Healing process starts

Self-harm has been an important aspect of my life for 11 years. I
am now realising I may have outgrown the behaviour. When I try to
cut myself I experience an unacceptable level of pain, as if my
body is screaming “No!” The thought of swallowing an overdose of
tablets makes me feel sick.

If very distressed I will still self-harm but I will not need
treatment at accident and emergency. This has both good and bad
points. In the past I have hurt myself and wanted human contact
afterwards which has been met at the hospital. But I have also
received negative responses from medical staff who do not properly
understand self-injury.

The last time I was treated at an A&E the doctor kept sighing
as though I wasn’t worth the effort. She said to me: “If you feel
depressed why don’t you just eat a chocolate bar?” Afterwards I saw
a psychiatric senior house officer. She kept asking me why I
self-harm, which I can’t explain that easily. On the care plan she
wrote “slashed” to describe my actions, a word I dislike. When I
tell other people I can’t self-harm now as I used to they say
“that’s really good”. They don’t understand how I am left feeling:
often very desperate.

The work with my community psychiatric nurse (CPN) has helped. We
came up with a contract signed by both of us. It is a list of ways
I can put my life back on track. The aims include cleaning my flat
during the sessions I have with two support workers, trying not to
cut because this has become cruel, avoiding low-fat foods and
contacting friends, if only by e-mail.

It also includes affirmations: for example, that I should continue
my voluntary work at the Citizens Advice Bureau (CAB) because I am
good at it and working there means something to me.

A service that I have turned to recently, when self-harm has been
less of an option, has been the e-mail address of the Samaritans.
Trained volunteers answer your correspondence within 24 hours. It
is as though someone is validating your feelings and asking
questions so you can explore them further.

I am also reminded by my CPN how far I have come in the time I have
been seeing her. Four years ago I was living in a hostel where all
the other residents were young mothers or pregnant girls. It was
very noisy and there was little privacy. I wouldn’t make eye
contact with anyone. I spent all my time in a hostel room trying to
cut chunks out of my arms and not letting the wounds heal. I would
later write letters to my CPN dismissing everything positive she
had said when we met. Now I enjoy being in my own flat, my
confidence has grown and I can see clients at the CAB and offer
them advice.

Although I miss the drama of self-harm – having to deal with an
injury and needing treatment ranging from stitches to surgery – I
know that my life is fuller than it has been for a long time. I
hope I can start to enjoy my progress.

Alex Williams is a volunteer and uses mental health
services