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This brief post is just to try and widen readership - more to follow from the underbelly soon

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Double-edged sword - Two sides of the blade

One of the reasons I started this blog was my incessant irritation of people’s attitudes towards self-harm. And yet, I have my own conflicting emotions in talking to and working with people who hurt themselves. It is possibly one of the most complex things I have come across and yet widespread views continue to purport it as straight-forward “attention seeking”. A caveat to what follows – I am not suggesting for a moment that self-harm is a great idea, but I do want to ask some uncomfortable questions.

I have often wondered what exactly is it about self-harm that triggers us so much? Listening to someone talk about how they want to cut themselves is painful, but why does it cause such an emotionally violent reaction in the listener? Self-harm can be conceptualized along a continuum and includes anything from smoking, drinking, taking drugs, gambling, spending too much, working too hard, risky sexual behaviour to sky diving and driving too fast. But we seem to place cutting, burning, hair-pulling and small overdoses on a completely different scale.

They are all ways of numbing pain, self-medicating or ways to feel alive. Some of these ways of coping just seem more palatable than others. Ironically alcohol and smoking cause more long term physical damage than cutting usually does. Of course there can be damage and scars. And anyone using unhealthy ways of coping will have an impact on those around them.

"We fear violence less than our own feelings. Personal, private, solitary pain is more terrifying than what anyone else can inflict." Jim Morrison

But there is a terror that comes along with watching someone hurt themselves. A helper’s helplessness. A paralysis in our lack of understanding that physical pain can temporarily relieve unbearable emotional and psychological pain; our disbelief that searing pain can shock someone out of psychological dissociation, that it can make them feel alive when they feel dead inside. When we label self-harm as suicide attempts, we miss the point entirely – they are mostly an attempt to stay alive, an attempt to live through the pain, relieve pain or feel alive. When we can see this more clearly perhaps we can actually have respect for the person who self-harms in their fervent attempts at life – not death.

But still it hurts to hear. We find our empathy and compassion draining away. We cannot adjust our vision to see through this lens on the world. It is a foreign emotional language and we cannot seem to grasp the translation. So we barricade our hearts against it, we shield our eyes from the ferocity of the blazing pain, as though it was burning us simply by standing beside it.

If this is how it feels to listen to someone’s desperation when they want to hurt themselves, what must it be like to be trapped inside that? To know no other way to find relief and yet be caught in this cycle where harming themselves also comes loaded with feelings of shame, failure, guilt, remorse, self-blame and self-loathing. And then to be met with more shame from the accusing voices of others. You’re wasting my time, you just want attention, oh it’s you again…

We should be yelling with celebration – oh it’s you again – you survived, you’re alive, you’re not dead. How very very brave you are.

Dr Murphy - signing off

Dr strange loves ruined things

One of my strange loves is broken, ruined buildings, like the photographs I found to go along with this post. The imagining of what they once were is not so different from imagining what could become of broken lives. I think that is one part of what draws me to this work.

What happens when your belief system comes crashing down round about you or shifts beneath your feet? Maybe you believed the world was a just and fair place – then you lost your job. Maybe you believed in true love that would last forever – then your partner left you for someone else. Maybe you believed in the innocence of childhood – then some small person you care about was abused. Maybe you believed you were invincible – then you got physically ill or disabled. Maybe you believed all babies were perfect – then yours wasn’t. Maybe you believed in family – then yours broke. Maybe you believed in the natural order of things – then you had to bury your child. Maybe you believed the world was a safe place – then someone attacked you. Maybe you believed in the sanctity of life – then someone you loved ended theirs. Maybe you believed in the power of your own mind – then you lost it. What if you believed in yourself – then one day woke up and didn’t recognize yourself in the mirror?

What happens when the things we place our faith in begin to disintegrate or disappear? We can make a choice to continue to battle against the reality of our situation. This sounds something like the mantras of “it’s not fair” or “it shouldn’t be this way” or “there must be a way to fix this”. Another choice is to shut down our feelings and reactions and just “suck it up”, “stop whining and get on with it” or “pull yourself together”. Another choice is to fall apart, disintegrate and disappear along with our beliefs. For some people life’s situations are so overwhelming that life itself feels like it is no longer an option. Death becomes a choice, in fact, it becomes appealing.

