Self Harm Awareness
SIAD (Self-Injury/Harm Awareness Day)
Freya Bryson (PGDiP, UKCP Member)
The 1st March SIAD (Self Injury/Harm Awareness Day) is an international observance aimed to raise awareness, compassion and understanding for self-harm, which so often remains private and silent.
Self-Injury and harm is a very sensitive subject: there are myriad reasons why someone might inflict harm upon themselves. I have found that all too often we have a specific culturally informed and stereotypical image of self-harm as something a younger person, an adolescent perhaps, might do in a more overt way such as through cutting themselves.
However, when we investigate self-harm, this seemingly counter-intuitive phenomena covers a range of behaviour, with corresponding scales of risk and harm, in which the person willingly or less consciously harms parts of themselves to obtain a pay-off.
What is Self-Harming Behaviour?
When we think of behaviour that hurts the self, we may have a knee-jerk reaction in thinking that it is nonsensical. Perhaps a way to broaden our understanding is to consider self-harm as a spectrum of behaviour: binge-watching Netflix until late knowing that the lack of sleep tomorrow will hurt your future self or, drinking too much at a social engagement which leads to a hang-over and a bout of anxiety. The reality is that most of us - at some point - have engaged in some form of self-injurious behaviour.
However, my experience as a former self-harmer and as a psychotherapist who works with people who self-harm is that these counter-intuitive self-injurious behaviours often have a particular pay-off or desirable outcome under the surface. If we can put aside our initial fear and listen deeply, respectfully and compassionately to someone who is being brave in talking vulnerably about their self-harm, often underneath there is a reason why such seemingly counterproductive behaviour is desirable.
Why Do We Seek to Harm Ourselves?
For some people it is a way of witnessing their internal struggles and pain - a way of making tangible more internal and abstract suffering. For some it is a retroflected emotion, such as anger which, with no other seemingly safe outlet, turns inwards. For others it is a way of gaining relief, for some a way of expressing pain to others without words, for some a response to feeling the need to self-punish.
Often it is a way to cope. The reasons can be manifold and specific to each individual. In my practice, if I can listen compassionately without judgement, offering permission for candid discussion around self-harm, this allows internal suffering to be voiced, witnessed and held.
This creates an environment in which pay offs have a chance to be discovered and alternative methods of gaining the pay-off can be explored and met, creating shared understanding and connection.
How Therapy Can Help with Self-Injurious Behaviours and Patterns
Of course, where there is harm, there is a risk and safety is paramount. As much as hearing about self-harm may provoke understandable concern and fear, responding with fear, anger and exasperation to a person who is engaging in self-injurious behaviour can be felt as shaming,which increases their likelihood to withdraw. This may further their risk if they continue to engage in self-injurious behaviour without help.
This is where therapy can be vital in providing a safe, non-judgemental environment with people who have the expertise to manage risk and provide a space in which self-injurious behaviour can be met with compassion and mutual solutions can be found.
