Healing Self-Injury

Lately I’ve been hearing from people that they feel alone, misunderstood, and isolated because those around them are so reactive to their self-injury. I think most of us have experienced this at some point, no? Some of us are ashamed of our need for SIV, others proud and protective, some simply accepting of it. Living with SIV challenges many relationships, including that which we have with ourselves. And it often challenges our relationships with others intensely.

Relationships with other people can be difficult when they learn about SIV. I am incredibly fortunate as I have many deep and delightful friendships with people who do not judge my scars. Yet true friendships take time and mutuality to evolve, and not all are wanting to do this when they meet a scarred person. Yet there are all sorts of relationships. On a recent conference call, when I was answering questions about SIV, we shifted into an excited conversation about the powerful healing influence many of us have experienced from relationships with companion animals. This is one of my favorite topics to talk about and it turns out that there were quite a few people like me on the call. We talked about how cats, dogs, birds, horses, and other animals provide us with an opportunity to connect with a living being that does not judge, that responds to us with sincerity, and that we are responsible for tending to. I’ve learned a great deal about who I am, and who I want to become, from life with my dogs and cats and, the past 5 months, my horse. I have learned about power, responsibility, vulnerability, tenderness, trust, living in the moment, taking risks, and having fun (I used to be much too serious). They have all been catalysts of healing for me, in ways that no clinical intervention could begin to touch. I have changed in my depths, and these relationships have challenged me to grow in the relationships I have with my own kind, humans. I wonder if this is true for you as well?

I caught my eyes filling with tears on my way to the barn this morning to tend to the horses. Not tears of sorrow, but of tender overwhelm. The horses have taught me so much, and challenged me to risk and grow in many new ways. They may be huge in size, but they are prey animals, not predators, and so they know fear. And they know trust. And I have learned deeper levels of calm and understanding and attentiveness from them. These are qualities I am learning to apply in other places as well, most importantly with myself and the people around me. For now it is time to walk the dogs, then play with the cats, and spend the evening with dear friends. All of whom celebrate this healing journey with me. None of whom look twice at my scars. I hope this blog is such a place of acceptance too.

Ah, finally liking this computer again.  The past weeks, actually months, have been full of frustration for me as I’ve experienced computer glitches.  Then a crash.  A big one.  Oops.  So, for anyone who has e-mailed me in the past few months and hasn’t heard back, please try again (my home e-mail is rutamaz@eohio.net).  My ISP is a small local company and could not give me access to my old e-mail from a remote computer.  I had to wait and hope this computer could be fixed.

And it has been, so I am excited about being back in touch (in the next few days please look at the web site, as there will be new postings of prose and poetry, really wonderful stuff).   I am not all that comfortable with computers or the internet as a whole.  Some of my problem is that I’m intimidated about learning computer skills.  Most of my problem is that, most often, I’d rather be cooking for friends, walking dogs, hiking in the woods, or even shoveling out my horse’s stall…

Recently a friend challenged me to get more interested in the internet and explore what is out there regarding SIV.  I haven’t begun to do this whole-heartedly yet (my challenge is that I have dial-up access, which is very slow), but I’m interested in learning about what is out there.  I’ve previously explored clinical sites that discussed “self-mutilation” and didn’t find much different than what I had seen in books or articles.  But what my friend told me about was the existence of “pro-cutting” web sites.  Have you found these?  What are your experiences and thoughts about this?

I’m wondering if the misunderstanding and intense efforts to control those who feel the need to self-injure has brought about a protective reaction is some folks who live with SIV.  I neither argue for nor against SIV, to me it “just is.”  Therefore, SIV can be understood and we can create opportunities for people to heal from needing SIV, if they want to.  I’ve certainly read a whole lot about how “horrid” and “pathological” SIV is and have written many times about how many coercive psychiatric practices, as well as bigotry and misinformation in the general public, have caused great harm.

But the idea of promoting SIV is a new concept to me and I am interested in what people are thinking and believing.  Is this a celebration of SIV?  Is this a way of finding comfort with people who understand?  Where can I learn more?  Anyone out there want to let me know what they think?  I’d appreciate hearing from you!

