A Round-Table Chat About Self-Harm

We've been "talking about" mental health for half a decade. This is a good thing – there's certainly less stigma around anxiety and depression now that there was five years ago – but talking isn't going to reverse years of systematic cuts to a health service that's now at breaking point and struggling to provide support.

Talking also only benefits those with conditions people feel comfortable talking about. When it comes to conversations about self-harm, for instance, discussion is pretty much non-existent.

"Self-harm is when you try to hurt yourself as a way of dealing with very difficult feelings, painful memories or overwhelming situations and experiences," explains Stephen Buckley, Head of Information at the mental health charity Mind. This might mean cutting, drug or alcohol use, or over or under-eating, but it can take other forms.

A 2018 report found that nearly a quarter of 14-year-old girls and one in ten 14-year-old boys in the UK said they had self-harmed. In a 2014 study by the Lancet, 20 percent of 16 to 24-year-old women reported having self-harmed at some point in their life. Looking at those stats, if you haven't self-harmed, it's likely you'll know someone who has – yet shame, fear and a lack of understanding can make broaching the topic seem taboo.

That's why we sat down with four young people – Ant, Tika, Yasmin and Dec, all in their twenties – as they discussed their own experiences of self-harm. Their stories aren't representative of everyone who has self-harmed, nor do they seek to provide any definitive answers – they're shared in the hope of making it easier for others to do the same.

Dec: I was 15, maybe 16. I couldn't tell you exactly why, but I was depressed. I was an insomniac, up all night alone with my thoughts, and started cutting myself. I was always worried about scarring, so they were shallow, in places other people wouldn't be able to see. I carried on doing the same thing on and off, probably most weeks, until about a year ago.

Ant: It started really as a child, punishing myself. A queer kid in a working-class Irish Catholic family. I didn't quite know why at first, but there was a sense of self-flagellation and guilt. I was probably about six, and I remember if I was feeling bad I'd sleep on the floor, and before mum and dad came in I'd get back into the bed. I developed an unhealthy relationship with food. That transferred into cutting when I was maybe 13? I think it was just like: I've tried the rest so I might as well see how this goes.

Yasmin: It's difficult to explain. I'd been depressed for years, and then when I moved to university in London it got worse. I only self-harmed a few times at my worst stage – I was really conscious about marks being seen. For me it wasn't just the harming, but thinking about it almost obsessively: I'd be constantly thinking about ways I could hurt myself, which comes with its own doses of embarrassment and shame.

Tika: I was 15, and it was always in places other people would see. It was such a paradox, because then I'd make such an effort to cover it up. I think it was a classic cry for help, but then I'd have so much shame the next day when I realised what I'd done. Even when I first started university I couldn't help doing it when I felt lonely or upset. I didn't realise at the time, but for me it was an addiction: 99 percent of me didn't want to do it, but 1 percent did, and I couldn't stop myself. It's like any other addiction – a shameful habit that's hard to stop.

Yasmin: You feel like you're doing something, exerting control. If I did that, I wouldn't – at least for a moment – have to think about everything else, which was so overwhelming. Or sometimes you feel absolutely nothing – you're numb, and thinking, 'I could just feel this one quite primitive feeling of pain.'

Dec: There's also something in having physical marks. A therapist once described it to me as an exteriorisation of an internal pain – it made things "real".

Tika: It's so hard to explain why. I'm still not sure I know. And that's what made it so complicated for other people to understand. People can be very sympathetic about depression, anxiety, eating disorders. Even people who can't personally empathise see how the world might get you down. It's the minute you say you physically harm yourself that people are like: "Woah, I don't get that. That's super fucking weird." That has always been the trickiest thing to articulate to people. If you haven't done it, you don't know – but I'm really not suggesting you try it.

Yasmin: I wouldn't have wanted someone to make a big deal out of it or, like, start giving me flyers. You know what you're doing and that it's a mechanism to cope with something you're feeling. You know it doesn't actually help in any way. It's like saying, "Be less sad." It's a symptom of something bigger that needs tackling. And I think that's the starting point: ask if everything is OK and go from there.

