It’s something not widely spoken of publicly. It’s something even less often understood. Self-injury (aka self-harm or self-mutilation) is not as uncommon as it is acknowledged.
Before going further, let’s get some facts and figures out of the way:
– An average of 1 in 5 females and 1 in 7 males will self-injure in a given year.
– Self-injury is linked to illnesses such as depression, bipolar disorder, OCD, anxiety, substance abuse (that is not a complete list)
– Not everyone self-injures for the same reason
– Most individuals who self-injure are NOT doing so in order to complete suicide
– Those that self-injure are not screaming for help; and are not just looking for attention (the majority hide what they’ve done)
– Around 2 million cases of self-injury are reported annually (more instances are out there, but few are reported)
– The most common forms of self-injury are skin cutting (70-90%), head banging/hitting (21-44%), and burning (15-35%)
On to the more personal aspect of this blog post.
Let me start with: I have NSSI. That stands for Non-Suicidal Self-Injury. I have no intent to complete suicide.
I don’t remember when I first self-injured (going to use “SI” in place of “self-injury” for the rest of this post). Honestly, I don’t. I think I must have stored memories from that time in my life somewhere in the back of my mind and haven’t been able (or willing) to find them again. My friend, Diana, told my therapist, during a session she attended, that I did it while I was her volunteer. Cassandra, my therapist, asked me about it. I gave her the answer I gave at the beginning of this paragraph. Diana’s response was, “You would come in in the middle of summer wearing long sleeves; and wouldn’t roll them up other than by accident.”
I do, however, remember when the act of SI began again. I LOVE Kay Redfield Jamison’s book “An Unquiet Mind.” I decided it would be an absolutely wonderful idea to read her “Night Falls Fast: Understanding Suicide.” That wonderful idea quickly took a damaging turn. The first chapter of the book had me beyond upset. It went into how suicide was viewed in countries across the globe- It was illegal in some countries through the late 1980s; and if you failed your attempt, you were thrown in prison and sometimes tortured. The chapter also went into how it was viewed by various religions- One preached that if you complete suicide, you would spend eternity in the 7th layer of Hell as a burning tree. I started searching everything I could on the subject. I approached a friend about how the Nazarene church (the Christian denomination I belong to) looked upon suicide; and I spoke to a nun, where I was working, about the Catholic Church’s view. I became obsessed and extremely distraught. I went on to the second chapter. It was fine. The third chapter started talking about a successful young man… Can you guess where the chapter was going to be going? Yeah, so could I. I wanted to finish the book, but Cassandra pointed out to me that that 2 out 3 chapters being upsetting- those aren’t great odds. Needless to say, she made me get rid of the book.
Those pages did more than just upset me. It triggered me. The SI began once again [and led to the visit Diana attended]. At the time, the SI, while not good, was minor. I’d use a pin and scrape it across my skin. I’d have marks, but they were extremely small and healed quickly. I couldn’t imagine using anything more than those pins, but I still had a friend keep all the sharp objects I had in my house over a weekend at one point. We, through my art journal and therapy sessions, worked passed the book and the SI went away for a bit.
The SI reared its ugly head every so often over the next several years. Slowly, it has gotten worse. I changed “instruments” a little over two years ago. I was going up and down, the anxiety was beyond bad. I had a new symptom that went along with the anxiety. My speech- I could barely pronounce words let alone string sentences together. That pin wasn’t doing it anymore. And those devices I couldn’t imagine using… I used them. (QUICK INTERJECTION- I want to point out that there are times in going to a psychiatrist or therapist that you have to be honest with questions that you never want to have to voice the answer to.) Both my doctor and therapist had to look at what I had done; and both proceeded to ask what I used. The answer was a knife. “What kind of knife?” After a pause, “A serrated one.”
