Article by Tony White
Sunday, 28 September 2008
Self harm prejudice
There was an article in today’s Sunday Times newspaper by Dr Cindy Pan on self harming. It is just a short piece and quite a good statement of what the literature says in general and it does in particular highlight a prejudice that is commonly, if not very regularly found in the writings on self harm.
There are a number of reasons why people self harm and I have listed four below
1. Cutting self to release stress and tension
2. Cutting self to get a sense of feeling real
3. Cutting self to manipulate others
4. Cutting self to get attention
Some self harm for these reasons
For some reason numbers 3 and 4 are seen in a most derogatory light by the general public and indeed in the technical literature as well. For instance Cindy Pan states, “While some have mistakenly viewed SIB (Self-injurious behaviour) as a “call for help” or a type of attention seeking behaviour, it is generally a highly secret activity, with self injurers usually going to extensive lengths to conceal and wounds”.
Why has she used the word ‘mistakenly’, what’s wrong with self harming to get attention?
Number 1 cuts self to release tension and number 4 cuts self to get attention. Both engage in self harm for a clear psychological gain, the first to release tension and the second to get attention. What’s the difference?
There is a belief out there, sometimes stated and sometimes not that when a person does attention seeking behaviour then they are considered pathetic, amoral, inferior or words to that effect. One is viewed in quite a poor light. This is for self harmers and otherwise.
Of course the support groups for self harmers have been quite vigourous in downplaying those who self harm to manipulate or seek attention. Understandably so, as they are wanting the public to view self harmers in a better light not a worse light. Some groups try to deny that there is any who self harm for attention seeking or grossly play down the numbers. Dr Cindy Pan seems to be doing the same. In some ways it has now become sort of politically incorrect to say that a person cuts self so as to get attention.
It took me five minutes to find this on the internet. There are thousands and thousands who are willing to put their self harming and their faces onto the internet for the whole world to see. Yes some do self harm very privately and there are others who are public about it. Obviously different motives are in play.
Whilst all this is good and well there is just one problem. There are people who do self harm to get attention and to manipulate others into certain actions. For instance the woman who cuts self because she knows that will get her placed in hospital for a couple of days. Or the person who self harms because they know that their suicidal statements will then be taken more seriously. What about these people? Not only do the general public look down on them but the self harm support groups deny that they even exist!
So these people:
3. Cutting self to manipulate others
4. Cutting self to get attention
have become the lepers of the leper colonies. They are at the bottom of the bottom of the pile.
One consequence of this shows up in Cindy Pan’s article. At the end she writes about what can be done to help self harmers. The focus is very much on those who self harm for reasons such as tension release or to get a sense of ‘realness’. There is little or none written on what you do for those who self harm to manipulate others. Why would one write about them when they have just stated that they kind of don’t really exist anyway.
In this way what she has written is representative of the clinical literature as well. There is very little written on what treatment one uses for those who self harm to manipulate others or to get attention. Again, how can there be as it is seen as politically incorrect to make such an assertion in the first place!
One treatment strategy that I have used with such people is working with their stroke filters in conjunction with an adaptation of the no-suicide contract which in essence is a no-self harm contract.
[Link: Graffiti]
There are a number of reasons why people self harm and I have listed four below
1. Cutting self to release stress and tension
2. Cutting self to get a sense of feeling real
3. Cutting self to manipulate others
4. Cutting self to get attention
For some reason numbers 3 and 4 are seen in a most derogatory light by the general public and indeed in the technical literature as well. For instance Cindy Pan states, “While some have mistakenly viewed SIB (Self-injurious behaviour) as a “call for help” or a type of attention seeking behaviour, it is generally a highly secret activity, with self injurers usually going to extensive lengths to conceal and wounds”.
Why has she used the word ‘mistakenly’, what’s wrong with self harming to get attention?
Number 1 cuts self to release tension and number 4 cuts self to get attention. Both engage in self harm for a clear psychological gain, the first to release tension and the second to get attention. What’s the difference?
There is a belief out there, sometimes stated and sometimes not that when a person does attention seeking behaviour then they are considered pathetic, amoral, inferior or words to that effect. One is viewed in quite a poor light. This is for self harmers and otherwise.
Of course the support groups for self harmers have been quite vigourous in downplaying those who self harm to manipulate or seek attention. Understandably so, as they are wanting the public to view self harmers in a better light not a worse light. Some groups try to deny that there is any who self harm for attention seeking or grossly play down the numbers. Dr Cindy Pan seems to be doing the same. In some ways it has now become sort of politically incorrect to say that a person cuts self so as to get attention.
Whilst all this is good and well there is just one problem. There are people who do self harm to get attention and to manipulate others into certain actions. For instance the woman who cuts self because she knows that will get her placed in hospital for a couple of days. Or the person who self harms because they know that their suicidal statements will then be taken more seriously. What about these people? Not only do the general public look down on them but the self harm support groups deny that they even exist!
So these people:
3. Cutting self to manipulate others
4. Cutting self to get attention
have become the lepers of the leper colonies. They are at the bottom of the bottom of the pile.
One consequence of this shows up in Cindy Pan’s article. At the end she writes about what can be done to help self harmers. The focus is very much on those who self harm for reasons such as tension release or to get a sense of ‘realness’. There is little or none written on what you do for those who self harm to manipulate others. Why would one write about them when they have just stated that they kind of don’t really exist anyway.
In this way what she has written is representative of the clinical literature as well. There is very little written on what treatment one uses for those who self harm to manipulate others or to get attention. Again, how can there be as it is seen as politically incorrect to make such an assertion in the first place!
One treatment strategy that I have used with such people is working with their stroke filters in conjunction with an adaptation of the no-suicide contract which in essence is a no-self harm contract.
[Link: Graffiti]
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