Secret Shame, Part 2

by Gordon Houghton

(Page 2 of 2)

II

'For a brief moment after the cut, there's nothing, not even pain. Then there's a sharp, short-lived sting. Then a duller wave which overwhelms it. And then the blood begins to flow.' (TDP, p. 68)

The first question most people ask when confronted with SI is: why do you do it? A group of self-harmers interviewed for this article gave replies consistent with Martinson's observations: 'I cut in order to feel something', 'I don't like myself much', 'it takes away all the black inside', 'it's easier for me to deal with physical pain than the emotional stuff'. It's a way of externalizing emotion, and imposing control on something which feels chaotic.

Respondents also identified feelings of intolerable tension or emptiness which can only be relieved by self-injury. As Rachel comments, 'the first time I cut, I was struck by the image of all the feeling I had slowly leaking out of my body through the wounds.' But the relief is only temporary. 'At first it did help, and after I cut I would be almost happy... but by the next morning I would be depressed and wanting to self-injure again.'

When it comes to the question does it hurt?, the feedback is more ambivalent. Some couldn't remember the pain, or didn't feel it at all because of their emotional numbness. Most said they felt 'a little', but 'it wasn't too harsh', or 'it hurt, but I didn't really mind'. A few thought it was 'very painful', but qualified it: 'I had complete control', 'I think that I deserve it', and even 'it felt great'. In all cases, mental relief was seen as more important than physical discomfort.

The connection between self-harming and control is reinforced by ritual. Some people make repeated use of special tools and particular rooms, listen to certain kinds of music, and have a firmly established order of events. Martinson suggests this is because 'the ritual helps the person focus their mind and block out everything except the act'. Favazza's explanation is more clinical: 'Ritualistic behaviours help cutters to bind their anxiety.'

While ritual appears to be optional, almost all self-injurers feel shame as a result of their SI. This is reflected in the attitudes of cutters towards their scars, typically self-loathing: 'I hate my body, so the scars don't really make any difference', 'I hate them and try to disguise them', 'I feel as if I deserve the scars'. Rachel's view is more practical: 'Since most people already know about my cutting, I have no fears about showing my scars. The only time I worry is at a job interview, or when I'm trying to impress someone.'

Shame makes it hard to admit to what you are doing, and self-injurers find it particularly difficult to find support. The medical profession - psychiatric personnel excluded - is a target for particular criticism. Bulletins on various websites allege that self-harmers are treated as 'a waste of time', and that one doctor even stitched a girl's wrist without anaesthesia: 'It was like he wanted to teach me a lesson, but instead he taught me that I could withstand more pain than I thought.'

Deb Martinson argues for a more sympathetic approach, pointing out that SI is little different from alcohol abuse, drugs, smoking and eating disorders. The best hospital program she's encountered is one in Beckenham, Kent, where 'clients are not forbidden to hurt themselves, but are expected to take responsibility for what they do. If they cut, they bandage their wounds, clean up their mess and talk to staff about what happened and how it could have been different.'

III

'You could, of course, pull yourself together. But it's much easier tearing yourself apart.' (TDP p. 146)

Those closest to the self-harmer understandably have most difficulty coping. Rachel says her parents 'were scared by it. My dad gave me a lecture on God and took my blades away. My friends were scared too, though a few of them stepped into help... But people trying to "fix" me only screwed things up more.'

Martinson offers some general advice for friends and families. 'The worst thing you can do is go away... and the second worst is to give an ultimatum. In most cases, the person doing this would stop if they knew how. They're generally not doing it to annoy you or manipulate you - although it can feel as though they are.' She also advocates maintaining an accepting, open attitude towards SI, recognizing the severity of the sufferer's distress, and encouraging them to seek help from a counselor.

Whether you harm yourself or know someone who does, it's important to remember that you're not alone. In the UK, there's the Bristol Crisis Service for Women, the newsletter SHOUT, the National Self-Harm Network, and many other local organizations. Books on the subject, such as Tracy Alderman's The Scarred Soul, offer a humane and practical approach. On the Web, too, there are dozens of good sites offering both professional help and personal confessions. For Deb Martinson, informality and anonymity are the Internet's great strengths: 'People can look for information without explaining why they want it, and it makes it easier for them to talk about it.'

Above all, everyone agrees that self-harmers should look for ways to change their behaviour. Martinson says that first 'you have to make a decision you no longer want to do it. After that, the only way to stop is to find other coping mechanisms and learn to substitute them for self-injury.' She suggests, for example, pressing ice against your skin rather than burning yourself, and then substituting something later for the ice. 'Match the activity to how you feel. If you're sad, do something soothing; if you're angry, do something physical.'

The main thing is to be kind to yourself. 'When you lapse, let go of the guilt and move on. Set positive goals and reward yourself for achieving them. Deal with the issues that underlie your self-injury... But do everything in small steps.' She also recommends support networks: 'the more people involved in a self-injurer's life who know and understand what's going on, the easier it is for that person to work towards a recovery.'

On a practical level, you should avoid materials which might lead you to self-harm, remind yourself of the long-term consequences, stay away from drugs and alcohol, or simply get a loved one to hold you until the impulse passes. In general, many people have found it helpful to accept their SI as a good thing, while at the same time recognizing it as a harmful behaviour. As one respondent said: 'It's okay to cut - it's just better to stop.'

If you succeed, bear in mind that your problems won't automatically disappear. As Rachel points out, 'Even if a person has stopped actively hurting themselves, they are still fighting the same battle, every hour of every day. It doesn't mean the issues aren't there, they are just better hidden.'

About the Author

Gordon Houghton is a journalist and author, and writes on the issue of self harm from personal experience. For more information please visit www.the-burrow.freeserve.co.uk