“Medical professionals, and people in general, find self-injury so difficult to deal with and so confronting because most people are unable to empathise with it. They find the thought of destroying their own flesh incomprehensible.”
Nellie Worringham gave a moving account of her own experience of self-injury and some of her experiences of therapy, as well as appealing to clinicians to understand self-injury from the perspective of consumers. She brought us into her world for a time through her diaries, inviting us to imagine her experience instead of avoiding it, to give us “a glimpse of the life on the ‘other side’, in the ‘other mind’”.
“When I open up my body, the yellow fat is the first thing I see. The bubbles of blubber that consume me. The blood runs out – a vein has been severed. My mind runs free for a moment. I make another cut, and now I can see the dark muscle underneath the fat. When I tense my leg, I can see the dark object moving. I cut again, and the muscle parts, although it’s tough, it doesn’t want to be separated. Now the blood is pulsing. The blood takes over my mind. I follow the flow and stare at all of the towels on the floor, saturated with blood. After a while, I start to feel faint. I put pressure on the cut. The blood seeps through the bandages I wrap tightly around my leg. It does this for hours. But then finally the blood clotted. And the bleeding stops, for now, anyway.”
“The blade penetrating innocent skin. If only that was enough… Just one step further… The blade severing the delicate veins and pulsing arteries. If only that was enough. Really, just one step further. The blade parting reluctant muscles. If only that was enough. Maybe just one step further. The blade dulling as it grinds through defiant bone. If only that was enough. Just one step further. I’m sure, this time, that will be enough”
“These fears and insecurities leave me breathless. The thought of confinement makes my chest feel tight. I imagine I am being constricted by a giant python, with each gasping breath for air, my chest is squeezed that little bit tighter, making the subsequent breath even more frantic and panicked. The amount of air needed to provide life to my body is much more than what my lungs are struggling to gasp for. When you talk to me, and prove you care, I feel like the snake loosens its grip ever so slightly. I catch a glimpse – see a flash – of a vision of me escaping the snake’s deathly hold. But then you are gone again, as quickly as you came. And the snake resumes its merciless task.”
“You are still here, even when I’ve closed myself completely in the dark. You almost make me feel like we can both share the dark, until I’m strong enough to walk, with you by my side, into the light. I don’t understand why you stick around for me, and seem to want to share these painful journeys with me. We haven’t shared one yet, but I’m getting closer to trusting you enough to let you into my world. If I let you in, I wonder if, together, we will eventually find an end to this fight. I think this alliance, you and me, is what I’ve needed to give me the strength to walk into the light.”
Nellie had a number of comments on what has been important for her in therapy. “I believe that it is vital for people who self-injure to have their say in treatment, rather than being treated like a child who is incapable of making any form of decision.” Nellie talked about the importance of a strong and stable relationship with a therapist who “understands that the road is likely to be long and rocky”. Without this stable relationship, “no matter how many therapies you try, recovery will be much more elusive”. The length of group programs may also have an impact on progress – a program that is too short may leave participants feeling let down. Nellie also asked us to consider some of her most negative experiences, including a group therapist who was “rigid and didn’t seem to see the patients as individuals”. Another therapy group she was involved in broke down because of participants dropping out and staff resigning. This provoked further discussion in question time about training for therapy and the need for support for stability in therapeutic teams.
Nellie ended by appealing to clinicians to remember that consumers that deliberately injure themselves are “often just the average girl you’d pass on the street. The well groomed, articulate young person, who underneath, is suffering immensely. Next time you engage with one of us, try to step into our shoes for a couple of minutes, or even seconds. I am your daughter, your sister, your best friend, your next-door neighbour. I’m the girl that you see down at the shops, who has grown up in a loving, middle-class family. Please take the time to get to know me, really listen to the words I say to you, and think out of the box if I don’t seem to be able to express myself with verbal words. Give me a pen and paper. Don’t do what so many others have done, and automatically judge me because I have injured myself. I’m not here to manipulate you, or make you feel bad. I’m hurting and I need your attention right now. Please remember that I am a human being, who is just as deserving as the stroke victim in the cubicle next door. When you are making a decision which will impact on the rest of my life, please remember these things.”
