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