This article was inspired by conversations with friends and colleagues, including Aimee Wilson of I’m NOT Disordered who recently shared on social media that she was a day away from celebrating one year free of self-harm. In addition to talking with Aimee about her achievement, in the past week I’ve spoken to two people beginning their respective journeys to shed unhealthy dependencies. One is working to break an addiction to sugar and unhealthy food. The other is determined to give up alcohol and nicotine. Despite very different situations and experiences, certain themes kept coming up, which I want to explore in this article. I should state up front that I have no first-hand experience of self-harm or addiction. My perspective is that of a caring and concerned outsider.
What Is Self-Harm and Is It Addictive?
Self-harm can take many forms. In the words of UK mental health charity Mind, “[s]elf-harm is when you hurt yourself as a way of dealing with very difficult feelings, painful memories or overwhelming situations and experiences.” In the charity’s words, “[o]nce you have started to depend on self-harm, it can take a long time to stop.” The Mental Health Foundation confirms that “[i]t is habit-forming, and some people believe you can become physically addicted to self-harm.” A friend with lived experience told me she definitely sees self-harm as addictive, especially if it is someone’s main or only coping strategy.
Respect and Understanding
When someone we care about engages in harmful practices, our instinctive response is to try and get them to stop. I’ve certainly felt that way in the past. The impulse is understandable, but it’s unlikely to help or be appreciated if it’s imposed without the person’s agreement, and without attempting to understand what led them there in the first place.
Unless the underlying issues are resolved or our loved ones find healthier ways to manage them, they may turn to self-harm again. This is not because they are “weak-willed” or lack what is sometimes still called “moral fibre.” I suspect people who use those terms have no idea what it means to be in such pain that self-harm appears the best or only step to take. Anyone who has been in that situation deserves respect, understanding, and support, not judgment or condemnation.
There’s No Single Road to Recovery
I’m unqualified to discuss how self-harm, addiction, or dependency are best addressed. I’ve included links to a number of organisations in the resources section at the end of this article. That said, it’s clear that no single strategy will be appropriate for everyone. I’m grateful to those who’ve shared with me approaches they’ve found helpful.
The protective effect of treatment for underlying health conditions, including mental health conditions, cannot be overstated. Aimee has written previously about how badly she was affected when one of her prescribed medications was stopped. Her safety was severely compromised until the error was identified and corrected. More generally, Aimee finds aspects of dialectical behavioural therapy (DBT) invaluable in keeping her safe.
Another friend used the Twelve Steps recovery programme when working with addictive behaviours in the past, and still finds it helpful. Under medical guidance, she’s started a new program to address her dependence on sugar/soda, caffeine, and unhealthy eating. She’s currently exploring whether a cold turkey approach, in which she attempts to give these things up all at once, will work for her, or if she’s better titrating herself down more gradually.
Fran and I have experienced our own struggles with weight and eating. We’ve learned how difficult it is to follow healthy strategies, and how complex our relationships to food and body image can be.
Whatever their situation, anyone working to change deep-seated behaviours deserves encouragement and support in doing so, recognising that it may take time to find something that works.
When the Time Is Right
Motivation and timing are hugely important in changing unhealthy habits and coping strategies. Perhaps we’ve reached a point in our lives when we feel we deserve to treat ourselves better. Maybe we’ve been advised to make lifestyle changes that mean reducing our dependence on things we’ve previously taken for granted. Perhaps self-harm or addiction is taking a serious toll on our physical and mental health. Whatever the impetus for change, the right time includes having appropriate support in place. This may include professional involvement. It certainly includes the non-judgmental support of trusted friends and family.
As I mentioned earlier, coercing someone into changing before they’re ready is unlikely to help in the long term. Self-harm might be the only control or agency a person feels they have in their lives. As unhealthy as that may be, prohibiting or preventing self-harm before realistic alternatives are available may do more harm than good. The exception to this is where there is a serious and immediate threat to health or life.
We Are All Dependent on Something
Most of us have unhealthy habits we indulge on a regular basis. Some, such as caffeine, smoking, and alcohol, are more socially acceptable than others, but they’re all unhealthy to some degree. We use them for the perceived benefits they bring, because they make us feel better, or help us manage the stresses in our lives.
I say this not to belittle the devastation that addiction and dependency can wreak, nor to equate my moderate drinking and coffee dependency with alcohol addiction, overdosing, cutting, or drug use. Rather, I believe that recognising our unhealthy behaviours, and how hard it can be to give them up, helps dispel the stigma attached to riskier and less socially acceptable behaviours.
