Self-harm

Self-harming is used by many people to cope

Most people, when they read, may not agree, unless you actually cut or harm yourself in any other way.

I have to admit that I was shocked when I read that almost 10% of young people in Ireland, self harm.  Don’t click off the page just yet if you are one of them.

image has words understanding self harm and dr Elaine Ryan logo

My background is working in the NHS with people who self harm, and I know it is a way of coping.
It is not attention seeking, or acting out, or any of those other type of labels.  You use it to cope.

Before coming back to Ireland, I worked as a Highly Specialist Psychologist in a Specialist Psychology Service (that’s a lot of specialists, but that was the name) for people with Borderline Personality Disorder, and as such, I am trained in Dialectical Behavioural Therapy, or DBT for short.

If you self harm or have been given a diagnosis of Borderline Personality Disorder, ( or BPD for short) you might have heard of DBT.

On this page, I am going to talk about self-harm, but you can read about Personality Disorder here.

Self Harm

The most common type of self-harm is cutting, so I am going to talk about that, but people also pick, hit themselves or take toxic substances.

Do you cut?

If you do, it’s okay, some things can help.  I am not here to judge you in any way nor offer you any nonsense or mumbo jumbo that you’re probably sick to the back teeth of hearing!  I can offer a bit of understanding and maybe tell you some things you don’t know.

Some things that may be of help to you fall under the following:

Chain Analysis

When you cut, it is useful to go backwards, to identify vulnerability factors.  Don’t just look at what you were doing a few minutes before.  Ask yourself

  • What was happening during the day?
  • Did anything upset me?
  • Did I sleep okay last night?
  • Did I take any booze or drugs?
  • Was I feeling unwell in any way?
  • Was I feeling anxious, annoyed, worried, stressed or sad?

All of these are vulnerability factors, which I am going to talk a little about now.

Vulnerability Factors

Your ability (and mine) to cope is impaired when you don’t sleep well, are hungry, have a fight with someone, or are hungover.  Learning to identify things that affect your ability to cope is one of the many ways that help.  If you wish to find another way to cope with life, rather than harming yourself, it is about applying a whole range of tactics together to help you achieve this.

Resisting the urge to cut

Again, if you have never self-harmed, you might not understand the urge.  If you don’t self-harm,  maybe you are a smoker.  Imagine if you and I fought, you would want a cigarette to help you cope.  If you didn’t have any and it was the middle of the night and you had no money, I would probably find you hoking for money down the back of the sofa before you happily jump in your car to look for an all night garage to buy cigarettes.  That’s the urge.  They help you to cope.

If you are comfortable enough with the idea that self harm helps you to cope, you cannot just decide, ‘okay, I’ll just stop then.’  You need to be building up skills to help you to cope in another way while you slowly try to stop cutting.

How do you do this?

This is the skills part of DBT.  You are taught to manage emotions that are difficult for you, and then you apply these new skills to some of the vulnerability factors (that we spoke about above.)

You probably already know that you cut when you are upset or when something is bothering you.  Learning another way to cope means learning to manage emotions differently.

The primary skills that help are the ones that help you to

  • Manage distress
  • Manage difficult emotions and
  • Manage interpersonal relationship

The idea is that if you can tolerate distress, sit with uncomfortable emotions and be more effective in all of your relationships, your need to cut shall dramatically decrease until you no longer cut.

The skills are admittedly a lot more complex, and I have just skirted around the topics, but hopefully, I shall have the skills posted online soon, and I am planning on some sort of a forum that I shall moderate should you need help with applying some skills.  I should say at this stage, my plans are not a substitute for therapy, nor am I able to work individually offering DBT, as it requires a team of professionals who are all trained in the model.  Saying that, I shall put some things on the site that might be of help to you.