Healing Self-Injury

Lately I’ve been playing with a question I was asked after a workshop I presented on SIV. A psychologist stopped to talk after the training and was arguing the need to have the right to restrain people who self-injure. I gave him my thoughts about how retraumatizing people who already are living in a world of pain serves no one, including the staff of the institutions in which restraint and seclusion (tying people down to beds and/or locking them in padded rooms) remain prevalent He remained adamant that all SIV must be stopped, that clinicians should not have to tolerate anyone who continues to self-injure. He proposed using psychiatric drugs to achieve this as well, but did admit that there are no drugs, used appropriately, that achieve the result he was after.

It was his next statement that I found interesting. He was adamant that if a psychiatric drug could be created to take away the need to self-injure, that all the people living with SIV would be more than interested in taking it forever. I told him that I didn’t think this to be true, but that I would ask the experts, the people who live with SIV. I believe that SIV is not “all bad” as this psychologist was presenting, that SIV serves a purpose in many people’s lives that helps them cope with the aftereffects of trauma and the struggles of healing. While living with SIV certainly has its down side, it also has a purpose. And as people come to understand the trauma in their histories the need for SIV abates as healing progresses. A drug that would solve the problem so simply would likely do what so many of the other drugs used previously have done, make a person so numb that they might lose touch with their pain and struggle but also become so numbed as to not feel truly alive. I presumed that the price of permanently drugging oneself out of the need for SIV would be too high to pay. I believe that SIV fades away as we learn to understand, experience, and release the pain, rage and disconnection that it manages. We can learn a great deal about ourselves from the urges to self-injure.

But he made me think and now I am curious. Any thoughts out there?

Sometimes when you meet people who touch both your heart and your soul you carry them around in your thoughts for quite a while.  Though your time with them might have been brief, it seems that the experience changes you at a great depth.  I have been holding very warm thoughts about four people I met this past July and I want to tell you about them.

A few months ago I spent two days teaching about SIV at a state mental hospital for children and adolescents in Virginia.  The hospital had decided to make an intense effort to reduce the amount of restraint and seclusion (being locked in a small room and/or tied down to a bed) being done to the young people there.  As SIV is one of the most common reasons that people get restrained or secluded, I was hired to teach some of what I know and to work with the staff.  I had the opportunity to meet with many people, including administrators, psychologists and nurses, and direct care staff.  I met many concerned people who struggled greatly to understand what SIV is about and how to help.  Yet the people I carry around in my heart today are the four young people I had the chance to meet for an hour.  They were currently patients, living behind the locked doors of that facility.

I was led onto a unit and found four young people seated at a table.  I introduced myself, told them why I was brought to the hospital, and asked them if they would be willing to help me.  They seemed surprised to be given a choice – I had forgotten how controlled are days behind locked doors.  I asked them to listen to a short version of what I had taught the staff and tell me if they agreed with what I was saying and offer ways I could improve.  After all, it was the environment that they were living in that I was trying to change.

They could not contain their surprise and disbelief when I let them know that I had lived with SIV and was a scarred person myself.  One young woman stared at my long sleeves, so I rolled one up so that she could see the old, faded, but permanent scars.  What happened then touched the core of my heart.   She reached out and touched my scarred arm, tenderly.  What a different reaction than most, no?  These people weren’t repulsed, they recognized our kinship.

With that we talked of our lives with SIV, our histories and what had brought us such great pain, fear and rage, and our hopes for the future.  We shared a few tears, quite a few laughs, and a hug or two.  The hour flew by and it was soon time for me to go back to the meetings with the staff people.

What the staff and I talked about is for another post.  What I am thinking about as I remember those four remarkable people is how important it is to feel accepted and understood.  At one point I asked if they knew of any other slang names for people who live with SIV.  I said I thought it was most common for us to be called “cutters.”  They let me know that the current slang term has changed and that they were considered to be the “emo kids.”  The “emo” stood for “emotional hardcore.”  They were, of course, seen to be some of the most difficult patients there.

So they are the “emo kids.”  When I was about to leave our group I thanked them and said that I would remember my time with the emo kids, how much I appreciated having met them.  They said that they had also enjoyed their time with me, that it felt unusual feeling  understood by an adult.  Now that I am nearing my 50th birthday I recognized I must look really ancient to them.  So I asked them how, since the term “emo kid” would not apply to me, I should define myself.  It was decided that I am an “emo granny.”  What an honor.

