Study into self-harm finds that the urge to cut never goes away

0 Comments | Sunday Herald, The, Jul 31, 2005 | by Judith Duffy Health Correspondent

NEW research has revealed that some people who self harm may never be free of the "urge" to hurt themselves.

A study carried out at the University of Stirling found that, just like people with addictions to drugs, alcohol or gambling, sufferers can struggle to overcome the impulse even if they have stopped self-harming for months or even years.

Some of the participants in the research, who ranged in age from 29 to 40, even kept their "favourite" cutting tool stored safely in case they needed it.

Rates of self-harm have increased in the UK over the past decade and are now among the highest in Europe.

It is estimated that one in 10 teenagers deliberately hurts themselves. However, little research has been carried out to understand and identify the processes involved in the urge to self- harm.

Dianne Cameron intensively interviewed people who were currently self-cutting or had self-injured in the past for her PhD at Stirling University's nursing and midwifery department.

She said: "What I found was that once the participants started self-cutting it was really difficult for them ever to be free of the behaviour again.

"They may be free from cutting in the sense that they haven't cut for a few months, weeks or even years, but it doesn't mean their lives are not still affected by the urge to cut."

She said the experiences and feelings that the participants had were similar to those felt by people who are addicted to drugs, alcohol or gambling.

"Most of them would not say they had stopped cutting, even though some participants had not self-injured for as long as two or three years, " Cameron added.

"Instead they would say it's three years since I last cut or two months since I last cut, as if they didn't want to completely let go of the behaviour.

"Some participants had a specific knife or tool which they liked to use when cutting and even though they hadn't cut for a few years, they knew where that knife was just in case they needed it.

"One participant referred to this as a 'safety net', and just knowing where the tool was helped them not to cut."

Cutting and burning are the most common forms of selfharm, but it can also involve taking overdoses of tablets or medicines, pulling out hair and scratching or tearing at the skin.

Experts say that while there are many reasons why people do it, the behaviour is often a method of coping with the emotional pain of trauma, such as abuse, or difficult experiences, such as bullying or bereavement.

Linda Dunion, director of the See Me campaign, which aims to reduce the stigma around mental health issues, said: "Self-harming behaviour is not yet well understood.

"That may be why there's so much secrecy and stigma attached to it. It's generally a sign of mental distress but it is too often dismissed as just attention-seeking.

"People who self-harm actually go to considerable effort to try to hide the behaviour from others, which can make it all the more difficult to identify individuals who need help."

Pat Little is the development manager for young people's services at Penumbra, one of the main organisations working in the field of self-harm. He said that, while the problem was generally only thought of as a young person's phenomenon, that was not the case.

"We have come across very young people self-harming, but also people in their 60s, " he said.

"The biggest group for admissions to hospital for selfharming injury is 33 to 44year-olds."

He backed the findings of Cameron's research, saying that never being free from the urge to self-harm was likely to be a "common feeling".

"It is mainly because people have learned to use self-harm as a way of coping with stress, " he said. "With something you know works, there is always the temptation to do it again.

"A lot of people, because they have managed to cope with stress in the past, can manage to stop it completely.

But for others, harming themselves much less frequently would be a success for them."

Little also pointed to the fact that while the problem appeared to be on the increase, agencies often struggled to deal with it because of a lack of understanding.

"There is a real need to bring the issue into the open and make it easier to go for help, " he said.

"For example, a lot of young people who self-harm are made homeless as housing associations and housing departments can't understand it and think, 'These people are too disturbed to have our accommodation, they need specialist accommodation.'

"In fact they are not dangerous to anyone and the issues are around their own distress, " he added.

Cameron, who is now an assistant psychologist at Aberdeen Royal Infirmary, agreed that more understanding about the condition was required, including among health professionals.

She said: "It is important not just to look at the cutting behaviour, but for professionals to understand the importance of the urge and how it affects the lives of people who are currently self- injuring or have done so in the past.

"Even though they haven't cut for a few years, it doesn't necessarily mean that they are managing to cope with the feelings that caused them to selfinjure and they might still be battling with the urge to cut."