Self Harm

Practical Help

By T. Jaden Ozwell

See Also: Self-Harm — Spiritual Healing

Trigger Warning: Self-harm, cutting. This article does not describe specific self-harming behaviors, but does extensively address causes for and reasons behind self-harm.

There are people who hurt themselves as an emotional release. You already know that. And you probably also know that your church and youth group are statistically assured of being home to at least one of them. Self-harm comes in many forms, but generally people just say cutting, because that is often where the other kinds lead. To someone who doesn't cut, the idea that hurting yourself could serve a purpose is often unfathomable, so I would like to try and help you understand and give a few thoughts on how to help a self-harmer when you encounter him or her.

Just to explain that I know of which I speak, here's a little background on my journey. I started physically self-harming when I was 19. I advanced through various forms of self-harm until I finally made the jump to cutting, because the other stuff just wasn't enough anymore. Not enough pain, not enough injury. For me, cutting is a way to express certain emotions such as anger and fear, turning them on myself rather than the people or situations that precipitate the emotion. It also serves as a way to feel anything at all when depression has me so shut down that nothing elicits a response.

People self-harm for all kinds of reasons. The ones I hear most often proclaimed by people who do not self-harm are "for attention," "because they hate themselves," and "because they are insane." In reality, those are not the main reasons the vast majority of people cut.

For the most part, cutting is just like any other behavior used to deal with emotional stress. Drugs, alcohol, and risky sexual behaviors may get more headlines and Hollywood movies, but cutting is an addiction with the same root causes as the more stylish ones. Self-harm releases endorphins and increases adrenalin, muting negative emotions like pain or anger and increasing your chemical ability to experience positive emotions like happiness or peace. It not only allows you to take out emotions on something (your own body), but changes how you actually feel.

Addiction? Cutting? I know it is not common to hear self-harm equated with addiction. But it is helpful when interacting with a self-harmer to see them through that lens. Just like you can't expect a cocaine addict to recover without extensive support, nor an alcoholic to never fall off the wagon, you have to have patience with someone who is cutting — and you must understand why they self-harm in the first place. People may become emotionally overwhelmed for a myriad of reasons. Obvious ones are abuse, sexual assault, and depression. But things like anxiety, stress, emotional numbness, broken family situations, or PTSD can also be catalysts for starting to self-harm. Anything you can think of may set someone down the path of self-harm.

Helping someone overcome self-harm is difficult for anyone — including someone like me who did self-harm. And it is hard to give generalized advice since the reason someone self-harms will affect how you and they deal with it. But, here are a few things to get you started.

1. Express that you care about them, no matter what they are doing. The stigma around mental illness in general, and self-harm in particular makes it an extreme risk to tell someone about self-harm. Don't be the person who confirms to them that who they are makes them unlovable.

2. Encourage them to receive or continue in psychiatric treatment and/or counseling. Again, self-harm is addictive and essentially a mere symptom of much deeper emotional concerns. Talking to you, an accountability partner, or pastor simply is not likely to bring them to recovery. They must address their situation similarly to any other medical condition using the best of therapy and medication (if appropriate). For me, leaving self-harm was abandoning the only thing that got me through the day. It takes a lot of help and strength to do.

3. Be careful how you ask what they do to self-harm. It can be very triggering to talk about. Getting a basic understanding of whether they are cutting or doing something else is legitimately important, since cutting can be far more dangerous than other forms of self-harm. But discussing tools they use or other details needs to be something you are certain they are comfortable and safe talking about.

4. If self-harm is done in tandem with drug or alcohol use, it is exponentially more dangerous, and you need to be even more emphatic about getting them psychological help or hospitalization. Substances dull judgment of how dangerous a behavior may be, numb the pain they are trying to inflict, thus requiring more extensive harm, and alcohol in particular thins the blood causing more blood loss than normal. To put it bluntly: accidental death is much more likely.

5. When hospitalization is necessary: This is a hard call to make from the outside. Essentially, if the person is considering or wants to perform self-harm that is likely to cause death or near-death, a psychiatric facility is likely in order, but not with 100 percent certainty. This is where a counselor is essential, as they will be more experienced in understanding when hospitalization is necessary. Obviously, if the person's psychological state advances to suicidality, hospitalization is a given.

Let me quickly address those common assumptions about cutting I mentioned above. First, cutting for the sake of attention certainly exists, though it is rare, in my experience. How do you deal with it? Not that differently than you do any other person's self-harming behavior. If someone feels so disconnected and uncared for that they are willing to injure themselves to get attention, then they clearly need help. Either they are truly isolated and neglected, or they have an additional psychological concern. Whichever the case, they need your love and help getting psychiatric care. Second, yes, some people cut "because they hate themselves," but it is never that simple. Generally that means a trauma caused them to feel incredible self-loathing, or there is an additional psychological concern that needs to be addressed. Again, give them love and help finding psychiatric care. Finally, "because they are insane" is a gross oversimplification. Yes, there is a mental health issue present, and statistically there are likely additional psychological factors such as depression, trauma, etc. However, the word "insane" implies they are beyond help or belong in a residential psychiatric facility, which is hardly ever true.

Self-harm has a lot of stigma and fear attached to it. While it is a terrible thing to be stuck in, and a difficult thing to watch someone go through, it is by no means hopeless. Never forget that no matter the stigma, Jesus always helped those in need. May we do likewise.

Note for those who self-harm: I found people who answered calls at three in the morning, let me crash at their home with thirty minutes notice, let me keep my job after multiple hospitalizations, and have never once stopped caring about me. If you are alone right now, please try to find someone again. You do not have to go through this without support. And if you are considering self-harm that you know is dangerous, please go to a hospital. I know you may not think of it as suicide, but if it could end in your death, you need the intervention a hospital can provide.

Image Credit: Brent Gambrell; "I blamed myself and began to drown in misery.; Creative Commons

TagsChristian-Life  | Depression  | Hardships  | Personal-Life

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Published on 1-18-16