This time, the marks, while light, didn’t go away completely. Scars that most would never notice. I did though. Every time I looked down. Again, with the help of Cassandra, I moved passed the SI for a bit. When it started again a mere few months later, I attempted the Butterfly Challenge. The challenge: draw a butterfly wherever you SI. If you SI before the butterfly fades, you’ve killed the butterfly. Obviously, butterflies don’t mean all that much to me. I went to the barn and was just hanging in Zoe’s stall. I was devastated. Neither flicking myself with a rubber band nor the Butterfly Challenge worked. Debbi came over to the stall. I told her about the challenge- and about how I failed it. She told me to follow her. We went into the barn office, she sat on my lap so that I couldn’t see what she was doing, and she got a permanent marker out. When she was done with my wrist, she showed me what she had written: Zoe. Debbi told me, “You’d never hurt her. You and I both know that you would never intentionally hurt Zoe.” I had to show Cassandra the cuts the following day, but she was more than okay with me writing Zoe again.
I was a bit manic when I went to the tattoo shop and had Zoe’s name permanently placed over the faded white on my skin. I was so excited that this was going to cover the haunting stripes and it would prevent more. Cassandra, forever my tie to reality, pointed out that while she wasn’t angry over the tattoo, she wanted to make sure I understood that if the urge to SI became strong enough, I would simply move to another location.
I hate when she’s right. Just as she said I would, I switched wrists the next time SI became a must. I say a “must” because when my OCD mixes with mania or anxiety, SI is a thought that doesn’t go away. It’s an obsession. I can visualize myself doing it. I can see it in my mind’s eye a clear as day. Cassandra has given me assignments for my art journal to do when the thought starts to occur with the intent of keeping my hands and head busy. The assignment works for a short time, but the obsession quickly becomes uncomfortable. I twitch. I pace. My mind won’t shut off. I crawl out of my skin. Relief is only obtained by the back and forth of the blade. On a mild occurrence, one act is enough. Other nights, I don’t get so lucky.
The last time I took part in SI was this past August/September. The cuts were deeper. The scars left behind are ugly. I wasn’t manic. My anxiety wasn’t sky high. The incessant thought took over my thoughts like a thief. I’d go walking at night in hopes that if I walked long enough, I could go home and just go to sleep. As I walked, however, I saw myself with my beloved knife drawing across skin. I’d walk faster, rubbing over Zoe’s name, trying to get the image to leave. When I couldn’t handle my journeys around the block I’d go home, still rubbing my wrist in a futile effort for relief. This round of SI was pure OCD- and it won with a score of seven.
Another uncomfortable conversation with my psychiatrist. It was obvious that the SI was worse. When I say that, I’m referring to the depth and number of cuts. We started by addressing the usual- Are you suicidal (they have to ask that)? How are the mania symptoms (we tick each off one by one? Depression? Anxiety? We went on to going
over what I used (she needs to know if I’m using the same thing), whether I make sure what I’m using is clean, and if I’m making sure to clean the wounds after I cut. She went over the best soap to clean the cuts with, the need to keep them covered with gauze, and the emphasis on doing my best to avoid infection. This was a subject we have touched on, but not one that she had went into this depth with before.
At NAMI, they noticed the gauze. They asked. I answered- honestly. They made sure I was keeping it clean; and they made sure I knew I could call any of them at any time.
I am not proud of SI. I have, however, come to terms with doing it. I go through emotional stages after compulsion passes [and that’s what it has become]. Grief, embarrassment… I don’t have blinking lights pointing to my scars, but I don’t hide them.
I will never say that SI is a healthy coping mechanism. In the same breath, however, I will say that no one should be condemned for it. They shouldn’t be made to feel ashamed or guilty or less than the amazing person that they are. The people that may seem the most put together could be battling SI in silence. Ending the stigma around it will hopefully help people reach out for help- if only to talk to a friend about what’s going on.
If you want to help someone struggling with SI:
– Ask how they are feeling
– Do not be judgmental
– Do not make them feel guilty about the effect it is having on others
– Let the person who self-harms know that you want to listen to them and hear how they are feeling when they feel ready and able to talk.
– When they do discuss it with you be compassionate even though you may not understand or find it difficult to accept what they are doing.
– Do not give ultimatums such as ‘If you don’t stop self-harming you have to move out’.
– Understand that it is a long and hard journey to stop self-harming.
If you need to talk to someone:
Text CONNECT to 741741
Suicide Hotline 1-800-273-8255