“Resilience
isn't a single skill. It's a variety of skills and coping mechanisms. To bounce
back from bumps in the road as well as failures...”
Jean
Chatzky
This year, for Self-Harm Awareness Day, I thought I’d create this slightly(!) jumbled-up post and it is honestly, mostly a mess because I actually just found out it was this Awareness Day at about half three in the afternoon on the day of it! So, this post is basically full of bits and pieces about my experiences of self-harm, things related to self-harm which I’ve learnt and witnessed throughout my mental health journey, and advice I would give to someone who is utilising it as a coping skill…
To Understand It, You Have to Go Back
to When It Started
In early
November 2006, on the way to School, I was attacked and woke up, slightly
beaten up, and in an alleyway a little way from home. Feeling stunned and confused,
I continued to make my way to School where I told a Teacher who then called my Mum,
and we reported it to the Police and went to the GP to check the bump on my
head and my black eye.
Shortly
after the attack, I began having panic attacks when I would get strange
flashbacks to waking up in that alleyway, and my abuser offered to give me a
pass which would allow me to leave School classes, but I had to go and sit with
him until I felt better. And that’s how he started hurting me. That’s how the
abuse started. For the following six months, it got to a point where I stopped using
the pass and instead, he would come along and call me to his Office, and no one
blinked or questioned it because they were so used to him supporting me.
In
early 2007 – not long after I turned 16 in February – he took things one huge
step further and I was raped. Not long after that, I hurt myself for the first
time by scratching my arm. Scratches which barely drew any blood. And I had two
slightly complicated, intense, and powerful motivations:
1.
He
had inflicted a ton of pain on me. The majority of that and the part which felt
the worst, was related to the fact that I actually wasn’t sexually active prior
to the rape. And that triggered this belief I had that only you should have the
right to hurt your body. So, I think that it massively became about control and
feeling that you should really be entitled to take charge of your own body.
2.
I
hoped that the scratches would make me less ‘attractive’ and that didn’t mean I
thought that I was pretty, but I think I was trying to desperately think of
reasons why he’d chosen me. And that, understandably, led to questioning if it
was my appearance. And so, in addition to self-harming through the wounds, I
also began massively restricting my diet so that I lost a lot of weight.
The Media’s Role & Influence Around
Self-Harm
To
begin talking about the media back then and how it affected me and my self-harm,
I need to start off with the current state of things… People talk a lot about
the media and the coverage mental health receives – mostly in terms of news
stories and the journeys of others which are most often published in various
media outlets. I’m actually a huge believer that a lot of coverage on the
topic, is largely negative, particularly that related to mental health and the
digital world. There are so many stories of people – particularly young people –
taking their own life because of online bullying or triggering and damaging,
influential content. There’s a lot of awareness of the various forum’s trolls
can use to send abuse and criticism to others as well as a good understanding
of the websites which exist which promote mental illnesses such as Eating
Disorders or actually provide tips on methods of self-harm. There is very
little publicity on positive and productive stories related to mental health
and the online world. I mean, how often do you read about people using the
internet as a therapeutic outlet and a place to off-load a lot of their thoughts
and feelings?! Or do you ever read about people like me who have actually made
a career or some sort of success from creating a blog or a social media account/group/page
which is inspired and motivated by their mental illness/mental health recovery
journey?
Back
then (2007), though, it was even worse! There was absolutely little to no talk of
mental health, self-harm, abuse, or rape in the media and not even so far as
media which I had access to as a sixteen-year-old, but the media in general. And
sometimes any coverage is good coverage because the absence of absolutely any publicity
or awareness of these topics left me feeling incredibly alone in my experiences.
This led to me feeling that no one else in the entire world had gone through –
or were going through – what I was. It also led to me feeling isolated in so
far as developing the belief that I had been singled out and separated from not
just my peers but, actually, from the rest of the world too! And that
loneliness and sense of being distanced from others, only exacerbated my thoughts
around, and my use of, self-harm.
