Self-harm: key facts
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1 in 10 people will self-harm by taking tablets; cutting,
burning, piercing or swallowing objects. It is more common in young
people, women, gay and bisexuals and in some sub-cultures. Some
people self-harm regularly - it can become almost an addiction.
What makes people
self-harm?
It usually happens in a
state of high emotion and inner turmoil. This may be caused by
abuse; feeling depressed; feeling bad about yourself or
relationship problems. You may do it because you feel that people
don't listen to you; hopelessness; isolation, feeling alone, out of
control or powerless. People who self-harm are more likely to
have been abused in childhood.
How does it make you feel?
Self
harming can help you to feel in control and less tense.
So, it can be a 'quick fix' for feeling bad.
What help is there?
Talking: Talking can help you to feel
less alone, to see your problems more clearly.
Self-help groups: People with the
similar problems can provide support and practical advice – and,
believe it or not, sharing your problems in a group does help
Help with relationships: Group therapy
can often help you to sort out difficulties in getting on with
other people
Talking
Therapy: Problem solving,
Cognitive Behavioural or Psychodynamic psychotherapy;
What works best?
All these treatments help. Some evidence suggests that
problem-solving therapy may be best.
What if I don't get help?
1 in 3 people who self-harm will do it again within a year.
People who self-harm are 50 times more likely to kill themselves.
The risk increases with age and is much greater for men. Cutting
can cause scarring, numbness or paralysis.
How can I help myself ?
When you want to harm yourself:
If you can ride out how you feel without self-harming, the
feelings will usually go after a few hours. You can talk to
someone, distract yourself by going out, sing or listen to music,
or do anything (harmless) that interests you. Try to relax and
focus your mind on something pleasant. Find another way to express
your feelings such as squeezing ice cubes (make them with red juice
to mimic blood if that helps), or draw red lines on your skin. Give
yourself some 'harmless pain' - eat a hot chilli, or have a cold
shower. Focus on positives. Be kind to yourself – get a massage.
Write a diary or a letter, to explain what is happening to you – no
one else needs to see it.
When the urge has gone: Think about
the times that you have self-harmed and what (if anything) has
helped. Go back in your mind to the last time when you did not want
to self-harm, and move forward in your memory from there. Where
were you, who were you with, and what you were feeling? Try to work
out why you began feeling like you did. Did your self-harm give you
a sense of escape, or relief, or control? Try to work out something
to do that might give you the same result, but that doesn't damage
you. Make a recording by talking about your good points and why you
don't want to self-harm. When you feel bad, play this back to
remind you of the parts of you that are worthwhile. Make a
'crisis plan' of what to do when you feel bad.
I don't want to stop
OK, but reduce the damage. If you cut, use clean blades.
Find ways of hurting yourself that don't damage your body (see
above)
If you can say YES to at least 3 of the questions below, it's
worth trying to stop?
- Are there at least two people who are willing to help me
stop?
- Do I have friends that I can go to if I get desperate?
- Have I found at least two safe ways that reduce the feelings
that make me self-harm?
- Can I really say to myself that I want to stop hurting
myself?
- Can I tell myself that I WILL tolerate feelings that make me
want to self harm?
- Is there a professional who will give me support and help in a
crisis?
If I harm myself and need treatment?
You have the right to be treated with courtesy and respect by
the doctors and nurses in the Accident and Emergency department.
Many departments have a psychiatric liaison nurse, or a social
worker, who can talk with you. Staff may want to go through a
questionnaire with you as a way of judging how at risk you are.
What can I do if I know someone who
self-harms?
- Listen to them without being critical. This can be very hard if
you are upset or angry. Try to focus on them rather than your
feelings – this is hard.
- Try to understand their feelings, and then move the
conversation to other things.
- Take the mystery out of self-harm by helping them find out
about self-harm on the internet or at the library.
- Help them to think about their self-harm not as a shameful
secret, but as a problem to be sorted out.
Don't
- Try to be their therapist – you have enough to deal with as
their friend.
- Expect them to stop overnight – it's difficult and takes
time.
- Get angry this may make them feel worse. Talk calmly about the
effect it has on you - in a way that shows how much you care for
them.
- Struggle with them when they are about to self-harm – it's
better to walk away and to suggest they come and talk about it
rather than do it.
- Make them promise not to do it again or make your involvement
conditional on them stopping.
Other organisations which might be
able to help you.
Updated: March 2007. For more in-depth information see our main leaflet
This leaflet is made available through the
generosity of the Charitable Monies Allocation Committee of the
mental health charity St Andrew's, Northampton
© (2007) Royal College of Psychiatrists. You can link to,
download, print, photocopy and distribute this leaflet free of
charge. But you must not change it or repost it on a website.
Please note that we are unable to offer advice on individual cases. Please see our FAQ for advice on getting help.
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