Wednesday, May 9, 2012

Self-Harm: What if I want to tell someone?

I need you to listen.

At some point you may reach a point where you feel the need to tell someone about your self-harm. The first thing here that came to mind was something akin to coming out of the closet if you’re gay or bi. It can actually be that difficult. That analogy stops there though. The reasons you may have for telling someone about self-harming behavior are many, many, many. Maybe you recognize that it is no longer healthy and need support, maybe you need to reach out about all your internal pain and your self-harm is only a part of it, maybe you want to quit but it’s too hard for you to do alone… in this way self-harm is almost like trying to recover from an alcohol addiction.
Before you open up some things you need to do. Don’t do it impulsively if you can help it. Plan for it. And above all, give them time to digest what you are telling them. Initial reactions are just as spontaneous as any other emotion. And we all know how irrational emotions can be. Allow the person time to think it over. If they don’t respond how you hope they do at first, it doesn’t mean they won’t get there. And it doesn’t make that support any less valuable.  Allow them some space to think about things if they need it and make sure you follow up with them or have them let you know when they’re ready.
With that said, here's a breakdown of things that could be really helpful [source] :
-          Be sensitive to the other person's feelings
It can be nearly as hard for them to hear it as it is for you to tell them. Realize that they're probably wondering what they did wrong or how they could have prevented you from feeling so much pain or why you turned out "sick." You don't have to accept their value judgments about your SI, but be open to hearing what they have to say about it. You might learn something, and you can teach them a great deal.

-          Explain that coming out is an act of love
Let them know that your deciding to tell them about self-injury is a sign of your love for and trust in them. Usually, a person decides to tell someone about his/her SI because s/he loves them, wants or needs their loving support, and is tired of keeping a whole part of her/himself from them. The desire to be open and to trust outweighs the fear of rejection or hatred or disgust. Let the person you're telling about your self-harm know you're not trying to punish, manipulate, or guilt-trip them.

-          Pick a place that is private and a time that is unhurried
This is serious stuff. Find a time when everyone involved is available for a long conversation. Do it in a place where everyone's comfortable and there's no need to worry about being overheard. If you're rushed or hurried or afraid other people nearby will hear and react, you're not going to be able to give your full attention to the conversation and neither will anyone else.

-          Don't tell others in anger
Don't use your SI as a weapon: "Oh, yeah, well look, you made me cut/burn/scratch/hit!" To get the love and understanding you're seeking, you may have to give some in return. Whether or not the person you have decided to share your secret with has contributed to the problems that led to your SI is irrelevant to the coming-out conversation. If you start getting angry and blaming, you're going to put the other person on the defensive and they'll get angry. The whole process will bog down and be hideously unpleasant and unproductive. Using SI as a weapon also increases the likelihood that the person you're coming out to will react in exactly the ways you're hoping they won't.

-          Consider enlisting an ally
If you have a friend or therapist who understands your SI you might want to ask them to sit in on the conversation. A neutral third person can help keep things calm.

-          Provide as much information as you can
This is crucial. The more someone knows about something, the less they fear it. Many people have never heard of self-injury or have heard weird sensationalized tabloid reports. Be prepared to give the person books or names of books, articles, photocopies, printouts, addresses of web sites, etc. Gather as much information as you can so you can answer their questions accurately and honestly.

-          Be willing (and prepared) to answer their questions
You may have to educate them about SI. Encourage them to ask whatever questions they may have. If they ask a question you don't have an answer to, say "I don't know" or "I can't say" or even "I prefer not to get into that right now." Be as open as you can. You might want to anticipate questions they'll ask and get an idea of how you want to answer those before you come out. You can ask other people who've come out what they were asked to get some ideas.

You should also have a good idea in your mind of what you want to do about the self-injury -- they're going to ask. Do you want treatment? What sort? If not, what's the rationale for not treating it? Do you want them to help you stop or control it? How can they help? What's too intrusive and what isn't? Now is a good time to start setting boundaries.

-          It's not necessary to bring up the most disturbing topics in the first conversation
Don't start by describing in technicolor detail the time you needed 43 stitches and a transfusion. It's probably best to avoid graphic descriptions of what you do; if asked, just say "I cut myself on the wrist" or "I hit the walls until I get bruises" or whatever. Try not to freak them out; you can give details (if necessary) in some other conversation.

-          Trust your own judgment
Do what feels natural to you. You know yourself and your family and friends far better than I ever will.

-          Communicate
Be willing to talk to the people you're coming out to about your reactions, and ask them to let you know what they're thinking. Communication goes both ways.

I’ll be honest, it was so long ago the I had to “come out” to people about  my self-harm that I don’t actually recall how I did it. I’ll have to look through my journals. When I did talk to people about it back then I don’t think it was at my convenience, or by my choice, though. It was often because someone saw my cuts and wanted to know, right then, what was going on. Or it was at a time when I had gone quite some period of time without harming myself and I could wave it off and tell them it was a long time ago. I remember when I told Roommate about it (maybe 1.75/2 years ago?). We had been talking about body mods or something about scars and scarification. I was matter of fact about my scars being self-inflicted. She said she suspected as much but she didn’t want to pry into something that I might not be comfortable with. That was kind of it for that conversation. We got into it deeper {no pun intended} when it came up at other times and she understood. I wasn’t actively looking for help or support quitting at that time though. I had come to terms with it and pretty much had my decisions about it well in hand, even though I hadn’t completely stopped yet.
It’s important to understand if the person you are telling is open minded enough to listen without judgment. Roommate has two degrees in psychology, so she knows how to handle this sort of thing very appropriately coupled with the fact that she’s just a caring person.
If I ever approached someone about my self-harm I was in such an emotionally volatile place that what I really needed was love and attention from that person. Evil-Ex, for example. After living with him for a few months I was on the verge of a complete emotional breakdown. I remember asking him to hold onto my knives for me so I couldn’t use them. Of course he already knew that I was a cutter but he’d never seen me in that state. Asking him to hold onto my knives wasn’t actually the help I needed. I could use anything to cut with. You can’t hide everything. It was my very misguided way of letting him know that things were very, very wrong with me and I needed support. At the time I didn’t have the ability to communicate the way I do now, I wasn’t communicating effectively, and the abuse had just started so I was in a highly triggered time for my BPD.
What I took from that, as difficult as it is to do, really try to evaluate the people you want to tell as objectively as possible. Just because you want with every last beat of your heart for them to love, care, and support you, doesn’t mean they can, will, or even want to. I needed desperately for him to want to care for me. He didn’t. This didn’t help.
Admitting you need help and support is an important first step. Choosing the right help and support is just as important.

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