Self harm is one of the most misunderstood coping strategies. So, why do people do it?
To an onlooker, self-harm makes zero sense. You hurt yourself, causing pain and an injury. The injury requires medical attention. You refuse to talk to the people who want to help. And then you do it again. And every time someone offers to help, you turn them away. But you say you want to get better. How are you going to get better if you don’t accept help?
Simply put, self harm is a way of coping.
We’re going to look at the reasons why people self-harm. We’ve already covered why self-harm isn’t attention seeking. But to recap… It just isn’t.
So, if it isn’t attention seeking, what is it?
Simply put, self harm is a way of coping. We all have ways of coping. They might be to go for a walk, have a long bath, or drink all the wine.
For the most part, these coping strategies will be helpful and reduce stress. And this is the paradox with self harm. It doesn’t looks like it is helping. But it is. And it doesn’t looks like it is reducing stress. But it is.
To understand self harm we need to see it from the perspective of the person self-harming, not the perspective of the onlooker. Over the years, the reasons people have given me for why they self-harm has generally fallen into one or more of four groups.
Because I Deserve It
When a young person has been through traumatic and abusive experiences, they can be left wondering if it was all their fault. They may have been told that it was their fault by parents or someone close. They may have come to believe it.
For instance, I know of a 9 year old girl who was told repeatedly by her mother that it was her fault her younger sister had been killed in a car accident.
Punishing themselves relieves the distress caused by their shame and guilt.
The young person can then feel guilty for having any enjoyment in life; “Why should I have fun when…”. They deny themselves pleasure. Punish themselves if they have had a good day. Make themselves live in unpleasant circumstances. They may punch and bite themselves, pull their hair, disfigure and disable themselves.
Punishing themselves relieves the distress caused by their shame and guilt. No approach to supporting a young person in this situation is going to gain any traction unless it is grounded in self-forgiveness.
It Relaxes Me
Stress is a peculiar thing. It’s highly unpleasant, you don’t want it, but you can’t just will it away. And when we’re overwhelmed with stress and anxiety, our brains stop working properly.
We lose access to the very parts of our brains that could actually be helpful to us: rational thought, intuition, memory, problem solving. When we are overwhelmed with stress, we are stuck in the present, hyper-alert to threat and unable to think about anything except how uncomfortable we feel.
Self harm, and particularly cutting, can help to alleviate that stress. People say that their stress literally flows out of them in the blood that escapes the wound.
My Pain is Visible
Mental and emotional pain are invisible. They’re not like a broken leg; you can’t point at them and explain why it hurts so much. Especially for young people, emotional pain is very difficult to communicate. They worry that they won’t articulate it clearly and the other person won’t understand or believe them.
Self harm can be a way of saying “This is how much it hurts to be me”
Self harm can be a way of saying “This is how much it hurts to be me”. It is a physical manifestation of their inner world, scarred, damaged, ugly, and painful. It makes their pain visible to themselves and, potentially, to others. This is absolutely not attention seeking.
In fact, many people who self-harm for this reason also cover up their injuries. Just because you want your inner pain to be visible doesn’t mean you want the world and his wife to know.
It Makes My Other Pain Go Away
Unlike physical pain, mental and emotional pain don’t go away with a paracetamol. For some people, self-harm is about converting mental and emotional pain into physical pain. This reduces the intensity of the emotional pain, making it more manageable.
It’s not uncommon for people who hear distressing voices to self harm. In these cases, the self harm helps to reduce the volume and intensity of the voices.
Self harm focuses the mind, making the rest of the world disappear
When the world around you is a frightening and full of danger, self harm can make it more muted. It can help to turn the dial down on the outside world. Self harm focuses the mind. By concentrating intently on hurting yourself, the rest of the world can disappear.
There are other reasons why people self harm, this isn’t an exhaustive list. But it does highlight how the people who self harm benefit from doing it. By understanding how they benefit, we can help them to start finding other ways of achieving the same goal.