Perceptions of Self Injury by Professionals: Diagnoses and Gender Stereotypes
Do you find that "professionals" (doctors, therapists, social workers, etc...) tend to want to focus on your self-injury even when you put emphasis on the fact it's not your largest current concern?
Does this happen even when you are a recovering or recovered self-harmer?
If cutting is not your primary method of self-harm, do you find that others assume that it is?
Self-harm is one of the criterion for Borderline Personality Disorder, but not any other diagnosis. If you have a diagnosis other than BPD, do you find that some professionals comment that your self-harm doesn't necessarily contribute to another diagnosis you have?
If you are anyone other than a cisgendered woman (so anyone that does not identify as a woman/female, or women who were not labeled female at birth), what are your experiences with sharing your self-harming behaviour with a professional? Do they assume you engage in non-cutting activities, or that they are actually suicide attempts, or just a part of being a "normal risk-taking young boy" etc...?
I'm also interested in any general comments people have on this topic, and experiences with gender stereotypes of self-harm and other stereotypes that professionals might hold that you have witnessed.
professionals, if they're decent, don't usually want to focus on it if you explain you know your triggers, you understand why you harm, why it can be bad and tell them you know first aid and aren't doing anything major.
counsellors freak out and only want to talk about self harm (in my limited experience) but that could be expected.
if your self harm wasn't superficial they want to focus on it (which makes sense in a way as harm minimisation is great) also because dealing with the underlying issues will take time so they need you to stay safe for that. also they're in trouble if they don't treat it as a big deal and if you do yourself serious damage.
my psychiatrist turned away people who just used self harm to cope because she saw they could be mentally healthy and just greiving or dealing with stuff. she thought it was a stupid coping mechanism even if minor mostly because scars are crappy reminders. she was wonderful.
in hospital i told them that i wasn't there to quit self harm but rather do anything to keep myself alive. though i appreciated i shouldn't do it in the hospital and should try to avoid it when on pass i told them i wouldn't come back or call them if i messed up because i deemed it unnecessary. that went down pretty poorly...but that makes sense because on giving pass they've said they think you will stay safe, they're very responsible.
in many cases i think it's more self interest than misunderstanding?
when i was IP the males there were frequently self harmers and it was seen as a serious issue and not treated differently. if anything with girls it was almost expected and deemed less of an issue and more likely to be seen as attention seeking.
i'm AFAB and though i'm not fussed on gender people assume i'm female these days (i've got pretty fem somehow) and i'm fine with that so i have little to offer on that front. i identify as female because it's easier.
Just wanted to say that instead of referring to self harm my therapist talks about 'cutting' when I do have other methods. I haven't bothered correcting her because I mostly do cut.
I've had mixed responses. Some have been willing to talk about the self-harm but not really focused on it. Others have really focused on the self-harm, which I didn't find helpful.
I once saw a psychiatrist who spent the whole half-hour appointment focusing on self-harm and actually refused to acknowledge any other issues. It irritated me, particularly as it wasn't a major issue - it has been years since I've self-harmed more often than a few times a year. But then, he also refused to believe that I didn't tell my friends when I had cut and that my mood was consistently low, which was actually why I was there. So, in my experience, while some MH professionals are very helpful with regard to self-harm, others have unhelpful preconceptions about 'borderline cutters'
"I know you're sad, so I won't tell you to have a good day. Instead, I advise you to simply have a day.
Stay alive, feed yourself well, wear comfortable clothes, and don't give up on yourself just yet.
It'll get better. Until then, have a day."
I've experienced ignorance from people who don't self-harm and even from people who have self-harmed. My former GP said "at least I wasn't cutting." When I opened up to him about my bruising.
I confided in a friend I thought I could trust about my self-injury. Her response. "Do you like the attention you get from it?" o_o are you serious? If I wanted attention why would I bruise in places that were easy to hide. Just...I have no words. Here's another she told me. "I don't know many adults who still hurt themselves." There are people in their 60's who self-injure. Epic fail.
And to me what really took the cake. She said "there are people who have had it so much worse than you and they don't hurt themselves." And it's belittling comments like that that make us want to hurt ourselves in the first place.
I hate that people assume that self-harm is just cutting. Or that bruising is considered "better" than cutting to some people. Or that bruising isn't a "real" form of self-harm and that it's "weak." That makes me want to bash my head into a wall.
Oh, if we do cut, we all cut on our arms. I started cutting again and I don't cut on my arms. Some other comments I've read from people who self-injure. "When I talk to someone who say they self-harmed show me one scar!" *face desk* Number one, some people just do not scar easily at all. I don't. Secondly, not all types of self-injury leaves permanent scars.
And another: "they claim to be cutters when they do scratches that hardly even bleed!" Ok, can i just please smack something now? The severity of an injury doesn't matter, but it's about the fact that you felt bad enough to do it in the first place.
We were all physically or sexually abused which led us to self-harm. No. While some have been abused, there are many people, like myself, who haven't been sexually or physically abused who self-injure. Self-injure is personal and the reasons are you unique to each person who does it. As well as what methods they use.
Last edited by Celticroots : 25-01-2014 at 05:58 AM.
Just wanted to say that instead of referring to self harm my therapist talks about 'cutting' when I do have other methods. I haven't bothered correcting her because I mostly do cut.
This one drives me up the wall, especially since I harmed myself in ways that weren't cutting for several years.
Several GP's, a counselor and a (non-statutory) support worker have known about my self-injury and none of those have put too much focus on it. This could be because it hasn't needed medical treatment (apart from an OD once). It's basically superficial stuff that only needs plasters. I've never done it very regularly either. In fact I think there was more concern when I hacked all my hair off!
