“There’s nothing to stop you shutting yourself up in your room, cutting, and then going back out again. That’s the amazing thing about self harm, you can have the happiest face on but inside, you can be screaming.”
Self-harm is a secretive condition, smothered under long sleeves and trousers which hide the telltale signs. For something that most people probably find impossible to understand, it is not uncommon. According to the Royal Institute of Psychiatry (RCP), about one in ten young people will self harm at some point. That’s equivalent to two or three people in every secondary school classroom in the country, and it’s four times more likely to affect girls than boys. The RCP also says that gay or bisexual people appear to be more prone to self harm. People who self harm are not mentally ill; however they still desperately need help.
I spoke separately to Lily (above) and Amy, both successful undergraduate students about this addiction which has plagued them since they were young girls. Amy, a first year, has kept her habit secret from her parents since she started to cut herself aged 12.
“I’ve been doing it for eight years and my family has no idea. I wouldn’t have the heart to tell them. I first started self-harming when I was in secondary school, mainly because I was being bullied and had a very negative self image. I thought anything I did to myself, no matter how much it hurt, could only be an improvement.”
There is not always a clear trigger or reason that someone begins to self- harm. Unlike Amy, Lily cannot pinpoint a cause, or even remember the first time she cut herself, just the surge of emotion which lay behind it: “I don’t think it was ever a conscious decision of, I’m going to sit down and cut myself, it was more feelings of so much pent up anger inside of me and that I just had to let it out. I don’t remember the exact time or the exact moment, but I used to use my nails and it was just a form of release when I was just so frustrated and so angry with myself that all I could do was just attack myself, there was no other option”.
The methods self harmers use to attack themselves are varied and inventive, and all deeply personal to each individual. They range from hair pulling, to burning, bone breaking and interference with wound healing (like picking out the stitches from previous cuts). The most common form is cutting. Like a drug, what ‘works’ at first can soon cease to achieve the desired effect. Lily started self harming using the most basic instrument she had, her own nails, before she “progressed onto knives and razor blades” after a month or so. The ‘ritual’ becomes commonplace, and what would once have been taboo broken. She explains:
“When it becomes more of an established thing – when you realise that you need this to keep yourself going, to keep yourself feeling human – then you start thinking more inventively, more creatively… yeah you just think, I could use this, I could use this. It’s quite a morbid process really”
The secrecy which Lily managed to maintain for a period helped her to justify her actions; if no-one knew, no-one but her was suffering, so no damage was done. The damage she did herself doesn’t appear to have factored in her reasoning at the time. Her own pain didn’t matter, as long as those around her were shielded from it.
“I didn’t want to stop for a very long time, because I felt like I deserved it, like it was a way in which I could keep on going because I’d punished myself, therefore I was more worthy. I was allowed to keep going because I’d already cut myself or scratched myself. And because no one knew about it it wasn’t affecting anyone except myself, it didn’t matter. So it wasn’t really anything I thought of stopping”
It seems that self harmers, by their very nature, suffer from low self esteem. Another recurring emotion is anger, anger which cannot apparently be released in any other form than that of physical pain, and isolation, meaning there doesn’t appear to be anywhere else to turn. Self harm is almost a literal manifestation of self hatred; the self that they believe is worthless must suffer as punishment for its shortcomings. Self harmers typically have difficulty controlling their immediate impulses, and don’t see themselves as ‘empowered’ enough to do so anyway. This makes resistance when the urge to harm takes over far more difficult than a person who has never experienced it might imagine.
Ironically those who suffer are frequently high achievers – clever, popular, and talented, those whom others would least suspect of having problems, or indeed deserve any form of ‘punishment’, physical or otherwise. By way of illustration, Johnny Depp, Angelina Jolie, Colin Farrell, Christina Ricci and Courtney Love have all spoken openly about their own experiences of self harm, and countless other celebrities (such as the late Princess Diana) are known to have self harmed at one time or another. For some self-harmers the desire to maintain their high standards can make anything less than the absolute best appear inadequate and thus a failure. It is this failure for which they do penitence in the form of their abuse. Lily explains the difficulty in letting go of these feelings:
“It’s been a lot better in the last year, but there are still situations where I feel bad about myself. If I’ve done something wrong, if I’ve had an argument with someone, if I’d upset someone, if haven’t achieved academically how I wanted I get the same feelings of intense anger and hatred. It all comes back again and it’s just this absolutely overwhelming sense loathing and you can’t get rid of it any other way unless you cut yourself, nothing else will do.”
