When we’re trying to cope with the stresses and strains of life, there may be times when we turn to self-damaging behaviours. The use of these behaviours is often highly stigmatised and this stigma can be worsened by a lack of understanding.
Self-Damaging Behaviours Are Wide-Ranging
Self-damaging behaviours can encompass a range of things. This includes (but isn’t limited to), putting ourselves in unsafe situations (e.g. having a lot of unsafe sex), picking fights, hair-pulling, skin-picking, drug-taking, alcohol abuse, over- or under-eating, over-exercising, using other eating disordered behaviours, ingesting things that don’t belong in our body, inflicting physical injuries on ourselves, or anything else that damages us either physically or emotionally.
It’s Not Just Teenagers
Many people associate self-harm with white, female teenagers.
Statistics show that self-harm affects almost all ages, not just teenagers. In the 2018-19 financial year, 75% of admissions for self-harm were for those over the age of 20, with 62% of total admissions being for those over 25 years of age.
In 2014, 5% of men aged 16-74 were recorded as having self-harmed in the past compared to 7.9% of women the same age. However, only 27.8% of men sought medical/psychological help compared to 43.1% of women. This significant difference in help-seeking is one example of how the statistics can become skewed, resulting in some groups being over-represented and others under-represented.
Those belonging to ethnic minorities are also frequently under-represented because cultural differences can mean that they’re less likely to seek help, too. A 2018 report highlighted showed that those identifying as Asian or Asian British are one-third less likely to be in contact with mental health services (in the UK).
The way self-damaging behaviours are recorded can also affect statistics. For example, picking fights or punching a wall may not be recorded as ‘self-harm’.
If statistics aren’t explained properly, for example in newspaper headlines, this can exacerbate commonly held misconceptions about who self-damaging behaviours affect.
Why We Use Self-Damaging Behaviours
We all have our own reasons for using self-damaging behaviours. Sometimes we might not know why we’re doing it – we just feel like we ‘need’ to, and know that it helps in some way.
We usually use self-damaging behaviours when the stuff we have to cope with outweighs our existing coping mechanisms. We’re not bad people, we’re just people who are trying to cope.
We Don’t Always Know Why We Use Them
Self-damaging behaviours don’t usually stem from one thing. More often than not they’re a complicated confusion of thoughts, feelings, events, emotions, distress, and overwhelm.
For many of us, working out why we use these behaviours, where they come from, and how they help us, can be a big part of our recovery. Understanding the purpose they serve can help us to replace them with less-damaging coping tools.
It’s Not Always In Response To Bad Things
Counter-intuitively, self-damaging behaviours aren’t always a response to bad things, they can be in response to the good stuff, too.
Good days can be confusing and overwhelming if we’re not used to them. We might not be able to recognise or name our feelings. Overwhelm can build until we can’t think; which is where the self-damaging behaviours come in.
We might feel undeserving of good things. This unworthiness can lead to confusion when people are nice to us. We might worry that they’re trying to ‘trip us up’ or that we’ll be ‘found out’.
Self-damaging behaviours can feel familiar, predictable, contained, and controlled. We might feel like ‘we deserve’ them. They’re there when everything else feels messy – whether those messy feelings are ‘good’ or ‘bad’.
Using Behaviours Doesn’t Mean We’re Suicidal
Using self-damaging behaviours doesn’t necessarily mean that we’re suicidal. Sometimes we might feel suicidal when using these behaviours, but sometimes we don’t. Self-damaging behaviours are a coping mechanism; whether we’re using them to cope with suicidal thoughts or with something else.
Sometimes It Doesn’t Feel Like A Choice
From the outside, self-damaging behaviours can look like a choice, but they don’t always feel that way.
Some behaviours, such as abusing alcohol or drugs, can become physically addictive. Our body physically craves them, and we may need medical support to help us withdraw from them.
Even if we’re not physically addicted to a behaviour, using it still might not feel like a choice. Self-damaging behaviours might reduce our anxiety to a manageable level. Voices in our head could tell us to hurt ourselves. Engaging with behaviour(s) can feel like something we’re compelled to do. Sometimes it doesn’t feel within our control; it can be incredibly scary.
They Help Us
We wouldn’t use self-damaging behaviours if they didn’t help.
Life sometimes feels like a stormy, dangerous area of water. We grab onto a log (self-damaging behaviour) to keeping us afloat; it saves us. Eventually, we reach calmer waters. Loved ones are stood on dry land. They can see us struggling, clinging to this heavy log. We can’t swim to shore whilst clutching it, but we don’t feel able to let go because it’s kept us alive during the hardest period of our life. Letting go requires a huge leap of faith. We might not make it the first, second, or third time. It takes practice and patience. We all have it within us to get to shore but it’s not a straight line.