My
thoughts on the media and mental health, abuse, and rape; are kind of like my
opinion on the stigma around those with a mental illness or those who are
survivors of traumatic experiences such as sexual abuse and rape. I believe that
the stigma and wrongly judgmental, derogatory, and destabilising attitudes and
responses to those people, has incredibly reduced since 2006/2007, but it’s actually
still nowhere near good enough. Nor is it of an acceptable state or point. And
so, I think that it sometimes becomes a bit about choice. That it’s about whether
you choose to focus on that negative and detrimental state or take a more
balanced view in concentrating on the positive progress, but with recognition
that there’s still both more work to be done and a huge amount of room for
improvement.
Running
a mental health blog with such a huge following – I believe we’re very close to
2.3 million readers! – I do feel a sense of expectation from readers (both new
and regular) who look at my content with a curiosity that pertains to how I
will tackle many of the topics most relevant to my life and my recovery journey.
I’d sum these up or guess the list of them as being self-harm, suicide, mental
illness, rape, and abuse. I think that lots of people wonder how I’ll phrase
difficult aspects of these topics, the wording and terms I will use, and the
experiences of mine which I will discuss and draw upon as learning opportunities
to provide advice and guidance, or as inspiration (in a sense of both positive
and negative ways).
Now, I
don’t want to sound as though I’m complaining or moaning in any way, but being
aware of this expectation, can actually instil a great sense of pressure and provide
a huge reason to be extremely conscious, careful, and thoughtful with the
content I create. And actually, in all honesty, I think that this is probably,
mostly, a good thing because it means I can produce kind, empathetic, and non-judgemental
blog posts. Which, I hope, can protect other survivors of rape and abuse or
people with similar experiences in so far as mental health, self-harm, and
suicide, and reduce the chance that they feel misunderstood, discriminated
against, and/or dismissed.
A huge worry I have though, is that people might come to I’m NOT Disordered with the thought, idea, and hope that I might provide influential content in so far as advice or tips related to methods of self-harm or suicide attempts. I recognise that this is likely nothing to do with the way I come across generally like on my social media accounts (@aimes_wilson on Twitter and Instagram) or even in person! And that it’s probably, mostly related to the blatant and sad realistic fact that there are blogs and websites out there which provide that sort of content and information; especially, as I said earlier, in relation to Eating Disorders. And this calls into relevance another opinion of mine in so far as the media and its influence on self-harm in particular; and that is the thought that if you Google or in some other way search, for content of that angle or theme, then you’ll find it. If, however, you search for positive stories of recovery, therapeutic advice, helpful resources, or details of supportive services, you will most definitely, discover that content too! Once again, it’s about how you look at things and controlling exactly what your perspective is and what you’re focusing on.
The Influence of Others
The
thought of the digital world having a negative influence on self-harm and
suicide – and just mental health in general! – is actually a great lead onto
this next part… This part is going to be a bit of a story-time! I have two
accounts from my two and a half years as a psychiatric hospital inpatient which
are particularly relevant to the topic of self-harm and others having a
negative influence. Both are a bit ‘graphic’ and potentially triggering to
some, so please be mindful of that before reading them.
The
first story is that one day, some of the staff came barrelling into my room
looking panicked and stressed and told me to go to the communal sitting room
because the ward was now on lockdown. I got to the room, which was just down
the corridor from my bedroom, and found all the other girls (it was a female
ward) in there too and literally no one knew what the heck was going on so
there were a ton of gossiping and rumours and people just generally guessing
and making assumptions.
Eventually,
the Ward Manager came in and told us that they had found a blade in the room of
someone who had just been taken to the medical hospital because of a self-harm
wound. Because that person had no leave off the ward granted, it meant that
someone else must have brought the blade onto the ward and then given it to
that person. They explained that because there had been around four other girls
taken to A&E for similar self-harm injuries within the last week or two, they
suspected that there might be more blades, and that’s why they were searching
our rooms. They said that whilst they were conducting the searches, we had to
talk amongst ourselves to determine who had snuck at least that one blade onto
the ward, and to have them admit to it to the staff.
