The constant change, uncertainty and isolation of lockdown has presented additional challenges for people living with mental ill health. I wanted to explore this more closely by looking at the much misunderstood issue of self-harm, and was lucky enough to catch up with Natalie and Emma who are our Recovery Practitioners in our Fife Self-Harm Service. They’re brilliant and here’s what they had to say.
We know there’s a relationship between self-harm and our emotions. Often when we experience emotional distress it is very unpleasant and we don’t quite understand how to process this. Add to this the fact that many people have never been encouraged to express themselves in this way or have the vocabulary to describe what is going on internally, the easiest way to get some relief is by taking it out on ourselves. This often manifests in replacing the emotional pain with an external pain which is easier to manage and able to rationalise.
It’s important to know that anyone can find themselves using self-harm as a coping mechanism. So many people use self-harm behaviours and will be completely oblivious to the fact this is a coping mechanism, especially if this is done in a socially acceptable way. For example, drinking alcohol to manage how we feel.
There are lots of stereotypes and myths around self-harm. Many people think that people who self-harm are attention seeking. This is a huge misconception and the majority of people we support feel a great deal of shame and embarrassment around their behaviours, and actually go to great lengths to hide it from other people.
The changes associated with lockdown and then the easing of lockdown measures pose challenges for people who self-harm. Loss of routine seems to be a major factor for the people we work with, leading to lack of motivation and uncertainty around how to structure their time in a meaningful way. Being around family more who don’t understand can lead to a more hostile environment which only increases the want to use unhelpful coping strategies. It can be a very damaging cycle where no one feels validated and ultimately intensity of emotion builds with no outlet. We can encourage people to research and gain understanding of their loved one’s behaviours as this is a complex issue and blame needs to be left out of the equation. There are lots of resources out there and allowing for an open discourse to take place can help everyone in gaining trust and potentially creating a healthier communication pathway for all.
During times of change, it’s really important to remember to be kind to yourself, don’t expect to not feel triggered. It’s normal to struggle with change, even good change! Have a diary or somewhere you can record the emotions arising for you the intensity you are experiencing these at. How long is it lasting? What can you do to keep safe in those moments? Move your body! This is so powerful in helping channel negative energies, and getting away from the tools you may use in your self-harm behaviours. Most importantly, find what works for you, everyone is different and responds differently. Make sure you can get some enjoyment from the things you choose as distractions.
Communication with loved ones is really important.
Having a clear way to communicate with the people you live with, whether that involves a scale you keep on the fridge which other people can see to indicate how you are feeling at a particular time or if you have a code word you use to indicate a time when you need extra support. Whatever works best for each person, so long as they feel comfortable and confident to reach out when support is required.
It can be difficult for loved ones, too. At times, family members may feel frustrated or confused by the behaviours associated with self-harm and initially might have a negative or unhelpful attitude towards an individual or situation and whilst this does often come from a place of love and concern, can be off putting for anyone who perhaps is struggling to find ways to open up and discuss how they are feeling and coping. It is therefore important that any approach is calm and doesn’t give reactions which will make anyone feel guilty (as they will likely already feel this way).
Simply being there and listening is often the most powerful thing you can to someone who might be struggling.
Here at Penumbra 20% of our colleagues are employed in peer support roles.
We know that peer support can be a very powerful tool in providing hope and reducing the isolation an individual may be experiencing during recovery.
It removes the stigma and can give a sense of life improving if there is someone with lived experience who can provide examples and techniques that were useful to them in reducing their self-harm behaviours.
Thank you to Natalie and Emma, for sharing your insight on self-harm. The Penumbra self-harm team have been continuing to work throughout lockdown and are supporting people through phone support, zoom calls and emails, depending what works best for each person. You can find out more about the Fife service HERE or read the Penumbra Self-Harm Factsheet.
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(since this story was published, Emma has moved on to a new role)