Written by and in loving memory of Natalie Wilson
Sub-edited by Lee Wyton
Children Who Self-harm Don’t Always Stop Just Because They Grow Up.
One in ten people self-harm according to the Royal College of Psychiatrists. Self-harm can take many forms including cutting, overdosing on medication, burning and scratching. Self-harm can also include other issues such as eating disorders, drug or alcohol abuse. People may self-harm because they feel alone, out of control, or unable to express themselves in other ways; but the reasons can vary from individual to individual. Some people are more likely to turn to self-harm to cope than others. Self-harm is more common in young people and females, and in particular, those who have experienced abuse.
The treatment that is receive as an adult who self-harms, compared to a child, is strikingly different. As a child people show worry, as an adult, people tend to be judgemental. The more scars you have, the more you have ended up in an accident and emergency department, the more likely you are to be met with criticism and judgemental reactions and the more likely you are to be perceived as a hopeless case. It feels as though people give up. When you end up in hospital, the staff no longer seem concerned like they did at the start. It all becomes very ‘normal’. Inside it can make you feel like nobody believes you can recover from this, and it can stop you from believing you can get any better. Even more dangerously, it can make you feel like you have to get worse to be taken seriously. This is especially the case if your self-harm continues into adulthood and you become diagnosed with Borderline Personality Disorder (BPD).
BPD is a disorder of mood, and can alter how a person interacts with other people. This can affect how someone thinks, perceives, feels and relates to others. People with BPD may also have a fear of abandonment, unstable relationships, a poor self-image, and severe mood swings, as well as intense anger, feelings of emptiness and behaviours that may be seen as being self-destructive, or impulsive. Being diagnosed can feel like a weight has lifted off your shoulders. Finally you know what is going on, and the first steps to getting better. You find you are not alone, and that this is not all your fault; but it can also have a negative impact.
The label of a personality disorder can lead to people accepting that self-harming is a part of your life and can become less inclined to believe you can stop, or even seem to believe it needs to be stopped. It is almost like it is accepted as a part of who you are. Sometimes you are blamed for it. Sometimes you are seen as an attention seeker, as someone who cannot have any positive life goals, and as someone who will not get any better. You are both relieved that you have an answer for what you are experiencing, but also terrified by people’s reactions. When asked by professionals what your diagnosis is, it can be hard to even answer at all. You shrug your shoulders and hope they move on because it is easier than having to handle their reactions. It is easier than worrying they are thinking this is all your own fault and you cannot get any better, because that is what you have been told before.
This is not true. People with Borderline Personality Disorder do get better, and people with Borderline Personality Disorder are not to blame for how they are. This is an illness, a fact which many people seem to forget. Of course, everyone in life is responsible for their actions, but there is a difference between being responsible for something, and being to blame for it. There are causes of Borderline Personality Disorder, but those causes are not the person who has it. The causes are numerous; there is evidence that genetics may play a role according to scientists at the University of Missouri. Claiming that this disorder is an alteration to a particular chromosome in genetic material which is factor that cannot be changed, but one of the more important and controllable causes is poor parenting and childhood abuse. You may have a personality disorder, but it is not who you are, it does not define you.
Your perspective, your goals and ambitions, your attitudes and your sense of self largely stem from how you are brought up. If you are brought up in a chaotic environment where your needs are not met, or where your parents ability to meet your needs regularly fluctuates and you are neglected, this impacts on all of these things. If a child is then also subject to physical, sexual or emotional abuse the impact can be severe.
So, if you ever come across an adult with a personality disorder, or who self-harms, try to remember that this person has a story (but no, they do not have to tell you it, nor should you expect them to). Nobody starts to hurt themselves for no reason. Everyone has a story. The person sitting in front of you with scars down her arms, or the patient in A&E that you see several times a month and you find yourself thinking “she’s a waste of our time, she does this to herself”…no. Things that happened to that person in their life brought them to this moment. This person may be an adult, but there was a time when they were not. They were once a child. A child who maybe did not get the help they needed at the time. A child who grew up to be an adult who still has not had their basic needs met, who has not learnt how to cope, who has spent the most fundamental years of their life scared, isolated, abused, abandoned or perhaps caring for someone else.
They deserve to be treat just like anyone else.
If you ever come across a child who self-harms, it is important to take their self-harm seriously. They are not attention seeking how you think they are. They need your attention, they need help. If a child does not get the help that they need, they could end up being that adult who is still trying to get their needs met. That adult who is in an Accident and Emergency department every week getting their cuts stitched back together, or who find themselves sat inside a psychiatric unit time and time again.