Although harmers gain some temporary ‘relief’ from their habit, the practise itself can perpetuate the very feelings of inadequacy which led them to self harm in the first place. Amy described this conflict: “There is usually a feeling of immense relief while doing the cut. There is something stimulating about taking control of your pain and your feelings. It’s also a very personal thing, something no-one ever has to see. Afterwards the guilt and shame generally take over. Usually the pain doesn’t bother me, but sometimes it can be unbearable, making you feel stupid on top of everything else.”
The stigma which surrounds self harm makes it still harder for anyone suffering to come forward and seek help, the fear of shattering the carefully cultivated image of coping the cost of admitting you’re not, seem too great. Lily is in her third year, and has also been self harming since she was 12. Her family have known about her habit almost from the beginning.
“My Mum knew I was depressed and I was having therapy at the time. The therapists asked me quite straight up, did I self-harm, and I said yes. They obviously told my Mum and she was aware about it, but I hid it. As the problem got worse she began to realise that I was getting worse and she started checking me every night before I went to bed. My main focus points were my wrists and my shoulders, and she used to check these every night to see whether I’d done it or not.”
Looking back, Lily is appalled by the thought of what her mother must have gone through. “Watching her daughter deliberately physically abuse herself over and over is just absolutely horrific to contemplate. At first she never let it show that it upset her, she was very functional about it. She’d do the checks and if she found something, she’d just ask me for the razor and take it away. Then as it went on she used to get more and more upset by it.”
Amy has never told her family, however her boyfriend is aware of her habit, and this has caused a great deal of tension within their relationship: “My boyfriend knows because he’s seen most of the scars, but this makes it very hard because its just another reason to feel guilty. We often have arguments about it, which drives me to want to cut again, so its like a vicous circle. I wish I could make him understand but I don’t think he ever will. He sees it as almost an insult when I do it.”
It is amazing nevertheless how much can pass over people’s heads- and how easy it is to hide self harming. I spoke to a girlfriend of Amy’s and the question of self harm came up. Amy’s friend agreed that it was certainly a tragedy that it was so widespread, however blithely added “At least I no-one I know is suffering, that would be so awful”. Lily agrees that it is all too easy to hide the fact that you’re injuring yourself- particularly at university, so full of distractions that an unmentioned problem can go conveniently unnoticed: “I remember going into my room and just falling to pieces, and then I’d come out again and be happy and my housemates would never know.”
Even more worrying is when, as, in Amy’s case, even those closest to them cannot (or perhaps will not) see what is right in front of them. “Occasionally my mum has seen scars and I’ve made excuses, which she has always believed.”
It is incredibly difficult to ask for help as a self harmer. Understandably, there is a fear of being judged, that one might lose the respect of everyone who thought that you functioned so well. The feelings which surround self harm – of isolation, inadequacy, and hypersensitivity to rejection, are exactly the type to prevent the kind of trust and confidence necessary to open up. Amy says: “Of course there is a social stigma around it. Emo anyone? I listen to metal and wear black. This is one of the reasons to keep it hidden. There is a massive sense of shame and guilt that it is hard enough letting people you’re close to know or see, let alone people who will judge you.”
Student life can make coping with an existing problem still harder; starting at university putting further pressure on someone already bowed under the weight of old stresses. Familiar support systems are gone; everyone is a stranger, and taking care of yourself on top of a degree workload can make maintaining standards still harder.
“I didn’t have the protective environment of my school any more. My first term was great and I had a really good time, but then in second term things got way more difficult. You get over that initial excitement of being a Fresher and going out all the time and you have to settle down, do work, make real friends. For the first time in a long time I started doing it again.”
She is adamant however, that if students suspect that a housemate or friend is self-harming, then they should not ignore their instincts. “People do it because they want help. Self-harm isn’t suicide, it’s a way of staying alive and it’s a coping mechanism. But there’s obviously something fundamentally wrong that makes a person do this to themselves. So if someone was to actively go up and say to them, ‘Is everything alright?’, then that can be the trigger for them to admit that no, everything isn’t right. I need help”.
It is naturally the people emotionally closest who can be of most help to self harmers in the initial stages of seeking further aid; however the responsibility is not with them to offer a ‘cure’ or become a counsellor. Lily stresses: “There are a lot of welfare systems in place, but students can be so anonymous. They also require the student to actively seek support, and if the student doesn’t do that and people have noticed that things are wrong, they need to be the ones who go to alert the welfare systems and then someone who is trained in welfare can go and speak to them and explain that they just want to know that they’re alright. But it’s making that first point of contact, and it’s then that friends can be so important. If people have gone to so much effort to hide it from their own families, they’re not going to open up to a doctor, it will be someone they can actually relate to.
Amy has never sought medical help. “But there have been times when I should have. I now have a scar across my stomach which is about 5mm wide and looks hideous. If I had sought help it might have healed a lot quicker, and not be as bad as it is now.”