When I started self-harming at the age of 15, I didn’t know it was a secret that I had in common with several close friends of mine. Battling with depression, I fell into the lure of self-harm and, at the time, I couldn’t foresee how it was going to overtake most of my adolescence. 

From 2015 to 2018, there was a war inside my mind and these were to be my scars from the battlefield but, in those days, it seemed like the only rational thing to do.

Self-harm is defined as deliberately inflicting injury on oneself without suicidal intentions. It is often seen as a symptom of a personality disorder or a mental disorder such as depression, anxiety or eating disorders. While the most prominent and widely discussed form of self-harm includes cutting one’s skin using a sharp object, scratching, burning, self-poisoning and substance abuse — all these actions fall under the umbrella term of self-harm. 

Ayesha Gul*, a 21-year-old law student felt like harming herself when she was 15 as it seemed to be the only way to cope with an unhappy relationship with her mother. Fights would often erupt between the mother-daughter duo and tension would ensue.

“Since I couldn’t talk back to her, anger would build up inside me,” recalls Gul. “I didn’t have anyone else to vent my anger out on, so I would take it out on myself by cutting myself or banging my head on the wall. It felt satisfying for that moment but I would regret the scars later.” Gul recovered with support from friends and it has been three years now that she hasn’t harmed herself.

Self-harm starts off as a coping mechanism, a means of seeking temporary relief from psychological pain, but only at the cost of leaving permanent marks on oneself.

Self-harm is an unhealthy coping mechanism that requires awareness, support and treatment

The latest (2012) World Health Organisation (WHO) statistics on suicide rates show that more than 13,000 people die by suicide annually in Pakistan. Not only is there a lack of awareness of and investment in mental health, there is no research or dialogue on self-harm either. According to the WHO, 24 million people in Pakistan are in need of psychiatric assistance but the country has less than one psychiatrist per million people, one of the lowest ratios in the world.

“Anything that is psychological is stigmatised,” says Dr Farah Nasim, a private practitioner in psychotherapy. “By not addressing the issue of self-harm, we are neglecting grave and critical issues that are the root causes of self-harm, such as parental neglect, flawed family systems, gender issues, sexual development and the lack of safety in our environment.” 

Social media also has a role to play in the deterioration of the mental health of young people, because of body image issues that many young people struggle with and which become a cause for self-harm. A couple of years ago, Instagram and Tumblr hosted graphic images of self-harm, with the former only recently banning such content. 

When my own self-harm addiction grew, I would browse social media, searching for self-harm images, which were easily accessible. These graphic images of wide-open wounds and blood encouraged me. 

Self-harm is a lot more common amongst our youth than we know or acknowledge. “In a class of 20 students aged 11 to 15, 13 would’ve indulged in self-harm,” says Dr Nasim. But since research on the issue is non-existent in Pakistan, there is no way to quantify this. 

Dania, 20, started indulging in self-harm from a very young age, without consciously realising what she was doing. The first incident of self-harm that Dania can recall was when she was only nine and she deliberately busted her lips. To her, self-harm was the “most accessible mode of expression” for certain experiences, for which she unconsciously blamed herself, even as a child. 

When the mode of self-harm shifted to cutting, Dania would have to visit a hospital occasionally to get her injuries tended to. On her first such visit to the hospital, she observed that the doctors and nurses weren’t surprised, sensing that she wasn’t the first person to show up in a hospital with a self-inflicted wound. Dania recovered after three years of therapy.

A dangerously common misconception about self-harm is that it is an “attention-seeking” behaviour, which is far from reality. People indulging in self-harm will go to any extent to hide their injuries and scars and, for the most part of it, they manage to keep it a secret from their families too. 

“For a long time, my family did not know about my affliction,” says Dania. “My suicide attempt revealed it.”

Because the permanency of the marks that self-harm leaves, coupled with the stigma attached to these scars, the road to recovery and thereafter isn’t smooth. Not only is there regret that one feels occasionally for making oneself go through such experiences, there is also judgment from society. 

The first response that Dania usually gets on her scars is questioning if they’re because of a ‘break-up.’ I have heard remarks such as “why are you displaying your art-work?” Another time, long after recovery, when I shared the reasons behind my scars, someone mocked me by saying “why don’t you do more of it?” These remarks echo the general lack of understanding in our society about self-harm. 

“To anyone thinking about indulging in self-harm, I would tell them that there is going to be a point in your life when you will move on from it, but the world will not let you move on,” says Dania. “Someone may just come up to you and brazenly make insensitive remarks.”

Recovery from self-harm is difficult but not impossible. It is important to seek help, be it confiding to a loved one and/or consulting a professional. 

For me, it took collective efforts from a close friend and lots of relapses to eventually recover. I believe this is a testimonial to the positive impact that understanding, empathy and support has on those who fight invisible illnesses.

Self-harm is rarely discussed openly. “If we don’t talk about self-harm, it means we are not talking about parenting, family systems, identity, gender and communication,” says Dr Nasim. “There has to be an open dialogue on these issues that affect our lives.”

The writer is a physics student and can be reached at somaiyah.hafeez2000@gmail.com
*Name changed to protect privacy

Published in Dawn, EOS, May 30th, 2021