Hello everyone
I hope this week has treated you well.
I would like to speak about self-harm, something that I have sadly been seeing too often recently. Self -Harm occurs when an individual deliberately causes harm to their self. It has many forms such as cutting, burning or hitting oneself. I don’t like that it is called ‘Self-Harm’ as I have noticed what this can do to an entire family. I have seen 3 teenagers this week who self-harm and I hope this reaches many others that may be suffering just the same.
There are quite a few reasons why people do this. Most commonly, it is a way of coping with life’s stresses. It is a method of using physical pain as a distraction and release from emotional pain. Self- harm may or may not be obvious.

There are people who do it on parts of their body which are clearly visible and others who try to keep it a secret and do it in places that aren’t. It is important to remember that both individuals are equally at risk or in pain. Claiming that people who openly do it are just looking for attention is a myth – they are simply crying out for help, hoping to be seen/ heard. Sadly, however, most who self –harm will do it in secret.

Self-harm typically starts at about age 14. The problem is particularly common among females but males do suffer as well. It is a dangerous and painful cycle, not much different from heavy drug/alcohol use. When people cut/burn, they do tend to feel better as tension is released. However, this is only for a short while as the painful feelings always return and therefore, the urge to self – harm returns. Self-Harm should not be confused with a suicide attempt. Most individuals who self-harm actually do it as a coping mechanism to avoid thoughts of suicide.

What causes self-harm?
Most individuals who self-harm suffer from some sort of mental illness such as depression, anxiety, bi-polar disorder and so on. It is important to identify the possible benefits of it. There are personal benefits to any and every action and without accepting and analysing these, there is no way of aiding; no way of finding an efficient substitute or solution.
Based on my research and the clients I have seen, self-harm is a way of easing the emotional pain by causing physical ones. It takes their mind away from the heavy burdens of constant stress caused by many different factors. Most commonly, it has been victims of sexual abuse in my office who self-harm. Some of them hurt themselves to avoid memories and flash backs of it while others do it as self -punishment as they wrongly blame themselves for the abuse.

Some do it because they are being bullied at work or school. Others do it as a method of control. This is the same with disorders such as anorexia. Sometimes, we cannot control anything that happens in our lives, which is of course very difficult. This can cause some people to want to take control any way they can- such as control what goes into their body or exactly what happens to it. This happens especially when the victim is unhappy in their home – have strained relationships or unusually strict parents. Some people self-harm because they feel nothing at all inside. They would rather feel pain than feel numb.

What does self-harm cause?
Again, please remember and understand that self-harm is a very short term solution. It is putting a band aid on a laceration that requires stitches. It causes many more problems than it solves.
People who self-harm are at much higher risk for suicide than people who do not.
It causes shame, guilt, low self-esteem and very often self-hatred.
It may cause strained relationships when your family, friends or partners have to find out, rather than being trusted and told. This is also going to sound quite negative but in life, bad things do happen- sometimes more than the good does. We need to learn to cope with these things early on in life. We need to find healthy ways of overcoming hardship. If we do not, we are at risk for so many other problems along with the self-harm such as drug/alcohol abuse and other mental illnesses. Self-harm itself can also become addictive and may seem like a compulsive behaviour that seems impossible to stop.

How can we recognise if someone is self-harming?
Of course there are the obvious scars, the tools that may be used, blood soaked clothes/towels and people fully clothed/covered during hot weather. Those who self-harm also commonly tend to pull out their own hair. However, it is important to also pay attention to behavioural clues as well. People who self-harm usually require long periods of alone time. They are irritable and angry if this is not a possibility. They experience fast mood changes -sometimes without any trigger. Their relationships are affected and suddenly strained – whether it be family, friends or partners. School and work performance will also be negatively affected as low motivation and loss of interest in any activity is common.

There will be obvious changes in their eating and sleeping patterns which means there will be fatigue as unusual weight loss or weight gain. They may act unusually insecure, displaying low self-esteem and self-neglect. This tends to lead to a change in appearance which differs with each individual. For example, some may make big changes such as dying their hair green or getting many new piercings while others may completely neglect even basic hygiene. There will also more often than not be a start or increase in alcohol/ drug use.
Remember, you do not have to be sure a person is self-harming before you intervene- just a suspicion is enough to.

How can we stop this from happening?
It is important to know that many individuals who self-harm do not actually want to die. However, this is possible as the dangers can be fatal such as hitting an artery or infections.
First and foremost, in order to stop yourself or even your loved ones from self-harming, the reasons why one chooses to do it must be identified. You cannot fix anything unless you know clearly what the problem is.

Recognise your triggers – is it because you are angry, sad, lonely etc.? It is easier to identify this if a feelings journal is kept. Write down exactly how you feel in the moments before you self-harm. I completely understand that the thought of actually paying attention to your feelings is a frightening one. Many like to avoid or numb the pain but in life, there is nowhere out but through. It is almost impossible to deal with any emotion unless it’s confronted.
Additionally, once the trigger emotion is identified, you will know what to avoid in order to not elicit that emotion.

Once you have identified this, reach out for help; confide in someone. Of course it will be helpful to tell a friend or family member but I would strongly advise that you go to your nearest health centre to see a professional. It is important to remember to give family and friends time to process this in order to effectively help you. Many victims do get upset when their news upsets others (as it seems selfish) but always remember that these are people who care about you. Therefore, discovering that you self-harm will be difficult news with a possible bad first reaction.

If you feel like you cannot stop suddenly, this is also understandable. In the meantime, de-escalate your intensity of self-harm. For example, if your method is self-cutting, try to do it less and cut less deeply. Then, find a substitute that works well for you during recovery. For example, a client of mine found that drawing a red line on the body part she would usually cut helped her to stop. Another client of mine that used burning felt that holding an ice cube to the body part he would normally burn was helpful.

New coping skills will also need to be learned. This mean you find things that relax you in order to distract yourself from the self-harm. This can be sports, dancing, singing, painting- whatever works for you! It is of course also beneficial to get plenty of exercise as it releases positive endorphins. Sleep well! Make sure you try and get more than 6 hours of sleep per night

If you know someone who is self-harming and would like to confront and help them, there are a few important things to remember. Firstly, deal with your own emotions before the approach. I know you care for them which means you may feel sadness or anger but this isn’t about you. Confront in a helping, unemotional way. Educate yourself on the issue- this article is just a start. Read up on self-harm as much as possible so you can understand why it’s happening. Do not judge! Self-harmers already judge and have negative feelings about themselves – they do not need this from their loved ones as well. Being supportive no matter what encourages healthy and open communication. Offer any support that they may need- don’t tell them what you think is best but rather recommend. They will want the right help when they are ready.

Since we all have heavy stress to deal with, it is important for everyone to know how to manage it. Therefore, next week I will speak specifically about coping mechanism and skills; how to develop and maintain them. Look out for it!

Thanking you for reading. Please keep sending any topics you’d like to talk about to caitlinvieira@gmail.com Or come in to see me at:

Georgetown Public Hospital: Psychiatric Department:
Monday- Friday – 8am- 12pm
Woodlands Hospital: Outpatient Department
Drug and Alcohol group meetings – Mondays 4:15
Good mental health group meetings- Wednesdays 4:15
Suicide Prevention Helpline numbers: 223-0001, 223-0009, 623-4444, 600-7896
Say Yes to Life and No to Drugs! Always