In this chapter, eight informative case studies are presented, seven by women and one by a man. Two show that self-injury is still active in the respondents’ lives; the remainder demonstrate that healing has been achieved. Each case study is summarised to draw out specific themes, and reiterate important learning components. The chapter concludes with two heartening testimonies and an overview of key points identified from all eight case studies.
Hurting Stories
Case Study 9.1: JulietI have been self-harming on and off for about five years. It was something I ‘learnt’ while in hospital with anorexia. I resented not having control over food any more and hated the fact that I was getting larger instead of disappearing. Initially I began to cut myself on my chest, arms and thighs. The cutting was fuelled by the repulsion I felt at my body and was directed particularly at areas giving me femininity. I was being forced to become an adult woman again and it frightened
me. The self-harm lessened for a year or so as the anorexia came back but then worsened again as I recovered from anorexia. It began to be closely linked with bingeing and other times when I felt very low or isolated. When my parents found out they were horrified and refused to talk about it. It was something that couldn’t be happening in our family and as such I felt terrible about it.
There have been whole months where I haven’t self-harmed, at other times it can be two or three times a week. It helps by providing a release for me – I can’t cry so my arm cries instead. I feel much more able to cope immediately afterwards, however within an hour or two I realise I’ve failed again and the shame and guilt thoughts and feelings set in.
Sometimes I don’t even know why I’m doing it – I just feel an enormous pressure building up, I get restless and edgy and something has to give. Other times it is linked directly to bingeing or desperation. Either way, I usually know a couple of hours beforehand that I will self-harm and that it’s just a case of how long I can put it off for. Part of me thinks that it doesn’t matter what I do to myself because it doesn’t affect anyone else (no one else knows about it) and I don’t like myself anyway. Another part of me knows that it isn’t a constructive way to cope and that I need to stop if only for practical reasons. I find it very addictive though and difficult to stop because it is so effective in releasing the unbearable hurt I feel at the time.
On one occasion I needed treatment for my arm when the self-harm was particularly bad about 18 months ago. Never again.
I was seen by the triage nurse then deliberately kept waiting for four hours while others arriving afterwards were treated first. Eventually, the psychiatrist I saw let me go on the condition that I came back for an appointment the next day. When I came back he told me I had to come into hospital or be sectioned so I had no choice.
It was one of the worst places I could imagine – I was woken in the night several times by various patients wandering into my room, one of whom was chanting. I discharged myself first thing on Monday morning.
The one amusing thing was the label the psychiatrist had given me – a ‘disorder of impulse control.’ Maybe I’m being cynical but Isuspect it was more for his benefit than mine since nobody explained anything about it to me.
I found very
little support available to me in either understanding or trying to stop self-harming. I believe, however, it is much more common than generally realised. There is a huge stigma associated with it – admitting to such a problem is in many people’s views tantamount to admitting madness.
I have encountered reactions such as shock, hostility, disgust and have been ignored because of it. I believe that self-harm is not seen as a high priority in the medical world because it is ‘self-inflicted’ and often seen as a cry for attention, when in fact sufferers can go to great lengths to keep such behaviour a secret. In my situation, no one knows about it except my GP.
I have been on anti-depressants for five years and have recently started having counselling once a week which I am financing myself since at least locally there is no suitable free or NHS counsellor. It is strange but in a nice way – trust is a big issue for me but I hope this will develop. It’s very healing to have a person there for me who accepts me unconditionally and I’m finding it is taking some adjusting to! We look at various issues such as expressing emotions, relationships and anything which I think is important to talk about.
What helps most is for those trying to help looking beyond self-harm to the person themselves – valuing them as they are and for who they are. However, I would like to see more help available for people who self-harm and to see health-care professionals better educated about it.
Attitudes must change in society too because criticism and condemnation only add to the shame and guilt felt already by the sufferer. With understanding, acceptance and love, the isolation felt by the individual lessens and with continued support I believe the need for self-harming patterns of behaviour can be left behind for good as new, constructive ways of coping are learnt.