Self-harming is much closer to home than we think and there are more forms of it than we are aware of. A study in 2016 had showed that it is one of the leading causes of death among youth in India. The Institute for Health Metrics and Evaluation had found that about 60,000 youth in India died every year because of self-harming.
Experts told HuffPost India that self-harm is becoming more common than we can imagine. Vaishali Rathore, of The Recover Clinic in Delhi said, ”Today, children are exposed to the idea that one can self-harm. The barrage of information one is exposed to adds to the risk of self-harming. Children often pick up the idea of self-harming if they see someone do it, like a family member or a friend.”
However, it is not just children or teenagers who self-harm. A Geethan, a counselor with Chennai-based counselling and psychotherapy institute Nibbana, said that in recent months, a significant number of patients have approached him are self-harming because of issues related to mid-life crisis. “Mid-life transition is a tricky situation. We grow up with a particular identity, but mid-life sometimes demands we create a new identity for ourselves. This creates a lot of disturbance in the mind and the body,” he said.
What is self-harm?
Mumbai-based psychologist Pushpa Kamath said, “There are different forms of self-harm. Hitting oneself, banging their head on the wall, both commonly seen in young children.”
Cutting or scratching exposed body parts with blades and other sharp objects is also considered self-harm.
However, self-harm can be much more than just hurting the physical body. Rathore said self-harm is a wide term.“It could rage from anything between negative self-talk to the point where the person is dysfunctional to physically harming oneself. It is a spectrum. Clinically it could mean a form of inflicting harm to oneself whether willingly or unwillingly, to a point where their life is at threat.”
Why do people self-harm?
A deep sense of guilt, self punishment or not having control over one’s life can lead to self-harm. These issues often stem from experiences of childhood — from abuse, authoritative parents, parents in bad relationships.
“Self-harm is a cry for help. It is because of the inability to cope with emotional pain Self-harming gives them relief and eventually becomes a coping mechanism. Sometimes people self-harm when they have an underlying poor ability to express themselves using words. In order to relieve themselves from distressing feelings, they resort to self-harm,” said Kamath.
“People do it out of compulsion and not out of free will."
For some people, self-harming can become the only thing that they have control over in their lives. Geethan said, “One may self-harm when they feel like they have no control over the distress that they are in. They do it to compensate for the powerlessness in that situation, to feel like they are in control.”
In this bid to gain control over their situation, it often becomes a habit. Rathore said, “People do it out of compulsion and not out of free will. They also sometimes get a sense of pleasure. Sometimes it does not come in the way of their functionality. There are stages of self-harm — at the thought level and when people indulge in the action. When it gets more aggressive, it becomes a habit.”
While seeking professional help is the only way to help yourself, experts told us steps we can take to deal with the urge. Here are seven things they suggested:
Change the environment
People often self-harm in their own protected spaces where no one can see them. Hence moving out of that space can help. Moving to a public place can often help people change the looping thoughts in their mind. “Wherever you are sitting, for that time being, change your environment. When you are stationary, if your mind is stuck, try to physically move your body. Moving out of the environment, from the situation, from the room or bathroom helps reduce the intensity of the thought. When it comes to self-harming, it is a thought that becomes emotion, emotion becomes energy or urge and then it becomes action,” Rathore said.
Listen to music
Music often helps people change their mood. Kamath said, “Listening to your favourite song or humming that song can help.”
It can even help break the loop of thoughts that lead to self-harming. “Music is very therapeutic. Our minds often needs certainty. So one can create a playlist of their favourite songs and listen to it every day and also in times of distress. Focus on one instrument,” Rathore said.
Often, letting out bottled up emotions by colouring or doodling can also help. Kamath said, “Mandala coloring books, doodling on paper or colouring can also be helpful.”
Rathore said that she often asks her patients to doodle on the part of their body that they usually harm. “We ask them to draw things on their skin that they really like with sketchpens, things that are meaningful.”
Experts say that venting often helps. Telling trusted people something like “I want to cut myself” multiple times can even help one from actually taking action. Kamath said for teenagers it should be a “trusted, non-judgemental” adult or a best friend. “It is very important for people to have important bonds with others. Sharing the emotion behind why people want to self-harm is very important. Recovering addicts often tell others that they have an urge, but don’t actually indulge in the action. Most self-harmers are not comfortable with anyone. They should fine people they are comfortable with, so that they can vent to them,” Rathore said.
Rathore said that for that anyone who is listening to a person venting out their urge to self-harm, should try every possible way to have the person move out of their immediate triggering environment. “They should take their venting as venting and not engage or reassure with what the person is venting in any way. This is just to buy time and allow venting.”
Play with your pet
Animals are known to have a calming effect on humans. Kamath said when feeling the urge to self-harm, “if you have a cat, play with it. If you have a dog, take it out for a walk.”
Breathing is known to help people centre themselves, get themselves out of their heads and concentrate. Kamath said, “Practice breathing techniques. Alternate nostril breathing can help calm the mind.”
“If we can take deep breaths to our gut area, it is a neutral space in the body. If you are able to take breath to the gut and keep breathing, the thought won’t translate into action,” Geethan said.
Maintain a routine
Rathore said that human brains like certainty. And the best way to give it certainty is to have a routine. “Sometimes people who self-harm have a very warped routine. So they need to do something, for at least one hour a day that helps them connect to themselves, something they enjoy. It should be an hour a day that is sacrosanct and it should involve just you,” she said, adding that it could be anything like exercising, yoga, chanting.
Seek professional help in the long term
While these are some of the ways in which a person who self-harms can help themselves, experts say the long-term need is to seek professional help. “Self-harm is just a symptom of a deeper emotional issue. One must seek therapy to address it,” said Geethan.
If the person involved is unwilling to work on themselves, Rathore said their trusted friend and partner can also “get in touch with an expert and work as a surrogate in therapy”.
If you or someone you know needs help, mail email@example.com or dial 022-25521111 (Monday-Saturday, 8am to 10pm) to reach iCall, a psychosocial helpline set up by the Tata Institute of Social Sciences (TISS).