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Why People Self-Harm


Why people self – harm

Life can be full of emotional up and downs and it can feel too much at times for people.  Some people choose healthy ways to deal with their stress, like doing a workout at the gym, going for a walk, confiding in a friend or listening to a meditation CD.  Whereas others have destructive coping mechanisms. For these people it can be difficult to self soothe.  Their unhealthy ways of tolerating stress and painful emotions lead them to harm themselves.  Self-harm is particularly a problem among adolescents.  Although it is important to note that adults also self-harm.  While most adults acknowledge that this way of managing their emotions is unhealthy, teenagers are usually unaware that it is a serious problem.  Worryingly, they see it as the only way to deal with their stress.

Amy is a teenage girl who self-harms.  She is withdrawn and depressed.  She is grateful that the weather is presently cold so she can wear long sleeved jumpers and cardigans, which cover her lacerated arms.  She usually wears black or grey to coincide with her dark mood.  She has not confided in her parents or teachers about her cutting.  She is afraid that they won’t understand, or worse still might make her stop doing it.  She is just one out of the large percentage of adolescents in Ireland who deliberately self-harms.

Dr Paul Surgenor director of research at Pieta House.   “Parents generally are not clued into this and don’t know how to respond. Self-harming is not an attention-grabbing thing, and they are not doing it to create visible scars, it’s very private and personal. People tend to cut the tops of their arms or legs where they cannot be seen. When parents do find out, all they see is the blood or the scars and they think their child is suicidal. They flip out and kids hate that, they can’t understand why their parents are making such a big fuss. There’s a disconnect there”.

“Nationally and in Pieta House, we know that self-harm is on the rise. And also that the gap between males and females is closing – it used to be associated with just girls. Presentations of self-harm to our services were up nearly 20 per cent last year. There is a big problem, especially among adolescents, in understanding what self-harm is and what it does.

They think it’s normal, they cut and feel better afterwards as it does give them an initial sense of relief.”  At Pieta, we never tell somebody to stop self-harming straight away, instead we gradually get them to look at other ways of coping.”

St Patrick’s Mental Health Services, and Pieta House, Ireland’s centre for the prevention of self-harm or suicide, hosted the first self-harm conference in Ireland on Monday 29th February 2016.

Professor Nav Kapur, one of the UK’s leading experts in self harm and suicide, spoke at the conference.  He says “It’s quite a common problem not just in Ireland and the UK, but across the world. Studies have found that 10-25 per cent of young people may have harmed themselves in the previous year and it can have potentially serious consequences.   When we followed people long-term, we found they were at higher risk of suicide or dying of other causes even if they had low intent at the time of the self-harm episode. Our studies have shown that the risk of somebody dying by suicide in the year after a self-harming episode is about 100 times greater than that of somebody in the general population.”

Director of services at St Patrick’s Mental Health Services, Tom Maher, said the hospital saw a high incidence of self- harm during 2008, but this began to decline again during 2013 – 2014.  He said that St Patrick’s treat people as an inpatient or as an outpatient in one of their dean clinics, if they are depressed.

He says “we found that the underlying emotional distress in our cohort of service users who self-harmed was not being dealt with by the structures we had in place so we decided to take a new approach to therapy. We don’t say ‘stop self-harming, we’ll get you better’, instead we give people the tools to deal with those nasty emotions themselves.”

Different factors associated with self-harm

  • social problems – such as being bullied, having difficulties at work or school, having difficult relationships with friends or family, coming to terms with their sexuality if they think they might be gay or bisexual, or coping with cultural expectations, such as an arranged marriage
  • trauma – such as physical or sexual abuse, the death of a close family member or friend, or having a miscarriage
  • psychological causes – such as having repeated thoughts or voices telling them to self-harm, disassociating (losing touch with who they are and with their surroundings), or borderline personality disorder.



Types of self-harm

  • cutting or burning their skin
  • scratching or biting themselves
  • pulling out hair or eyelashes
  • punching or hitting themselves
  • taking tablets or poison
  • excessive exercise
  • anorexia or bulimia nervosa
  • alcohol or drug abuse

Signs of self-harm

  • unexplained cuts, bruises or cigarette burns, usually on their wrists, arms, thighs and chest
  • keeping themselves fully covered at all times, even in hot weather
  • signs of depression, such as low mood, tearfulness or a lack of motivation or interest in anything
  • self-loathing and expressing a wish to punish themselves
  • not wanting to go on and wishing to end it all
  • becoming very withdrawn and not speaking to others
  • changes in eating habits or being secretive about eating, and any unusual weight loss or weight gain
  • signs of low self-esteem, such as blaming themselves for any problems or thinking they’re not good enough for something
  • signs they have been pulling out their hair
  • signs of drug or alcohol misuse

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