UNDERSTANDING SELF-HARM: AN EMOTIONAL RESPONSE
March is “Self Harm Awareness Month” and March 1st has been specified as “Self Injury Awareness Day”. Mental health professionals are highly concerned with such conditions that elicit self harming responses. Plenty of research work has been devoted to find out reasons behind it and identification of possible preventive as well as treatment programs to manage the condition. Literature suggests labelling of the condition most commonly as ‘self-harm’, ‘self-injury’ and ‘self-mutilation’. “Self-harm can be understood as deliberately harming surface of one’s own body mostly by cutting and burning, and less commonly by scratching, interfering with wound healing, pulling hair, hitting or punching and piercing the skin with sharp objects”. It is typically a non-suicidal behaviour; or, differently saying an unhealthy way to cope with excessive frustration, anger and emotional pain. Most of the times individuals who attempt for self harming behaviours are themselves unable to explain the reasons behind their harming acts; however, most common responses are described as ‘temporary way to wipe out emotional or mental pain’. Such behaviours usually have an addictive quality and individuals who attempt for such behaviours once, keep continuing it in future also. Although Self harming behaviours give temporary relief to those who attempt for it but usually it is followed by excessive guilt, shame and relapse of their emotional disturbances. Common signs and symptoms of self harming behaviours include scars, fresh cuts, blood patches on cloths, keeping sharp objects, covering full body even in hot weather, emotional instability or impulsivity, unpredictable intense emotional response, feelings of helplessness, hopelessness and worthlessness, and difficulty in sustaining social/inter-personal relationships. Most commonly identified risk factors for self harming behaviours include:
- Teenage and early adulthood where individuals face peer pressure, loneliness and conflict with authority figures.
- Mental health concerns like depression, borderline personality disorder, anxiety disorders and post-traumatic stress disorder.
- Influence of alcohol and other recreational drugs also triggers self harming behaviours.
- Certain life experiences like physical or sexual abuse, emotional neglect, unstable family environment, issues with parents etc. provoke self harming acts.
- Company of individuals exhibiting self harming behaviours may lead to trial of self harming acts and persist in future.
Self harming acts carry a variety of complications with them such as infection in wounds, permanent scars and worsening of shame and guilt feelings; however, the most complicated situation associate with it is the “risk of suicide”. Although self harming behaviours are not intended towards suicide but they definitely include high risk of the same due to intense emotional distress.
As a primary care response it is essential for the family members of the sufferer to notice and identify risk of such condition and take adequate action. If the condition belongs to their child it is essential to talk to their paediatrician or health consultant who could refer them to a mental health professional or a child therapist. If the condition belongs to a college going boy or girl it is important to talk to their school/college counsellor to understand the issue adequately and avail necessary opportunity for psychological treatment. If the condition belongs to mature adults it is essential to be calm and have a discussion on what is going on and identify possible causes behind it. Also, there is a need to take your family member to a mental health professional to deal with the problem more effectively and provide adequate management plan.
The condition is very common yet less understood in our community. This article is an attempt to make people aware about this condition and take appropriate action toward its management. Mental health professionals have been able to understand and manage the condition well with medication, psychological and psycho-social interventions. Now, it’s the responsibility of society to avail services and help their loved ones.
If you have any query related to this article or any other mental health issue, feel free to write me back.
Consultant Clinical Psychologist