Hello Everyone,

I am beginning to get used to writing this blog and intend to post more frequently. First, I want to thank all of you who sent comments to the previous two posts. They are greatly appreciated. We are beginning to create the community I’ve been hoping for, especially as The Cutting Edge is coming to a close (the final issue of the newsletter is still being written and should be mailed in the next 4 weeks).

So many of your comments raised questions about the difference between healing from self-injury and simply stopping the behavior. Some of you are living with self-inflicted violence (SIV) while others are concerned for those you care about. While I hope that you access the resources on the web site (I’d be greatly interested in your opinions), I have a few thoughts to share.

From the past 20 years of speaking with people who live with, or have healed from needing SIV, the teaching that I do, and my own experiences, I believe that people heal from the need for SIV in many ways. The healing journey is a personal one, yet I hope everyone has support along the way. Support is one of the goals of this blog and web site. Healing cannot be mandated. SIV, while obviously having its consequences, also serves some crucial purposes in the lives of the people who need it. When there are no (or few) other options, SIV can even help someone stay alive in the moment. For many people who live in such emotional pain that they consider suicide as a solution, SIV has been a temporary salve to that pain. The goal is to attend to the profound discomfort that underlies the need for SIV while expanding the options one has for dealing with life’s very intense struggles.

A history of trauma underlies the need for SIV. SIV is one of the ways people cope with the aftereffects of abuse, loss, neglect, disaster and other forms of trauma (trauma can be obvious or subtle). It helps people get by, to attend to their intense emotions, disconnection, and difficulty with expression that trauma brings. As we heal from the trauma, we heal from the need for SIV. While some people find that making an actual decision to stop SIV has been very helpful, others heal from the need for SIV without any direct focus on it. We are each an experiment of one, yet there are commonalities in the experiences of those who have talked to me about their healing over these past 20 years. Coercion and shame are never helpful. Understanding and acknowledgement of one’s strengths are. I have delved into these ideas at lengths and invite you to read the articles on the web site and offer your opinions.

One comment I need to address is the one questioning whether I “support” SIV. This is not an uncommon question about my work, especially in the professional trainings that I do. Because I do not condemn SIV it might appear that I support it. I do neither. SIV serves a purpose in the lives of the people that need it. It also has its consequences. I do not find judging SIV, nor the people that live with self-injury, useful. I have been privileged to witness the healing of many of us who have needed SIV and I have found that few of us truly salved the old wounds (of trauma as well as SIV) in an environment that was judgmental. My SIV has left me with scars, yet it also is one of the ways I coped with what felt intolerable, inexpressible and unbearable. While SIV is, by definition, an act of violence, for me it was an act of self-defense. Now, many years down the road from picking up the razor or the hammer or the match, I can acknowledge that it was one way I coped during some very brutal days and years. It was part of my survival as I began to learn about healing and, now, living. I am so glad I made it to this point!

I have been busy traveling lately, speaking to various groups of people about why some of us live with self-inflicted violence (SIV), and what helps people heal.  What I have talked about more and more as I do these trainings is the awareness that all people do harmful things at times.  While it may not be as obvious as the cuts, scratches, bruises or blisters that come from SIV, other forms of self-harm are more dangerous, yet not as strongly reacted to as SIV.  Some forms of self-injury are quite subtle, and might even be societally supported, such as overworking and overspending.  I have found it hopeful to have all people consider the various ways that they have “harmed” themselves, why they did so, and if they want to change their self-harm or not.  This has been a most useful tool in building a bridge of understanding between thsoe who live with SIV and those who do not.  The more we understand, connect, and relate to each other, the more we can help each other and ourselves.

I am adding material to the web site and invite you to look at several more publications and let me know if they are of use to you.  I am also going to look up an editorial I wrote a while ago, just on this topic of the many forms of self-harm, and post that as well.   Please let me know what you think!  We at Sidran have had recent problems with our e-mail so I apologize if you did not get through to us.  Please give us another try.

Welcome to the Healing Self-Injury blog!  This blog is dedicated to the idea of creating a place that people who live with self-inflicted violence (SIV), or those who care about them, can have to feel accepted, heard and supported.  Both the Healing Self-Injury web site and this blog are the continuation of The Cutting Edge: A Newsletter for People Who Live with Self-Inflicted Violence, a newsletter I began in 1990 and which will be ending shortly.  This is a time of transition.  While I am sorrowful to end the paper publication, I am very excited about the potential for creating a sense of community electronically.

To those of you who subscribe to The Cutting Edge, your final issue will be on its way in a month or so.  Some of what has been published in the newsletter over the past 17 years can already be found on the Healing Self-Injury web site.  There are also some recent new publications posted there that I am hoping will be helpful.   Please let me know what you think of them!