This describes how our self-damaging behaviours often originate from a helpful place. We didn’t start using them out of the blue.
The Cloak Of Shame
Engaging with self-damaging behaviour(s) can leave us with a cloak of shame. We often feel say horrible things to ourselves, far worse than anything anyone else could ever say to us.
Other people’s responses to self-damaging behaviours can be harsh. Many people who’ve used a self-damaging behaviour have been treated badly or spoken to in a hurtful way. These judgements and words can come from friends, family, strangers, medical professionals, employers, colleagues… just about anyone. This adds weight to our cloak of shame.
Every time we’re treated badly, by ourselves or others, we become smaller, pull the cloak a little tighter, and try even harder to blend into our surroundings.
Shame fuels silence, making it harder for us to reach out for the support we need. It can worsen our feelings of worthlessness and hopelessness, so it becomes even harder to stop using self-damaging behaviours. This can very quickly become a vicious circle.
Using self-damaging behaviours doesn’t make us an ‘attention-seeker’. Many of us are private about our behaviours. We do them in isolation, hide any ‘outward’ signs, and don’t tell anyone. Shame can overwhelm us.
Some of us do hurt ourselves to communicate to others that we’re not okay. The term ‘attention-seeking’ can have negative connotations, but we all need attention, and if we’re using these behaviours to communicate, then it is likely that one (or more) of our needs aren’t being met.
We prefer the term ‘care-seeking‘; we want someone to care for us, and to help us care for ourselves.
Some self-damaging behaviours mean that we need to seek medical attention.
This often makes us feel guilty. Many of us worry that we’re wasting health professional’s time (we’re not) and that we’re a drain on society (we aren’t). This can be exacerbated by the stigma that comes from members of the public, or other patients, and the treatment that we receive from some medical professionals.
We deserve help and support; to be shown dignity, respect, and care. There’s no reason for us to feel guilty for ‘taking up people’s time’, because health professionals are there to help us with our health needs, and support with self-damaging behaviour is a health need.
Replacing Self-Damaging Behaviours
Replacing self-damaging behaviours with healthier coping mechanisms is one of the best ways to stop using them because it still allows us to have an outlet for the things we’re coping with.
If we think of our struggles as a pressurised canister, the ‘stuff’ inside represents the things we have to cope with. Life stressors get added to the canister, increasing the pressure inside. Coping mechanisms act as holes, releasing some of this pressure. Self-damaging behaviours might not be the ‘healthiest’ coping mechanism, but they’re still a way of coping; they still release some pressure.
If we suddenly stop using them, then those holes disappear. Pressure can no longer escape through them. Without any new coping mechanisms, there are no new holes. ‘Life’ still goes into our canister, so the pressure builds and builds until we feel unable to cope.
Learning new skills to manage our thoughts and feelings, self-soothing, talking to people, and having a list of things we can use instead of self-damaging behaviours can help us to keep creating holes in our canister, and stop us from reaching the point where we feel as though we can’t cope.
Lapse Vs Relapse
Working towards a life free from self-damaging behaviour(s) isn’t a straight line. It’s hard work and will almost certainly involve lapses along the way. Lapses don’t mean that we’ve relapsed. They mean we’ve slipped and might need a little more support for a while to help us get back on track.
Visible Signs Of Self-Damaging Behaviour
Sometimes, self-damaging behaviours leave visible signs.
Sometimes, when we recover, they stop being visible, for example, if we’re underweight then we can work towards being a healthy weight.
However, some physical signs, such as scars, remain long after we’ve recovered.
Coming to terms with the permanency of these outward signs can be a difficult part of the recovery process. Visible scars mean that people we’ve never met will often know that we’ve engaged in self-damaging behaviours before they even know our name.
Some of us choose to cover our scars up, others don’t. If it’s a sunny day, we’re in a t-shirt, and we have scars on our arms, we’re not ‘showing off’ our scars. We’re hot, it’s a sunny day, and we’re wearing a t-shirt.
Asking about, or drawing attention to our scars, isn’t helpful. It’s intrusive. We know that our scars are there, and usually don’t want to disclose our experiences to a relative stranger. Please don’t make it awkward.
We’re trying. We really are.
It might not always look that way to others; we might slip up now and again or use self-damaging behaviours regularly for a while. Perhaps it looks like we’re self-destructing, but we’re usually trying to our best to cope with life as best we can. We’re trying to hold our head above water, and to ‘get through it’, whatever ‘it’ might be.
Recovery Is Possible
For some of us, recovery is about reducing our self-damaging behaviours to a manageable level. Others aim to stop using them altogether.
Whatever recovery means to us – we can get there. It might take time, we might need lots of help, support, patience, kindness, and care. We will slip up and get up more times than we can count. But we can get there. Recovery is possible.
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