Zoe feels depressed, empty, and numb. She lacks the energy to cope with the day ahead of her. The world around her seems fuzzy and unreal, almost as if she is wrapped up in cotton wool, and she cannot think straight. She lights up a cigarette, and starts burning circles on her thigh. When she begins to feel the pain from the burns the haze lifts and she feels different – she can think straight, she feels energised, more alive, more real, and she is ready to face the day.

Arabella is having a flashback. She is seeing vivid images in her mind of traumatic events that she experienced as a young child. She is terrified and feels very small. Her heart is pounding; she is sweating and shaking. She grabs a knife from the kitchen drawer and makes a cut on her left forearm. As soon as she sees her blood flowing, the frightening pictures fade from view. She feels calmer and safe. After carefully dressing her wound and cleaning the knife, she makes herself a hot drink, switches on her favourite record, curls up on the settee and quickly drifts off into a deep and peaceful sleep.

Beyond Reason

If read through the eyes of someone who has never self-injured, these fictional scenarios may have caused a furrowed brow of bewilderment. Perhaps the thought of what Zoe and Arabella do to themselves made you flinch, or you found yourself thinking something along the lines of, ‘But I just don’t get it – that’s horrible – how can anyone possibly do that to themselves?’ or ‘It’s beyond reason, it just doesn’t make sense’. Be assured that if your thinking took a similar route, you are certainly not alone. Self-injury frequently stirs up negative emotions in loved ones, caregivers and society in general. Typical reactions include shock, anger, revulsion, fear, and panic.

Self-injury is widely misunderstood. It is an uncomfortable subject to think about, to talk about, a difficult behaviour to accept, and dealing with the issue presents many challenges to caregivers. The motivations that drive self-injury are diverse, and the behaviour can hold a multitude of different meanings. Further, while those of us who don’t self-injure may ponder long and hard trying to make sense of the seemingly senseless, the behaviour usually, though not always, makes perfect sense to those who practise it.

Too Familiar

If read through the eyes of someone who self-injures, the scenarios may have felt too close for comfort. Alternatively, you may have felt reassured to know that you are not the only person in the world who self-injures – many think they are. Perhaps you don’t understand what makes you want to hurt yourself and that’s what drew your attention to this book; maybe you feel isolated, desperate, or misunderstood, and are wondering what to do for the best; or perhaps you are seeking ideas on how to stop or reduce the behaviour, or are considering seeking help.

My hope is that this book will bring those of you who self-injure comfort and reassurance that with the right help and support there is a road out of self-injury. Moreover, I remain optimistic that you will acquire some therapeutic tools to help you on your healing pathway. It takes courage and determination to leave self-injury behind, and it would be remiss of me to tell you that letting go of self-injury is an easy process. However, as you will see later in the book people do recover, or they manage to reduce self-injury to a more acceptable level. Often, the hardest step is the first one – admitting to having a problem and reaching out for help.