My diagnosis is depression. Sometimes they've written 'depression and anxiety'. On letters to do with benefits my GP adds 'self-harm' to that. I can't remember anyone ever speaking to me about self-harm in relation to my diagnosis. On the rare occasions they ask the question will be something like "Have you harmed yourself at all?" and my GP has mentioned it being a "coping mechanism."
The time that was very different to this was in a long-term psychotherapy group, run by an experienced therapist who had qualified as a psychiatrist. The group was extremely bad for me and I confessed that I had started cutting either before or after the group in order to get to it. (I cut at home not on hospital premises.) The therapist said that unless I promised not to cut I had to leave the group.
There were people in the group who did bulimic behaviors at times, or abused alcohol and painkillers - and they did not have to promise to stop. This seemed a really unbalance reaction to cutting, particularly when my cutting was really shallow and therefore probably a lot less dangerous medically.
Just wondered about the way you phrased your questions - is this a topic you're going to write about?
My GP was really awkward about it and was not at all helpful. She made me show her my arm and when I did she said "Ooh yeah," grimaced and ran her fingers across my cuts which was the weirdest reaction ever I thought. I dont have very much experience with this though so I dunno maybe it's normal. When I talked to a counselor I did find that she wanted to focus on SH even though I dont think it's my biggest problem. She also keeps asking me why I do it and what triggers me even though I have no answer at all.
Just wondered about the way you phrased your questions - is this a topic you're going to write about?
Don't plan on it. Mostly, wondering about things I have heard.
The optimistic-former-academic in me hopes that the phrasing will help any future academics out there to consider these questions in their research/focus.
Thank you for everyone who has shared their stories so far! I'll eventually share mine, but only if this gets to a second page.
I've actually found that they have focused less on it than what I had expected. I mean, I definitely ended up in A & E far too many times for it to be an accident. I was surprised that this was never really mentioned despite how severe it got at points. In a way, it was good that it wasn't mentioned because I would have hated that at the time, but now it's slightly concerning considering how badly I was hurting myself.
I'm now recovered and I do find that it does get brought up every so often. When this happens it goes one of two ways. I either get embarrased and brush it off or I actually talk about it. Depends on the situation and what the context that it is being mentioned in is.
I used to self harm in alot of different ways but only ever went to hospital for cutting so I think it was definitely assumed.
I am diagnosed with BDP although, I was always told that it would be a lifelong thing and that I would never recover fully. That was bullshit because I now seem to deal with the ups and downs automatically and have been off meds for over a year and a half.
I am a transguy but I do see my self harm linking to this so it is brought up when talking to professionals at the gender identity clinic as it is a big part of my past and stopped when I came out to myself so it is linked in a way. Weirdly, this is one of the few situations I am comfortable talking about it.
The world is just illusion always trying to change me.
You will find wonder wherever you can, and spread joy whenever you are able.
I felt emotions of gentleness and pleasure, that had long appeared dead, divide within me. - Frankenstein.
I noticed that when I stopped self-harming I was no longer taken as seriously or regarded as much of a threat and so received less / slower care. This was despite the fact I had even more harmful thoughts than self-harming and clearly expressed the need and want for help.
I feel like it's wrongly used by many professionals as a way of assessing 'how bad' you are feeling. Those who don't engage in self-harm, or sometimes even those who engage in self-harm behaviours other than cutting, I've found are often not taken as seriously. Or when you begin to self-harm less they assume it is because you are feeling better. This has affected me greatly.
Do you find that "professionals" (doctors, therapists, social workers, etc...) tend to want to focus on your self-injury even when you put emphasis on the fact it's not your largest current concern?
Does this happen even when you are a recovering or recovered self-harmer?
If cutting is not your primary method of self-harm, do you find that others assume that it is?
Self-harm is one of the criterion for Borderline Personality Disorder, but not any other diagnosis. If you have a diagnosis other than BPD, do you find that some professionals comment that your self-harm doesn't necessarily contribute to another diagnosis you have?
If you are anyone other than a cisgendered woman (so anyone that does not identify as a woman/female, or women who were not labeled female at birth), what are your experiences with sharing your self-harming behaviour with a professional? Do they assume you engage in non-cutting activities, or that they are actually suicide attempts, or just a part of being a "normal risk-taking young boy" etc...?
I'm also interested in any general comments people have on this topic, and experiences with gender stereotypes of self-harm and other stereotypes that professionals might hold that you have witnessed.
To be honest, my care team rarely concentrated on my SH - except when I'd ended up in hospital from it. They were more concerned about what triggers me self-harm and ways in reducing this trigger (mostly through DBT skills)
I, like Neko, have noticed that since I stopped self-harming I have next to no care from MH teams. I went from having a CPN, a Social Worker, a Support Worker, seeing a Psychiatrist every month and having a individual DBT therapist to seeing my Psychiatrist every two months.
Most of my care team were careful to call them 'self-harming behaviours' rather than specifically 'cutting' or such like. My GP was the best I found as he asked me what behaviours I did that would be considered self-harm and then said he would call them 'self-harm behaviours' from then on, but he would like me to explain which ones I was referring to when we spoke about them.
I have BPD so I can't comment on the next question really - except that one of my friends was diagnosed with 'BPD traits' when the only thing she showed in any way BPD-like was self-harm.
I hope that made some form of sense.
♥It's the ups and downs of living life this way. Promise me you'll never go away. Just stay with me through one more night because it's always darkest before the light and now I promise you I'll never turn away. I won't let you give us one less heart to break...♥
