The fifth part of our series, first published as a single article in the Healthcare Counselling and Psychotherapy Journal last year.
Because self-injury is experienced as a coping mechanism, it is a mistake for carers or professionals to push for a cessation of the self-harming behaviour.
Those who are trapped in the cycle of self-injury or self-harm feel under a great deal of pressure to ‘stop’. They know it is not ‘normal’ to hurt themselves, and because they worry a lot about how people perceive them, they will go to lengths to hide their self-injury and keep their emotional difficulties to themselves. Even those of us who can talk about self-injury do not want to become a burden to our friends and carers, so we play down our distress. The pressure to ‘quit’ is intense, and people frequently go through a Herculean struggle to resist the impulse to self-injure, often for the sake of others.
Parents, teachers and friends may feel that if the self-injury goes away, everything will be all right. However, focusing on ‘stopping’ self-injury, as if this is all that is wrong with a person’s world, is counter-productive. Such preconceptions drive self-injury underground, and people will be unable either to be honest or to discuss their secret hurt. Counsellors and psychotherapists, who rely on the therapeutic relationship with clients, may be better placed than most to know that trust and honesty are critical to understanding and healing.
With all the will in the world, resisting the compulsion to self-injure can be impossible over the long-term. In the short-term, people can consider distraction techniques and alternative activities, as described below. However, in terms of helping people to break away from a chronic reliance on self-injury as a coping mechanism, it is counterproductive for professionals to put pressure on people to ‘just stop’.
Rather than talking about ‘stopping’, I would suggest that counsellors discuss the idea of ‘moving away from self-injury and self-harm’ and replacing self-injurious behaviour with other, more adaptive coping strategies. If a person has new ways of dealing with upset, stress, mental ill-health and difficulties in their life, they have new choices and options regarding how to behave. If a person learns to seek health and happiness, and to be in control of their own life, they may then be able to leave self-injury behind them.
Coming next: Care for yourself and your clients.