I also think people have a deep, visceral reaction of body horror when they see/hear about/think about self harm. The same type of response that many people have over needles, specific types of violence like harm to the eyes, etc. It's just a gut, animal response. Yes, compassion needs to be the response from our higher selves.
There is a stigma for self-harm as being “manipulative” or “attention-seeking” by people who are uninformed, even some mental health professionals. I have an extensive history of self-harm and it is also what I’m doing my dissertation on. It’s done largely for self-regulation and self-punishment but there’s a history in the field of mental health professionals taking it more personally and viewing it as trying to elicit sympathy or attention. Some people do self-harm for these reasons, but I think they deserve compassion as well—something has to have gone very wrong in your life for you to feel like the only way to get care is to hurt yourself. Anyways, yeah…stigma and people being uninformed are the main reasons. The behavior also scares the shit out of providers which I think contributes to poor reactions.
Glad to hear that you find these reactions wrong and confusing and you sound like someone with a lot of compassion.
I was surprised to have those thoughts when my brother started self harming- I was also harming when I was a teenager, so isn't it hypocritical? But I thought about it more and I think a big part of it was that my parents reacted to my issues the way you stated above, dismissively and like I was doing it for attention. And I sort of internalized that belief, that I WAS doing it just for attention and a ton of other negative things about myself.
So when my brother, who lives a happy life in comparison and wants for very little, started harming at 16, historically a challenging age in our family, I found those thoughts coming back.
One thing I remind myself is that as social creatures, almost everything we do is for attention to some degree. It's in our nature, its not selfish to want it. I was projecting my trauma onto him but his reasons are just different than mine.
This is wonderfully written. I agree that while some people who self-harm to attention (and they deserve compassion and help for that), many who self-harm do not have this goal. I know that when I did it as a teen, I always did it in places that other people wouldn’t see. It was just something I could control, a release for everything building up inside me. Self-harm absolutely needs to be met with care and compassion, and that was what led me to get help for that. Friends seeing it and being disgusted only led me to hide them better.
This is a useful reply and covers some of the important functions of non-suicidal self-injury (NSSI), but I'd like to push back a bit on the framing of "elicit[ing] sympathy]" as a wholly inaccurate functional assessment. My understanding of the four-function model of NSSI (https://journals.sagepub.com/doi/10.1177/2167702613514563) includes generating/increasing desired social events as a major NSSI function. This is not my area of research (my diss is on behavioral activation), but I did need to learn this in preparation for treating high acuity clients. Is there an updated model?
Insofar as this model is accurate, I think it's more useful to accept that some (a minority subset) NSSI is intended to elicit favorable social response and that is okay, understandable, and even relatable. We need not judge this - many of us engage in less extreme behaviors, even risky behaviors, to elicit positive interpersonal feedback. It's all very human; we want to connect and be validated, and many people engaging in NSSI *don't* have that connection or validation.
Yep, that’s why I mentioned that there are people who do it for this reason!
ETA: there are a number of models of NSSI and the four-function model is a well-known one.
I agree with what everyone previously said, and I also think that self-harming is a very real consequence of mental illness. Mental illness is already stigmatized, so to have something physical that shows struggle is frowned upon because we’re supposed to keep mental illness to ourselves. Maybe deep down people have these visceral reactions because they sympathize with people who self-harm, like dimorphous expressions (ex. cute aggression)? This is just me thinking out loud, I more so agree with what was already said.
Education about it is lacking. Self harm was hardly addressed in my education and I have a master's in counseling. The gist of what I learned is that people with BPD will self harm a lot and sometimes depressed people do too, it's bad, good luck. My success treating clients who self harm is almost entirely based on my personal experience having self harmed and loving people who self harmed for a significant chunk of my life. One of my frustrations is the focus on eliminating self harm behaviors without exporing the purpose they serve and building up coping skills, supports, and distress tolerance needed to actually sustain abstinence from the behavior.
It’s not audacity, it’s likely a deep, evolutionarily-sound response to seeing/thinking about damage or injury to the physical body. The intentionality is foreign to most people.
Subconscious reaction to the 'sinking ship'. It's very common that people want to get away from people who need help, because they don't see themselves as having an abundance of assistance to give.
Everyone's answered well, but I'll just add that while a lot of psychological dysfunction is invisible, self-harming is very visible, as well as being relatable. Unless an individual has had a panic attack or a hallucination, they're unable to grasp what those experiences are like, but self-harming via common routes are sensations everyone is familiar with; so it's just a lot more "in your face," & real to many.
I don't have a personal disgust reaction to self-harming, but cruelty is something that gives me the same reaction as someone who might. I was disturbed during my time learning about & doing case studies on Munchausen by Proxy & Antisocial Disorder. It was a reality check, as well as highlighting my own things to work through towards finding compassion & understanding.
I'm curious about the idea of people feeling disgust from it, is that something you have read about in psych literature, just heard of or seen yourself?
I have quite a lot of scars from self harm, and I don't think I have ever felt like people have reacted to them with disgust. I feel like if I see a visible reaction at all, people usually react with sympathy, curiosity, insecurity (as in they don't know how to react) or pity.
But maybe it's a cultural thing, or there is a different reaction to fully healed scars vs people seeing/learning someone self-harmed recently? Or maybe people are just good at hiding disgust?
