Carolyn Smith was 25 when she became part of a British epidemic: she began to cut her own flesh, to punish herself over a failed love affair in which she was unfaithful. That was four years ago. Now the university librarian has published the story of her recovery from self-harm.
The UK has the highest incidence of self-harm in Europe, says the Mental Health Foundation and the Camelot Foundation, which are jointly conducting the UK’s first inquiry into self-harm. Early findings show that one teenager in ten self-harms by cutting their skin, burning, scalding, hitting, scratching, hair pulling or swallowing poisons. Children as young as 7 are doing it. Girls outnumber boys by seven to one, but boys’ rates of self-harm have nearly doubled since the 1980s. More than 24,000 teenagers end up in hospital in the UK each year after deliberately harming themselves.
Smith says that as a child, she would throw scissors at a wall when she got angry. But in her 20s she turned the anger against herself. “I scratched keys down my arm. And I felt the pain that had been inside but I hadn’t known how to communicate. Physical pain replaced emotional pain. It brought relief. I should’ve just shouted, but felt I didn’t deserve to be heard.”
Self-harm is often about self-punishment as well as numbing feelings of anger and worthlessness, says Lynn Greenwood, a psychotherapist at St George’s Eating Disorder Services, London, which works with adolescents and adults who injure themselves. “A lot of self-destructive behaviour is around the inability to enter into conflict. The person often has a sense their anger will be uncontrollable or monumentally destructive. Sometimes they fear retaliation, so anger gets expressed through their body instead.”
Although Smith was older than average when she began cutting, her behaviour isn’t unusual. Maggie Turp, a psychoanalytic psychotherapist and the author of Hidden Self-Harm: narratives from psychotherapy (2003 Jessica Kingsley), says, “Through my training workshops, I have a lot of contact with schools. Teachers and other staff describe a growing number of self-harm incidents. In Freud’s day, fainting fits and paralysed limbs were a accepted way of expressing distress. Now self-harm has arrived at that position. It’s a mode of self-expression learnt through reading and listening to friends. But the underlying distress is real and needs to be seriously attended to.”
So what should parents do if they notice cuts? “It’s important to stay calm,” Turp says. “Ask how the person is, and how they feel in the run-up to and after self-harming. Ask if they ever feel tempted to self-harm and yet manage not to, and how that feels. Try not to be too frightened or to condemn, or this might become an unapproachable subject.” Some self-harmers have serious problems; for others it is a transient phase, says Turp.
“But it’s impossible to be sure, so take every event seriously and talk it through to find out what’s driving the behaviour. ”
Smith finds it impossible to pinpoint a root cause of her distress. She says she had a normal childhood in Huddersfield with her mum, dad and sister. “I was shy but pretty happy, although Dad was ill a lot. He had his first heart-attack at 32 when I was two. By the time I was 7, he’d had two heart-attacks and a stroke. But my family found it hard to talk about things. Their attitude was, ‘Don’t talk about it and it’ll go away’.”
None of her family realised she was cutting. “I didn’t show anybody. I was living in Huddersfield when my love affair ended. Then I moved to London. It was my first professional job. I felt wobbly and alone. That’s when I progressed to razors. I wanted to bleed everything out. My thoughts were often self-rubbishing.” Despite having a flatmate and a new partner, Smith hid her self-harm for a while. “When asked about marks on my arm, I’d blame the cat.”
Eventually her partner realised what was happening and persuaded her to try psychotherapy. It worked. Four years later Smith rarely cuts. “It’s been a struggle. But I’ve found out how to put feelings into words and to think about things that, in the past, I would have tried to blot out. You learn that unhappy feelings are OK, instead of trying to make them go away,” she says. “Eventually words kept splurging out, in sessions with my therapist, and at home on to the page. I want to be a writer.”
Her first book, Cutting it Out: A Journey through Psychotherapy and Self-Harm, was published last month. Now she’s writing a novel. Smith believes that her relationship with her therapist was crucial to her recovery. “Cutting off emotionally to numb feelings is a feature of self-harming. With my therapist, I can talk about what’s going on. The point of my therapy has been to bring things into the open.”
So is there a cure for self-harming? “It’s more about recovery, finding healthier replacements for these coping mechanisms,” says Greenwood. For Smith, that includes taking care of her body instead of injuring it, as well as learning to talk about her feelings. “I swim twice a week. The monotony of swimming lengths calms my mind.” Turp explains that using your body, and repetitive movements, can provide a soothing outlet for feelings. “It ’s a healthy way of linking mental and physical experience.”
Smith no longer regularly cuts, though she acknowledges that lapses are possible. “I feel strong enough not to, though. Therapy has made me more aware of what I’m doing and why I’m doing it. Now I know it’s about choice.”
Cutting it Out : A Journey through Psycho- therapy and Self-Harm by Carolyn Smith, published by Jessica Kingsley (£12.99), is available from Times Books First at £11.69 (p&p is free) Call 0870 1608080 or visit www.timesonline.co.uk/booksfirstbuy. For help: Young People and Self-Harm, UK, visit www.selfharm.org.uk; British Association for Counselling and Psychotherapy: 0870 4435252
‘I kept a razor by the bed’
The auditorium dims. The spotlight snaps on. A beautiful young singer holds her audience with her lyrics and the power of her voice. Watching her confident performance, it’s hard now to imagine how difficult it once was for Ash Hayhurst, 21, an Edinburgh singer/song-writer, to express her feelings.
Hayhurst was 13, and her grandfather had just died, when she began cutting herself as an outlet for her grief. “I was really sad and didn’t want to burden my parents who were already upset. At first I made superficial cuts on my arm with a compass. Then I moved on to a penknife.”
Hayhurst’s parents found out after her mother took her to the GP because she wasn’t sleeping. “He took my blood pressure and saw the cuts. After that my parents started going through my room and taking things away. We’ve talked since about how they reacted. I realise now they were scared but at the time they came across as angry. That made it hard to talk to them.”
Over the next five years, Hayhurst’s cutting became more frequent. At 18, although initially eager to go to university, she found it difficult to be away from home. “I kept a razor and tissues on my bedside table. I would cut up to seven times a day.”
Crucial to Hayhurst’s recovery was communication with others who self-harmed via a website which provides mutual support, called www.recoveryourlife.com.
“I started moderating the message boards to make sure people didn’t talk about their self-harm too graphically, in case it set others off. I would talk to people online and advise them how to stop, even though I hadn’t yet stopped myself.
“One day, I thought, ‘Hey, why aren’t I taking my own advice?’ And finally I did. I stopped three years ago.”
