Self-harm, which is also called self-injury or self-mutilation, is the act of deliberately hurting one’s body in an attempt to alter a mood state.
There are different ways people engage in self-harm behaviour, such as cutting, scratching, biting, pulling or picking the skin or head banging.
The subject is usually not spoken about openly, and those who engage in self-harm, a problem experienced by thousands of South Africans, often hide the act very well.
Who engages in deliberate acts of self-harm?
It could be anyone: a colleague, your boss, a friend, a final-year medical student, or even your own child. Imagine someone you loved was taking a knife or razor blade and cutting themselves repeatedly, and then hiding the wounds. Or perhaps burning themselves repeatedly with a cigarette?
The wounds inflicted are deep enough to bleed, the burns severe enough to scar, but not to kill.
In an attempt to numb their emotional pain, those who engage in self-harm behaviour endure this horrific reality. Injuring oneself can be a means of communicating anger and distress to other people when there are no other ways.
Seeing the blood from cuts can result in a sense of well-being and strength, feelings that might have been stripped away by past trauma. Internal pain resulting from trauma such as family problems, sexual or physical abuse, or emotional neglect, can be unbearable and only be released or “forgotten about” through the pain that comes from deliberate self-harm.
The relationship between self-harm and suicide:
Research has shown the risk of both suicide attempts and suicide is significantly higher in those who have engaged in non-suicidal self-injury. Among those with a history of self-harm, 70% have attempted suicide at least once and 55% several times. It appears that self-harm behaviour is a risk factor predictive of subsequent suicidal behaviour.
Any act of self-harm should thus be taken seriously and can be seen as a sign that the person is experiencing significant emotional distress.
Someone you know is engaging in self-harm behaviour, how can you help?
1. Encourage them to talk. You might not have the answers but you can listen and show your concern.
2. Do not feel the need to pretend that everything is okay if it is not. If you are sad by what the person is telling you, it is okay to cry with them. If it makes you scared, tell them you are scared.
3. Do not make the person feel guilty. Saying things like “If you loved me you wouldn’t do it,” or “Don’t do it – for me?” only adds to their guilt and self-loathing. Their behaviour has nothing to do with their feelings for you.
4. Don’t be an ostrich and pretend it is not there – be sensitive but willing to help them when they are ready.
5. Suggest professional support and offer to go with them if they are afraid.
Angela Te Roller is an academic quality manager at Boston City Campus, and was a guidance counsellor at a high school in Cape Town for many years. When a 14-year-old boy she counselled completed suicide, she decided she needed to understand the subject better. She completed two years of research on people who had engaged in acts of deliberate-self-harm, at Groote Schuur Hospital, and feels very strongly about the need for creating a non-judgmental supportive environment as an ongoing addition to medical and/or psychological treatment (this is where the support group comes in).
The Helderberg Self-Harm Support Group is hosted every last Thursday of the month, from 7pm to 8.30pm, and the United Church on Andries Pretorius Street in Somerset West has kindly allowed the use of a warm, cozy venue. For more information, call Angela at 082 783 8549, or the South African Depression and Anxiety Group at 0800 21 22 23.
Image: drawn by Angela Te Rollers’s daughter, Damica.