Every Day Is a Victory
No matter how long or short a time has passed since someone self-harmed, smoked a cigarette, or took a drink or drugs, it’s worthy of respect, recognition, and celebration. Every day safe or dry or clean is a victory.
Aimee uses the tally and day counter app Teal to track her progress, and shared milestones with me from time to time. I celebrated with her on each occasion, recognising the effort it took and its significance. To me, each milestone is equally important. I’m as proud of her for staying free of self-harm for 365 days (and counting) as I was when it was one week, or ten days, or a month. In a few months, another friend will be three years free of self-harm. That is no more (and no less) an achievement as Aimee’s one-year milestone, or someone marking their first day of safety or sobriety.
Relapse Is Not Failure
The flip side to celebrating milestones is acknowledging that relapses happen. Making changes is hard, and it’s not uncommon to slip back into unhealthy patterns. It’s natural to feel you’ve failed yourself and others if that happens, but I’ve never felt my friends have failed themselves, or me, or anyone else. Quite the contrary. It takes enormous courage to acknowledge you’ve resorted to behaviours you’re trying to leave behind, to pick yourself up, and continue the journey. That’s the hallmark of a hero, not a failure.
Sharing Our Stories Matters
On a work call the other day with fellow Mental Health First Aiders, I mentioned that my friend had marked one year free from self-harm. It led to a couple of them sharing their stories. It was a telling reminder of how many of our friends, families, and colleagues deal with such things, or have done in the past. One colleague described how she successfully broke a long-term smoking addiction following a programme described by clinical hypnotherapist Max Kirsten.
Another shared how she used to self-harm on a daily basis because it was the only thing that helped her handle what she was dealing with at the time. I thanked them both for their honest and openness. For me there’s nothing as compelling as hearing someone tell their story. That was the motivation for the books Fran and I have written, and it’s the motivation for every article published on our blog.
Feed Hope Always
The stories my friends and colleagues shared were sometimes painful to hear but ultimately hopeful. No matter how difficult the journey may be, and despite setbacks and relapses, there is always hope. That said, success is by no means certain or necessarily permanent. Lacking lived experience I can only relate what others have told me, which is that you never completely recover from self-harm and addiction.
One friend said she feels she’s unlikely to resort to self-harm in the future because she’s developed more healthy coping strategies, but she can never be certain something won’t happen to overwhelm those strategies and push her towards self-harm again. Staying safe is a matter of ongoing vigilance.
Recognising this places a responsibility on all of us, to feed hope, and support others on their journey. Self-harm and suicidality are different, but as Fran and I describe in our book, we all have the capacity to help keep someone safe — or not.
Fran distinguishes suicide interrupters, “those who are able to defuse the suicide bomb,” and suicide aggravators. The latter are people who, consciously or unconsciously, impact her so adversely that suicide seems a viable choice.
A careless, ignorant, or judgmental remark can have consequences long after we’ve forgotten what we said. In a recent tweet, Aimee recalled how badly she’d been affected in the past by someone saying she would continue to self-harm. This person’s lack of belief in her potential for recovery led her to lose faith in herself. Fortunately, she was able to change her perspective. One year on, her success is a testament to her courage and determination. As she rightly said, “How wrong did I prove him?!!”
Afterword
Announcing her achievement on Twitter, Aimee invited her followers to imagine it was a year ago and they could give themselves one piece of wisdom or advice. I would tell the Marty of a year ago to take nothing for granted and to fight with all he has for the people who mean most to him. And above all, to remember to include himself in that list.
Resources
Mind self-harm page, with links to organisations including Harmless (user-led organisation that supports people who self-harm, and their friends and family), LifeSIGNS (user-led self-harm guidance and support network), National Self Harm Network (NSHN), and Samaritans.
NHS addiction page, with links to addiction services and help dealing with drug addiction, alcohol addiction, smoking and gambling.
NHS drug addiction: getting help.
NHS self-harm resources page, with links including Self Injury Support webchat (women and girls), and CALM webchat (men).
Scottish Association for Mental Health (SAMH) page on self-harm.
The Truth About Self-Harm, leaflet (PDF) by Mental Health Foundation.
International helplines, suicide hotlines, and crisis-lines hosted at TherapyRoute.com.
For further information including help and crisis lines, see our resources page.
Photo by Fauzan Ardhi on Unsplash
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