Self Harm: It's About Survival.

Self Harm is something I never openly talk about to anyone and it’s something that holds a huge amount of stigma in today’s society. So much so I feel ashamed to be even writing this. I guess in writing this I am doing my bit to tackle that stigma and raise awareness of this very secretive and self destructive behaviour. I think a lot of this shame comes from reactions I have had to deal with when I’ve disclosed this ‘dirty little secret’. Reactions from both family and friends which have induced this longstanding and torturing feeling of shame.

Self Harm takes various forms some of which might seem terrifying or even disgusting to those of you who don’t engage in it. I’m not blaming you for your natural response; as humans it is instinct to protect ourselves from pain and hurting ourselves falls under that umbrella. However, people who self harm may be causing themselves pain but really they are doing it to feel better. Makes very little sense, right? Well I know it’s a hard thing to grasp especially if you’ve never hurt yourself so I’ll try and explain this clearly. When the body is injured the brain naturally releases the ‘feel good’ hormones called endorphins in response. Endorphins lift your mood and you end up feeling better. So really by self harming the sufferer is causing pain in order to lift their mood; the only difference is that it’s deliberate pain and not accidental. Self Harm can therefore be seen as an emotional regulator put in place when the sufferer can’t access healthy ways to feel better like receiving a hug or talking to a loved one.

Another reason why sufferers self harm could be to use it as a form of punishment. I know for me I have used cutting, burning, starving, and overdosing in order to punish myself for doing something wrong. I’m a perfectionist and therefore I do struggle with seeing myself as failing all the time when humans make mistakes everyday. Because my emotions are intense and my behaviours are extreme I do turn to self harming to punish myself. It’s destructive and painful but I do feel like I deserve it most of the time especially if I feel I’ve hurt a family member or a friend. When I feel very low or numb and empty I do turn to cutting or burning in order to feel something. Emptiness is a difficult emotion to describe but the best I can do is that it’s like that feeling when nothing matters. You’re just existing and nothing is actually making you feel anything. It’s intolerable for me most of the time because I would rather feel something. Anything. The pain from a blade or a burn can provide a feeling that I’m real. That I’m alive. It brings me back into the present especially when I’m experiencing a flashback or severe dissociation. In this respect I want to feel that pain and I want to see myself bleed because I’m alive. It’s an odd thing to get your head around but I suppose if you’ve never felt empty or you've never dissociated then you won’t fully understand the appeal. 

Overdosing is usually a distraction from intolerable emotions. I flip constantly between Anxiety, Anger, Depression, and sometimes Happiness. Because they are off the charts in terms of intensity I struggle to sit with them and act appropriately. Due to my impulsive nature I act before thinking and I’m usually guided solely by my emotions. I get overwhelmed quickly and therefore reach for tablets as a quick fix to feel better. The sickness and pain that comes from an overdose is usually enough to distract me from the emotional turmoil within my head and body. It’s replacing mental pain with physical pain; something I’m more able to deal with. This isn’t a sustainable self harm behaviour, none of them are really, because I put my health at risk due to impulsivity and emotional instability. Overdosing is something I am constantly working to stop but until I am able to fully tolerate my emotions and lower their intensity, I do use it as a crutch to keep me alive.

I am covered with many scars with a large amount along my left arm and wrist. I have self harmed for nearly 12 years in one way or another. It’s become a coping mechanism which has adapted to my needs over time. I no longer see a hug as comfort; I see a blade or a box of tablets. This is very sad and I do really wish to change this mindset. I think when you grow up in a dysfunctional environment you do reach for destructive coping mechanisms in order to survive. I don’t blame 11 year old me for scratching her hand raw whenever she got anxious. I don’t blame 13 year old me for reaching for that sharpener blade to feel something and punish herself for the bullying at school. I don’t blame 19 year old me for starving herself in order to feel in control. And finally, I don’t blame 21 year old me for reaching for her first box of paracetamol as an escape. She did what she had to do in order to survive. Self Harm isn’t shameful; we use it to survive. Remember this.

NG Tubes and Forced Fluids: My Stay in the General Hospital.

The more I've tried to write this the more anxious I have become because this is a very difficult article to write. Going back to that mindset isn't easy and to think of myself so desperate is something I struggle to dwell on. However I wanted to document this part of my journey because I have made an awful lot of progress since then and sometimes you've got to reach rock bottom to realise you need to fight harder for your life. It's about learning you deserve more than a mere existence. You deserve life.

