Trigger Warning – If you are affected by any of the issues raised in this article please reach out for help. Contact details for organisations that can help are at the end of this article.
“Children show scars like medals. Lovers use them as secrets to reveal. A scar is what happens when the word is made flesh.” ― Leonard Cohen, The Favorite Game
There are so many sayings about scars. The ones that are popular are those that depict them as a sign of survival, of strength, or of having struggled but come out the other end. I think for a self-harmer, these descriptions might resonate because (and I can only speak for myself) many of them are closely related to the reasons we started self-harming in the first place.
For me, my scars and injuries are a way of knowing and seeing that my struggle is real. This used to be more important than it is now. There was a time when no one in my life knew that there was a problem and I was this capable, successful person working away and constantly needing to prove that I could be better and better. Inside I had two realities and the injuries were the way of making the second one real. This pain must be real – I have a way to prove it. Sometimes it went deeper than that – I must be real – I bleed, I feel pain, I have skin that can break.
Professionals can ask questions about self-harm in a way that makes me wonder if they think they come across as calm and non-judgemental. The sheer effort achieves the opposite. As they murmur their questions: “Is it superficial? What did you use? Has the frequency decreased?” I wait for someone to look and to wonder what brought me to this. What goes on in the mind that can only be appeased by causing pain and harm to the body? Many of the professionals in my life hide behind the theory of it all. Self-harm. Trauma. BPD. Stress. Dissociation. Numbness. None of these things are untrue but none of them tell the full story as well as the simplicity of the injury:
I hurt.
I am hurting.
Self-harm brings about some practical difficulties. Scars. In many, I hope most cases, the scars will fade and won’t always be visible. In my case they are with me forever. The colour will fade and the angry look of them will subside but they will never disappear. Part of my recovery is learning to live with scars.
Did you know that there are different types of scars? I’ve learned by experience. Anyone who has had surgery will understand this too. In my case, I have some keloid scarring-these are scars that are raised. If you run your hand along my arm over my sleeve you’ll feel them. I also have flat scars and these are the ones with more chance of eventually fading to near invisibility. I have scars that are decades old and some that are recent. The best way to prevent or reduce scarring is to tend to the original injury, keep it clean and don’t interfere with the healing process or exacerbate the wound. This isn’t something I’ve been able to do and it’s brought me to where I am now.
Sometimes scars can be intensely itchy. This is a sign of healing and new skin adjusting to itself but it’s uncomfortable. I have to be careful about what products I use. Scented creams are comforting but ultimately irritating. Aloe Vera is cool and soothing although it needs to be washed off before it sparks off the itching. The best products strangely are apple cider vinegar and ordinary everyday table vinegar. They calm the itch and reduce the risk of infection (they can initially sting especially if let get near an open wound). Diluted Tea Tree is good in small amounts as is unscented oil and creams with Vitamin E. Bio Oil has been recommended to me but for practical reasons I need to keep to cheaper options. Tight clothing and heat make the itching worse. When it’s particularly bad, my doctor can prescribe medicated creams and usually advises anti-histamines.
As I type this, I can imagine many people reading and thinking: “well don’t do it then”. Doesn’t it seem ridiculous to have this hardship when I have caused it? I say it to myself often enough. My therapy has given me many, many good and safe alternatives to self-harm and bit by bit I am addressing each of the triggers. What’s left now are the things that leap out and grab me unawares. BPD (Borderline personality disorder ) causes feelings and responses that can spiral out of control very quickly unless I am very mindful with my DBT (Dialectical behaviour therapy) skills. When that spiral happens, I have learned that rational thought and impulse control are difficult and the urge to self-harm is almost impossible to resist. Almost impossible but not completely. It can be done.
Because everyone who self-harms is unique, so too will their solutions be but there are things that I have learned work for me. When my emotions overwhelm me the shock of pain is a powerful antidote, therefore, finding that shock in other ways is crucial. The trick is to have them handy so I don’t have to “think” too much to find them. Ice packs, splashing cold water on my face, even a cold shower. Intense exercise for a few minutes can put the energy elsewhere even temporarily. The best thing is my “DBT drawer”-a drawer near where I sit most evenings where I keep items that are comforting, enjoyable or interesting; art supplies, books, notebooks, creams, nail polish, toys to play with my dog. The sight of it is very comforting.
Universally, an obvious solution but not always an easy one-keep items you associate with self-harm out of reach. Depending what they are, this might be inconvenient but it might also buy you time when the urge hits to distract or to find another way.
When the day comes when there are no more fresh or healing injuries, I will be left with the scars and I have been at this point many times over the years. I have gone on holidays by myself and practised walking about in short sleeves, letting myself practise for a life where I will learn to live with them and be prepared for peoples’ reactions. Not easy. I worry that my scars will be a trigger for others. Then I worry that my whole body is one giant trigger warning. I worry about how repulsive they make me. I worry about their permanency.
As I recover, I am left with the reality of scars. They will need to be minded all my life. I will need to protect them from sun. I will need to protect them from me. The skin will be vulnerable to the elements, to products, to anything that makes it more delicate than it already is. I will always need to be mindful of who I can be comfortable around and when and where it is important to keep them hidden. I’ll need to know what I want to say and who I want to say it to. But none of this is unique just to scars. If the injuries have been a metaphor for the pain, then I can buy into the cliché and let the scars come to represent the healing.
“Scar tissue has no character. It’s not like skin. It doesn’t show age or illness or pallor or tan. It has no pores, no hair, no wrinkles. It’s like a slip cover. It shields and disguises what’s beneath. That’s why we grow it; we have something to hide. ” ― Susanna Kaysen, Girl, Interrupted
Help information
If you need help please talk to friends, family, a GP, therapist or one of the free confidential helpline services. For a full list of national mental health services see yourmentalhealth.ie.
- Samaritans 116 123 or email jo@samaritans.org
- Pieta House National Suicide Helpline 1800 247 247 or email mary@pieta.ie – (suicide prevention, self-harm, bereavement) or text HELP to 51444 (standard message rates apply)
- Aware 1800 80 48 48 (depression, anxiety)
If living in Ireland you can find accredited therapists in your area here:
Information from ReachOut.com on self-harm here
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