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Death was not a worry

Posted: 04 March 2004 | Subscribe Online


Last October I relapsed into serious self-harming. I don't know what triggered it except perhaps my continued fears around recovery. There was also a family crisis and the lead up to Christmas was stressful and lonely. Once I started harming myself I couldn't stop. I'd need to justify to myself that I'd gone "far enough" after each episode. This usually meant needing wounds stitched or having repeated blood transfusions, each after just a few days of cutting. Having a parvolex infusion after taking paracetamol also made the overdose "complete". I also felt the only time this would happen was if I almost killed myself through self-injury.
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My actions caused professionals to think I was suicidal. This wasn't the case although I wouldn't have cared if I'd died as a result of self-harming. I just wanted to push my body to its limits, like when I walked for 35 minutes to accident and emergency after losing a lot of blood.

Respite came in the form of involuntary admissions to the local psychiatric ward (under sections 2 and 3 of the Mental Health Act 1983). The first time I was in hospital I resented being there. As I didn't have the means to harm myself I'd bang my head on the rim of the toilet out of frustration. I'd fantasise about escaping and throwing myself under a car on the nearby motorway. My second admission coincided with Christmas and I decided to use the time to think through why I was hurting myself in such extreme ways.

Other than containment, hospital didn't offer any solutions. I willingly took both olanzapine and then risperidone (atypical antipsychotics) but hated the side-effects that occurred even on low doses. These included a vastly increased appetite and slurred speech. The only interaction with qualified nurses was when they dressed my arms. There was no one to talk to about how I felt except for when my community psychiatric nurse (CPN) and support worker visited. Although I had a named nurse, she worked nights and never offered to give me any time. A charge nurse admitted to me that they didn't know what to do with patients who self-harmed.
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What did break the cycle of self-injury was being discharged and having an intensive care package in the community. This involved thorough care co-ordination by my CPN and extra hours with my support worker. I also had the opportunity to see the CPN from the deliberate self-harm team at A&E. This was up to three times a week and we'd discuss harm minimisation. We also covered gender issues, distraction and cognitive techniques. He encouraged me to rearrange the priorities in my life so that self-harm was further down the list. I also appreciated the involvement of my consultant psychiatrist who didn't force any medication on me or see it as the answer. I'm now confident that I've stopped harming and think I can live self-harm free for longer than the 18 months between the previous and most recent cycles.

Alex Williams is a volunteer and a mental health service user.


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