Following my first admission to Wotton Lawn Psychiatric Unit in August 2014 I began to drastically decrease my food intake. I was eating a very limited amount of food and exercising alongside this. It was miserable and absolute torture but I was convinced losing weight would help. Or Anorexia convinced me it would. As well as this I was overdosing nearly everyday on paracetamol to the extent that the tablets themselves lost all meaning; they could have been smarties for all I cared. I was going missing a lot. I was in the midst of a severe mental health crisis and I was experiencing hallucinations. Not only was this worrying to my treatment team but also to my loved ones. They would get frequent calls from the police because I had yet again disappeared and I was a missing person. The truth is I chose to go missing because I didn't want to be Sophie Clayton anymore. I wanted to escape myself. However, as described in my previous post, I was sectioned under Section 2 of the Mental Health Act. My rights were taken away in order to protect me from myself.

My first few weeks in Wotton Lawn were filled with restriction. I refused to eat anything and my weight started to drop considerably into the danger zone; I was near my lowest weight again. This was of great concern to the nurses on the ward and they tried to encourage me to eat small amounts. I refused because they had taken away my other coping mechanisms and I was sort of rebelling. They took away overdosing and self harm so I reasoned I could immerse myself in Anorexia. And I took it to a whole new level.

For 5 days I refused to eat and drink anything. I was starving and dehydrating myself to death. Although I wanted nothing more than to eat something or drink a pint (or 20) of water, I could not allow myself to do it. The voice I my head said no. I desperately cried to my parents and my friends to help me and they encouraged me to take sips of water but I flat out refused. I was growing very weak and I couldn't get out of bed; my body was dying and my mind was disappearing. I wasn't Sophie anymore. I wasn't anyone. The doctors took regular bloods but it wasn't until day 5 that they were forced to act because my blood sugar had dropped to 2.1 and my kidneys were beginning to fail. My body was starting to shut down and I still would not let myself even take a sip of water. This is one of the many things people fail to understand about Eating Disorders; we love food and drink so much that we punish ourselves by restricting them. It's not about the food it's about control. It's about coping with something bigger than the human need to eat and drink.

I was transferred to Gloucester Royal Hospital because I needed emergency treatment. I was told that I would receive just fluids when I left Wotton Lawn but when I got there the doctor also ordered an NG tube. This tube would supply my body with the essential nutrition it needed for it to recover. Immediately I freaked out to the nurse who was on one to one with me. This wasn't the plan. I was too fat to be pumped full of liquid calories. The control would vanish. How would I cope now? YOU CAN'T TAKE THIS AWAY FROM ME. I cried and picked at the cannula they'd already put in for my fluids. 

But my efforts were futile because I was on a section; the doctors could treat me against my will and now I'm so very thankful that they did. So I was moved to an admissions ward and the nurses put up more fluids and a vitamin drip. Once I was calmer (after a strong sedative) two nurses prepared to place the NG tube. I was terrified but a part of me desperately wanted them to just force me. I had no fight left and I just wanted them to do it for me. I wanted food and I wanted drink more than anything. I cried as they steadily inserted and guided the tube through my nose and down my throat into my stomach. It felt very uncomfortable and I had to fight the voice telling me to pull it out.

After an X-Ray confirmed it was in place, they moved me to a ward higher up in the hospital and started the feed. I was on a very slow feed because of my risk of re-feeding syndrome. However, slow as it was, the feeling of absolute disgust Which spread throughout my body felt unbearable. I tampered with the feed constantly and pressed stop on the pump numerous times because I'd had enough. But I know now that the feed and fluids were saving my life. Maybe at that moment I didn't want to be saved. Maybe I wanted to die. But hindsight is powerful and you have no idea just how grateful I am now for that little purple pump. 

It saved Sophie. It saved a person who could not make a decision about life and death; it gave her time to decide fully for herself. 

This was my turning point in terms of Anorexia recovery but also it marked a real change in my treatment plan. It altered the steps I would later take after being discharged back to Wotton Lawn and beyond. There was no going back to starvation or dehydration after that because that was death and I decided to live. I chose life the minute I left hospital and I continue to choose it to this day.