This isn’t a post about government cuts. This is a post about self harm. Bow out now if you think it’s not your thing, and consider yourself warned with all the other appropriate warnings so as not to trigger the vulnerable or induce vomiting in the queasy. Not that I’m going to be talking about anything particularly graphic. This is more a mini ponder on why the fuck it is that medical and mental health professionals ask how deep, bad or serious any injury is that you have done to yourself, but specifically cutting and burning.
I can understand that they need to establish whether you’ve got a graze, wound that needs dressing or stitching or whether you have maybe lopped off a finger. But that’s not the kind of questioning I am worried about. That kind of questioning is saved for A&E, when you generally whip out your wound because that’s why you’re there. And most sane insane people would not present at A&E if they did not need a dressing or stitches or whatever. So, by default presenting at A&E would mean it is serious, serious enough, right? The kind of questioning I am concerned with is the kind you get at assessment for a mental health service; the kind of questioning you get from a therapist, psychiatrist or psychologist. When they want to see your healing wounds or scars. And what it is that they do with that intelligence gleaned from an ogle at your damage.
There’s three points I have beef with. Number one is that wounds and the depth or severity of those wounds do not directly reflect on the damage going on upstairs, inside your brain. Number two is that the very asking of these questions pose a number of reactions, the worst being internal thoughts, that a patient will have. Do they not believe me? Have I done it badly enough for them to care? Will they laugh at my self harm? Will they talk about it to others? And finally number three, the fact that self harm on the most part is a highly private matter for most people, myself included, and just like bulimics don’t purge with the bathroom door wide open I’m fairly sure most self harmers don’t want their damage on show for all to analyse.
On the first point, and I should start by saying that I have gathered this information from friends and personal experience, some of the worst damage done to oneself is often when pissed, high or in a dissociative state. The deepest cuts and toughest burns have sometimes been made accidentally. Not the act of self harm, but how severe the damage is, and this might not relate to being most upset, it might just relate to being less careful. You might not go to A&E and you might end up with a rather fat scar on your arm. And in future times you might be questioned about that, it being presumed that you made the injury at your lowest point. But instead you say, “Oh that? I was just pissed.” And all the many millions of little scars, nicks, tears and welts, they might end up overlooked, all the signs of your daily, undending upset and frustration, just ignored or summed up with the tag of superficial, in your eyes, meaningless. And that can lead to further upset.
That brings me on to my second point. What other people think of you. What they are thinking but not saying. You let them in to this very private world that no one sees, and it takes you forever to roll up your sleeve or trouserleg, lift your top up…whatever. You let them in and the second you show them what is under those clothes you watch their face. They are trained to have zero reaction. And it’s at this point where you feel crushed and lost, not at all proud of your handiwork that sometimes you are so satisfied with it means you are going to stop, at least for a while. You’re there, and they’re there. Your self harm is there and the air in the room has gone flat. You feel exposed, put your injuries away and wish you’d never been asked the fucking question in the first place.
Point three. Self harm as a private delight. Engaging in self harm is such a private activity, it’s a friend and a foe, it’s a means of coping, it’s for some a psycho-sexual drive, exciting, exhilarating, a release, a sense of being alive. It’s habit forming and addictive. It can be like writing a journal or diary. How would you feel if someone read that diary? How would you feel if you got caught masturbating to porn? Mid-binge or mid-purge? It’s comparable to all these things. And to show yourself to someone, anyone, let alone a professional who is making some kind of a judgement about you once they have seen the damage you have done to yourself, takes a lot of courage. I would argue that it can have a real detrimental effect on a person and push them further into a secret world of self harm.
When I started this blog I promised my family and friends that I would not include personal accounts, stories or information about my private life. I don’t think it is breaking that promise to let you know my method of deflecting the ‘How serious is the damage?” question. Having been asked by various professionals how bad my self harm is (on one occassion actually being told to bluntly “Show me”) I eventually began recording (when I remembered) the damage I was doing to myself. When I had quite a collection I sent copies of it to my psychiatrist and psychologist and told them never to ask me again, because it would also be along those lines, and if it ever got worse then they would see from records that I had presented at A&E (which I would only do should a limb be hanging off).
Many thanks to The Mental Mouth for allowing bus to republish this article. You can also find The Mental Mouth on Twitter.
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