When we’re confronted by someone who is self-harming it brings up all sorts of difficult feelings: fear, anger, guilt, condemnation. When the self-harming results in a suicide attempt these feelings are magnified. What we can lose track of is what it is like for the individual whose suffering is being expressed in this way. The best way to understand what they are going through is to listen to them, and particularly to listen out for how they experience others’ reactions to their self-harming.
The subject of taking an overdose is particularly fraught with stigmatizing attitudes; if you do this and regret it afterwards you know that you need to tell someone, but doing so can be terrifying because of the knowledge that you may be judged. Self-harming and then seeking help can look on the outside like some kind of ‘attention-seeking’: one young woman described how the first time she had to seek medical help after an overdose the attitudes of the A&E staff reflected this. She felt judged and misunderstood and was frightened about seeking help in the future because of this experience. The next time she took an overdose the last thing on her mind was seeking attention – she did it impulsively because at that moment she wanted to die, or at least harm herself as punishment (as she herself to be a ‘bad person’).
When she had to go to A&E she was very nervous in case she experienced judgemental attitudes again. However this time, and throughout her stay in hospital, the care was fantastic. There were no snarky comments from nurses, the A&E doctor held her hand and said she’d endeavour to make sure that she would get the help she needed so she wouldn’t be in this position again, and further doctors listened and let her talk about what had happened without jumping in with pre-conceived ideas of what her motivations were.
This experience of people listening from the very beginning, and being able to talk things through, enabled her to come up with plans to stop it happening again, and to start to get better much quicker. And now she feels safer about seeking help if it were to happen again.
I think the lesson that we can all learn from this is recognise the person behind the behaviour. To remember that we don’t know the intentions of that person, and that person may not be entirely sure of them either. Self-harming may have seemed the only (or the least worst) option available to them at the time. Above all, we need to remember that this person is someone who deserves dignity and respect, just like anyone else.