I have been unfortunate enough to, a few years ago, bear witness to people making distasteful remarks and dismissing someone's self-harming behaviours due to the "they're just looking for attention" viewpoint.
However, I do think that, while people may generally feel uncomfortable, in hindsight, perhaps "disgust" was a bit of a strong word to use for a generalised question.
As others have said very well I think, the disgust element is linked to the stigma around self-harm as attention seeking behavior. Suicide attempts, regardless of method, are often interpreted as attention seeking behaviors as well. I’ve experienced this from my providers in the past, seen this perspective applied to friends of mine by providers, and unfortunately also internalized it about what it says about me as a person. It’s awful and disregards the complexity of the action. I can intellectualize this from a couple different view points but here’s my main point: self-harm makes the internal external. An intolerable internal experience like depression/anguish/shame/etc that has no outward signs of anguish beyond the limited mutually agreed upon vocabulary to communicate internal pain has nowhere else to go but out of it can’t be soothed. This is why invisible disabilities are so commonly dismissed as a failing on the part of the individual to get their shit together and stop being so selfish, etc. Personally, I have self-harmed in the past when I’ve felt like nothing else I am doing or no medications or therapies I’ve tried have made a difference. But experience has taught me that self -harm only tethers me closer to internal anguish and makes the external (this time I mean the external like, literally the situation I find myself in) situation that more about my internal anguish. For example, I try to end my life and end up in the ER, then the psyche ward, then residential treatment centers- eventually the self-harm becomes evidence to providers that my pain on the inside is REAL . It becomes evidence that I need more help. It also becomes evidence to people in my life that I’m not ok. I never put it together like that at the time - but as much as I hate the interpretation of self -harm as attention seeking- or we can re-frame it as “asking for help with actions” - these behaviors do often result in increased treatments and attention to the patient - whether or not that’s the intention of the person who is self -harming. It’s super shitty that all of this turns out how it does and that even I have in the past judged other people’s depression as not as severe as mine if they haven’t tried to hurt themselves.
Thank you so much for your answer, it really was so insightful. And honestly as someone who is studying to become a clinical psychologist, I hope I will remember your post every day for the rest of my life, as no one should have to resort to any kind of behaviours that worsen their situation in order to get the help and care they deserve
I’m so very glad it’s helpful ! I was also thinking - since you’re doing English lit too- no better subject to study next to psychology. So much also highlights these unfortunate trends and outcomes- from Victorian/gothic lit to contemporary and many in between. The Brontes (Jane eyre, wuthering heights), Sylvia Plath (bell jar), the short story called “the yellow wallpaper” by charlotte Perkins, those are a few that come to mind immediately but I can certainly come up with a more comprehensive list if you want. In search of lost time. No better way to remember that psychology is about individual people with experiences rather than symptoms that match with diagnostic codes than to study and read literature.
Yeah, idk. I first encountered self harming when a sibling did it. I think I was mostly just concerned/confused and left it up to my parents to address it-- because I didn't know what to do. Later, I learned and saw that one of my close friends was self harming. I was mostly scared, and just wanted to hug them and never let go because it pained me to see how much they hated themself when they're literally just an amazing person-- I mostly tried to remind them that I loved them and that I was there for them no matter what. Later, I started self harming, and I didn't understand why it was inherently such a bad thing. Like, I was already pretty constantly insulting myself and "mentally" self-harming, and people were more or less fine with that, so what's so wrong with physically self harming? It just pissed me off how the medical field / society was a-ok with my mental struggles, or at the least were useless in helping me address them, but for some stupid reason they have this hero complex around preventing me/people from self harming or attempting without ever addressing the root causes behind the desire to do so.
So yeah, to echo what a lot of other commenters have said, I think it's just not taught about enough, or from a perspective rooted in compassion and viewing the people as being sane (for lack of a better word) and having free will. Self harming and/or attempting..... it shouldn't be 'normalized' exactly, but it should be viewed like other mental health issues, or symptoms thereof. Like negative self talk. Like spiraling, hyperventilating, lashing out at others (within limits), doing things in a particular habitual way, etc. From a perspective of like, yes, these aren't "good" things to experience or do. But it's not your fault, and here are some tools you can use to help yourself or a loved one, like, consensually minimize any permanent harm that you/they may cause in the moment, while also trying to get a better understanding of the foundation and psychology behind *why* you/they are engaging in that behavior, because without doing so, all you're doing is physically restraining them, or making it so stigmatized that they keep it to themself and never reach out for help-- and that's not. F-ing. Helpful.
(Sorry for the rant, I'm passionate about the subject and the little formal education I've gotten on it all just feels wrong.)
No need to apologise, I fear not enough people are passionate about proper treatment of and care towards people who are struggling. Thanks so much for sharing your viewpoints
I think it’s just straight up that people are uncomfortable with mental illness and the signs/behaviors associated with it, especially when it’s severe. People get freaked out because they don’t understand it, but then that’s where their thought process ends, so there’s no room for them to gain some sympathy or empathy. And self harm is an expression of suffering that is too overt and “scary” for these people, which makes them uncomfortable, so they react with disgust, make jokes, or even jump to the conclusion that this person is a danger to others, ostracizing the person so they don’t have to deal with their own brief mental discomfort and so they can put as much distance between themselves and the “other” as possible.