I was
honestly in shock for a good few minutes after hearing that! And that was mostly
because I was very dedicated to the huge belief and opinion that whilst self-harm
had – on some occasions and on a very short-term basis – helped me to manage
difficult moments, thoughts, and feelings; I would absolutely and categorically
never recommend anyone else use it as a coping mechanism. It became one of the many
situations I’ve now experienced where I’ve learnt that despite being raised by
my Mum to always treat others how you would like to be treated, not everyone
else believes or abides by that principle too. Even those who I show that
courtesy and respect to!
The following
few hours were very tense and volatile, and I think something which definitely
didn’t help the situation was that the psychiatric hospital specialised in Personality
Disorders and so every inpatient had that diagnosis. And, at that time, one of
the symptoms of Borderline Personality Disorder (BPD) was uncontrollable and irrational
anger! So, yeah; we weren’t the best group of people to be around each other at
a time like that! There were so many arguments; especially when the girl we all
suspected swore on her children’s lives that it hadn’t been her! There came a
point where, she finally admitted to it, and where a lot of the other girls who
had been in hospital over the past fortnight, admitted to passing the blade to
each other, and finally; the staff had finished their searches and joined us in
the sitting room.
Those girls
confessed their part in this horrible incident to the staff and I ended up
giving a little speech! I talked about how the staff – and many mental health
professionals in general – always preach about responsibility and taking responsibility
for our actions, and that those girls not doing so, were giving them every
right to go on about it. I also spoke about not ever wanting someone to go
through the things which I have – including using self-harm as a coping skill –
and afterwards, one of the staff began a round of applause for me. Initially, I
resented her for it because I felt it really separated me from the other girls…
It’s no secret that there’s a huge us vs them culture in mental health, and that
doesn’t change in psychiatric hospitals, nor does it change if you actually
even try to defy it! And so, receiving an applause from the staff, left me conscious
that all the girls would think that I was on ‘their side’ but it actually didn’t
take me long to recognise that I want to separate myself from people like that.
I want to be different to people who encourage others to self-harm. People who promote
that. I want to have absolutely no resemblance to them.
The
second story also comes from that inpatient admission. A while after I had been
there, a girl was admitted and she came onto the ward with a t-shirt on and the
first thing that I think everyone noticed, was that she had absolutely no
injuries to her arms. No bandages. Not even scars. As I got to know her, I
found out that her method of self-harm was dangerously abusing her insulin
medication because she was diabetic. Sadly, she became the exact example of a recognition
I had developed from my very first psychiatric hospital admission; the
professionals are effectively robbing you of your unsafe coping skills and if
they aren’t replacing them with positive and productive methods, what else
could you do?
Being
hospitalised doesn’t mean your difficult thoughts, feelings, and memories stop,
so they’re always still there to leave you feeling that you need to manage them
in some way. To regulate them. To cope with them. And with psychiatric
hospitals trying very hard to be ‘places of safety,’ this often means that an
inpatient gets ‘creative’ in developing an alternative coping skill. And often,
this can mean self-harming in a way that is actually more medically dangerous
than what you had been doing in the community. It’s backwards… and it’s
reality. And it meant that when I was finally being discharged from the
hospital, that girl had both forearms bandaged from her wrists to her elbows
and was scheduled to have surgery to repair the damage she had caused.
I had
some insight though, insight that meant I felt that her new coping mechanisms
weren’t 100% influenced by the hospital regulations and absence of access to
her insulin. There was a point where I had unescorted ground leave which meant I
could go around the hospital grounds without a member of staff. I ended up climbing
over our fence, over the fence of the elderly people’s home next to the hospital,
and out of the gate for the house whose garden I ended up being in! I got a
taxi from the nearby shops and was gone. When the Police eventually found me in
a nearby city, I had made a suicide attempt and with the ambulance destined to
take forever to come, the Police rushed me to the medical hospital with their
lights flashing and siren blaring. When I got there, I refused the lifesaving
medical treatment, and I was put on life support to be given the treatment against
my will. That treatment was extended in length because my blood tests began
showing signs of organ damage.
