Deliberate self-harm is the term used to describe behaviours that involves a person intentionally injuring or hurting themselves. Deliberate self-harm can take both direct (e.g. suicide attempts, overdosing, hanging, cutting, etc.) and indirect (substance abuse, eating disorders, excessive exercise, engaging in risky behaviours etc.) forms. In most cases, self-harm is not intended to be fatal. Often people use it as a way of regulating their emotions during times of emotional distress or as a way of dealing with difficult memories. For others, they may use it as a method for self-punishment or to show others how bad they feel. While the intention might not always be to end one’s life, deliberate self-harm is still extremely serious and usually reflects an individual who is experiencing extreme levels of unhappiness and distress.
One area of deliberate self-harm research has been devoted to finding out how people access information about deliberate self-harm. With the emergence of the internet, we now have access to a constant flow of information and communication networks at our fingertips. While this means that people who are experiencing distress can readily access helpful information and support, the internet also hosts access to sites that encourage deliberate self-harm behaviours, provide information on how to complete such behaviours and forums that discuss these behaviours in a negative and unsupportive context.
A recent psychological study carried out by psychologist Becky Mars and her team at Bristol University and in partnership with the Samaritans in the United Kingdom, demonstrated that a large proportion of young people use the internet to search for information regarding suicide and deliberate self-harm. Of a sample of almost 4000 young people, they found that approximately 22% of this group had deliberately self-harmed in the past with 11.9% reporting having come across sites/chatrooms discussing self-harm or suicide, 8.2% having searched for information about self-harm, 7.5% having searched for information about suicide and 9.1% having used the internet to discuss self-harm or suicidal feelings.
What these statistics highlight is that a large proportion of people are engaging in deliberate self-harm behaviours. As well as this, they illustrate that people are turning to the internet as a source of information for suicide and self-harm. Thankfully, Mars and her team found that people were more likely to have accessed positive and supportive resources than resources promoting or offering dangerous information regarding suicide and self-harm. These figures highlight that such information is readily accessible and that those individuals who are at-risk of suicide or deliberate self-harm are more likely to access this type of information instead the negative information.
Nevertheless the negative information is out there and is easily accessible for someone who may be looking for it. If you suspect that you or someone that you know is at risk of deliberate self-harm, the best thing that you can do is prepare yourself with the information that you need for assessing and responding to such risks. Given the current findings, it may be beneficial to monitor that individual’s internet usage and search engine terms. If you feel that there is an immediate risk, please contact a medical professional or bring yourself or that person to a place of safety (local doctor, emergency room, etc.). It is important to respond in a supportive and engaging manner. Try your best to remain non-judgemental and calm. Try to learn about the problem and promote seeking professional help.
The following information can be helpful when assessing and responding to risk for deliberate self-harm behaviours:
- A number of factors increase the likelihood of an individual engaging in deliberate self-harm behaviours, these include:
- Presence of a mental illness (e.g. depression, anxiety, borderline personality disorder, chronic pain).
- Presence of emotion regulation difficulties
- Low self-esteem
- Misuse of drugs and alcohol
- Sociodemographic factors
- Females are more likely to engage in self-harm but males are more likely to complete suicide
- Gay, lesbian and transgender individuals
- Individuals from lower socioeconomic status
- Significant or stressful life events such as bullying, history of sexual or physical abuse, parental/marriage separation, excessive stress at school/work, etc.
- Things to look out for if you suspect that someone you know is at risk of completing deliberate self-harm behaviors:
- Extreme changes in mood
- Social withdrawal and increased time in isolation (e.g. spending a lot of time alone in their bedroom)
- Loss of interest in things that they used to enjoy/school/work
- Changes in sleeping/eating patterns
- Avoidance of wearing clothes that expose their arms and legs
- Strange excuses for injuries such as scratches or burns
- Hiding or washing clothes/sheets
- Purposeful hiding of blades or lighters or equipment that might be used in deliberate self-harm
- The presence of excessive drinking/drug misuse
If any of this information prompts your concern, please do not panic, there are a number of treatment options that have been shown to be effective in the treatment of deliberate self-harm behaviours. Both medication and psychotherapeutic treatments exist. Often times, psychotherapy is advised as it allows you to deal with the source of the problem behaviour and learn new ways to cope. There are several forms of psychotherapy that can be helpful including Cognitive Behavioural Therapy (CBT), Dialectical Behaviour Therapy and Acceptance and Commitment Therapy (ACT). The type of therapy that you or someone that you know should engage in depends on the type of difficulties that you are presenting with. Professional consultation is therefore advised.
Often times, deliberate self-harm masks a bigger problem that can and should be treated. The internet offers an initial point of contact for information and support for deliberate self-harm and suicidal behaviours but should not be used to replace professional guidance and support. Please follow the following steps if you feel that someone is at risk:
- Call your doctor.
- Call 911 for emergency services.
- Go to the nearest hospital emergency room.
- Call the Crisis Line Association of BC (250-753-2495), or 310 Mental Health Support Line (310-6789) or the Crisis Intervention & Suicide Prevention Centre of BC (604-872-3311/604-872-0113).
Niamh Allen, M.A. B.Sc.