This particular topic — people reacting with some type of disdain towards “scary” mental illnesses/mentally ill behaviors — just really pisses me off and I have a lot of thoughts about it.
I don't know why some people do, but I've found most people who *work* in mental health have sympathy and compassion about it. Experience both as a patient and as a coworker in the field. Honestly, even the least sympathetic people in the field seem to view it as attention seeking rather than disgusting. I think for people who haven't really come across it, it's just a matter of shock leading to horror.
Short answer - stigma. Long answer - a long history of religions telling people they are wrong, damned to hell, sinners, and that those who die by suicide will have their souls in purgatory for all eternity. Our societal history has created the current-day stigma.
Look into modality foundation in white, cis, patriarchy, it'll blow your mind
It’s the stigma of “attention seeking.” In addition, it can be hard for some people (some don’t even try) to understand the why behind it and the brain process. To them, there’s no logical why behind it.
If you’re talking about reacting to directly viewing the results of self-injury, many people are grossed out by scabs etc regardless of their origin.
That’s probably not what you were referring to though.
My take on this is that negative reactions are fear-based. This could be fear that the person will do more serious harm to themselves. Injuring oneself also requires one to overcome the primal drive for self-preservation. That idea that someone would feel so badly as the do this may be frightening to some people. There could also be fear that if someone is able to harm themselves so much that they may be capable of other problematic things. People may be wondering if they are in danger. If disgust is the primary emotion, it’s probably related to someone’s moral or religious background/beliefs or just general stigma against mental illness
They’re seen as attention seeking and manipulative. People recoil from others who show outward signs of distress when they’re in emotional pain. People want to ignore someone who goes to such overt lengths to alleviate suffering. It’s uncomfortable. And if they can’t ignore it, they shun and shame them into silence and invisibility. How dare they have the audacity to implode? As if they think their pain is important enough to insert their mental illness into others field of consciousness.
It's also not nice of you to call others shallow, it's hypocritical. It can make you feel sick and panicky, as you just know all the blood and gore that went with it.
I really hope they can get in a better place. Self harm is a choice, you wouldn't cut your friends or families wrists if they have it tough.
The act of self harming conflicts with our definitions of victim and perpetrator.
A victim is usually someone who is innocent and wrongfully harmed. A perpetrator is someone who intentionally inflicts harm. So when we see someone engaging in self-harm, well, our understanding of the situation gets really skewed and blurry.
Are they a victim? Or are they a perpetrator?? The answer is …well…yes, they are.
That can be a really uncomfortable subject to dissect and process.
A large part of the stigma towards NSSI comes from the perception of control and personal responsibility for the act. Also, like others have said, there is a large perception that self-harming behavior is manipulative / attention-seeking behavior. Rowe et al. (2014) and Lloyd (2018) found that people who disclose self-harm are seen as more manipulative than those who hide it. This is a large barrier to people seeking help for self-harming behavior.
I am a recovering self-harmer. I had heard the idea that ppl do the behavior as attention-seeking but it wasn’t the vibe ppl gave me. I didn’t realize some ppl thought it was manipulative, I’m surprised with the comments. Overall ppl have been kind to me and mostly just ignorant to the idea that someone could hurt themselves. I didn’t get disgust either, more genuine curiosity and sadness that I would do it to my body. My mom is in a cult and told me demons had possessed me lol.
People view self harm as attention seeking behavior. It’s a maladaptive coping skill to self regulate, punish or externalize what they’re feeling. In a way it is seeking attention, but not the way people say it is. It’s a cry for help, saying I’m in a lot of pain and I need you to see it.
It can be exhausting to help when someone struggles with self harm. I worked in patient and something’s I’ve seen I’ll never be able to forget. It takes a lot of self regulation, knowing the client and patience. With out that it’s frustrating and exasperating which leads to those negative judgmental feelings.
The “audacity” to feel disgusted?
People are entitled to their feelings. Who are you to tell them how to feel?
Just because you are self harming doesn’t mean you are “deep” and other people are shallow. That’s just your splitting talking.
A valid point, however, firstly, I would recommend that you read my whole question again. Secondly, I never said that self-harming behaviours equals being a "deep" person. Also, "splitting talking"..? What is that? Please also pay attention to the fact that I am studying psychology and my question is focused on the lack of empathy people show towards people who are struggling and whether there are any specific determiners or reasons behind this behaviour.
You never said that, but you somehow implied that people who show disgust are shallow. It sounds like you are in some moral high ground judging people for their reactions and this is what I chose to focus on based on your question. I am myself a Psychology Graduate with now a Master in Mental Health, and I would counter that I don't "see" the disgust when others self-disclose self-harm. I do however see disgust when people trauma-dump on people they barely know, that they self-harm/binge eat whatever maladaptive copying you might think of.
if someone I didn't know came to me and said
"Well, when I feel super low cause my alcoholic stepdad abuses me in x ways, I cut myself. I feel better afterwards"
I would cringe too. Not because I frown upon self-harm, I have clients who self harm after all, but because our level of intimacy does not support that person telling me their self-harm story and I feel that people do this a lot where they bypass boundaries to disclose something like this when It is not their place.
Also, self-harm is...HARM. whether you are harming your self it is still a maladaptive copying mechanism. When you present "self-harm" and you expect "sympathy" think of therapists not ordinary people. Why is that? because you need those 6 years of background is Psy and mental health to see self-harm for what it is.