When I
was woken from the coma, I was taken to the Psychiatric Intensive Care Unit (PICU)
which was above the ward I had been on for over one year. A ward where one
patient had suffocated another and where we constantly heard screaming, banging,
and alarms ringing. It was the largest kick up the bum I had ever experienced.
I felt so physically poorly from being anaesthetised for so long and I was incredibly
terrified being on that Unit. It meant that I finally recognised that I didn’t
want that to be my life. I didn’t want to keep going through all those horrible
things and being in that horrible place. So, when I was eventually transferred
back to the original ward, and when I was on the verge of discharge a year or
so later, that girl asked me what had caused the turnaround in my mindset, and
I told her about the life support and the PICU. The next thing I knew, she was
trying to escape the exact way I had and when the staff didn’t take her to the
PICU she ended up asking to be sent there! And I had never felt so terrible. So
guilty.
I remember
having a huge argument with her and saying that she’d left me feeling
completely responsible. A little later, I was going down the corridor on the
ward and when I passed her bedroom I heard funny noises. I moved to continue
walking before getting the very honest thought that if something was wrong, I
wouldn’t forgive myself for not doing something. So, I peered through the
window in her door which staff used to do checks when we were in our rooms or
asleep, and saw her on the floor, with a ligature, and her face was turning blue.
I screamed for help and attempted to kick her door in numerous times before the
staff came because she’d locked it and only the staff had keys which could open
them. Eventually, the staff came, and I watched as they started doing CPR on
her still body. They revived her and she was taken to the medical hospital.
That evening, in our daily evening Reflection meetings, I cried and said I was
responsible and that I would hate myself if she had died. Literally all the
girls reassured me that she was a grown person and was responsible for her own
actions. That she was responsible for taking my story and using it as
inspiration or motivation to do what she did. That she could have very equally taken
it as positive inspiration and used it to create the thought that she didn’t
want her mental health to get as poorly as mine had.
It Got Worse Before It Got Better
That
incident leads me on to this part… The part where I tell you that my own
self-harm had to get so much worse before it got better. Because despite being
deemed as being in recovery and being discharged from the section of the 1983 Mental
Health Act I had been detained under for over two years, that didn’t mean
everything had suddenly gone. That it was all over and had disappeared or been
completely resolved – two things which I feel professionals lead you to believe
are the definitions of ‘recovery.’ That once you reach it, that’s it. This
terrible lie can be so damaging because if that person experiences a ‘blip’ or
a relapse, they are left feeling like an absolute failure and losing all hope.
It is so much more positive and so much safer to tell mental health service users
the reality in that often, you can still struggle whilst being in recovery.
So,
those scratches that didn’t draw blood, ended up becoming deeper and drawing blood.
Then, they ended up bad enough to need steri-strips (sticky stitches) and then
real stitches. And then, plastic surgery to repair the nerves and tendons I
severed on a few occasions. And that evolvement gave me similar thoughts to the
recovery ones I just talked about in that I began feeling hopeless and panicked
in worrying; ‘how the hell could this possibly get any worse?’ and ‘what is it
going to come to eventually?!’
The Two Dialectical
Behaviour Therapy Skills I Found Most Helpful For Self-Harm
1. Self-Soothing:
The most fundamental mindset to develop in order to find this skill helpful, is
to recognise that your body deserves love. That you deserve pleasant things.
2. Mindfulness: The
way to find this most beneficial, isn’t necessarily to use it as a meditation
technique or breathing exercises, but instead; to use it as a method to
completely focus on a distracting activity so that it is more effective.
For more general information,
details of the other Modules and skills it teaches, and worksheets on Dialectical
Behaviour Therapy:
Dialectical Behavior Therapy:
DBT Skills, Worksheets, Videos
For
help and support specifically for survivors of rape and abuse who are
struggling: