Solingen 93

Domestic Violence and Abuse

Seeking Attention – The Self-Harm Expert by Satveer Nijjar

– Self harm does have it specific
functions for individuals but the trigger and that’s
what people often ask about, what is the trigger point? And I’ve been delivering training
now for a number of years, and often people want a
justification into the self-harm behaviour. This individual, young or
old, must have gone through something really
catastrophic in their life to justify self harm behaviour. And often when we hierarchy
distress, what comes up is oh, they must have been sexually abused because anything else in
a lot of people’s minds doesn’t justify it because
it’s very relatable. So, it can’t be that divorce
because I went through a divorce, it can’t be a
breakdown of friendships, cause I’ve broke down with my
friends, can’t be body image because I don’t like the way I
look and I never self harmed. But sexual abuse is still
seen as something that, thankfully very few individuals
go through, but clearly is an extremely traumatic experience. But it seems to be that is
a reason whereas in truth, it’s anything that causes
an individual distress. And for one person that might
be, an example I often use, is getting ten A stars
and one A in their exams and feeling like a failure. But society will tell
them “you haven’t failed.” But that to them is
that big trigger event. For another person it
could be sexual abuse, physical, emotional, friendship breakdown, relationship breakdown,
it could be body image, it could be gender identity,
could be cultural conflicts, absolutely anything. And I think as a society
we need to stop hierarchic distress because it leaves
individuals, especially young people feeling
unjustified in accessing support because their problem’s not that big. You know, how can they dare
complain about something when somebody else’s mom’s died, you know, and their problems just
minor, it’s like they’ve got an eating disorder or
they just don’t like the way they look and until they get
to a stage where they feel their problem’s big enough
to take on your time or whoever time it is, they stay silent. But the distress is still
there and then the distress can manifest itself as
self harm and as we know from statistics, one
in ten, one in twelve, depending on what stats
you read, young people are self-harming. And that’s shocking and
that’s just the young people that we think we know about. I go into schools and I ask young people to raise their hands
in an assembly, I mean, I was at school a few weeks
ago, 120 young people in a year, put your hand up if you know
someone who’s ever self-harmed? Over three quarters raise
their hands and that is everywhere I go, whether
that’s the class size or an assembly. So lots of young people
are aware of self-harm, and a lot of young people are self-harming whether it’s on one episode,
so that poor exam results or the divorce of their parents,
that friendship breakdown, or it’s something they end
up returning to because that distress was never
managed so then it becomes their coping strategy for
future negative experiences. So, in regards to stigma and self-harm, it is absolutely huge. One of the exercises I
do in training is looking at common phrases and language
used around self-harm. And when we just look at research papers, the phrase deliberate
self-harm, and that comes up time and time again, the
best practises saying “we shouldn’t be using that phrase.” I mean, just think bout
it, deliberate self-harm, you did it to yourself on
purpose, it’s very negative and it’s full of blame, but
the biggest phrase I have found that comes up every single
time is attention-seeking to the point where I
actually call my business “attention-seekers” because
it is such a prevalent, to me stigma, associated with self-harm, and so negative as well, oh,
they’re just attention-seeking, it’s attention-seeking
behaviour, yes self-harm can often be very visible
but we’ve gotta remember there’s lots of hidden forms of self-harm, not everybody will injure
themselves on their forearms, it’s not all about cutting,
there’s many different ways, and the vast majority of
individuals who self-harm, never tell anybody or by the
time they do tell someone it’s been weeks, months and
even years that they’ve been self-harming before they disclose it. So, if it was attention-seeking,
surely it’ll be the very first time they
did it, everybody would know about it, we’d see
it outside on the streets, you go around someone’s
house and they’d be doing it there, whereas we know
self-harm, for the vast majority is a very, very private act. Self-harm’s got functions
for the individual who is carrying out the
behaviour, it’s not something done without purpose, at the
time, the individual may not fully understand why they’re self-harming. I self-harmed and when I was self-harming, I couldn’t tell you why I was doing it, I was doing it because it
got me through the trauma I was going through at that
time, it kept me going. Now I can easily relate
the functions of self-harm to what I was doing, so
it was my coping mechanism at times of distress, it’s
something I kept returning to because I felt safe in that behaviour. It was my control, the
control, I couldn’t control anything else that was going on around me but I could control,
for me it was cutting, what I cut, where I cut, when I cut and how deep I cut, it was my distraction. People struggle with that one
at times, because self-harm especially self-injury the nature of it, is a very painful experience,
you know, we do hurt when we self-harm, we’re
not immune to pain, but that in itself was a distraction cause that physical pain, or actually
carrying out the self-harm, distracts you from whatever
was causing you distress, and then you’ve got the
self-punishment side of it, you think you deserve it cause
you got low self-confidence, low self-worth, low
self-esteem because of whatever you’re experiencing that
is causing you distress. So you deserve to be hurt. You deserve, for me, the
new scars, you deserve to go through this pain, dependent
upon the form of self-harm for the individual that’s going to vary. And then, for me, the biggest
one, for others as well, is that communication of emotional
pain stress and distress. But in the first instance,
remember self-harm is something that the vast majority
of people do in private, so it’s a communication to
yourself that you’re struggling this is how much it hurts me,
and people will often say, “well, why don’t they go and
talk to someone, you know, “didn’t you have people around you?” I had lots of people around
me and lots of the individuals I speak to, who come and
disclose to me at the end of sessions, whether they be
professionals or young people. Will say “we have got
people around us, but just “don’t know how to start
that conversation.” Because often the things
that someone’s going through either are too traumatic for
them to verbalise themselves they might not even know
what’s wrong with them and as a society we’re always