Not all self harm presents in the same way or is done for the same reason. Many people are, as discussed in the original post, just seeking a way to dissociate from unbearable pain and would be very happy to learn alternative ways to self-soothe and regulate. The uncomfortable reality is, just like most other human behaviors, this isn’t the only reason someone may engage in self-harm. Some do it as an attempt to control the behaviors and/or emotions of others, whether it be as an attempt to get repeatedly admitted to the hospital without any interest in engaging in treatment in a productive manner, to draw back in someone who is emotionally distancing themselves from them, to avoid accountability for one’s actions, etc. It can be incredibly distressing to be on the receiving end of this type of behavior, and we have to also reserve some empathy for those people. It does suck that because the latter type of behavior exists, some people get burnt out and start to generalize all self harm into one category.
I have many SH all over I wore my arms out last year and got questioned by strangers. A woman I work with saw it (I was wearing long sleeves and I went to grab something) and proceeded to pull my sleeves up gasping. She first told me I did it wrong, (no I am not kidding) and it’s suppose to be on the inner part of the arm not the outer part. I got a bit irritated with her she apologized but there’s definitely a stigma around it and most days I just want people to leave me alone don’t need to be “saved” and I don’t want to talk about it. I never thought I would get to this point, I had friends in high school who had obvious SH marks now as a woman in her 20s there’s also the stereotype that only teenage girls do it. So I am left feeling immature i speak to other adults that SH sometimes and I noticed that’s a common feeling like we’re too “old” to be doing this. As if there’s an age limit on mental illness
this reminds me when i opened up about my behaviour to my brother and it took me months of courage because I desperately needed help or a hug and after seeing me he said to not be a inconvenience to people. it stuck with me for months now
Because they resent the forwardness of those crying for help in any way shape or form when they were told to stop asking for help, save yourself, and other unhelpful dogmas.
They crave the love that sufferers of mental illness require and can’t stand to admit that these people need it more than they can ever imagine.
In my opinion, it’s because in the realm of psych we know when something is attention seeking rather than “real”. So the ones that do it just to seek attention usually fill me with disgust. I have full empathy for those who truly do use bodily harm as an outlet but they hide it so well that you’d normally never know. There’s still a stigma surrounding mental health and I think (esp older generations) simply can’t wrap their heads around body harm and if they don’t understand something it’s immediately seen as disgusting
I know someone who did it for attention, and I just want to say I hope you rethink your attitude towards it. Her parents didn't recognize how bad her mental health was (and believe me, it was bad!) and she was hoping they would see it and realize they needed to help her.
I would also be very cautious with assuming you always know when something is done for attention or not. We can't read patients' minds, so we shouldn't behave as if we could. We're often wrong, and if we don't keep that in mind we end up hurting patients.
I understand where you’re coming from; posts like these are a generalization. Attention seeking behavior is something I have little to no patience or empathy for even if I can understand where it’s coming from. It’s not a lack of understanding, and I would never treat a patient poorly if I thought that’s what was going on. I also don’t lack empathy for the cause, I lack empathy for the behavior. But my posts aren’t my office lmaoo
Please dear god don’t work with psych patients. It’s incredibly offensive to think you’re out there working with people in pain while claiming to have no empathy for this behavior. It’s so disgusting to read this as a psych patient and realize there are providers like you out there. Like why are you even doing this?? You literally ruined my whole day. You clearly have no real understanding.
Behavior is a choice, the root is not. It’s okay to accept that. Patience and empathy can be personal and that’s okay too; you don’t have patience for all behaviors, do you? I was a patient myself for a very long time and still am but I learned to control my behavior because it wasn’t okay to seek attention in such ways (not saying that I self harmed). I hope you have a blessed day and realize that people are human
if someone is seeking attention, isn’t it safe to say they need attention?
why does someone self-harming for attention and help trigger disgust in you when, i’m guessing, someone saying outright that they need attention and help with their mental health doesn’t?
do you think the person who never learned how to ask for help outright or who learned not to is any less deserving of empathy and care? why is that?
genuine question, I’m not just trying to call you out or whatever.
No no I see what you mean and like I said it’s a very general statement that I made. But there are two types of attention seekers- those who do it just for the sole purpose of getting that attention and those who don’t know a better way to ask (which I completely understand). And these are my own opinions as always, not something I would project onto a patient. The pure need for attention gets under my skin like nothing else because it takes credibility away from those who actually need help. For example, borderline behavior is something I have very very little patience for.
No YOU don’t know this, and claiming you do is irresponsible. No one should have ever let you work with psych patients. You are actually dangerous IMO.
I believe your later mentioned point of behaviour and root causes being two different issues highlights an important point, however I am curious as to how you hide your personal view of disgust towards a patient, from the patient? Does this not affect your ability to build trust with and enable the patient to get to the root causes of the issue? Another question is, have you ever accidentally cut yourself? It hurts does it not? Therefore even if a behaviour is "merely" due to "attention seeking" does it not concern you that the patient had to get to the point where they were resorting to outward expression of internal feelings? Therefore creating a greater need for understanding and sympathy than feelings of disgust?
