You’re gonna carry that weight a long time…

I had my bloods done this week. I have blood taken most weeks. This time I had a new nurse. She asked about my scars (nicely). I replied self harm. She exhaled sympathetically and said ‘it certainly left its mark’. Ain’t that the truth.

There’s the obvious scars all over my skin. The toll on my body that you can read about in my medical records and the indelible marks on my mind. Then the more I thought about it the clearer I saw that self harm has permeated throughout my life. I have so many habits, rules & thoughts that all loop back to a time when I was routinely hurting myself. The depth of it is both a revelation and strikingly obvious. Which is confusing, so I’m just going to unpack it here. Someone once told me they read my writing because it’s the best way to work out what I’m actually thinking. That’s often why I write it. So, excuse me if I explore my insides with an audience.

There are seemingly trivial things that at first glance appear to be just casual preferences. I only buy dark bedsheets. All my bedding is black or red or purple. Sure, I like those colours, but really I switched to exclusively dark tones because you can’t get blood stains out of the lighter ones. You also can’t see the stains between washing. I realise how gross that sounds, but when you always have open wounds, your sheets are continuously bloody. You get used to it. Ditto all of the above for dark coloured jammies. Along similar lines is my constant manicure. I’ve always liked to paint my nails. However, I didn’t need to keep my nails painted at all times until cutting came along. If you didn’t know, it can be really hard to get blood out from under finger nails. You can scrub for hours and still see red. Covering the tell tale crimson tinge became routine. My love of shiny black polish on my toes has the same origins. My toes don’t see a lot of blood these days, but necessity has grown into habit. My cardigan collection also has secrets origins. I have a million cardigans, shrugs etc. Whenever I buy any outfit I immediately run through what cover up I could match with it. I don’t even keep my scars covered anymore, but I still find myself buying items to hide under. Again, precaution has become ingrained.

Bed

The tentacles extend further. Years of self harm has skewed my perspective on a number of things. For instance, if you accidentally injure yourself I am the best and worst person to ask for help. I’ll definitely give top notch wound care advice. I know what dressing you need and how to clean every gash. I’ll also almost always think you’re making a fuss of nothing. I’ll probably think you can manage without medical assistance unless your leg is hanging off. When you cry or complain about the pain, I will be outwardly kind, but inside, I think you should cowboy up. Your call an ambulance is my stick a plaster on it. I know I’m wrong, but that’s how my mind works. Furthermore any accidental injury that anyone ever tells me about will arouse my suspicion. Same deal for most scars. I spent years lying about cuts and breaks and burns. I have concocted excuses of every kind. No matter how plausible your story I will have a moments doubt. It’s no reflection on you. I know you didn’t do it to yourself. It’s just that I also know that people lie. I lied. To everyone. Repeatedly. Habitually. For a very long time. It warped my thought process. Oh and if I have an accident I spend a lot of time carefully crafting how I will explain it. My head’s first assumption is that everyone shares my doubts. I’m always scared that someone will think I’ve fallen off the recovery wagon. Logic kicks in and throws the crazy out, but there’s a delay.

Black toe nails & tattoos

I never answer the door in short sleeves. Everyone knows they can’t just drop by my house. In the past I didn’t know if myself or my home would be fit for visitors. The anxiety of unexpected guests lives on even if the pools of blood do not. My first aid tin is always extensively stocked. I still can’t go anywhere without a cover up. My days of hiding every scar are gone, but my brain needs to know I have the option.

Blood transfusion

Watching cinematic portrayals of gore annoys the hell out me. I know that slash wouldn’t produce so much blood. Blood doesn’t stay wet that long. Cutting your wrists is nowhere as easy as films would have you believe. Cold water and salt is how you remove a blood stain. Rotting blood smells a bit fishy. A troponin test will determine if you’re having an actual heart attack. Stitches in the stomach don’t really hurt, don’t bother with local. The body takes 4-6 weeks to replace the red cells when blood is lost. Drs will usually insist on an transfusion when haemoglobin drops below 7 g/dl. Learning the topology of Langer’s lines allows for cuts to be made in the correct direction to reduce scarring. Inadine patches will prevent infection. Anti bacterial gel stops scars from itching. Scalpel blades can be bought in art stores. Ice can burn. Arterial blood pulses. My brain clings to all of this and more. Information, dictums & routines that no longer serve purpose, but retain a hold. That nurse was more right than she could ever imagine. Yup, self harm leaves one hell of a mark.

You should see my scars… 

Today is self injury awareness day. I’ll be honest I’m fairly jaded about awareness days. Especially those of the mental health variety. Too often they seem to me to be highlighting the wrong things. Today hasn’t broken the mold. Almost everything I have read in relation to self injury awareness day (SIAD) has focused on the usual stereotypes. Some have just missed the point entirely. So, I have decided to share a little of what goes on in the head of a person who is hurting themselves Specifically, this person. 
I don’t fit the stereotypes. I didn’t hurt myself as a teen. I wasn’t bullied & had a picture perfect childhood. I was never desirous of attention or seeking care in the form of dressings & kind medical professionals (ha!). I’m not stupid or dangerous or crazy. I have fought this battle as an articulate, independent adult. I’ve hidden wounds & scars through university & work alike. I kept a secret shrouded in stigma. Constantly confronted with the idea that my problem was one that should only face little girls. Shamed by the opinion that I am an incompetent drama queen. 
I am none of the above. Rather, I am woman who suffered trauma that altered my life. In the depths of anguish I stumbled upon a solution; a maladaptive survival technique. An act sought out to gain control when I felt powerless. Lamentably, my source of control rapidly overtook me & established dominion. Self harm is so complicated. It’s scope is different for each individual. For me, it become all encompassing. My daily thoughts circled around if/when I would cut. Being proficient was paramount. Every cut had to be ‘better’ than the last; I sought deeper wounds, more blood, more damage, more more. Self harm entangled itself into my identity. 
Admitting that & asking for help felt like relinquishing part of my self. Not only was I facing the loss of self harm, but also the strong, capable parts of myself that made me feel worthy. Admitting that I could no longer cope was the most vulnerable I have ever been. Believe me when I saw that to face stigma & prejudice in that state is crushing. To gather all your courage to tell a therapist the ugly truth & be faced with a ‘just stop’ attitude is soul destroying. Equally dragging your blood soaked self to a&e only to be treated with disgust can break a person. That the is the problem I & many others most need addressed. 

I believe SIAD should be about acknowledging the complexity of the issue. We should be focusing on changing the attitudes within the medical profession. Yes, let’s educate our communities about mental illness, but let’s also change the entrenched attitudes within the institutions that have the power to destroy lives. The worst stigma I have faced has been from dr’s & nurses who ought to have known better. Stigma is never positive, but I’ll take a hundred ignorant strangers over one cruel dr. Being unable to safely access treatment can kill. We need to take the fight to that front line.