Since the last post was an expose of some of the worst that is written about people who live with SIV, I thought I’d balance it by writing to you about my most beloved resources.  I’ve made the mistake of presuming that everyone is aware that these exist, but it’s been a long time since I’ve mentioned them.
There are two publications that I always recommend to people who ask me for resources.   The first one is a book, Self-Injury: Psychotherapy with People Who Engage in Self-Inflicted Violence, written by Robin Connors (copyright 2000 by Jason Aronson).  I know, it sounds like a boring clinical text.  It is meant for clinicians, but it is not boring and I think anyone and everyone should read it.  Robin Connors approaches the topic of SIV in the kindest and wisest way of any clinician I have ever met or read.  She explores the reasons people turn to SIV, how it serves them, and how to create connections that promote healing.  Not only does she not promote coercion, she advocates against it.  She explores the power of emotions, the impact of trauma, and the centrality of relationship in the healing process.  Not only is the content rich and filled with understanding and hope, but her writing style is warm and inviting.  For example, one of her subtitles is: “Presence as the Heart of Intervention.”  This book is primarily an example of the healing potential that can occur in relationships between people who live with SIV and clinicians who are willing to treat us with dignity, understanding, mutuality and support.  It is a thick book, over 400 pages long, and written for clinicians, yet I think it can serve everyone.  People living with SIV will feel understood and validated.  People looking for helpful therapy can find an example of how it can look here.  Clinicians can find remarkable guidance and wisdom.  Family members and friends of those who self-injure can gain understanding and awareness for themselves in the chapters that address the challenges therapists face when working with folks who self-injure.  I wish this book was available in every library and that it was required reading for anyone in a helping profession.  It recently came out in paperback, so I hope it is less expensive than it used to be (though I must admit I’d never regret spending a good chunk of money to get it).

For those not interested in such a thick text, and especially for folks looking for solutions for their own SIV, I recommend another publication, Understanding Self-Injury: a workbook for adults.  Co-authored by Kristy Trautmann and Robin Connors, the second edition was published in 2004 by Pittsburgh Action Against Rape (PAAR, 81 South 19th St., Pittsburgh, PA 15203).  This 63 page workbook is the most useful “self-help” resource I’ve found.  It helps people living with SIV explore the reasons for their SIV and discover alternatives to self-injury in a very respectful and encouraging way.  The authors acknowledge that SIV does not simply go away, and focus more on self-understanding rather than “making SIV stop.”  They help people feel understood and validated wherever they may be.  I think this manual is a wonderful resource for people of any age and would be helpful for anyone interested in the topic as well.

So, here are two resources I find very hopeful and encouraging.  Are any of you familiar with them?  What do you think?  Other resources we should be talking about?

I recently read an e-mail from a beloved colleague that I must share with you. Recently I’ve been saying that I sense a shift in understanding about SIV, that perhaps people who live with self-injury will no longer be so demonized. Well, I’ve learned that I am, once again, a bit too optimistic. The article she sent me to read verified this.

This article, which came out in the Times on line (United Kingdom) on Dec. 16th, 2009 contained the quote in the heading of this post. This quote was deep in the belly of the article which was focused on women as perpetrators. At best this article intended to point out that women, and not only men, can be predators of children. The author suggested that this is apparently a new concept to many, including those in the criminal justice and mental health professions. So I thought this might be a useful piece.

I was wrong. Instead of looking at the impact of childhood trauma through the lenses of victims as well as predators, considering boys and girls as well as men and women, the author vilified women. And, most upsettingly to me, she vilified women who self-injure. So now women living with SIV (women labeled anorexic were inc luded in the description of self-harm as well) can be presumed to be predators, and also have their SIV interpreted for them, as “sexualized acts of aggression.”
What a damaging and cruel thing to say, especially as the person saying this is a therapist. Here we go again. People living with SIV have long lived under the curse of being labeled “borderline” and I didn’t think there was a worse label than that. But perhaps this tops it. What do you think?

