How Do You Define Self-harm?

[theshadowoftheliving]

Soooo …. a question that I don't want to write down, nevertheless discuss with my therapist. BUT, I'm reaching out to see if it is something that I should disclose to her when I see her in two days.

I have a history of self-harm. Cutting, mostly, although you could consider the eating disorder I had as part of it, and the general reckless behavior I've had over the years. I've had a solid twelve-year reprieve from cutting. I just don't anymore. But the behaviors that border on self-harm …. none of these have stopped. They just don't leave scars or other really long-term marks that I have to explain, so I've rationalized them away as unimportant. But are they?

My therapist asked me, point-blank, the other day if I was self-harming or thinking of self-harming. I told her no. But now I think I need to backtrack …. The other week, I clawed at my arm badly enough to make scabs that took more than a week to disappear. I just caught myself from hitting my arm repeatedly and a bruise is arising. And I think about hurting myself allllllllll the time.

Do I have to disclose? What actually counts as self-harm? Nothing I'm doing will cause lasting damage, so I've always assumed that it's no big deal. But is it? These boundaries are so fickle and shifting and I have trouble knowing where they lie.

 

[mrsps]

I would class clawing yourself which makes scabs self harm. I guess it is anything that harms or hurts ones body. I have a problem with over eating, I guess this can be classed as self harm ....... I am basically killing myself with food!
Be interesting to hear your T's view on what she considers self harm

 

[anonymous]

Yes, that is indeed self harm.

Anorexia
Bulimia
Binging
Purging
Drugs
Alcohol

Can all be considered self harm, too, it's just that they're not typically labeled as such.

There's also

Hitting
Slapping
Bruising
Burning
Scratching
Cutting

And so on.

Self injury is pretty much anything you do to intentionally hurt yourself, whether or not it leaves a mark.

I knew a girl who used to drink poison. No marks, right? Very much self injury.

 

[jaccat]

Yeah, it's something I've wondered. On and off I've picked and scratched at myself for years (before that I used to bang my head against stuff). I'm pretty certain a lot of therapists would qualify it as self harm, yet the NHS therapist I saw (for six weeks) told me it wasn't. Personally I don't think he was capable of imaging the amount of damage one can do to oneself without 'tools'. So much focus is on self-harm by cutting I think people forget there's lots of other ways to do it. In my opinion if you intentionally do anything to yourself with the purpose of causing injury it's self harm.

 

[digger]

I sometimes struggle with this kind of thing myself because the idea of self harm is so much the norm for me. I don't often act on it any more but have thoughts about still most days.

There are things I do, or have done, that don't actually leave any physical mark, that I'd still class as self harm. The way I have to 'test' whether it's self harm or not is to ask myself if I would consider it as something harmful if I witnessed someone else doing it to themselves, which may be a helpful test for you too.

Do I have to disclose?

Have to? No, you get to make that choice yourself. Would it be beneficial to have that conversation with your T though, is another question. Sounds to me like it could be a useful one to have, even if it's just in a more general way.

 

[desiderata310]

Also to add to the list:
working out beyond what is ordinary without proper nutrition or regard to one's "limits" and without regard to certain parameters.
so exessive workouts can be added to that list.

I realized that my tendency to look at a training plan and then say to myself "i can do more" and did this all the time was a form of self injury that was seen as acceptable- even somewhat normal in the tri circles. At some point it when crosses the line between driven and self flagalation it's no longer acceptable but I don't usually know that line till well after I've crossed it.

 

[Kefira]

I air on the safe side and consider anything intentionally destructive physically or emotionally to be my self harm urges surfacing.

I'm working hard to avoid cutting. But my eating disorder is mostly self punishment based too. I hit myself when under particular stressors, and in the past I've had such destructive tendencies sexually that at times I had to seriously consider whether it was crossing that line.

There are some behaviors that are inherently destructive but sometimes it becomes about analyzing the reasons behind the action and whether it has crossed into excess.

 

[theshadowoftheliving]

I sometimes struggle with this kind of thing myself because the idea of self harm is so much the norm for me. I don't often act on it any more but have thoughts about still most days.

This. The thoughts are so normal to me that I never stopped or backtracked to think about whether or not they were problematic until I was asked directly.

Self injury is pretty much anything you do to intentionally hurt yourself, whether or not it leaves a mark.

And I have trouble defining "hurt" for myself …. the definitions I would apply to other people never seem accurate or applicable to me. I have the recurrent thought that I don't matter, anyways, and I'm unimportant, therefore none of the stuff I do is worthy of disclosure/attention/intervention.

I guess I should try to talk to her.

 

[digger]

And I have trouble defining "hurt" for myself …. the definitions I would apply to other people never seem accurate or applicable to me.

This is why I do the 'would it look like harm to me if someone else was doing it to themselves?' test. I still find it hard to apply it to myself, but it gives me a better idea of whether someone else would consider it to be harmful, which is hopefully at least a step in the right direction.

With things like this, I also try to look at why I should be the exception to the rule? Do I really have a valid argument for that?

I hope you find a way to start talking around some of this with your T.

 

[theshadowoftheliving]

I think my argument is that I'm terrified of perceived repercussions of disclosing any self-harming behaviors. I think I'm over-reacting and catastrophizing. I know that.

I also struggle because talking is so, so, so hard for me. Writing - I've got that. I sound so much more eloquent here than I could ever in person, and when I show up for my sessions I clam up and have trouble getting anything at all out beyond the completely superficial. But I'm working on that.

It's affirming to hear that this stuff is worth the effort to speak about ….

 

[digger]

I also struggle because talking is so, so, so hard for me. Writing - I've got that. I sound so much more eloquent here than I could ever in person, and when I show up for my sessions I clam up and have trouble getting anything at all out beyond the completely superficial. But I'm working on that.

A lot of my communication with my T is through writing.

I think my argument is that I'm terrified of perceived repercussions of disclosing any self-harming behaviors

That's understandable, and something I'm sure a lot of can identify with. I certainly can. I still think it's a valid conversation to have. Are there specific repercussions that you're worried about? What sort of reaction would you be scared of most from her?

 

[The Albatross]

Wikipedia actually has a pretty good breakdown for me: http://en.wikipedia.org/wiki/Self-harm