h2g2 The Hitchhiker's Guide to the Galaxy: Earth Edition

Hello

Right here I come wading into this with my size 9s so I'm really sorry if I hit any toes (This is just my usual woory at talking about sensitive issues I have no personal experience of). I will also start by apologising if I'm just thinking aloud in bits of this comment or redoing what others have said, but I haven't had chance to read all the previous posts, and to be honest I'm not sure how to handle commenting on this.

Looking at it, it's an addition really to having a go at yourself, and like any addiction it's a case of personal choice and personal responsibility. You can't be made or emotionally blackmailed into changing your behaviour you have to actually want to change it. But would the addiction comparison be helpful? I understand your reluctance to use other resources as they work for some people and not others and this is a personal account after all.

I wonder about the title still, this entry seems to be more of an account of breaking the addictive self harm cicle.

One thing I am quite sure of though is that the smileys will be removed, as is the nature of the guide.

Sorry this is garbled, but basically I think this is a very specific account of how you went about changing, or at least trying to change your behaviour. So maybe you want to mention identifying situations that make it hard for you to cope, and how you dealt with them.

I'm sorry I really don't know about this, I'd better just cut this short before I really put my foot in it.

Researcher PSG

Captainkath -,

I totally recognize whatyou're saying, but there is a risk to the site if we start to give medical or psychological advice. It is very possible to say, for example:

Common treatmens for melancholic depression include: SSRIs, TCAs, atypicals (esp. carbamazepine) in addition to behavioral therapy.

That statement is a fact and while other treatments are used, certainly the ones mentioned are truly coomonly used.

To say something like:
if you are depressed you should try to use behavioral therapy as one mode of treatment
violates BBC policy. We cannot distribute medical advice. If it fails the BBC is liable. Then the site gets sued, then the site gets closed, then we are all sad. There's too much to lose and to alter the message in a minor way is appropriate.

friar
ps. sorry for typos, i'm holding a fidgety baby . .

Hi PSG,

I dont think it can be classed as an addiction - well not in the way that most people interpret an addiction to be. It is a coping mechanism, in the same way slamming a door is when you are annoyed, but you wouldnt call slamming doors an addiction. Having said that it is incredibly hard to give up and usually the SI is replaced wuth another less self destructive coping mechanism in the same way someone giving up smoking chews gum, so i guess i know what you mean.

"and like any addiction it's a case of personal choice and personal responsibility."
We do all take responsibility for our own actions, but it isnt a case of personal choice. This is not a path i would have chosen, and can think of no reason why one person does SI and another doesnt (with similar life experiences, I mean, as i think it has been shown that such self loathing and self hate can be due to traumas experienced, leading to a mind state that makes a person more likely to use self-defeating behaviours to cope)

When I started it, i was 15 and had never even heard of SI before so what made me even think of it i dont know but thats the way it is, certainly not a choice.

Maybe the title should be something along the lines of 'Self harm - my way out...'

At least this is getting some healthy opinions and hasnt been lost in the backlog!!

Mort

Hello

I didn't mean personal choice or responsibility in the way you say, I mean't it in referrence to stopping, I had no doubt starting was something inavoidable (or at least something unchosen). I mean't it like you have to choose to stop really and truely, and also have to take responsibility for stopping (another personal choice), saying I will use this to help make myself better rather than saying I'll do this and that will make me better. I think I probably should have explained that bit better.

Researcher PSG

Okey dokey

Mort

Actually looking back at my first post I should have phrased it better.

Researcher PSG

Friar,

Yes indeed, I believe I made that exact distinction myself, the two statements you make do not contain any incorrent facts, one is advice the other is opinion expressed as fact. The changing of one letter in the statment from 'you Should' to 'you Could' would render it acceptable. The issue here is not whether people should offer medical adivce (or any for that matter but I'll argue that point in a minute) but the manner in which they do it. I presume the use of researchers and other editors is to iron out exactly this kind of crease. And I think in that case the advice was not the problem but the opinion!

If people should not offer medical advice due to possibility of legal action then to be fair this site should be closed down anyway as nothing could be said about anything. Using that principle it is impossible to offer religous, philosophical and metahpysical opinion. Any discussion on lifestyle choices enters the same dodgy litigious area. To illustrate my point I believe it would be fully possible as a citizen living under British law for me to claim that as an adherent to the Christian faith a posting on the Council of Nicaea published by this site is defamatory and inciting religious hatred - it's facts are false, opinion presented as fact, poorly researched and with a distinct anti-Christian bias. However I'm not that niaive or stupid.

I am well aware that the majority of readers will not enter into suble philsophising about the problems of epistomology and interpretation, however I feel your point lacks a certain internal cohesion.

PSG - the brian doesn't quite run on such simple lines. You claim you have to choose to stop - I would disagree. This is mostly semantical but to my mind you have to want to stop. Therefore your statement, in my expereince and thus opinion, should be rephrased as 'you have to chose to want to stop' which is a little daft.

About five months ago now I decided I wanted to take control of my life back. This meant being able to manage my emotions in a more productive fashion. This meant finding better ways of coping with both the thoughts that produced the emotions in the first place and finding helpful coping mechanisms. This means five months down the line I am finding I need to cut less. I never chose to stop cutting, it's been the consequence of other choices stemming from the fact I wanted to cope with life.

I think it's likely most people would see little difference between chosing to stop cutting and wanting to stop cutting but there is a significant one. Many times over many years I had 'chosen to stop cutting' which merely meant I took up smoking, or drinking, or abusive relationships to compensate, and went back to it during the next anxious period. Only when I wanted to stop (in the sense of finality) as a consequence of accepting I had larger problems in my life that needed addressing, was I able to begin to stop. It's a case of once the causes were tackled the symptoms would dissipate.

I made this point in an earlier post, to simply chose to stop cutting doesn't actually help, you have to want to get your life back and be prepared to understand why you do it, which due to the nature of the epistomological frameworks we work with and the functioning of the human being as a holistic (psyhic and physical) individual, is likley to involve a huge amount of time investment. This whole ramble illustrates my point about the sheer complexity of the issues surrounding self harm - does one person decide not to cut and thus sort out life, or does another sort out life and thus stop cutting. Those are just two sides (and two issues) of what is probably a dodecahedron. It is impossible to make simple and unqualified statements about this issue - and I know it's a trap I fall into myself on occasion.

Now, it's most definately not an addiction, in the medical, psyhiatric or coloquial sense. There is a sometimes numbing effect (due to opiates) in people who self harm (especially abuse victims) but it is not a psychological or physical addiction. Habit it may be, but let's not overstate our case.

If you are interested Mort there is a lot of psych stuff out there on the very issue of why some people bounce when faced with trauma and other's dont. I have no idea how much faith you place in childhood experiences as formative but the argument runs thus. Human beings are social creatures, we are not born with fully developed faculties (oh that we were!) and thus our behavioual, cognitive and emotional responses (all intimately linked) must be learned. These are learned from the significant role models around us, namely parental figures for the early years. In order to deal with traumatic experiences well an individual must have certain mental resources to fall back on, such as problem solving skills, a full sense of self and independence and so on. Such skills are first developed through the relationship with the primary care giver, most often the mother. A mother who in play encourages her child to develop and grow through sympathetic learning and play will rear a child who is adept at coping, a mother who dominates play will rear a dependent child.

There's a whole load more stuff surrounding this issue (such as attatchment bonding and the key role it plays in producing adjusted individuals) but it would be pointless to go into now. One book I found useful is 'Handbook for Treatement of Attachment-Trauma Problems in Children' edited by one Beverly James, ISBN 0-02-916005-7. Alice Miller's work (although focused much on pedagogy) is another good place to start investgating the arena of parent-child relationships regard trauma and attachment.

I know its not easy - nor is it related to intelligence - nor is it always related to abuse. I know there are no simple answers, only simpletons who offer them.

Thanks for talking about your experiences, all of you, as I said I know a girl who tends towards this, and I'll be taking all this advice to her - can't take the actual thread because she knows my nickname - but thank-you all of you.

Hello again

Right, I don't feel comfortable arguing about this, but their is a couple of points raised I wish to address, as I think I obviously didn't get them across first time. So please don't hit me, ok

I think I may have made the point about choice badly judging by what you have said, I was using choice as an indication of locus of control, any action to stop this behaviour would, I assume from what I read, have to come from a personal internal decision rather than any external influence. I wasn't trying to simplify into a simple step what you have to do to make that choice, just say who has to make it. (In your example you said you chose to take control, by making that choice you where choosing to modify your behaviour to life, and in consequence, I assume, stopped cutting. But my point is you had to choose to make that change, rather than being pushed into it.) I also didn't say if you make this choice you are guarenteed success, there is of course alot more to it, but without makeing the choice youself for you, then you are more likely to be guarenteed failure. Also rephrasing wise we all make choices, be they the result of subtle internal dialogue, or clear cut. And yes on some level we do choose what we want, which makes me a little confused by your rephrasing of the sentance.

One point I feel fairly happy on is your dismissal of the word addiction, as the oxford referrence dictionary puts it :
the condition of doing or using something as a habit or compulsively.

Which seemed to fit what I was reading, now I may have misread, but to say that it fits in no sense was wrong as far as I can see at the moment.

Anyway I'm just trying to clear up my point, I could still be wrong.

Researcher PSG

whoops meant to say:
"One point I feel fairly happy debating about is your dismissal of the word addiction, as the oxford referrence dictionary puts it :
the condition of doing or using something as a habit or compulsively.

Which seemed to fit what I was reading, now I may have misread, but to say that it fits in no sense was wrong as far as I can see at the moment."


I should really check more closely before hitting post message.

Researcher PSG

Ai, ai ai.

Right, To my mind there is a gulf between a habit and an addiction. Dictionaries by their very nature must find synonyms which may be close to the actually word we are trying to define, but not identical to it. I am in the habit of eating toast for breakfast and drinking coffee whilst reading The Guardian, this is not an addiction, nor is it a compulsion. The conflating of the two words, habit and compulsion to illume the word addiction is telling I think. Habit and compulsion have very different force and very different loci. To be compelled is to be forced to act with the implict assumption it is against one's wishes or natural inclination. I have already indicated my understanding of habit - which to clarify is an action or behaviour pattern that is regular, repetetive and often unconscious. The use of these two words would suggest addiction falls inbetween these two.

However using the Encarta we get a different definition, 'a state of physiological or psychological dependence'. Part of my point is that in the arena of mental health 'addiction' has a specific reference under which self injurious behaviour cannot be classed. Seeing as we are attempting to move away from generic and faulty understandings of this topic I thought it prudent to mention this. Further it is my opinion, from much experience (literal and academic) that the force the word addiction carries in lay usage is too strong to be applied to self destructive tendencies. Most people will be more 'addicted' to caffeine than cutting. Self injury is not a compulsion, it is a habit, to add the force that comes with addiction (implied by the word compulsion) is, in my opinion, misguided.

Regards choice and want, I did state it was largely finickity semantics but in general understanding a 'choice' is a rational cognitive event made when a situation has been assesed and 'want' is a more implusive, emotional driven desire. For instance I may want to eat chocolate but I chose not to. I may chose to spend the day revising in the library but I really do not want to.

It was your conflation the two meanings as though their use was interchangable I was having issues with. For instance I did not want to stop cutting, but I have chosen to try and get my life back on track and thus it is a consequence. It was not neccesary for me to desire cessastion in specific self destructive tendences for precisely that to happen in consequence.

Take the war, it would be hard to suggest that the politicians desire anyone to die because they have chosen to take action (misguided or otherwise) against Iraq.

Choice is not a indication of a locus of control, merely a cognitive event, hence my statement that I have 'chosen' to give up cutting on many an occasion but without the concomitant desire to get a grip on life it was going no where. Rational cognition, if not backed up by emotion and expereince, is a notoriously flimsy tool. To my mind it is not that 'I have to chose to want to' but 'I have to want to be able to chose to'.

I did start writing a paragraph or two on the links between cognition and emotion but I don't think it's worth it. I would imagine we are largely arguing the same point, as stated many times, it's likley semantics, but, given we have no other clues to help us discern meaning over the electronic medium, I think it's important.

Hello Catwoman,

Firstly let me pass on my thanks to you for having the fortitude and honesty to post this to h2g2. This is a subject *very* dear to my heart and I have been following this entry's progress since it entered Peer Review - within my immediate family there is a self harmer and I fully understand the trauma involved for the sufferers and their families.

The reason I am posting here is that we don't see this as an *Edited* Guide Entry. While we have many medical personal perspective pieces in the Edited Guide, none of these, as far as I know, deal with stages of recuperation/healing from a condition that causes sufferers to self-injure. We have to tread a very delicate line when offering advice of this nature on an issue that doesn't have just one solution. The road to healing varies from person to person. Sadly, a disclaimer does not cover any possible crisis.

As ever, I'm here to listen.

Ashley

i believe there was a suggestion from the writing workshop about trying it in the post?

CaptainKath - beware mentioning foreign affairs

This has already caused a great deal of discussion (the subject matter - not the article as such) which is fantastic for a subject that i feel the world would rather hide as it is too unpleasant for them to look at. (personal view)

Maybe it will be a guide 'talking point' one day (if it hasnt already)

Catwomans story will always be part of h2g2 anyway available through the search engine.

Cheers everybody for the thoughts and dealing with a sensitive issue in a responsible manner (sorry thats sounds patronising )



Mort

oh well never mind
thank you for reading it anyway.
kitten kisses x

Thank you for your understanding and thank you for a great entry which epitomises the courage, bravery, pride and trust the h2g2 Community can generate.

Hello again

Captainkath I think we are getting bogged down in word definitions, which we could probably hammer out if we where talking rather than using postings. And on some level I feel we may be getting so bogged down in word play we aren't really adding to each others understanding. So rather than reply to what you have said I'd rather ask some questions, and hope to get direct answers as I know I do not understand and my original post was in part an attempt to.

Right,

When self harming occurs is it a compelled reaction to a situation, or a psychological device to counterbalance some strong emotion or feeling?

When it comes to changing this behaviour or changing the reaction to life can any external influence compell you to change without some internal decision?

I really didn't want an argument, I wanted to understand, so please do not deconstruct my words, instead try and explain.

Researcher PSG

Okay I shant try and deconstruct your words but I must emphasise that nobody can communicate effectively unless they share a common understanding. Dialouge can often lead to sheer confusion if this is not so.

I'm not sure I neccesarily see the distinction you have drawn in your first question, I assume you are attempting to posit a dualistic difference between external events and internal perceptions? Working on this assumption I shall try and explain.

It is impossible to draw such a rigid distinction. In simplistic understandings of reality, such as Christianity has held for much of it's existence, these dualism are prevalent. They attempt to section reality into diametrically opposed categories (male/female, spiritual/physical mind/body) and then to assign positive and negative values to them. Modernity does not work like this, we see everything as being much more interconnected, gender is seen as partly constructed through society, we do not see our sense of the spiritual as neccesarily other wordly, we do not treat the mind and body seperately. Even history and ideas are part of an interconnected web. These old black and white categories are seen in the thinking patterns of depressives and suicidal individuals, and often self harmers.

Now, to illustrate with an example not explicity about self harm, the insights cognitive theraphy has allowed us.

