SELF INJURY - SCARS THAT WILL NOT HEAL

Factfile

Most people who self injure dislike the term 'self mutilation' as it suggests an intent to harm and maim the body, which is usually not the case;

Self-injury is probably the result of many different factors, such as a lack of role models, or never learning appropriate ways of expressing emotion;

There is growing evidence to indicate self injury may be a result of specific problems within the brain that cause an increase in impulsive and aggressive behaviour. Impulsive aggression, combined with a belief that expressing it outwardly is bad, mightlead to the aggression being turned inward;

Those who self injure come from all walks of life and all economic brackets. Some manage to function effectively in demanding jobs, such as teachers, lawyers and engineers;

Ages typically range from early teens to early 60s. The incidence of self injury is about the same as that of eating disorders, but because it's so highly stigmatised most people hide their scars, bums, and bruises carefully;

Self injury is a coping mechanism, just as some turn to alcoholism, drug abuse, overeating, anorexia, bulimia and smoking;

Self injury is very rarely a failed suicide attempt. People who inflict physical harm on themselves do so as a way to keep from killing themselves;

Medications, such as mood stabilisers and anti-depressants have been tried with some success, but there is no magic pill for stopping self harm;

Therapeutic approaches like learning new coping mechanisms reflect a growing belief that much can be done to solve the problems and issues underlying the self-injury.

On the surface, Simon has it all. He has the gleaming new sports car, the city living apartment, the successful career, the wide circle of friends.

He enjoys a comfortable, financially-secure life and is still two years off the big 30.

But the smiles and the trappings of success mask a dark secret.

Since his mid-teens Simon has suffered from a debilitating ailment - he feels he is unworthy of success and cannot come to the terms with the fact he has done well for himself.

From the age of 15, this ailment has manifested itself in the most brutal way. Simon's arms, permanently covered by long-sleeved shirts and jumpers whenever he is in public - whatever the weather - bear the ugly scars of more than a decade of selfinjury.

'I used to think 'Why am I doing this to myself?', but I've managed to trace it back to my boarding school,' he reveals. 'I won a school prize at 14 and got teased and bullied remorselessly. Ever since I' ve hated myself for doing well.

'I got A and B-grades in all my GCSEs and celebrated by cutting myself 12 times, one for each subject. When I did well in my A-levels and got a place at Oxford University I cut myself so badly I had to go to the A&E department of my local hospital.

'Every time something goes well for me, I feel I'm not worthy. I can' t express the reasons why and the only thing that feels like it works is to injure myself.'

Experts agree that self injury is normally done as a way of coping with overwhelming periods of emotion, to help deal with feelings of unreality or numbness, to make flashbacks stop, to punish the self and stop self-hating thoughts. Self injury is seenas more about relieving tension or distress than anything else.

Yet, in truth, the level of 'expert' awareness about self injury is very limited.

Simon, in common with many others like him, has needed hospital treatment on occasion after injuring himself. However, he has experienced a response bordering on hostility from medical staff.

'There did seem an anger that I was taking up valuable time with something that was self-inflicted when people suffering injuries caused accidentally were having to wait. At no time did anyone ask why I was doing it. The attitude seemed to be to patch meup as quickly as possible and get rid of me.

'It was only 18 months ago that someone offered me help. I now receive counselling and I've been given a few techniques to try when I find myself in difficult situations.

'But it still bubbles beneath the surface. My counsellor complemented me a few months ago on how well I had responded to our sessions and I went home and made a deep cut in my forearm.'

Not surprisingly, Simon finds it almost impossible to talk about his selfinjury. His family, closest friends and employer all remain unaware of the torment he feels.

But he does feel he is making progress and he wants to help raise awareness of what is happening to thousands like him.

Tomorrow is Self Injury Awareness Day and organisers hope to encourage people - from parents of sufferers to the medical profession - to find out more about the issue and try to begin to understand what lies behind the emotive title.

Most researchers agree that self injury is not done with suicidal intent or to gain some form of sexual pleasure.

Although cut-ting is the most common form of self injury, burning and headbanging are also very common. Other forms include biting, skin-picking, hairpulling, hitting the body with objects or hitting objects with the body. Although it is a crude andultimately destructive coping mechanism, it works in the mind of the person doing it and so can have addictive qualities.

'I felt unworthy and I felt that when I got any attention I needed to be punished,' recalls Simon. 'So cutting myself was a way of dealing with all those different emotions I was feeling.

'In a strange way, it made me feel better about myself. So it did become addictive and I didn't think twice about it.'

Simon knows the next big step is telling his parents and friends. And hefeels the time is now right. As a result of the counselling sessions and self-help group he regularly attends, he feels more confident about revealing more about his self injury.

He has also embarked on a serious relationship, his first since his early twenties. Initially he used his normal excuse to explain away the deep scars on his arms to his new girlfriend - they were the result of a car crash in his late teens.

But he has now told his girlfriend the truth and no longer feels so selfconscious about exposing his arms to her. 'She has been amazing, a lot more understanding than I thought possible.

'It took me ages to understand all this, so I didn't think anyone else would be able to cope. But she still loves me for who I am and I don't feel any anxiety about the fact that I have a successful relationship.

'We're taking this slowly. It is a clich, but it is a case of taking one step at a time and taking very small steps.

'The next step is to tell my parents. I'm 99 per cent sure they will react in the same way as my girlfriend, but until the moment arrives there will always be that nagging doubt.'

Simon has been amazed how many people attend the same support group as him and at their diverse ages and backgrounds.

'It can affect anyone at any time,' he adds. 'This is not all about teenage girls struggling with growing up and spending hours in their bedroom.

'It is not about suicidal young men who feel the world is passing them by.

'The sooner people realise how widespread this is, the easier it will be for us to talk about it and deal with it.'

For information log on to www.selfinjury.org.uk, or contact the mental health charity Mind on 0845 7660 163.

Paul Groves, Perspective: Self abuse scars that time will not heal. , Birmingham Post,