gratz,K.L. & Chapman, A. L., ( 2009). Freedom from Self harm: Overcoming Self-Injury With Skills From DBT And Other Treatments. Oakland: New Harbinger Publications.

Sutton, J. (2007). Healing the Hurt Within – Understanding Self-Injury And Self-Harm, And Heal The Emotional Wounds. Oxford: How to Books Limited.

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22 thoughts on “What Are The Scars All About?

  1. I don’t cut myself, but I do pick at myself a lot. I do it when I’m anxious, or even bored, and sometimes I don’t realize I’m even doing it. I have some body issues, namely that I cannot stand peeling skin or scabs or anything that makes the body imperfect. I even want to “perfect” those around me, though generally I can hold myself back. My children’s cradle cap drove me nuts, though, and I admit I brushed their hair and used lotion, shampoo, etc to get rid of it, even though it was really only a cosmetic thing.

    It never really occured to me just how long I had done it until I thought back to when I would swim all the time as a child, and burn as well. I would peel all the skin off of my face, because I hated peeling skin. Red, raw skin was better. I horrified my poor mother, but it just seemed to be what I needed to do. When I noticed that my daughter sometimes picked at her skin absent-mindedly, I told my therapist. They assured me that it wasn’t my fault that she did that sometimes too (she hasn’t harmed herself with it, it seems an unconscious habit, and I stop her when I see her doing it). They tried to put me on OCD medicine, but it made me sick, so I got off of it and stuck with the antidepressants.

    The worst thing I would do is pick at the dry skin on my feet, and make sores that caused pain when I walked. I went through a lot of bandaids, and my husband started noticing and expressed concern. That was embarrassing. But I figured it wasn’t that bad because I wasn’t actually cutting myself with a blade or anything, right? I never did seriously hurt myself.

    Anyway, I haven’t really picked in a while now. It’s mostly a stress reaction, and I haven’t been to work for a while due to illness, so maybe that’s part of it. Or maybe I’m in “remission”. I think part of healing is recognition – realizing what you are doing, and that it is harmful, but not shameful, and you need help. That’s a biggie, and the toughest. I know this is a long post, but I wanted to add my experience. I do hope your post helps someone who is struggling with this and afraid to tell.

    1. NZ Cate

      Thanks for sharing this Alice. I know it’s not easy stuff to be open about. Actually I can relate to the picking, and I also find myself wanting to ‘tackle’ imperfections on my skin. Much as it is hard stuff to face in ourselves I am convinced that the first step to recovery is to acknowledge the issue.

  2. I was saddened and stunned as I read through this heartwrenching post. But nothing prepared me for the shock of reading this. “The doctor who treated me refused to give me a local anaesthetic while he stitched the large wound. He told me that I had done this to myself, so I could take a bit more pain.” That made me rage. Would a doctor tell a lung cancer patient that they could die in pain because they wouldn’t have cancer if they hadn’t smoked? Or would a doctor refuse to treat someone who had fallen of a mountain and broken their back because they chose to go up the mountain. Or would a doctor refuse to treat a child who had swallowed a small toy because they should have known better. I shan’t go on!
    Self harm needs compassion and understanding. Thank you your being brave enough to share. I’m so glad you’re here!

    1. NZ Cate

      Thanks Carolyn. I think that is probably nearing the worst treatment I have ever received at the hands of a doctor because of my mental illness. What scares me is how many other people get treated with the same type of attitide. You’re quite right that compassion and understanding are so important for people who struggle with self harm.

  3. THANK YOU For sharing this post. I agree that self-harm is one of the most misunderstood and hard to explain parts of a mental illness. I also wondered “why do I want to do this?” and your post reflected many of the complicated reasons people self-harm. Thank you for your openness and honesty.

  4. Bourbon

    As always, great post. With a personal history of over 10 years of self harm I can relate to it a lot. I hope this reaches a very wide audience and changes people’s attitudes towards SH xx

    1. NZ Cate

      Actually I love that you didn’t read it. 🙂 I think that’s great. And what was there was for people who don’t understand self harm, so I don’t think you have missed anything. Keep taking care of yourself. ❤

    1. NZ Cate

      Thanks Kat. In a lot of ways I’m glad for your sake that you don’t know a lot about self harm. I wish none of us needed to. But then I’m also glad that people are taking the time to learn about it, that way hopefully giving some more understanding and acceptance to those who struggle with it.

  5. Hi Cate

    Count me in – I describe myself as a recovering self-harmer. 🙂 I hit myself, mostly to create pain when internal pain/frustration was too great to cope with. A lot of people do it in other ways without realising they are actually self-harming – guys who punch walls in anger, people who drink too much or take drugs… the list of self-harm types are as endless and creative as there are humans. I rarely do that now, maybe once every six months, but it still is there within me. I fight it back at least five times out of six. For me it’s the need to set free an unbearable emotion by creating pain. Interesting side note – I don’t suffer from depression. I have blue days, but I’ve been checked once and done the tests now and then and I never score as depressed, but I do score HIGH on anxiety and panic disorders. Fear can leave you just as drained and incapable, but it is different. I watched the black dog and thought anxiety sufferers need their own dog! 😉 i think he’s white. He blanks out your mind in white light terror, he makes you incapable of thinking, doing, moving.

    I have walked over and hugged him once or twice, but he still sneaks up on me when I least expect it and… WHITE DOG fear takes over.

    Thanks for this place to talk and share and think. You’re doing good work here – for others and for your self. xx

    1. NZ Cate

      WOW! That is so great that you have learnt to fight it. I know it is so hard to do. And I love the idea of the white dog. I don’t have too much problem with anxiety (which surprises me sometimes) but I know how immobilizing it can be for those who do struggle with it. Thanks for sharing.

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  7. I had never really understood self-harm or the need to do it (that I’d seen in movies and read in stories) until I had my worst breakdown during my IF journey. It was 1.5 years into TTC with no result and I was consumed with a huge deluge of ugly feelings that were just too painful to bear (grief, jealousy, envy, anger, self-pity, frustration, bitterness, self-blame, self-hate). My heart was aching so badly that all I wanted was reprieve from the pain in my heart that was too unbearable – then cutting myself crossed my mind. I felt that I needed to focus on something else rather than the pain in my heart.

    I gasped after the thought of doing it crossed my mind! In the end I didn’t do it, though I cried so much and I lashed out everything at God (that helped!). I yelled at Him and just let it all out without editing myself. I didn’t do it out loud, though but before then I thought that if I wanted to be a “good” Christian, I shouldn’t have done all those things. Actually after I lashed out, I started thinking, “Hey, He knows every little thing I’m thinking about, so why not lash out to Him instead of trying to curb everything inside and pretending that I can hide those nasty thoughts from Him?” Funnily enough, I felt His arms around me after I lashed everything all out to Him (it helped start the healing journey).

    I’m sharing this also to break the myth about who else has felt the need to self-harm. I was 31 when I had that breakdown and I’ve never been bullied and there aren’t anyone close to me who’s done anything like this.

    I’m SO SORRY to hear about your experiences with that kind of a doctor. Geez…and I DO hope many more people read this post of yours!

    1. Thanks for sharing your experience Amel. I’m sure it helps when others can see they’re not alone. I’m glad you did what you did instead of cutting. I know it depends on your view of God, but I believe God is strong enough to handle the yelling and screaming we need to do sometimes. And actually I suspect he prefers that to us sticking to the ‘nice’ words. It’s honest, after all.

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