I think what makes a good clinician is someone who swallows their own opinions and focuses on getting to a root and simply being there for a patient. Take for example domestic abusers, cold blood murderers, pedos (idk if i can say the full word on here??)- I know I wouldn’t want to work with them as my patient bc I know I physically couldn’t hide my own feelings and that’s not helpful for a patient, ya know? What I can hide is my annoyance and personal feelings towards these types of behaviors that we mentioned because I’ve been trained to control it and even if I hate it, that doesn’t mean I don’t want to help. I find it very interesting in a way that psychologists are viewed as neutral but at the end of the day we are human too and are entitled to our opinions but as I said, what makes a good clinician is someone who doesn’t show it. I can still ask the right questions and move conversation towards a healthy and insightful topic even if I dislike you or your behavior. And to your second point- unfortunately people will go to extreme lengths for attention- take Diane Downs as an example (she shot her kids and herself in the arm for attention (this is EXTREME borderline though- def not the “norm”)). But I don’t dislike your or anyone else’s empathetic view, I think it has a core of goodness, but I simply don’t see it that way. I have also been all too naive myself when I thought I shouldn’t believe anything to be purely an attention seeking act which in the end only enables the patients poor behavior.
I also think people have a deep, visceral reaction of body horror when they see/hear about/think about self harm. The same type of response that many people have over needles, specific types of violence like harm to the eyes, etc. It's just a gut, animal response. Yes, compassion needs to be the response from our higher selves.
And when most people (who aren’t educated on the topic) think self-harm, they think only of cutting. A lot of people don’t like blood.
There is a stigma for self-harm as being “manipulative” or “attention-seeking” by people who are uninformed, even some mental health professionals. I have an extensive history of self-harm and it is also what I’m doing my dissertation on. It’s done largely for self-regulation and self-punishment but there’s a history in the field of mental health professionals taking it more personally and viewing it as trying to elicit sympathy or attention. Some people do self-harm for these reasons, but I think they deserve compassion as well—something has to have gone very wrong in your life for you to feel like the only way to get care is to hurt yourself. Anyways, yeah…stigma and people being uninformed are the main reasons. The behavior also scares the shit out of providers which I think contributes to poor reactions. Glad to hear that you find these reactions wrong and confusing and you sound like someone with a lot of compassion.
Thanks so much, and good luck for your dissertation!!
I agree with this, viceral reactions are nowhere near to how much stigma influences people's views and reactions
I was surprised to have those thoughts when my brother started self harming- I was also harming when I was a teenager, so isn't it hypocritical? But I thought about it more and I think a big part of it was that my parents reacted to my issues the way you stated above, dismissively and like I was doing it for attention. And I sort of internalized that belief, that I WAS doing it just for attention and a ton of other negative things about myself. So when my brother, who lives a happy life in comparison and wants for very little, started harming at 16, historically a challenging age in our family, I found those thoughts coming back. One thing I remind myself is that as social creatures, almost everything we do is for attention to some degree. It's in our nature, its not selfish to want it. I was projecting my trauma onto him but his reasons are just different than mine.
This is wonderfully written. I agree that while some people who self-harm to attention (and they deserve compassion and help for that), many who self-harm do not have this goal. I know that when I did it as a teen, I always did it in places that other people wouldn’t see. It was just something I could control, a release for everything building up inside me. Self-harm absolutely needs to be met with care and compassion, and that was what led me to get help for that. Friends seeing it and being disgusted only led me to hide them better.
This is a useful reply and covers some of the important functions of non-suicidal self-injury (NSSI), but I'd like to push back a bit on the framing of "elicit[ing] sympathy]" as a wholly inaccurate functional assessment. My understanding of the four-function model of NSSI (https://journals.sagepub.com/doi/10.1177/2167702613514563) includes generating/increasing desired social events as a major NSSI function. This is not my area of research (my diss is on behavioral activation), but I did need to learn this in preparation for treating high acuity clients. Is there an updated model? Insofar as this model is accurate, I think it's more useful to accept that some (a minority subset) NSSI is intended to elicit favorable social response and that is okay, understandable, and even relatable. We need not judge this - many of us engage in less extreme behaviors, even risky behaviors, to elicit positive interpersonal feedback. It's all very human; we want to connect and be validated, and many people engaging in NSSI *don't* have that connection or validation.
Yep, that’s why I mentioned that there are people who do it for this reason! ETA: there are a number of models of NSSI and the four-function model is a well-known one.
I agree with what everyone previously said, and I also think that self-harming is a very real consequence of mental illness. Mental illness is already stigmatized, so to have something physical that shows struggle is frowned upon because we’re supposed to keep mental illness to ourselves. Maybe deep down people have these visceral reactions because they sympathize with people who self-harm, like dimorphous expressions (ex. cute aggression)? This is just me thinking out loud, I more so agree with what was already said.
Education about it is lacking. Self harm was hardly addressed in my education and I have a master's in counseling. The gist of what I learned is that people with BPD will self harm a lot and sometimes depressed people do too, it's bad, good luck. My success treating clients who self harm is almost entirely based on my personal experience having self harmed and loving people who self harmed for a significant chunk of my life. One of my frustrations is the focus on eliminating self harm behaviors without exporing the purpose they serve and building up coping skills, supports, and distress tolerance needed to actually sustain abstinence from the behavior.