A man enters a busy party and experiences an overwhealming sense of panic, feels nauseaus and finds it hard to breathe. It would be very easy to state that it is the external event of a room full of people that has caused him to panic. But let's scratch a little deeper, he panics because he fears that he will make a fool of himself, he will spill his drink or not be able to talk to people in an interesting manner. Here the panic has come about because of a prediction about how he will behave and the emotion that elicits. Take it one step further again. What is causing him to assume he will make a fool of himself? This may well stem from an underlying self confidence problem in which he firmly believes he is boring. So the panic here stems from a belief about himself.

Thus here we have three levels, an external situation, creating a thought and an emotional reaction, stemming from (an often unexamined) fundamental belief or rule. Now is it possible to actually pin point which of these caused him to panic? No, they are part of an interconnected chain of events: belief leading to irrational thoughts and emotion, then leading to action (such as leaving the party or avoiding social situations), all triggered by a historically conditioned situation.

Such cognitive patterns are also present in the minds of self harmers, other phobics and neurotics. In self harmers the end result is to damage themselves. A significant majority of the population is unaware of these cognitive chains, we work on unchallenged assumptions most of the time, which is all well and good when the assumptions are rational and in line with normative practice. Assuming stepping in front of a moving bus will land you up dead is a rational assumption, assuming stepping onto a bus will effect the same result is not.

So I think to answer your question the answer is neither, the self harm stems from a faulty belief about yourself, with self harmers it will often be formed around some sense of failure, inadequacy, guilt and deserving punnishment. Quite when, where, why and how such thinking patterns were hardwired into a persons life is often an academic question. Challenging the beliefs themselves is proving enough to significantly help people. The idea of underlying beliefs producing certain patterns of thinking is also proving useful in helping those with chronic pain or terminal illness lead better lives. Did that answer your question? If you want further information on the subject then Aaron Beck is the man who formulated the idea. The most recent edition of 'All in the Mind' dealt with exactly this topic.

I think the simplest answer to you second question is yes. I know you dislike semantics but this is a tricky area, is an attitude the same as a descision? For instance if I am depressed but have a general assumption life will get better have I a) made the decision to live or b) chosen not to die, or c) made no decison at all.

To refer specifically to my situation because this is the experience I have been arguing from, the decision for me to enter therapy is not one I made. Wheels were set in motion and with the general assumption that medical professionals around me knew better than me in this situation, and be more objective, I let it happen. I made it plain I wasn't at ease with the situation but did not call a halt to proceedings. Ie is a decision not to make a decison, a decision?

The main point I was trying to make was the idea of consequences. The results of any action or decision will be far reaching. It could be claimed that in deciding not to decide about therapy, I chose to stop cutting, eat properly, stop burning, mend relationships with friends, not to think about suicide, finish my degree, get a job, meet a partner, settle down ad nauseum. But I don't think I neccesarily did, it could just easily be claimed I decide to relinquish control and let other people make my choices for me, thus making sure I would never 'get-better'. There are explicit and implicit decisions. Or course in thinking about a matter we will weigh up some of the possible consequences but never all. Which was precisely my point. I still claim I have never actively chosen to give up cutting nor have I always wanted to. The incremental rises in the desire to stop have come about as a consequence, they most definately were not there during the intial forrays into therapy, in fact quite the opposite, losing that very efficacious coping mechanism was frightening and inconcievable.

Hope any of that helps in any way.

I hope we're going to get an article from you on some subject Captainkath, you write clearly and objectively, and obviously have strong views.



Catwoman, I think its a shame we can't get this edited, but thanks again for sharing it with us. Stay strong.

I don't know about this, Ashley. In A602876, we have an account by someone with a brain cyst. Yes, self-infuring is not the same as a brain cyst, but both are accounts of someone living with a very serious condition.

I think that this entry has a lot of potential in the EG. It doesn't claim to be the only way of dealing with it -- merely one person's perspective. And it was in PR because there isn't an entry that deals with this subject.

However, I note it's out of PR, so I guess it's a moot point.