How to survive and create healing environments when so many consider people living with SIV as deviant and potentially dangerous? How to challenge this brutal stigma? How do we find compassion for ourselves and each other?
We can keep finding each other, and supportive people in our lives (whether they have lived with SIV or not) and we can learn that we are survivors, that we are strong, and that we are capable of enormous courage and kindness. We can be living examples that we are not what someone else has judged us to be. We can continue to connect through our words, our art, and our presence here and on the web site and in our homes and communities….. until the change that we can imagine will come true.

I’ve been re-reading one of my favorite books lately, Rachel Naomi Remen, M.D.’s My Grandfather’s Blessings: Stories of Strength, Refuge, and Belonging. There are few books I read more than once.  After all, I have large stacks of “to be read” books scattered throughout my cabin.  Yet lately I‘ve been relishing the rereading of this one and want to tell you about it and gather your thoughts as well.

Through her many stories, Rachel Remen teaches me about healing.  Much of what she has to say, regardless of the person or the illness that the writing is about, touches me tenderly.  In sharing some of her words with you, I wonder what you will think of them.  Although she never mentions SIV, I think her words are profoundly eloquent and describe the core, universal principles that promote healing from the need for SIV.

People who live with SIV are often misunderstood.  Understandably confused and frightened, people around us typically get invested in making SIV “go away.”  They want us “fixed,” for the SIV to disappear.  Unfortunately most mental health professionals want the same thing.  They don’t often understand (nor is it a priority to) the profound pain and distress that SIV temporarily soothes.  And sometimes we don’t understand ourselves either, and hope that there is a “fix” for us as well.

Seeing yourself as a fixer may cause you to see brokenness everywhere, to sit in judgment on life itself.  When we fix others, we may not see their hidden wholeness or trust the integrity of the life in them.  Fixers trust their own expertise.  When we serve, we see the unborn wholeness in others; we collaborate with it and strengthen it.  Others may then be able to see their wholeness for themselves for the first time.     (pg. 199)

What a difference in experience between someone wanting to fix us compared to someone serving us, helping us to see our strengths.  To be seen as “bad” or “broken” wounds the spirit.  To be understood as whole people who are suffering provides a fertile soil for healing and expansion.

Whether we ourselves live with SIV, carry the scars from having needed it in our pasts, or are people who care about those who self-injure, we can all serve each other.  Hopefully this blog is one place that can happen.  We need not try to change each other here.  We can share our journeys, our struggles, and wisdom with each other.  We can accept who we are and accept each other without needing to fix anything.  Sometimes the more we can accept where we are, the more opportunities arise for healing.  Trying to “fix” ourselves without understanding and accepting who we are in the moment tends to backfire.

The greatest blessing we offer others may be the belief we have in their struggle for freedom, the courage to support and accompany them as they determine for themselves the strength that will become their refuge and the foundation of their lives.  I think it is especially important to believe in someone at a time when they cannot yet believe in themselves.  Then your belief will become their lifeline.     (pg. 292)

What do you think about that?

In the process of beginning to upload past issues of The Cutting Edge I’ve been looking through the old issues. I’m always touched by the poetry, prose and artwork that people sent over the past 18 years. I’m glad that the newsletters will now be available through the web site (some are already posted, more will follow; each has editorial, contributor, and review sections).
Several different poets sent in poems that they used the same word to title their work. I remembered this when I came across one of them. It is titled “Battlescars.” I have been moved by each of the poems with that name and am reprinting one of them here for you:

BATTLESCARS

I lay my fingers tenderly upon them
some fine and white with age
some tanned brown, smooth and flat
Some raw. Raised. Angry.
Too new to be at peace with being.

I have been asked if I feel shame
over their being.
Shame?
Does the conscripted soldier
feel shame over shrapnel wounds?
Remnants of past savages.

My battle scars!

