Death was not a worry

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.

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.

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.