Life on the edge

The UK is now the self-harm capital of Europe. Over the past
decade the number of British cases of self-harm has accelerated to
the point where one in 10 teenagers deliberately self-harms. More
than 24,000 young people are admitted to hospital each year after
harming themselves and the average age for a child to start
self-harming is 13. There are reports of seven-year-olds hurting
themselves deliberately.

Concern has been growing for some time, and last week the first
ever inquiry was launched into deliberate self-harm among 11-25
year olds. It will be jointly run by the Mental Health Foundation
and the Camelot Foundation. The 18-month inquiry is being chaired
by Catherine McLoughlin of the King’s Fund, and will report to
national and local government with recommendations for practice and
policy. “Young people are telling us something when they harm
themselves,” she says. “It’s our duty to listen.” There are 20
members on the inquiry panel, including representatives from
Barnardo’s and the National Children’s Bureau.

The inquiry will research the incidence, causes and treatment of
self-harm. It will receive evidence from people who self-harm, the
practitioners who work with them and academics.

Self-harming most commonly takes the form of cutting the skin and
overdosing on painkillers. Other methods include burning, hitting,
scalding and scratching.

Opposite, three young people talk about the major life traumas that
led them to start self-harming.

‘I just wanted to see blood’

The first time Mary Potter* harmed herself was by accident. She was
13 and washing a glass when it broke and cut her hand. Her uncle
had just started what was to become three years of sexual abuse and
Mary felt numb and withdrawn. Cutting her hand made her realise she
could still “feel” and a few months later she cut her leg with a
knife. “I just wanted to see blood and have a tangible feeling of
pain,” she says.

Mary regularly self-harmed using razor blades to cope with the
abuse: “I knew what my uncle was doing wasn’t supposed to happen.”
When she was at university Mary had an abusive boyfriend who made
her feel like her uncle had. One night she drank a bottle of vodka
and took 80 paracetamol. She was found unconscious by a cleaner who
called an ambulance. Six months later Mary took another large
overdose and this time her friend called an ambulance. Nurses at
the hospital made her feel like she was “wasting everyone’s time”.
Since then she has taken 20 smaller overdoses “to pass out and not
think”.

Now aged 29 and teaching English to refugees in London, Mary
continues to self-harm about once a week. Before each incident Mary
does not know what to do with herself. During the act she feels a
sense of control and is calmer afterwards because she has
“punished” herself. She cuts her legs because they are easier to
hide from her family and employers: “I feel guilty because if the
people who care about me knew, it would hurt them.”

Mary’s older sister knows she self-harms but her parents do not:
“If they knew it would cause far too much trouble. I’d have to
explain everything and I don’t know if they’d believe me.”

When she lived overseas for a year she had psychotherapy, something
she found helpful. She is currently on a waiting list for a
psychotherapist and takes anti-depressants and anti-psychotics. She
urges social care staff not to judge or get angry with people who
self-harm but to help them find alternative coping
mechanisms.

‘The medical staff see me as a waste of
time’

Alex Williams began cutting herself with Bic razors when she was
16. She felt out of place and overwhelmed at her sixth form
college. At the same time she started to diet because she felt
“big” in comparison with her classmates. This soon developed into
anorexia and her lowest weight was four stone four pounds. “From
that time I’d scratch my arms whenever I felt I wasn’t in control,”
she says. “After cutting I would wrap myself up in a cardigan and
it was very comforting.”

When she was 20 and in the Priory for her anorexia she took her
first overdose of painkillers because she was anxious about being
discharged. Since then she has taken about 10 overdoses, taking up
to 40 tablets at a time.

It was after Alex went into residential care for her anorexia for
two years, then aged 21, that her self-harming worsened: “There I
learned other ways to self-harm, it normalised it.” She says being
among other people with an eating disorder and who self-harmed
helped, as they knew how she felt.

Alex uses double-edged razor blades to cut her arms because they
are easy to cover up. After she does it she has a huge sense of
relief “especially if I have lost a lot of blood”. She says she has
to continue to self-harm because of the ritual: “I’m afraid of
disappointing myself by not doing it.” When she feels she eats too
much she cuts herself and has removed pieces of her forearm and had
10 blood transfusions as a result of her actions. “The medical
staff see me as a waste of time and resources.”

She is in touch with a community psychiatric nurse, a social
services support worker and a consultant from her hospital’s mental
health department in Kent. She fears her access to services will be
reduced and she has to prove to professionals that she “is not OK”
by harming herself. Alex recently went for 18 months without
self-harming before relapsing. She says staff and services need to
“be flexible to an individual’s needs” when trying to help
them.

‘Self harm is the last stop and prevents me from going
further’   

When 19-year old Sam Hayder’s girlfriend Amy* died in a car
crash three years ago he blamed himself because she was travelling
to see him. He was so distraught he punched a wall and kept on
hitting it until his wrist broke. He says Amy was “the first good
thing that happened to me for ages” and her death destroyed him. He
was also frequently bullied at school: “I felt different to
everyone there apart from Amy.”  Her death started Sam on a
downward spiral. When he was 17 he began to self-harm by cutting
himself on the chest and legs, punching himself and burning himself
with a lighter and under hot water. He continues to self-harm “in
exceptional circumstances, when I’m really wound up”. He says it
stops the numbness he feels and brings him back to reality.
“Sometimes it is about watching myself heal. It’s like ‘if my wound
can heal then maybe the rest of me can?'”   After he has
self-harmed he is relieved but sometimes feels even worse. He does
not describe himself as a self-harmer: “I’m someone who uses
self-harm to cope. Self-harm is an active choice against committing
suicide, it’s the last stop and prevents me from going further.” 
Sam is the oldest of six children and comes from a Muslim family in
East London. He feels under pressure from his parents, who he does
not get on with, because they compare him with his cousins: “My
mother says: ‘Why can’t you be like them?’ They have an idealised
view of other people that is unrealistic.” Although his parents
have seen superficial scratches on his arms they have never spoken
to him about it and he thinks they do not realise how serious it
is.  Sam has not approached social care services for help,
preferring to get support from a self-harm website: “It is the only
thing that keeps me going.” 

*Names have been changed