The undeclared war rages on
At times, the desire to abandon the fight is
Fierce
I am often dizzy from the wrath of the battle
Unsure of which direction leads us upwards
Conscripted to be part of this torment
Rightfully ensnared by the Furies

In the pale lull between skirmishes
I find reassurance in these fine lines and jagged squiggles
which bisect my arms, crosshatch my abdomen
Each one evidence of blood spilled into the swirling spiral
But each, too, evidence of a battle won
not without costs, but not without compensations.

I am.
Bottom line.
I am.

C.L. Davis

This poem makes me think of all the different reactions both I and other people have had to the scars on my body. Mine are still noticeable, though much more faded. I haven’t needed SIV in many years, yet the scars are still visible. Sometimes I’m aware of them and sometimes I’m not. On occasion other people notice them. Some ask questions, others just back away a bit. There are times I’ve answered questions directly, other times I simply lied. I’ve always wondered why some people feel comfortable talking to me about the scars even though I’m a complete stranger to them. It’s an interesting discussion I’d like to have with you. What are your experiences with scars? How do you feel about them? How do you feel about the scars of others? How do you respond to people who look at you or talk to you about scars? Let’s talk.

HELLO AGAIN!

Writing – it’s my love/hate relationship.   It takes a very strong wind to get me moving my pen to paper.  Today the wind got my attention and I am back to this blog.  I’ve missed it and I’ve missed you, dear readers.

The power of wind that has gotten me writing took two forms, one literal.  On a work trip to Cheyenne, WY I stole away for a day.  I left the city and drove to Vedauwoo, part of the Medicine Bow National Forest, renowned for its challenges to rock climbers.  I began hiking and soon my eyes moistened with tears as I began to take in this majestic area.  It was stunning, humbling, beautiful and exciting.  Several times I lost the marked trail and hiked up boulders and crawled around in cracks.  I kept moving up, eager to see a bit more of the rock, the sky, and the mountains in the distance.  I bundled myself against the strong wind while at the same time feeling the cold of snowmelt trickling and the warmth of the granite itself as the day got warmer.

Why am I writing about this?  Because this day of hiking came after a day of work during which I had the opportunity to speak about trauma and healing from SIV.  I met some wonderful people, my words seemed valued, and I felt hope that clinicians were beginning to understand those of us who live with scars created by our own hands.  And the following day out in the wild gave me time to appreciate my own journey.  The rock and birds, scrub pine and prairie dogs, didn’t care that I was scarred.  I sat in my happiness, grateful for this life I’ve had, including the despair and terror and rage.  It was all good as it had led to that moment of being out there, the work and the wilderness.

Later I returned to Cheyenne and had dinner with a colleague, poet Gayle Bluebird.  Feasting at the end of a long day we talked of work, of trying to help transform a mental health system that can seem as set in its ways as the boulders I scrambled on.   And I remembered that the change that matters is the one that comes one moment at a time.  Person to person.   And I remembered this blog.  Not being computer savvy I keep forgetting that I can write any time (the newsletter was published quarterly and I think I’m still in that rhythm).  Living in a rural area with dial-up access, using the internet does not come automatically to mind.  I had forgotten the connection I could feel through this blog.

Your words mean a great deal to me.  Every reply to a post, every letter or e-mail.  Sometimes I take so long to write that I worry that I have offended you.  Time seemed to fly by as I was doing others things, having forgotten this blog.  So I was just recently reminded how much I miss it.

As we parted, Gayle gifted me with her most recent book of poetry, written about her daughter and her daughter’s dying.  I read the first two poems and wept, tears because the words were so moving, rich with a delicate celebration as well as sorrow.  How do people heal?  Person to person.

Gayle was the metaphorical wind that has pushed me to write again.  She brought back to me the power of art, written or visual, to speak in profound ways.  I have missed the prose, poetry and art sent in by contributors to The Cutting Edge.  I remembered the poem that Gayle wrote for the newsletter, “For Children Who Keep Banging.”  I am sending that poem out so that it will be placed on the web site and hope that you all find the time to read it.  It speaks to my heart and I hope that it touches yours.  I hope that you are moved to write as well and, if you do, to send it to the rest of us.  Person to person, we heal.

