Self Injury: Attention Seeking?

Self injury is not the hidden condition it once was. The sterling efforts of doctors, academics and patients have led to a widespread understanding of self injury as a means by which some people cope with their emotions, or trauma. At present it is a recognised symptom of borderline personality disorder (emotionally unstable personality disorder) although most people seem to recognise that it occurs within the context of other mental disorders as well. There are a plethora of websites by self injurers offering support and information about this symptom.

One of the things that these websites offer is usually a list of myths about self injury and self injurers. A frequent entry on these lists is that the idea that self injurers do so in order to seek attention from others is a myth. I have seen this repeated on many sites, but it is not something I wholly agree with. As it happens, neither do others; the highly respected Secret Shame site states:

Communication — Some people use self-harm as a way to express things they cannot speak. When the communication is directed at others, the SIB is often seen as manipulative. However, manipulation is usually an indirect attempt to get a need met; if a person learns that direct requests will be listened to and addressed the need for indirect attempts to influence behavior decreases. Thus, understanding what an act of self-harm is trying to communicate can be crucial to dealing with it in an effective and constructive way.

I can perfectly understand why some people state, sometimes vociferously, that self injury is not about wanting attention from others, because our culture is very repressive when it comes to mental and emotional health. For want of a better word, we live in a “macho” culture where confessing to ill-health, particularly mental ill-health, is seen as a sign of weakness. Calling attention to ourselves, demanding help be given, is seen as selfish, in many cases. As a female self injurer I can see this in my life in certain ways.

1. As a female : Women have a hard time sometimes, particularly online. If you read mainstream magazines and papers such as the Daily Mail, women there seem only valued for their looks – many of their articles about female “celebrities” give very little clue to the personalities of the women involved. They do, however, give a lot of information about the makeup/diet/surgery a woman has had. It is rare to see women with a strong voice in these papers – and when they exist they are subject to vile abuse from people online. The impression I get is that, in the public world (not necessarily individually) the only attention a woman can get is for her looks. Women with non-standard looks, such as fat women, “ugly” women and so on are also subject to abuse and cruelty. For a woman to “defile” her looks by self harming is shocking in our image-obsessed culture, and women online who admit to self harming can face cries of “attention seeker”. It is not that our culture does not wish us to call attention to ourselves – but rather that it allows attention in a limited sphere, if we are beautiful and thin with good skin then we can call attention to ourselves as much as we like – we may even be forgiven a serious job like reporting the news or being a doctor or scientist – just so long as we fit a stereotypical ideal. So I would say that for women (men have a different issue regarding “attention”, I have not covered that because I am not a man) “attention seeking” via self harm has a very negative meaning in our society.
2. As a mental health service user : Mentally ill people have a funny profile in the media. You get your “celebrity mentals”, your Stephen Frys and so on, people who do not publicly seem to have the meltdown, life-destructive side of mental ill-health. Then you get people who attack and/or kill people when psychotic, which then leads to calls to incarcerate everyone. Although much has changed, thanks to campaigning groups, the mentally ill are still stigmatised. For a mentally ill person to call attention to themselves by being unwell is a red flag to a bull when it comes to employment discrimination, harassment and so on, because people with bad mental health are supposed to be quiet and not scare those who currently enjoy good mental health. Particularly in this society we are supposed to work productively, act “normally” and calling attention to our problems – for example by visible self harm – is frightening, I think, for people with a stereotypical and stigmatising view of mental health.

What is wrong with seeking attention?

I don’t really see anything wrong with seeking attention for problems that we have. I have reached a stage where I would rather seek attention now, and say something is wrong, than hide it, and have massive problems later. This is probably why I haven’t self harmed in some time.

Why do we think that asking for help is wrong or a sign of weakness? I would say – and I know it is clichéd – that it takes a stronger person to admit to needing help than to pretend nothing is wrong. We make ourselves vulnerable by confiding in others, I certainly feel vulnerable telling someone I need help, but I have learned that it firstly does help, but also that I have a strength in me to open myself to another. I think of it as being like communion – and this is why I think communion in hospital is important, where we open ourselves and join with each other through Christ, where we hold all in common, from the weak to the strong, from the foot to the hand to the body to the Head, we are all one.  I think that sharing our problems with one another is important for Christians, and to be honest, important for others as well. There has to be a trust, and it may perhaps be betrayed, but sharing helps the soul in a way that struggling on by yourself does not.

I don’t think that if we self harm hoping that someone will hear us, even if it is only ourselves, that we are doing something wrong. Sometimes it takes seeing wounds on me for me to realise that yes, I am  ill, I am not “faking it”, I am not imagining things, I really do feel that bad. Others, too, know it as a sign that I am not coping, that I need help, support, that maybe I need to be told a few jokes, it doesn’t have to be a big thing. Doctors, too, understand self harm as a symptom in a way that they don’t necessarily understand when I say “I’m depressed”. Doctors seem to be visual people, if  I turn up dirty and smelly,  they understand I am not well. If I turn up bleeding, they know I am ill. If I turn up washed and dressed and tell them I am suicidal it is almost like they say to me, come back when you’ve hurt yourself, then we’ll take you seriously.

Do I self harm for attention? Partly, I’d say. Even if it is only for my own attention. I don’t think there is anything to be condemned in that, because frankly we all need to give more attention to each other, and if you are mentally ill then yes, you need some attention! If you realise someone has self harmed, listen to them, talk to them, don’t just say “oh they’re attention-seeking so I’ll ignore it” – ask yourself why you don’t think they are worthy of your attention? It isn’t exactly normal  behaviour to be self harming so I don’t see why  it should be considered unworthy of your time and help.

Ah, this hasn’t come out like I wanted. I’m tired. Night-night.