Trigger warning: This post discusses self-harm. It will mention methods of self-harm, as well as immediate first aid and scar covering.
I talked about self-harm a bit in my last post, but it’s so silenced that I felt the need to talk about it again. If you don’t want to read about it, there’s no shame in that. It’s a heavy topic that not everyone is ready to discuss (yet). But at the same time, if no one talks about it, nothing will ever get done. No progress will ever be made. So, at great risk of making people uncomfortable and having another awkward conversation once my family has read this one, I’m oversharing and venting again in hopes that someone will realize they aren’t alone.
Don’t expect anything super official in this. A lot of it comes from my personal experience and what I’ve read on Reddit/Quora type sites. Not exactly academic sources. But mental health discussions rely on the personal, not just the distanced and numerical. Here goes.
What are you doing?
Self-harm goes far beyond cutting. A lot of methods won’t leave marks or require sharp or hot objects. You always hear about the teenager wearing sweaters all year to hide their scarred wrists, but that’s just a small fraction of self-harmers. For starters, if you are cutting, it isn’t always on the arms.
Basically, anything you are doing with the intent to harm yourself is self-harm. Pinching, scratching, cutting, burning, unsafe sex, reckless driving, abusing drugs/alcohol, over/undereating… it can look like anything. No sweaters required.
Make no mistake, all forms of self-harm are equally detrimental and concerning. I used to think I was fine because I was “just pinching my arm a little, it’s not like I’m cutting”. When I first opened up to someone that I was self-harming, she seemed relieved when I said I was scratching and pinching. It was like she no longer had as much to worry about. Not to say she didn’t care, but that’s the general feeling about self-harm. As long as you aren’t at risk of bleeding out or something, it doesn’t sound very serious. I mean, I fell for it, and I was the one doing it.
You can think about self-harm in a similar way to how you’d think about drug use. It usually starts small. Smaller dosages, weaker drugs, whatever. But it worsens as you go along. After a while, you need more to get the same high. You may start turning to higher dosages or stronger drugs. Self-harm can work the same way. Maybe you start with scratching. No big deal. The marks go away in a few hours, max, so there are no long-term physical effects. But now you’re learning to rely on it. Now, when a situation arises that triggers you, you do it again until, eventually, it doesn’t help you enough. So now you’re scratching more, or cutting, or burning…
It doesn’t always work like that, but it can. It’s a slippery slope. If you’re considering it but haven’t done anything yet, DON’T. It’s not worth it, trust me. It’s easier to not do it the first time than to stop yourself later.
Why would you want to do it?
Imagine you’ve had a really rough day. You finally get home and you’re mentally worn out. So, to take your mind off your problems, you sit in front of the TV for a few hours. Congratulations, you’ve distracted yourself from your problems for a short period of time using escapism. Or maybe, after having a heated argument with a family member, you start snacking or drinking. You’ve found comfort through food or alcohol instead of facing your concerns head on.
People find all sorts of ways to comfort or distract themselves. Escapism (movies, books, video games, etc.) removes us from problems for a time. Food, alcohol, or drugs comfort us or weaken our negative emotions. For some people, self-harm can provide the same distraction or comfort. Emotional pain can be harder to deal with than physical pain. By hurting oneself, s/he is now faced with an easier form of pain. You can slap a Band-Aid on a bleeding cut easier than on a bleeding heart. No, it won’t work for very long, but neither do any other methods of distraction.
Other people might feel the need to punish themselves for something, and may use self-harm to do it. Some use it as a way to avoid taking their anger out on others. Just like you might squeeze a stress ball when you’re mad at your friend, another person might squeeze their arm instead.
Can’t you just stop?
Not always. I wish, but it isn’t always that simple. Finishing your favorite show’s finale won’t necessarily keep you from re-watching the episodes. Yes, you know how it’ll turn out now, but you enjoy it, and watching it has become a bit of a ritual for you. Someone else may have realized their self-harm isn’t doing anything for them. They know how it’ll turn out if they do it again, but they (in a weird way, might) enjoy it, and doing it has become a bit of a ritual for them.
On a more serious note, there is a possibility to become addicted to self-harm. This doesn’t happen to everyone who tries it (praise the Lord), but it’s something to be aware of. Once you get addicted, it can consume your thoughts. You’ll constantly get cravings, which can be equivalent to those experienced by a heroin addict (don’t quote me on this; I don’t remember where I read it). When trying to quit, you may experience withdrawals, which suck.
Do you need attention that badly?
Where to even begin with the stigma…
I’ve said it before and I’ll say it again: SELF-HARM IS NOT ATTENTION SEEKING. Yes, there are always going to be exceptions, but as a general rule, this cannot be assumed. Most self-harmers try as hard as possible to keep it a secret. If someone admits to you that they’re self-harming, it’s because they’ve finally worked up the courage to ask for support or accountability. DO NOT SHAME THEM FOR IT. It’s not a joke or a game. Don’t push them further into silence than they may have already been. Put any stigma or preconceived notions aside and be there for them.
It’s also important to be aware that self-harm and suicide attempts are not the same. A person can self-harm without ever experiencing suicidal thoughts. A suicidal person may not self-harm. Yes, a person struggling with one is more likely to do the other, but they are separate problems.
What can I do to help?