I am coming back home to this blog and web site.  So sorry about having drifted away.  It’s good to be back.

I’ve missed writing to this blog. Got caught up with work and busy holidays and the time has just flown by. But I’ve got some time now, stranded in the Detroit airport, trying to get home after a work trip. This job was interesting – I was asked to tape two TV episodes for a series on mental health in Missouri. One episode’s topic was trauma and trauma-informed care; the other was self-inflicted violence (SIV). As much as I despise cameras, I thought this was a great opportunity to talk about what I believe and hope for when it comes to promoting understanding and healing for people with psychiatric labels, especially those who live with SIV. I really enjoyed spending time with the host of the program, Tom Parquette. The more we talked, the more I realized that we shared a vision of change. I hope that our dialogue is useful to people.

Yet sitting here, thinking about the conversations that were taped, I realize that I wish I had made stronger statements about the horrific impact of coercion in the psychiatric system. While Tom often urged viewers who might be struggling to seek help, I would occasionally caution people to be wary of the potential dangers that come from seeking help when you live with self-injury. Not all help is the same. Some of us have found hope and understanding from mental health professionals. But many of us have also been greatly harmed by people with the same credentials. When you live with SIV, you run the risk of being coerced into “treatment” – the belief that, since you live with SIV, you need to be acted upon “for your own good.” And it is not uncommon for “treatment” to consist of being locked away or tied down (and then being billed for it). While the goal of my work is to help create a system where trauma-informed care is available to anyone who wants it, the majority of the mental health system currently uses coercion in some form.

So what is the harm that comes from being coerced? As I thought about what I wanted to say I remembered the writing of psychiatric ex-patient, activist, and mentor Rae Unzicker’s words in her piece History, Principle, and Definition of Consumer-Direction and Self-Determination (published in The International Center for the Study of Psychiatry and Psychology Newsletter, Spring 2002, pg. 4-8). These are the words that I wish I had with me during the taping of the shows. It’s too late to say them to the cameras, but I am glad that I can share them with you.

In the article, Rae boldly spoke about the many ways psychiatrically labeled people are patronized and managed, even in the name of “empowerment.” While discussing the evolution of the consumer movement she forcefully brought out the reality that freedom cannot be possible as long as coercion remains an integral part of psychiatry. She made us consider that, while consumers can promote many changes in the system, of what merit are they when force remains? She wrote:

Involuntary treatment is the battleground – not better services, more money for SSI, managed care, or any of the other important issues we discuss politely.

Because it is the fear of civil commitment that drives each of us… You don’t get upset – and you certainly don’t get your parents upset. You become in a thousand little ways more cautious, less expressive, blander, less alive – so you don’t stand out, so no one notices you. And this is the beginning of the encroachment, when spiritual death begins. It is a day-to-day tyranny, a slow wearing down of the spirit.

No longer do you trust your own bright clear inner voice. No longer do you know what’s best for you. But someone else does.

Her words describe some of my experiences in the psychiatric system when I was being “treated” against my will. As a result I sometimes, after all these years, fear speaking my mind, whether in front of a camera, an audience or a friend, because I am afraid that someone will lock me away again. One look at my scars, no matter how old, and they might be able to get away with it. Is this likely to happen? No. But is there a remnant of fear deep in my gut? Yes. I thought I’d share it with you. That will lesson its power and next time, when I’m in front of the cameras or the audience or the friend, I will speak a bit more strongly and clearly. I will agree that people who live with SIV should have access to, and be able to ask for, all the help possible, but that there remains potential danger in the asking. I will remind myself and others that we must continue to create places of healing for ourselves and each other that do not depend on any organized system of care. Care comes from our own and each other’s understanding and tender hearts. Hope that you are taking care of yours and I thank you for listening to mine.

I wanted to share the wisest sentence I have heard about healing from SIV. This pure and simple sentence is the answer I use when I get asked “How can I make myself stop cutting, burning, punching myself?” I say the same when I am asked by friends and family of people who self-injure, or mental health or criminal justice professionals, how to “end self-mutilation.”

