Rates of self harming increased by 33 per cent last year – but there is help available, and increasing awareness is the first step to aiding recovery, writes ROISIN INGLE
MOIRA* BEGAN CUTTING herself when she was 11 years old. Almost 10 years later, the Dubliner remembers the first time she dismantled a pencil sharpener and used the blade to cut her wrists. Her home life had always been difficult. Shunted between feuding separated parents, she found the family situation painful but didn’t feel able to discuss her problems.
Self harming became a way to communicate her pain. “It was like I found an easier way to deal with all the stress,” she says. “Cutting myself was something I did nearly every time I got upset. Over the years it got worse, I started getting what I now know were panic attacks and the cutting became more regular. By the time I was 15 or 16 I was doing it every other day.”
She rolls up a sleeve to show forearms criss-crossed with scars, some faint and silvery, others more prominent. As the years passed she never graduated to knives or other implements, preferring the childish connotations of the pencil sharpener blade.
“I think I was afraid to use anything else. I started using it as a child and I never grew out of it,” she says. There is, though, a particularly unsightly scar – long and painful-looking – that is one of the most recent, the result of a drunken night out when she had a row with her boyfriend, the father of her now one-year-old son.
“I smashed a glass and used it on my arm. It was the first and last time I ever did anything like that. There was blood everywhere. I had to go to hospital,” she says. She still has occasional twinges in her arm due to nerve damage caused by the incident.
The cutting provided some relief and a kind of escape from her problems but most of the time it was followed by feelings of shame and self-loathing. “I saw lots of counsellors over the years and sometimes I would exaggerate to them what I was doing. I suppose I was kind of hoping somebody would do something”.
LAST WEEK IT emerged that the number of people seeking help at Pieta House, one of the country’s largest crisis centres for self harm and suicide, rose by 33 per cent last year. This included 292 people who were treated for self harming.
The latest report from the National Registry of Deliberate Self Harm Ireland also showed a worrying increase, recording 1,000 incidences of self harm between 2008 and 2009, from close to 11,000 hospital admissions to almost 12,000.
Dr Ella Arensman of the Cork-based National Suicide Research Foundation says the economic downturn has been a factor in the increase. Of particular concern is the 11 per cent increase among men, the highest rate since records began six years ago. Most self harming is done by young people – almost half of those who presented were under 30 years of age.
According to Joan Freeman, founder of Pieta House, the only centre in Ireland offering treatment specifically to those who self harm, the behaviour is often “lumped in” with suicide attempts.
While the self-harm category is the most high risk when it comes to suicide, she says it should be treated very differently.
“What we know is that self harm, for many people, is a way of communicating distress. It happens with people who haven’t been taught how to express fear or pain, or emotions that occur under difficult circumstances,” she says.
“The body becomes a blank canvas, with the scars and the wounds telling the story of the crisis a person is going through.”
Medically referred cases have been well documented but Arensman says the hidden cases are likely to be far greater in number. She points to a school-based survey of 4,000 young people conducted a few years ago which found 9 per cent of those surveyed had engaged in self harm.
“Of that group, 85 per cent indicated that, while they had self harmed, they had never been in contact with the health authorities. From this we were able to estimate that, across the country, there are around 60,000 cases of self harm that are not coming to light,” she says.
There is evidence to show self-harming rates have increased in line with the increase in alcohol and drug abuse. “I don’t think we are taking self harm and suicide as seriously as we should be at the moment,” she says.
“Over the last three years, self harm and suicide have increased, but there hasn’t been a similar intensive response. We are facing a major paradoxical situation where we can see the rates increasing while the capacity of services to deal with it is going down. The very last services that should be cut during a recession are those in the area of mental health.”
Freeman, author of Cover Up – Understanding Self Harm points out that self harming does not just include drug overdoses or cutting, the most widely used methods, but can range from chronic nail picking, scalding or swallowing objects such as batteries. Other socially acceptable self harming behaviours, she says, include bingeing on food or alcohol, extreme dieting, smoking or cosmetic surgery.
In the five years since Pieta House was established, five centres have been set up around the country, including busy facilities in Cork and Limerick.
Around 4,000 people aged from six to 83 have been given treatment which is based on helping clients find more healthy methods of self care and self expression.
“We never tell them to stop,” she says adding that such a strategy might increase the person’s anxiety levels or make them fearful of confiding in anyone about their issues. A symbolic “Darkness Into Light” walk from dawn on Saturday morning in venues across the country will help raise funds for the centres which provide all treatments completely free of charge.
While Freeman says many of those who self harm do not have psychological disorders, Moira’s self harming came to an end almost a year ago, not long after the birth of her son, when she was diagnosed with a personality disorder – a diagnosis which, she explains, came as a huge relief.
“I knew there was something wrong,” she says. “I knew there must be a reason for the panic attacks and cutting myself. Since I was diagnosed my emotions are much more controllable. I do still think about cutting myself but I don’t act on it.”
She knows she needs ongoing support and has regular appointments with a psychologist who she says has been “amazed” by her progress. “It’s like something clicked in me when I realised there was a reason I was doing what I had been doing,” she says.
“There is a way out for people,” says Freeman. “We need to communicate the message that there is help out there and there is hope.”
* not her real name
The annual Pieta House fundraising walk will be held in Dublin, Limerick, Cork, Clare, Kerry and Galway this Saturday, May 7th. For details of the 5k events and to register see darknessintolight.pieta.ie.
Helplines for those in need of support with the issues raised in this article include the Samaritans (samaritans.ie, 1850 60 90 90) and Aware (aware.ie, 1890 303302)
