Life After Self-Harm

A Guide to the Future

Ulrike Schmidt, Kate Davidson

• Publisher: Routledge
• Year: 2004
• ISBN:
  9781135446826
• Edition: 1
• Topic: Psychology
• Subtopic: Psychotherapy
• Index: Psychology

In many countries there has been an alarming increase in rates of suicide and self-harm, yet the stigma attached to these difficulties often leads to sub-optimal care.

Life After Self-Harm: A Guide to the Future is written for individuals who have deliberately harmed themselves. Developed through a major research project the contents of the manual have been informed and shaped by many users and expert professionals. Illustrated with multiple case-histories, it teaches users important skills:

• for understanding and evaluating self-harm
• for keeping safe in crisis
• for dealing with seemingly insolvable problems
• for developing coping strategies
• for re-connecting with life.

Health workers who regularly come into contact with individuals who have self-harmed will find the wealth of practical advice in this book extremely valuable for recommendation to patients either as a self-help book, or in the context of brief therapy.

Chapter One

Getting started

Introduction

You have recently attempted to harm yourself. Perhaps it is the first time in your life, perhaps it is something you have done several times before when you felt unable to cope with problems, tensions or crises. Perhaps you wanted to die, perhaps you harmed yourself for a different reason, perhaps you are unsure about why you did what you did.

At the moment you may be experiencing a mixture of feelings and thoughts. You may still feel extremely shaken up by what you did. Part of you may feel pleased or relieved to be alive. You may feel angry that someone stopped you from harming yourself, or you may feel ashamed about what you did. Perhaps you don’t want to be reminded of what happened, as the problem or crisis that caused you to harm yourself has now blown over. Perhaps the problem that led you to harm yourself is still looming as large as ever and seems completely impossible to overcome. Perhaps harming yourself is the only way you know of dealing with certain intense feelings or desires and nothing else works as well.

In any case you may be asking yourself why you should bother to read this book. Perhaps you are in two minds about it. You may even be tempted to throw it away and declare it useless before you have looked at it. Feeling that everything is useless is a very common feeling in people who are suicidal. Our intention in writing this book is to get you to stop and think. Don’t just say: “I am past being helped, I have tried it all and I know it all.”

Our aim is to try to help you to understand why you got to the point at which you harmed yourself and to help you look at whether there might be different ways of dealing with the difficulties that you are facing. We cannot tell you what to do, but you should know that we have tried and tested this book with many different people who have come to see us with similar difficulties to yours. Many of them have found it helpful. So perhaps you should buy yourself some time and read the book. You owe at least that to yourself. What do you have to lose?

You are Not Alone

As health professionals we work with a large number of people who have attempted to harm themselves. Every person is unique, but something that many people who attempt to harm themselves have in common is a feeling of loneliness and isolation and that nobody understands their particular predicament and how they feel. Another common problem is experiencing difficulties in relationships with an important person in your life. In this book you will come across some life stories of people who have harmed themselves. With some of them you may feel you have something in common, with others you may feel you have nothing in common. All the stories are the stories of real people whose names we have changed in order to protect their identity. We hope that their examples can show you that you are not alone.

Calling a spade a spade

You may wonder why in this book we sometimes talk about self-harm and at other times about “attempted suicide”. Suicide is the most extreme form of self-harm. Deliberately hurting or harming yourself can mean a lot of other things to you and to other people apart from expressing a desire not to live any more. Because people vary so much in their reasons for hurting themselves and in the degree of their wish to die, we will sometimes talk more generally about self-hurt or self-harm rather than attempted suicide.

Why do People Harm Themselves?

There are many different reasons why people attempt to harm themselves.

For some people harming themselves is like “pulling an emergency brake on a run-away train”. They feel their life has got out of control and they don’t quite know how to gain control again or make anyone notice.

Take Sylvia for example.

Sylvia’s story

Sylvia is 42 and has a son and a daughter aged 14 and 11. Their father left Sylvia when the children were little and she has had to bring them up single-handedly. Over the last year Sylvia has had lots of trouble with both her children. Both of them have started to truant regularly and Sylvia has had to see their teachers on several occasions. The 14-year-old boy has also got into trouble with the police over vandalizing a telephone booth. On several nights he has stayed out all night. Sometimes he has come home drunk, and Sylvia suspects that he may be taking drugs. Whenever Sylvia has tried to talk to him, he has been uncommunicative or rude. “I was worried sick about him, but he would take no notice of me. We’d have these blazing rows in the middle of the night. I would shout at him and tell him that he’d end up in prison if he wasn’t careful and that I’d have to get him put into care – but he wouldn’t listen.”
At the same time Sylvia’s relationship with her boyfriend of three years got worse, as he repeatedly told her she was a bad mother who was unable to keep her boy under control. Sylvia began to feel more and more upset, tense and panicky, thinking that something dreadful was going to happen. She couldn’t sleep at night and her GP prescribed some Valium. She also became very irritable: “I would just snap at anybody who crossed me.” Sylvia began to drink too much, often on top of the Valium. This led to more arguments with her boyfriend who threatened to leave her. “I was in a total state, I just couldn’t cope any more.” After one particularly bad argument with her boyfriend one night, Sylvia took an overdose of painkillers and Valium. “All I wanted was for someone to take notice of how rotten I felt. I just wanted all my problems to go away.”