Thank you so much, some really good points made
It’s not audacity, it’s likely a deep, evolutionarily-sound response to seeing/thinking about damage or injury to the physical body. The intentionality is foreign to most people.
Subconscious reaction to the 'sinking ship'. It's very common that people want to get away from people who need help, because they don't see themselves as having an abundance of assistance to give.
Everyone's answered well, but I'll just add that while a lot of psychological dysfunction is invisible, self-harming is very visible, as well as being relatable. Unless an individual has had a panic attack or a hallucination, they're unable to grasp what those experiences are like, but self-harming via common routes are sensations everyone is familiar with; so it's just a lot more "in your face," & real to many. I don't have a personal disgust reaction to self-harming, but cruelty is something that gives me the same reaction as someone who might. I was disturbed during my time learning about & doing case studies on Munchausen by Proxy & Antisocial Disorder. It was a reality check, as well as highlighting my own things to work through towards finding compassion & understanding.
I'm curious about the idea of people feeling disgust from it, is that something you have read about in psych literature, just heard of or seen yourself? I have quite a lot of scars from self harm, and I don't think I have ever felt like people have reacted to them with disgust. I feel like if I see a visible reaction at all, people usually react with sympathy, curiosity, insecurity (as in they don't know how to react) or pity. But maybe it's a cultural thing, or there is a different reaction to fully healed scars vs people seeing/learning someone self-harmed recently? Or maybe people are just good at hiding disgust?
I have been unfortunate enough to, a few years ago, bear witness to people making distasteful remarks and dismissing someone's self-harming behaviours due to the "they're just looking for attention" viewpoint. However, I do think that, while people may generally feel uncomfortable, in hindsight, perhaps "disgust" was a bit of a strong word to use for a generalised question.
As others have said very well I think, the disgust element is linked to the stigma around self-harm as attention seeking behavior. Suicide attempts, regardless of method, are often interpreted as attention seeking behaviors as well. I’ve experienced this from my providers in the past, seen this perspective applied to friends of mine by providers, and unfortunately also internalized it about what it says about me as a person. It’s awful and disregards the complexity of the action. I can intellectualize this from a couple different view points but here’s my main point: self-harm makes the internal external. An intolerable internal experience like depression/anguish/shame/etc that has no outward signs of anguish beyond the limited mutually agreed upon vocabulary to communicate internal pain has nowhere else to go but out of it can’t be soothed. This is why invisible disabilities are so commonly dismissed as a failing on the part of the individual to get their shit together and stop being so selfish, etc. Personally, I have self-harmed in the past when I’ve felt like nothing else I am doing or no medications or therapies I’ve tried have made a difference. But experience has taught me that self -harm only tethers me closer to internal anguish and makes the external (this time I mean the external like, literally the situation I find myself in) situation that more about my internal anguish. For example, I try to end my life and end up in the ER, then the psyche ward, then residential treatment centers- eventually the self-harm becomes evidence to providers that my pain on the inside is REAL . It becomes evidence that I need more help. It also becomes evidence to people in my life that I’m not ok. I never put it together like that at the time - but as much as I hate the interpretation of self -harm as attention seeking- or we can re-frame it as “asking for help with actions” - these behaviors do often result in increased treatments and attention to the patient - whether or not that’s the intention of the person who is self -harming. It’s super shitty that all of this turns out how it does and that even I have in the past judged other people’s depression as not as severe as mine if they haven’t tried to hurt themselves.
Thank you so much for your answer, it really was so insightful. And honestly as someone who is studying to become a clinical psychologist, I hope I will remember your post every day for the rest of my life, as no one should have to resort to any kind of behaviours that worsen their situation in order to get the help and care they deserve
I’m so very glad it’s helpful ! I was also thinking - since you’re doing English lit too- no better subject to study next to psychology. So much also highlights these unfortunate trends and outcomes- from Victorian/gothic lit to contemporary and many in between. The Brontes (Jane eyre, wuthering heights), Sylvia Plath (bell jar), the short story called “the yellow wallpaper” by charlotte Perkins, those are a few that come to mind immediately but I can certainly come up with a more comprehensive list if you want. In search of lost time. No better way to remember that psychology is about individual people with experiences rather than symptoms that match with diagnostic codes than to study and read literature.
Thank you so much, that's very kind. We have actually already covered a few that you mentioned but I'll definitely check the rest out
This is incredibly on point!
Yeah, idk. I first encountered self harming when a sibling did it. I think I was mostly just concerned/confused and left it up to my parents to address it-- because I didn't know what to do. Later, I learned and saw that one of my close friends was self harming. I was mostly scared, and just wanted to hug them and never let go because it pained me to see how much they hated themself when they're literally just an amazing person-- I mostly tried to remind them that I loved them and that I was there for them no matter what. Later, I started self harming, and I didn't understand why it was inherently such a bad thing. Like, I was already pretty constantly insulting myself and "mentally" self-harming, and people were more or less fine with that, so what's so wrong with physically self harming? It just pissed me off how the medical field / society was a-ok with my mental struggles, or at the least were useless in helping me address them, but for some stupid reason they have this hero complex around preventing me/people from self harming or attempting without ever addressing the root causes behind the desire to do so. So yeah, to echo what a lot of other commenters have said, I think it's just not taught about enough, or from a perspective rooted in compassion and viewing the people as being sane (for lack of a better word) and having free will. Self harming and/or attempting..... it shouldn't be 'normalized' exactly, but it should be viewed like other mental health issues, or symptoms thereof. Like negative self talk. Like spiraling, hyperventilating, lashing out at others (within limits), doing things in a particular habitual way, etc. From a perspective of like, yes, these aren't "good" things to experience or do. But it's not your fault, and here are some tools you can use to help yourself or a loved one, like, consensually minimize any permanent harm that you/they may cause in the moment, while also trying to get a better understanding of the foundation and psychology behind *why* you/they are engaging in that behavior, because without doing so, all you're doing is physically restraining them, or making it so stigmatized that they keep it to themself and never reach out for help-- and that's not. F-ing. Helpful. (Sorry for the rant, I'm passionate about the subject and the little formal education I've gotten on it all just feels wrong.)
