In my experience dealing with mental illness and the many issues that have come with my particular brand (no two are completely alike), if I had to pick out the most stigmatizing element it would be self-injury. Over the years I’ve been told I was dumb, silly, attention seeking, a hard case, and even scary because of my self-injury. Some of the comments came from people who didn’t know any better, but at some point all of those adjectives were used by doctors or mental health professionals to describe me and/or the behavior. People really just don’t seem to get it, which is fair in my opinion, and are often quick to judge and make assumptions about me, and my mental stability, which is less fair. As a result, I’m going to focus on this topic for the next few posts. My goal is that whether you’ve engaged in the behavior or not, you’ll be able to identify with my experiences or at least better understand what’s going on here.
First, for those of you a less familiar with it, self-injury (aka self-harm or the lesser used and some consider more offensively named, self-mutilation) is probably most commonly cutting oneself, but also includes scratching, burning, hitting, head banging, or bone breaking. Whatever the mode, the point is that someone is purposely inflicting some kind of physical harm on themselves. In my experience, it’s not the what that trips people up, but the why and the how (how could you do that to yourself? Doesn’t it hurt?). I’m going to try to break those down here. But before I do, let me first clarify that, like mental illness as a whole, self-injury is also a very personal endeavor. There may be some similarities across people, but everyone has their own brand. These have been my experiences and although I have spoken to others who have generally agreed with me, mine are certainly not true for everyone.
I started by scratching myself when I was eleven years-old and have continued, on and off, ever since. I’ve had two-year stretches when I did not, but then something would happen and I’d find myself returning to old habits. As a result, I’m not sure if I’ll ever be able to say I’m 100% over it, though I would like to think that, this time, that is the case. I’ve done the scratching, cutting, burning, hitting, and head banging, though my most frequent mode has always been cutting. At times this has been at the more extreme end of the continuum. I’ve had stitches on four occasions, had to be hospitalized for an infection once, and on one occasion needed surgery to retrieve a pin I had lost in my arm. After so many years of repeated injury, both my forearms are pretty well covered in scars, along with a scattering on my stomach and thighs. I know it’s common for people to feel the need to cover their scars, but other than a brief period at the beginning of high school, I never have. It’s all part of the No Shame mantra for me (hold that thought for a future post).
Honestly, I don’t know. I suppose it makes sense to ask me how could you do that to yourself? but that’s never been a helpful question. In fact, I would advise against ever asking that question to anyone who does or has self-injured. Does it hurt? Sometimes, but that’s not really the point. As counter-intuitive as this may seem, although for me it could come out of a desire to hurt myself, more often than not pain wasn’t the objective. Often the most serious self-injurious acts did not hurt at the time. Granted I’ve always had a pretty high pain tolerance, but asking me with a look of astonishment or shock if what I did to myself hurt – when it did not – just made me feel even more like a freak or some kind of awful anomaly of a person than I already did (which is saying a lot).
This is something I’ve actually talked and written about a lot over the years, so is pretty easy for me to explain. When it came down to it there were two motivations and with each motivation came its own type of self-injury.
1) I was completely emotionally numb and needed to feel or see something that would reaffirm that I was still a real person. I did exist, was human, and the pain when I did feel it or at least the blood that I saw was proof of that. Without too much graphic detail, this motivation resulted in a larger number of cuts that were more superficial.
2) Everything was going so fast and felt out of control that I needed to focus on something to make it all stop. The best way I can describe this is that I became this ball of anxiety and felt trapped in my own body. Your heart is racing. You feel like you’re about to jump out of your skin. You just need to find anything that will take your attention away from this feeling and on something else. This motivation was more dangerous for me in my self-injury severity. All the anxiety meant that my already high pain tolerance was further elevated. The self-injury was fewer in number, but much more severe.
In either case, the initial goal WAS NOT suicide. I cannot make this clear enough. In my experience people often see self-injury and get freaked out thinking that the person wants to kill themselves when in the vast majority of situations this is not the case. Self-injury is actually a coping strategy. Maladaptive, sure, but I have experienced moments where it was one of the few things that was actually working to save me from a suicide attempt.
On the other end of the reaction continuum is the “they’re just doing it to get attention.” Particularly the case when the self-injury isn’t considered “serious” enough. Chicken scratches, as we used to refer to it on the adolescent psych unit (and look down on those who had them, but that’s a whole other issue and topic of conversation). At the end of the day, either the over or under-reaction to self-injury probably isn’t helpful to the people hurting themselves for whatever reason, but the under-reaction and denigration, I would argue, is the worse of the two. This issue of attention seeking is particularly troubling to me, and really requires a post of its own…
For my next post, I’ll pick up there. (See what I’m doing there? Establishing some suspense to keep you coming back for more.)
About Tracy Deyell
Tracy Deyell is a Ph.D. student living with major depression and bulimia. Follow her story on HMC’s Supportive Minds’d blog, or follow her on Twitter.