Ever heard of someone cutting or hurting themselves to make them feel better? Where emotional battles often remain unseen, the scars of self-harm can be a visible sign that someone has attempted to cope with emotional pain by hurting themselves. Many young people are fighting this terrible battle.
The act of deliberately hurting oneself, usually through cutting, hitting, or scratching, is a critical behaviour that is becoming increasingly common, especially among teenagers and young adults.
Linda Sterkenburg, a clinical psychologist from Kempton Park in Gauteng, explains that self-harming is caused by a combination of mental health difficulties and stressors or triggering events that surpass the individual’s emotional coping abilities.
“The contrary is also possible, as it is sometimes seen when individuals express feeling nothing, are numb, or are emotionally disconnected and therefore harm themselves in order to feel something,” she says.
‘I would cut myself’
Nokuthula Mkhonza from Pretoria, who started self-harming at the age of ten looking for an escape from reality, is almost a year self-harm-free. She recalls not being able to control her feelings and remembering things she wishes had never happened as her biggest triggers.
“I would cut my wrists with glass and would purposely break glass to use it. I’ve gotten myself admitted four times since 2020 so people around me took time to trust me around sharp objects.
“Loneliness can drive you to self-harm, so I call my friends and my mother because I tend to want to self-harm most of the time when I’m alone.
“Also, I now understand that it’s not worth it. One cut too deep, and you’re gone or in the E.R. My doctors are also great; they understand me and are willing to listen. It’s like having someone hold your hand with every step you take,” says Mkhonza.
After being formally diagnosed with clinical depression and anxiety, Vikelwayinkosi Msomi from Durban, who is also now self-harm-free, started harming herself in 2019 by using a shaving razor. She says it felt like a way to escape her depression.
“I used to cut my thighs, and then it was my arms (wrists) from there. At first, I never understood why, but after therapy, I gathered that I don’t relate to emotions of hurt or pain; hence, I divert them to something physical.
“And once I bleed, only then can I see the pain I’m feeling or going through, but it’s more of a relief from not wanting to relate to or feel any emotion,” explains Msomi.
“I’ve joined things that force me to be around people, like the gym, sports, and just any varsity activities that can keep a person busy. Therapy, apps to keep track of and keep the journey going as well as a support system, from your family to your friends, assist in managing it.”
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Treat the underlying cause
Sterkenburg explains that noticeable behavioural changes such as isolating or withdrawing from others, wearing long-sleeved clothes even when hot, frequent excuses for bruises or injuries, a tendency to impulsive behaviour, and emotional instability are a few signs that can indicate that someone may be self-harming.
Depending on the underlying mental health condition, Sterkenburg states that effective interventions for self-harming might differ, but she has found that awareness tends to be a big determining factor in the treatment.
“The individual must be willing to see the self-harm as a problem that needs to be addressed; if they don’t recognise it as a problem, the prognosis of treatment also becomes smaller. Various therapeutic approaches have been found effective, such as dialectical behavioural therapy (DBT), cognitive behavioural therapy (CBT); and mindfulness-based therapies.”
“I use a lot of psychoeducation because I believe if we want to learn to control or change something, we must first understand it. I also draw strongly on skills training from CBT and DBT in order to equip the individual with constructive emotional coping skills,” she says.
This can help
Distraction and the use of alternatives or substitution behaviours are also often used to deal with the urge to self-harm.
Sterkenburg suggests some ideas, such as:
- Cutting or smashing clay moulds using a blunt object.
- Squeezing ice in your fist.
- Cleaning
- Listen to music or watch a feel-good movie.
- Exercising
- Focus on your breathing (deep breathing).
- Express yourself by crying, drawing, or writing whatever you are experiencing inside of you.
- Mindfulness grounding by focusing on your environment and your five senses (what do you see, hear, smell, feel, and taste) around you.
- Doing yoga
- Use an app like ‘Insight Timer’ (there are various) to do some guided meditation.
- Doing something nice for someone else.
- Taking a hot or cold shower or bath.
Furthermore, she adds that self-harming is often misinterpreted as linked to suicide attempts, which is not always the case; in fact, it rarely is. Another misconception she mentions is that it is just done in an attempt to get attention.
“Both of these misconceptions lead to loved ones frequently responding with judgment, condemnation, or anger, which is not constructive.”
Clinical psychologist Linda Sterkenburg
The role of loved ones
“Loved ones should try to still demonstrate love, understanding, and acceptance of the individual. We might not agree with or understand certain behaviours, but it is important that the person is seen as separate from their behaviour and that they are loved and accepted.
“Rather than responding with assumptions, judgments, and threats, try to demonstrate care and concern by trying to help and encourage them to try and understand their emotions or reasons for self-harm and investigate or try to find healthier alternatives,” advises Sterkenburg.
If you or someone close to you need help, please call the South African Depression and Anxiety Group (Sadag) on 0800 567 567 or check out their website.
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