In a state of heightened emotion or psychological trauma, cognitive function can shut down. Coping strategies and problem solving skills become impaired as the brain is overloaded with the stress hormone cortisol. Thinking becomes like the mental equivalent of running a marathon in a pantomime horse costume. The weight of death bears down like a blanket of metal chain-mail.

It is a dark place and yet, a flicker of life remains. The human instinct to live powers through our lifeblood. We will protect ourselves, to the death. We will fight off wild animals, attackers, the enemy with a rifle, fire, floods and tornadoes. We will find ways to stay safe. Indeed, this is the paradox which we label anxiety. When our fight, flight, freeze response, inbuilt for protection of life, goes into overdrive – this is often perceived as weakness. Anxiety and panic attacks paralyse and yet they are designed to protect our very lives.

“There is a vitality, a life force, an energy, a quickening that is translated through you into action, and because there is only one of you in all time, this expression is unique." Martha Graham

Anxiety, which some camps claim can be sorted with a dose of short-term therapy, is underestimated in its force to drive people to the brink of suicide. It is also one of the things that drives people to harm themselves - unbearable emotion. Self-harm is more often about trying to stay alive than to die. It is a perfect parallel with the process of suicide – to protect ourselves from pain. Because suicide offers a chance to kill the painful internal torture.

And yet, life flickers, in the darkness. Let’s not take our eyes off it.

Dr Murphy - signing off with gratitude for the wave of support I have received in my new venture (ps - pics are my own)

The dark underbelly of mental health

I believe there's a space in between where unspoken words hover un-uttered, un-written and unheard. Maybe they shouldn't be said then, maybe there's a reason for not saying them out loud. But I am curious…what might happen if I start to talk about the things that hurt - where it hurts? I have few answers, but I have a lot of questions.

Oh right! That might mean a diversion from my familiar and comforting "look on the bright side" platitudes and slopping around in buckets of statistics to take a risk and poke about in the underbelly of mental health, the dark side of suicide and the edge of self-harm. Anyone interested in coming along…

Let me explain, I've spent the past 10 years talking almost every day about suicide - with people, for people, about people. I train, I talk, I read, I write, I study. I listen. I repost all the wonderful amazing efforts of those I know around the globe who also do this work, but I realised that I also want to talk, I have something to say about how it feels to be this person who spends a lot of her time surrounded by death and pain and struggle and survival - and I suspect other people might have something to say about this too. So that's the stuff that hurts.

The where it hurts - is maybe a little more controversial. I'm interested in this because of the chasm that is often portrayed between personal and professional interest in these topics. There seems to be a grand canyon between survivors, service-users and the professionals who get paid (or sometimes not paid) to help them. This spans everything from statistics that tell us barely anything about anything, not least why suicide always has been and continues to be part of the human condition, to a consistently harsh treatment of people who self-harm by certain groups of professionals.

What's up with that? Why is there still such a lack of understanding for people who try to take their lives, or hurt themselves? Why is it so hard to listen to death and pain - do we think we're going to catch it? Are we scared that finding empathy for someone in that darkest place will touch our own buried pain or cast shadows on the illusions of our lives? For me, personally, it is about acknowledging our own humanity and fragility and that sometimes when we are in that deep dark pit with someone that we can feel it tugging at the edge of our own consciousness.

There are training courses to tell us what we should be doing, what's helpful, what works - I know, I deliver them, I believe in them completely. I am all behind the research that is looking at protective factors and the resilience that keeps people on this planet alive every day, despite pain and unbearable circumstances. But I am also interested in all the spaces in between, what are we not saying - maybe there's some gold dust in there?

“Irrespective of any external, regulatory force, our capacity for feeling is in itself an insatiable and bottomless abyss.”

Émile Durkheim

And I'm not going to feign altruism for a moment, that I'm blogging for the greater good. I am curious about what I have to say and what anyone else out there has to say too and I am hoping that getting into the habit of writing regularly will kick my ass into gear to produce at least one of the books I claim to have hiding inside me - the current idea is dark and twisty and all about death and funerals - ah the lure of exploring an entirely fictional world…
Dr Murphy - signing off