For some people harming themselves is the only way they feel they can reach out to other people, get care or get noticed by others. People who harm themselves in order to appeal to others may not themselves be fully aware of why they are doing what they are doing. Often they are people who as children did not have the affection, support and care that every child deserves, and may have endured abuse or mental cruelty from their parents and other adults looking after them.

Darren’s story

Darren (aged 27) is the oldest of three boys. He has been in prison on several occasions for grievous bodily harm and robbery. His mother was an alcoholic and his parents split up when he was six. Thereafter his mother had a string of boyfriends most of whom had alcohol problems themselves. When Darren was nine his mother’s boyfriend sexually abused him and threatened that he’d kill him if he told anyone. Another one of his mother’s boyfriends regularly beat her up and, “When one of us boys tried to step in to stop him hurting our mum, he’d get really vicious. Once he smashed my head into the tiled bathroom floor and wouldn’t let go. I was so frightened I thought I was going to die.” Darren had to go to hospital because of the injuries acquired on that occasion and eventually the children were taken into care: “I can’t tell you how many children’s homes and foster homes I have been in.” At the age of 13 Darren tried to hang himself in his room in the children’s home. He was discovered by one of the other boys. “For a while everyone became very concerned about me. I was sent to see a shrink, and one of the workers in the children’s home spent a lot of time trying to talk to me. She was the only adult who was ever good to me. However, she stopped working there after a few months.” Since then Darren has made over 20 attempts to hurt himself. He has taken overdoses after arguments with his girlfriend. He has cut his wrists after losing a job. “Sometimes I don’t know why I do what I do.”

Sometimes someone who has previously coped reasonably well with life, gets overwhelmed by one or several catastrophic events, which makes them feel that they are total losers and that they can’t come to terms with. Take William for example:

William’s story

William (aged 45) had had his own reasonably successful business. However, during the recession, he lost everything and his wife left him.
“My wife couldn’t come to terms with the fact that we had to give up our comfortable life style. She seemed to blame me for the fact that I could no longer provide for her or the children. My teenage children who had been to private schools suddenly found themselves at a rough local comprehensive where my daughter was bullied and teased for her posh accent. My wife then started an affair with an old friend of mine and in the end left. I felt like a complete failure. What was the point of going on? How could I ever recover from the situation?”
William began to think increasingly about not wanting to live any more. At first he pushed those thoughts aside but more and more the idea of committing suicide seemed like his only option. He bought a lot of tablets and waited for a weekend when his daughter was not at home. He then wrote a long letter to his daughter and to his mother apologizing for letting them down. He took the tablets expecting that nobody would want to contact him for several days. However, a friend came to see him and became very suspicious when William didn’t come to the door and called for help.

In other cases someone gets trapped in a situation where they feel increasingly hopeless and can see no way out. To the outsider the situation may not seem as hopeless but because of the person’s particular upbringing, beliefs or values they cannot free themselves from the trap they are in. The story of Sally given below is a case in point.

Sally’s story

Sally (aged 24) is the oldest daughter of a Hong Kong Chinese family. She has four younger sisters and brothers. She has grown up in the UK, and has many English friends. “I could never please my father; he wants me to be a good Chinese daughter, but I am not.” Sally was the only one of her siblings to stand up against her father. There were daily arguments in the home. “He would shout at me for any reason. He didn’t like my hair, my dress, the people I liked, nothing about me. He would always tell me how useless I was, and how I didn’t respect him enough. My only way of keeping him quiet for a few days, was to give him some money to feed his gambling habit.” Sally felt lonely and unsupported in her family. Her mother never dared to speak out, and her younger brothers openly supported the father. Her sisters like her mother were too frightened to speak out. For a few months Sally moved out from home, however, for financial reasons she moved back home. “I felt like one huge failure. Things got worse at home after I moved back in. My fath...

Table of contents

• Cover
• Title
• Copyright
• Contents
• Acknowledgements
• Major health warning
• Note to health care practitioner
• 1 Getting started
• 2 What to do in a crisis
• 3 Learning to solve problems
• 4 Learn to change your thinking
• 5 Alcohol, drugs and pills: do you need to cut down or stop?
• 6 Some further thoughts
• 7 For relatives and friends