Understanding self-harm
Page 10
Short Report
Disclosing self-harm
Key findings:
- 84% of participants sought to hide their self-harm from their family, and 66% sought to hide it from their friends
- Young age was associated with disclosing to friends
- The most common reason given for hiding self-harm from family was to avoid the negative emotional impact a disclosure was expected to have on them (38% of non-disclosers). This was also the second most commonly given reason for hiding self-harm from friends (21%).
- Lack of understanding on behalf of family (26%) or friends (22%) was cited second-to-most often as a reason for hiding self-harm.
- Participants who sought to hide their self-harm from their families most often expected them to react with anger (31%), upset (21%) or shock/horror/fear (16%).
- Participants who sought to hide their self-harm from their friends anticipated shock/horror/fear reactions (20%) to disclosure, or their friends being confused or bewildered about it (13%).
- One in five participants who sought to hide their self-harm from their friends did so despite anticipating that the friends would be supportive if they were told about it.
- Only 10-15% of participants who sought to hide their self-harm expected their family and friends to recognise mental distress as the main reason for self-harm.
- Most commonly, participants who sought to hide their self-harm expected family and friends to think that they were seeking attention (22% and 19%) or mentally ill (19% and 25%).
Fear of being misunderstood and concern about the impact of disclosure on others were identified by the participants as the most significant barriers to telling family or friends about self-harm, followed by being ashamed, guilty or embarrassed about harming and fearing condemnation as a consequence of disclosure. However, other barriers were suggested by participants’ answers to questions about anticipated reactions to disclosure from family and friends, and about what they expected their family and friends to think their reasons for self-harm to be.
As previously discussed, we found that participants felt unable to express their inner lives, were prone to self-recrimination and self-loathing, and assumed that their thoughts and feelings are out of line with what their family and friends would find acceptable. These findings can help us understand some of the participants’ responses to questions about disclosing self-harm.
First, we found that only 10-15% of participants who hid their harm anticipated that their family or friends would recognise the fact that their self-harm is a response to emotional distress. It seems that their inner lives, carefully hidden, are expected to be invisible to others. That in turn makes understanding self-harm difficult – if understanding a behaviour requires knowledge of the reasons and feelings behind it (we think it does). This goes some way towards explaining the prevalence among participants of the idea that family and friends would not understand their self-harm.
Second, participants expected family and friends to explain self-harm by mental illness. This may present a barrier to disclosing self-harm in at least two ways, the first of which is the obvious and often cited stigmatisation of mental health problems.
The second is one that links with the fear of being misunderstood. Explaining self-harm by reference to a mental illness can in some cases be used to cut across and devalue or even invalidate explanations that refer to the reasons and feelings of the individual who harms. Yet for the most part, self-harm is intentional, motivated behaviour, goal directed and even when impulsive, governed to some extent by the person’s reasons and beliefs. This came across very clearly during this survey. To substitute all this with a view of self-harm that treats it as a simple symptom of a medical condition is a misunderstanding of the worst kind, insofar as it negates the whole domain of discourse within which understanding could take place.
One important qualification is needed here. Some of our participants wrote that they never harmed deliberately, that is, in every instance their self-harm was an automatic action over which they had no conscious control, even if they were conscious of it while it was going on. These participants felt that self-harm is something that happens to them, rather than something that they do, and consequently, their self-harm might be more appropriately thought of as a symptom of illness. Or what do you think? Click here to tell us whether you think that self-harm is a symtom of illness, or something else. And how deliberate is 'Deliberate Self Harm' (DSH), as it is called in academic literature?
Earlier, we described how there appeared to be a ‘secret self’, and how it could be separated from the ‘social self’. The third and fourth most common reasons for hiding self-harm could also be related to this split; participants were worried about being condemned if truth of their self-harm came out, and they felt ashamed about it. These feelings and concerns both reflect and are likely to feed into the separation of selves. Self-harm becomes yet another shameful secret, to be kept for fear of being judged, even rejected (this was a concern with respect to disclosing to friends). However, to feel shame it is not necessary to expect condemnation. We found that one in five participants who hid their harm from their friends, did so despite expecting them to be supportive if they were told about it. We discuss some reasons for this in the Full Report, including fears of being pitied or thought of as mentally ill, which can engender shame, and the (also shame-related) feeling of standing out as different to, and therefore separate from others.
Interestingly, several people who were unwilling to disclose self-harm despite anticipating supportive reactions talked about their role as “the strong one” in their peer group. In other words, they felt that distress and its expressions were inconsistent with their ‘social self’. Equivalent concerns were expressed with respect to the familial context also: participants were concerned not to disappoint, not to fail expectations. It is as if the ‘social self’ has been created to meet these perceived expectations (e.g. “I can't live up to any of their expectations, so I hide most of me”), and disclosure of self-harm would reveal the ‘more than meets the eye’: “[My family] might look at me as though I am a different person than the one they know. They might know it's not just self harm but because of the stuff going on in my head.” We wonder where these perceived expectations of perfect health and happiness are coming from? What do you think? Click here to tell us.