Today we bring you the third part of my article published in the Healthcare Counselling and Psychotherapy Journal last year.

The media tend to focus on young girls who cut themselves. Women’s magazines and teen magazines for girls reflect their audiences, so naturally stay focused on girls who self-injure.

By contrast, men’s magazines hardly touch the subject –perhaps a reflection of the fact that men do not want to talk about things they perceive as weakness. When I started looking for information about self-injury in 2000, I searched the web and found some informative sites, run by girls, for girls. As far as I could tell, they were all American. I soon decided that as a male in the UK, I could provide a perspective, so I started writing and web publishing. Since founding LifeSIGNS (aka FirstSigns), I have been in contact with many men and women who want to see the media redress the imbalance in reporting.

Self-injury is definitely not a girl thing in our experience. FirstSigns has always suspected that a bias in published research may be responsible for the apparent predominance of females who self-injure, and a report by M.J. Marchettoi suggests that this is indeed the case:

’No gender differences were observed among skin-cutters, most of whom reported experiences of trauma. BPD [borderline personality disorder] was recorded for a minority of those skin-cutters without a history of trauma… although these results provide further confirmation of a potential association between prior trauma and repetitive skin-cutting, they rigorously challenge the validity of reported gender differences for this behaviour. Further, this study has identified that repetitive skin-cutting can arise independently of BPD and prior trauma.’

For further information about male self-injury see: http://men.firstsigns.org.uk

Professionals working with clients who self-injure should endeavour to drop any preconceived ideas about gender differences and accept that, whatever the (obviously incomplete) statistics tell them, self-injury can affect boys, girls, men and women from all backgrounds and of all ages.

The statistics on self-injury are obviously incomplete for several reasons. First, they tend to be collated from Emergency departments, where ‘self-injury’ has often been included in ‘suicidal behaviour’ tick-boxes. Second, research that directly polls people misses men because there is no agreed definition of ‘self-injury’, and also because men are unlikely to discuss weakness no matter how anonymous the questionnaire. Third, the vast majority of people who hurt themselves do not seek help either from A&E departments or their GP, so it is impossible to have reliable, relevant statistics when self-injury is hidden as it is.

Self-injury is the hidden affliction; it is a difficult subject, and even harder to talk about from a personal point of view. People who self-injure worry about other people’s reactions, including the reactions of healthcare professionals. Will they be thought of as weak? Will they be considered stupid? Attention seekers? Acting out? Childish? A waste of time? Only through understanding and by providing accessible routes into care can professionals begin to reach people who would otherwise never talk about their self-injurious impulses.

i Marchetto MJ. Repetitive skin-cutting: parental bonding, personality and gender.
Psychology and Psychotherapy 2006; 79: 445-60.

Coming next: Not so irrational.