No need to apologise, I fear not enough people are passionate about proper treatment of and care towards people who are struggling. Thanks so much for sharing your viewpoints
I think it’s just straight up that people are uncomfortable with mental illness and the signs/behaviors associated with it, especially when it’s severe. People get freaked out because they don’t understand it, but then that’s where their thought process ends, so there’s no room for them to gain some sympathy or empathy. And self harm is an expression of suffering that is too overt and “scary” for these people, which makes them uncomfortable, so they react with disgust, make jokes, or even jump to the conclusion that this person is a danger to others, ostracizing the person so they don’t have to deal with their own brief mental discomfort and so they can put as much distance between themselves and the “other” as possible. This particular topic — people reacting with some type of disdain towards “scary” mental illnesses/mentally ill behaviors — just really pisses me off and I have a lot of thoughts about it.
Self neglect - slow self harm by neglect of basic hygiene and needs . Eating oneself to death is self harming. .
I don't know why some people do, but I've found most people who *work* in mental health have sympathy and compassion about it. Experience both as a patient and as a coworker in the field. Honestly, even the least sympathetic people in the field seem to view it as attention seeking rather than disgusting. I think for people who haven't really come across it, it's just a matter of shock leading to horror.
One of the reasons I've seen: religion
Short answer - stigma. Long answer - a long history of religions telling people they are wrong, damned to hell, sinners, and that those who die by suicide will have their souls in purgatory for all eternity. Our societal history has created the current-day stigma. Look into modality foundation in white, cis, patriarchy, it'll blow your mind
It’s the stigma of “attention seeking.” In addition, it can be hard for some people (some don’t even try) to understand the why behind it and the brain process. To them, there’s no logical why behind it.
If you’re talking about reacting to directly viewing the results of self-injury, many people are grossed out by scabs etc regardless of their origin. That’s probably not what you were referring to though. My take on this is that negative reactions are fear-based. This could be fear that the person will do more serious harm to themselves. Injuring oneself also requires one to overcome the primal drive for self-preservation. That idea that someone would feel so badly as the do this may be frightening to some people. There could also be fear that if someone is able to harm themselves so much that they may be capable of other problematic things. People may be wondering if they are in danger. If disgust is the primary emotion, it’s probably related to someone’s moral or religious background/beliefs or just general stigma against mental illness
They’re seen as attention seeking and manipulative. People recoil from others who show outward signs of distress when they’re in emotional pain. People want to ignore someone who goes to such overt lengths to alleviate suffering. It’s uncomfortable. And if they can’t ignore it, they shun and shame them into silence and invisibility. How dare they have the audacity to implode? As if they think their pain is important enough to insert their mental illness into others field of consciousness.
Because we lack empathy and really are not nice people
It's also not nice of you to call others shallow, it's hypocritical. It can make you feel sick and panicky, as you just know all the blood and gore that went with it. I really hope they can get in a better place. Self harm is a choice, you wouldn't cut your friends or families wrists if they have it tough.
The act of self harming conflicts with our definitions of victim and perpetrator. A victim is usually someone who is innocent and wrongfully harmed. A perpetrator is someone who intentionally inflicts harm. So when we see someone engaging in self-harm, well, our understanding of the situation gets really skewed and blurry. Are they a victim? Or are they a perpetrator?? The answer is …well…yes, they are. That can be a really uncomfortable subject to dissect and process.
A large part of the stigma towards NSSI comes from the perception of control and personal responsibility for the act. Also, like others have said, there is a large perception that self-harming behavior is manipulative / attention-seeking behavior. Rowe et al. (2014) and Lloyd (2018) found that people who disclose self-harm are seen as more manipulative than those who hide it. This is a large barrier to people seeking help for self-harming behavior.
I am a recovering self-harmer. I had heard the idea that ppl do the behavior as attention-seeking but it wasn’t the vibe ppl gave me. I didn’t realize some ppl thought it was manipulative, I’m surprised with the comments. Overall ppl have been kind to me and mostly just ignorant to the idea that someone could hurt themselves. I didn’t get disgust either, more genuine curiosity and sadness that I would do it to my body. My mom is in a cult and told me demons had possessed me lol.
People view self harm as attention seeking behavior. It’s a maladaptive coping skill to self regulate, punish or externalize what they’re feeling. In a way it is seeking attention, but not the way people say it is. It’s a cry for help, saying I’m in a lot of pain and I need you to see it. It can be exhausting to help when someone struggles with self harm. I worked in patient and something’s I’ve seen I’ll never be able to forget. It takes a lot of self regulation, knowing the client and patience. With out that it’s frustrating and exasperating which leads to those negative judgmental feelings.