Most people, even some who live with SIV, focus almost completely on making SIV go away, as if it were an evil to be eradicated, after which there would be peace for all. This attitude is understandable, yet it has caused incomprehensible suffering for many who have lived with SIV. When you only care about making a behavior stop you will do anything you feel you can to make it stop. So the mental health community, and the general public as well, have accepted the need to “force” people to stop SIV. What does this force look like? Simply stated, coercion is never pretty. Nor is it effective. Force, most often, replicates previous trauma that the person who is living with SIV is trying to cope with.

If you keep healing, you will reach a point where you no longer need SIV. That will be your time to live without it. In the meantime acknowledge that it serves as well as harms, and nurture compassion for yourself while you are on the journey. SIV does not need to be forcibly stopped. SIV often helps people cope when suicide seems the only possible solution (many people don’t understand this and equate SIV with suicide attempts). I think it is crucial that we find things to live for, whether we self-injure or not, as we struggle with the pain of our histories. Many of us go on for our children or other groups of people we care about. Some turn to the arts or nature. We can discover things we are passionate about to balance the pain and the fear that we live with. And we can find others who share the journey. It helps to have a safe place to discuss all this, and that is how I hope this blog feels – like a safe place. What is it that keeps you going?

My thanks to those who have posted comments to this blog.  It is beginning to come alive to me, this new way of creating a community of people who live with SIV and our allies.  I am still new to this format, but the posts I have read remind me of The Cutting Edge, the newsletter that will soon be coming to a close.  Many of your words touched places in my heart.  Historically, the topics of repulsion/revulsion towards those who live with SIV, the idea that SIV has no purpose and must be stopped at all costs, and the link between deep and profound trauma and the need for SIV have arisen repeatedly in the history of The Cutting Edge.  To see these topics addressed in your posts made me think that we are beginning to create our own community where we can discuss our lives with SIV without fear of repercussion or judgment.

Rae questioned if many people are repulsed by or afraid of those who live with SIV.  People often have intense, judgmental and negative reactions to SIV.  It takes courage and effort for others to deal with their own intense reactions and assumptions about self-injury and learn to understand the purpose SIV serves and what helps us heal.  These allies are wonderful.  While some of them do exist in the world of mental health care providers, they are not easy to find.  Therefore, much of the time when we turn to help from the worlds of psychiatry and psychology we tend to find more trauma, little understanding, and urgent demands that we stop what, to us, feels necessary.  As Shade and others wrote, many of us fear the ending of SIV in our lives.  Of course this makes sense as it has helped us get through incredibly difficult times.  Drugs won’t help us learn how to let our feelings flow through us, help us understand how profoundly trauma effects us, nor give us the hope, community  and wisdom we need to heal and live lives we never dreamed possible.

Diane, your writing about your childhood touched my heart deeply. I do not know of anyone who has lived with SIV who didn’t have some form of trauma in their history.  Often, but not always, this has included surviving childhood abuses.  The SIV we turn to helps us manage many of the repercussions of our histories.  That is why I do not believe that attempting to simplistically make SIV “go away,” whether through drugs or any other means, is useful.  While SIV has its consequences, it also has its assets.  The drugs that are used to “stop” SIV do much of what you described - they change thinking and they change feelings.  While some people find the use of psychotropic drugs helpful in their healing, most say that being “slammed” with intense dosages of psychiatric drugs, especially the antipsychotics, leaves them feeling numb, “dead” inside, and inhuman.

Finding help from people who understand trauma is often difficult, but worth the effort.  There are some professionals who understand and are helpful (Sidran’s help desk might be a useful place to begin a search), but there are also other supports available.  People who live with or have healed from needing SIV can offer enormous wisdom and compassion.  The Cutting Edge newsletter was begun nearly 18 years ago to create a community of survivors, people living with SIV, and their allies.  It is my intention that this blog and the Healing Self-Injury web site do the same.  I think our community has begun to create itself.  Thanks to all for writing.