If someone you know is self-harming, please be patient with them and treat it like any other addiction or bad habit. It requires time to break, they need support instead of ultimatums, and cold turkey isn’t always the best option. Treat the first week without it as a huge achievement. Celebrate the small victories, don’t shame them if they relapse, and try not to treat them too differently now that you know. It doesn’t help knowing our stable relationships have now been disrupted or altered in some way because of us.
Have a conversation, but don’t force it. They’re allowed to not answer questions. And please don’t wait until they can’t leave to discuss this. Having a break is okay. Like I said earlier, this is a very heavy topic. Don’t expect it to be a one-and-done conversation. Address whether the person is experiencing suicidal thoughts, what they’re doing, whether they’re taking precautions/doing it safely, and try to get at why they’re doing it. It’s extremely possible that they won’t know, so don’t press too hard.
Before you worry about removing unsafe items from the person, ensure they have an understanding of relevant basic first aid (cleaning wounds, sterilizing anything they’re using, etc.). It sounds counterintuitive, but if a person wants to self-harm, they’ll do it with anything. Taking away a razor or lighter won’t take the problem away with it. It’s better to make sure they have clean items (if they’re even using anything) and/or that their hands/mouth are clean. Do they have antibacterial soap to wash their hands and clean wounds? If they’re biting, do they have what they need to reduce the risk of infections from plaque and bacteria (again, antibacterial soap is a must).
Once they’re ready to take the next step, you can remove any problem items or offer a safer replacement. A rubber band or hair tie can be worn on the wrist to pull at while they transition from self-harming (like a nicotine patch for smokers, I guess).
If they receive medical/psychological treatment for self-harm, be an ally for them. I’ve been medically gaslit and shamed by professionals. It doesn’t make anything better. If you’re informed that this is happening and you’re in a position to do something, help them find a new doctor, stand up for them, something. If you aren’t in that position, just be there for them and continue encouraging them, since this could make their road to recovery harder.
Lastly, make sure you have some sort of support for yourself. It can take a toll on you, too. Even if you can’t/don’t give specifics, make sure you have someone to turn to should you begin to feel weighed down, depressed, or scared. I’ve heard too many stories of people whose mental health will suffer because they spent everything they had on helping someone. You can’t help your loved one if you’re falling apart, too.
I’ve already started, so what now?
First things first, make sure you’re being safe. If you’re pinching or scratching, make sure your hands and nails are clean. If you’re biting, maybe brush your teeth first (I don’t know enough about biting to know if this is really important, but better safe than sorry, I guess) and be sure to clean the wound with antibacterial soap afterward. When cutting, avoid arteries and major blood vessels (wrists, neck, inner thigh, etc.). The thicker the area, the better off you should be. If you’re burning, treat the wound as soon as you can. Again, I don’t have much knowledge of burning. If I find out more about that and biting, I’ll add more information later.
If you’re bleeding, apply pressure until bleeding stops. Don’t use anything fuzzy on a cut (e.g., toilet paper, fuzzy towels). Paper towels are usually safer, or fabrics that aren’t fuzzy. When bleeding stops, wash the area with antibacterial soap and warm water. It will usually sting and it may bleed again, but it’s worth it to avoid an infection. Gently dry off the area (again, with something that isn’t fuzzy) and apply a bandage or wrap. Continue to keep the area clean as it heals. When it scabs, don’t scratch it, no matter how badly it itches.
If you’re using an item/tool, be sure it’s clean. Use sterilizing wipes or something similar if you have access to them. Worst case scenario, use soap and water. If cutting, new blades are safer. They’re usually cleaner and sharper. Duller blades require more pressure and can do more damage than anticipated.
If you’re using sex as self-harm, use protection of some sort (condoms, birth control, etc.). When using drugs, see if you or someone you trust can get Naloxone (to reverse opioid overdoses) and have some record of what you’re taking in case emergency medical services are required (so they can know what you’re on to best respond). If you’re undereating, ensure the food you do get has enough nutrients to keep you going.
How do I hide my scars?
You don’t need to. Honestly, you don’t. I understand that there can be feelings of embarrassment and shame in them, but they’re just your story written in a painful ink. If you’ve made it through to the other side, then they’re a reminder that you fought a brutal battle and won. If you’re still in it, then it’s proof you’re still here and willing to fight.
Should you choose to cover any scars (or just any marks that are still healing), there are different options depending on where they are, how big/small, and how noticeable.
For larger areas or more noticeable scars, you may be able to get camouflage makeup, or just use waterproof makeup. Depending on where you live, some hospitals can prescribe camouflage makeup.
If you have scars on your wrists, you can wear bracelets or long sleeves. I’ve worn scrunchies and bandanas on my wrists to cover more.
For arms and legs, you could try lacy sleeves or tights. There are all sorts of different, cute accessories and clothing to inconspicuously cover any scars. Options may be more limited for men.
Even if you’re going swimming, you have options. Long-sleeved swimsuits, water shoes or other foot coverings (they make them for hygiene reasons, so there’s an excuse for you, too), waterproof makeup… you’ll have more options than you realize.
See, that wasn’t so hard to talk about, was it? You can read that as sincere or sarcastic depending on how you’re feeling right now.
To close, I need to mention the most important thing. Even when self-harm, escapism, food, etc. all fail or end, God is still there for you. His presence will never leave you, no matter how you feel. I’ve found a lot of comfort in Isaiah 54 and Psalm 34. I’d highly recommend reading either/both of them. It also makes a huge difference when you have someone to pray for you. I speak from experience on that one.
I hope this has helped, and I wish you all the best.