Ant: If one of my friends knew, and they didn't have experience of self-harm themselves, I would appreciate them making me aware they knew. I wouldn't want someone to impose themselves. It's different if someone has experienced it themselves, but if not? Offer to be there to talk. I wouldn't want someone to tell me to stop. You know you should.

Tika: It's complicated, because when I was younger I didn't see why it was so bad. People have all sorts of ways to cope with the mood they're going through. For me it was always very superficial. I didn't see the big deal. I might have resented anyone saying anything. Now, I realise it was a wake up call when my family and friends noticed and said something.

Dec: A non-dogmatic, non-imposing approach is probably best. Say: "I'm here for you. If you want to talk to me now, or if you're about to do something. There's no judgment." But also don't then have an expectation that I will talk to you, or demand to know why I decide not to. It's a secondary recrimination – I feel guilty for doing it, and guilty for not telling them. But if you notice something really harmful, proper deep cuts which look life threatening, someone needs to intervene. Otherwise, just be there as a friend.

Ant: Just don't comment, don't stare. I know they're there, thanks. You don't need to say anything if they're old and faded. Let me start that conversation when I'm ready.

Dec: Also, don't fetishise it. Sometimes I go home with people and I've undressed and they've noticed scars. Most people ignore it, or say they or a friend have been through the same thing. But once a girl was kissing my scars, saying they were really beautiful and a sign I survived. Don't do that. Also, think about your language – don't refer to music as "wrist slitting" music, for instance.

Yasmin: There is also a tendency to romanticise self-harm. It's not beautiful. It's very frustrating and nobody really wants to feel like that.

Ant: There came a point where I was like, 'What the fuck are you doing – you've cut all your leg up, and for what?' Then I'd just keep going back to it. I went for a year without going back to it. Then maybe last year, two years ago, my mental health dipped again… in the last two years I've probably done it only two, three times.

Tika: For me it was therapy, and I know how privileged I have been to be able to access that. When my parents found out they were super supportive. Having someone able to listen objectively and knowing they're not incessantly worrying about you, that they understand the issue. Learning to see this as a symptom of an illness has been the biggest thing.

Dec: Actually, for me, most of the therapy I've had through the NHS has actually gone quite badly. I think I hoped that it would fix me, but ten sessions don't fix everything. A lot of the time I relapsed into the self-harm after it ended, disappointed that I didn't feel any better. I think you should definitely try therapy, but also be aware that there are no quick fixes. Self-harm just stopped doing anything for me in the end. My girlfriend at the time didn't want me to do it, and for some reason, in that specific relationship, I decided to stop. I wanted to be able to not have clothes on and not feel ashamed.

Ant: There are apps. They didn't help me much, but they're there. Knowing you're not alone is also good to know. If you want to talk to anyone, you should. Lots of people are very sensitive. Some people will say the wrong thing, and that's probably OK too. It is a completely unique experience you're going through, but people can be there when you want. For me, finding things to be passionate about also really helped. Getting engaged with the LGBQ+ community helped me find an identity, a community to engage in.

Tika: Therapy, if you can access it. In the short-term there are practical tips: stab a pillow, put a rubber band on your arm and ping it, exercise. But, for me, those things didn't work – and don't be alarmed if that's true for you. It doesn't mean you're worse, or beyond help, or things can't get better. There's no agreed method.

Yasmin: Find spaces you feel comfortable in. In the South Asian community, for instance, the conversation around mental health is different to that in other places. See if there's an organisation or group, or just other people who might have similar backgrounds and experiences. It's like finding an extended family. And remember there's no hierarchy in this: whatever you're going through, you're not taking up space.

Dec: Identify where your triggers are so you can avoid them, whether that's places or people or topics. And when you can't avoid, at least you know you might feel like doing it, and you can think, 'Am I OK with that? Do I want to do something to prevent it?' Making plans, calling a friend. The most simple technique is, when you want to self-harm, wait five minutes, if you can. And then wait another five minutes. And another. The odds are the feeling will subside. At the end of the day, self-forgiveness is the most important thing.

If you are affected by any of the issues in this piece, help and support is available from Selfharm UK, The Samaritans and Mind.

@MikeSegalov / @bekkylonsdalephoto