pushing for a what’s wrong? And an answer to it. And when you’re just
shrugging your shoulders, especially as a young
person, I don’t know, I just feel crap, that’s not good enough. Then we push them, what’s
wrong, no, tell me, is it this, is it this? And that then makes them feel even worse. So then the only way they
feel they can communicate their distress is by harming
themselves cause this is how much I’m hurting. And it’s this scar or the
length of ligature I tied, or it’s this burn, this
scratch, how many times I’ve banged my head or how
much hair I pulled out, but also it can be
communication to others, but then it gets seen
as attention-seeking, it might be someone’s way of saying “look, “I might be smiling
and I might come across “as this, this, this, but
actually I’m really struggling.” And me showing you these
scratches or this burn or whatever it might be, or
telling you about my overdose, isn’t just a cry for help
or just attention-seeking, it’s me trying to say
“actually, I feel really shitty, “I am really, really struggling.” But all too often it
can become dismissive, it was just a cry for help, it
was only three paracetamols, it was just superficial cutting. So what’s the message we’re
potentially giving out to that young person? Do it worse and come
back to me with something bigger and better cause
until then I’m not going to take onboard your distress? Which once again is really, really sad. So often individuals, say
that could be professionals, teachers, social workers,
parents, etc will say “how can I spot if my
child is self-harming?” And to be honest, it’s one
of the most frustrating questions I ever get asked
because for me, the issue is “why are we waiting for the
child to be self-harming?” To spot that, what we should
be asking is “how do I spot “if my child’s in distress?” “What am I looking for?” Because it’s distress
that leads to self-harm cause I could say “oh look
for obvious cuts and burns “and scratches, changing clothing,
wearing long sleeved tops “all the time.” Well that’s not going to
be useful for the person whose pulling out their hair,
that’s making the assumption that everyone cuts their
forearms or burns themselves on their forearms,
there’s so many different types of self-harm. For me, what it would be,
is to say that “okay, yes, “if you do see any marks on
a child that are unexplained, “to broach that child about them.” But not assume that it is self-harm because it could be abuse,
it could be an accident, but I think because
everyone’s so caught up with teenagers self-harm so
it must be that, but keep an open mind but not
ignore it because if it was self-harm, and we don’t
broach the subject, the scars that you might have noticed, that burn you might have noticed, a message that you could
potentially be giving out is that you don’t care. You’ve seen it but you don’t care. Often people don’t broach
it because they’re fearful, that they won’t know how
to respond if that child does disclose it’s self-harm
but for me, yes, the key, is looking for signs and
indicators of distress in a young person, any
change in usually behaviour, which can vary from child
to child cause every child’s unique, cause that could
be an indicator of distress and then from that, it
might manifest that there’s self-harming, it might
manifest that it won’t, that they’re not. And if they’re not,
that’s brilliant, but that gives us a chance early opportunity to work preventatively
to prevent self-harm from potentially occurring,
get them the support early on, provide them with
distraction techniques, coping mechanisms to manage
distress not just at that point but in the future as well. Often people will say “what’s
the best way to approach “someone who’s self-harming
or a disclosure of self-harm?” And to be absolutely honest,
it’s not rocket science, I think often people feel that
they’re not the right person to manage a disclosure
because they’ve never self-harmed before, how can
they know what it feels like, it needs professional intervention. But what we’ve got to
remember is, if you’re the one whose discovered the
self-harm or the disclosure’s been made to you, no matter
who you might be referring on to, if we get our approach
wrong to that disclosure, that can then be the
barrier to that young person engaging with further support. People say “so what should I
do, how can I make it okay?” And it’s not rocket science. Care, compassion, dignity,
respect, they are the key things, but these are things
that we should be doing without even thinking but
suddenly because it’s self-harm, the stigma comes into it,
the fear comes into it and that can almost go out the window. And I appreciate why
fear can come in to it, I am the mother of a 15 year old child. I understand as a parent
why it might be scary, my child has self-harmed
and it’s the worst feeling in the world, as a parent
you might feel you failed, but you can’t allow these
feelings to impact upon the child. Be open-minded, listen
to them, do not pressure the young person to tell
you why they’re doing it. One of the biggest questions
that we’ll instinctively ask “why you’re doing this to yourself” And then we’ll get
frustrated cause that child’s shrugging their shoulders
saying, “I don’t know.” Or they might give a
reason that seems out there in the big wide world
as absolutely minuscule, pathetic, there’s people
starving in the world, there’s wars going off,
and you’re cutting yourself over a breakdown of a friendship group? But to that young person
that is absolutely huge. So, it’s about listening
to them and believing them, and believing that their
distress is real to them, no matter how you feel
you would have handled that situation. Often it can be difficult
if the child is experiencing something that you
personally have experienced. You might think I’ve
never self-harmed before, I didn’t self harm for
that, so why are they? Just be open and honest,
if you know you are going to struggle with this, be honest, “I don’t know where to
go with this but together “we can look at ways of moving forward, “thank you for telling me.” Because it was a really hard
thing for that young person to disclose. And if they’re not ready to
talk, just let them know, that you are there for when
they are ready to talk. Or pass them on to an
organisation or suggest to them websites, safe websites,
where they can seek support and information from cause
in the first instance, they might not be ready
for a face-to-face chat with someone to talk
about issues that they’ve never actually verbalised before.

Cesar Sullivan

3 thoughts on “Seeking Attention – The Self-Harm Expert by Satveer Nijjar

  1. I totally disagree. It may be true in the PAST before the internet and social media but now days people post pics of their scars all over social media. If you have EVER ONCE taken a picture of your cuts or scars you're an attention seeker. If you have ever once referenced it outside of a therapists office or the day you ask for professional help you are seeking validation and attention

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