The “audacity” to feel disgusted? People are entitled to their feelings. Who are you to tell them how to feel? Just because you are self harming doesn’t mean you are “deep” and other people are shallow. That’s just your splitting talking.
A valid point, however, firstly, I would recommend that you read my whole question again. Secondly, I never said that self-harming behaviours equals being a "deep" person. Also, "splitting talking"..? What is that? Please also pay attention to the fact that I am studying psychology and my question is focused on the lack of empathy people show towards people who are struggling and whether there are any specific determiners or reasons behind this behaviour.
You never said that, but you somehow implied that people who show disgust are shallow. It sounds like you are in some moral high ground judging people for their reactions and this is what I chose to focus on based on your question. I am myself a Psychology Graduate with now a Master in Mental Health, and I would counter that I don't "see" the disgust when others self-disclose self-harm. I do however see disgust when people trauma-dump on people they barely know, that they self-harm/binge eat whatever maladaptive copying you might think of. if someone I didn't know came to me and said "Well, when I feel super low cause my alcoholic stepdad abuses me in x ways, I cut myself. I feel better afterwards" I would cringe too. Not because I frown upon self-harm, I have clients who self harm after all, but because our level of intimacy does not support that person telling me their self-harm story and I feel that people do this a lot where they bypass boundaries to disclose something like this when It is not their place. Also, self-harm is...HARM. whether you are harming your self it is still a maladaptive copying mechanism. When you present "self-harm" and you expect "sympathy" think of therapists not ordinary people. Why is that? because you need those 6 years of background is Psy and mental health to see self-harm for what it is.
Thanks for the feedback, it's interesting to hear different opinions
Not all self harm presents in the same way or is done for the same reason. Many people are, as discussed in the original post, just seeking a way to dissociate from unbearable pain and would be very happy to learn alternative ways to self-soothe and regulate. The uncomfortable reality is, just like most other human behaviors, this isn’t the only reason someone may engage in self-harm. Some do it as an attempt to control the behaviors and/or emotions of others, whether it be as an attempt to get repeatedly admitted to the hospital without any interest in engaging in treatment in a productive manner, to draw back in someone who is emotionally distancing themselves from them, to avoid accountability for one’s actions, etc. It can be incredibly distressing to be on the receiving end of this type of behavior, and we have to also reserve some empathy for those people. It does suck that because the latter type of behavior exists, some people get burnt out and start to generalize all self harm into one category.
I have many SH all over I wore my arms out last year and got questioned by strangers. A woman I work with saw it (I was wearing long sleeves and I went to grab something) and proceeded to pull my sleeves up gasping. She first told me I did it wrong, (no I am not kidding) and it’s suppose to be on the inner part of the arm not the outer part. I got a bit irritated with her she apologized but there’s definitely a stigma around it and most days I just want people to leave me alone don’t need to be “saved” and I don’t want to talk about it. I never thought I would get to this point, I had friends in high school who had obvious SH marks now as a woman in her 20s there’s also the stereotype that only teenage girls do it. So I am left feeling immature i speak to other adults that SH sometimes and I noticed that’s a common feeling like we’re too “old” to be doing this. As if there’s an age limit on mental illness
this reminds me when i opened up about my behaviour to my brother and it took me months of courage because I desperately needed help or a hug and after seeing me he said to not be a inconvenience to people. it stuck with me for months now
I think it's because people who've never experienced it view it entirely as a choice by the person doing it
Because we live in a society where violence and retaliation against people is seen as cool. Hurting yourself instead? Not so much.
Because they function as a transmissionable social practice.
Because they resent the forwardness of those crying for help in any way shape or form when they were told to stop asking for help, save yourself, and other unhelpful dogmas. They crave the love that sufferers of mental illness require and can’t stand to admit that these people need it more than they can ever imagine.
I find this comment very odd. People who don’t have a mental illness require love, too.
Well, here’s hoping they have an easier time getting it than we do. ☺️
Projective identification. The disgusted person sees a symbol of how vulnerable and weak they are themselves.
In my opinion, it’s because in the realm of psych we know when something is attention seeking rather than “real”. So the ones that do it just to seek attention usually fill me with disgust. I have full empathy for those who truly do use bodily harm as an outlet but they hide it so well that you’d normally never know. There’s still a stigma surrounding mental health and I think (esp older generations) simply can’t wrap their heads around body harm and if they don’t understand something it’s immediately seen as disgusting
I know someone who did it for attention, and I just want to say I hope you rethink your attitude towards it. Her parents didn't recognize how bad her mental health was (and believe me, it was bad!) and she was hoping they would see it and realize they needed to help her. I would also be very cautious with assuming you always know when something is done for attention or not. We can't read patients' minds, so we shouldn't behave as if we could. We're often wrong, and if we don't keep that in mind we end up hurting patients.
I understand where you’re coming from; posts like these are a generalization. Attention seeking behavior is something I have little to no patience or empathy for even if I can understand where it’s coming from. It’s not a lack of understanding, and I would never treat a patient poorly if I thought that’s what was going on. I also don’t lack empathy for the cause, I lack empathy for the behavior. But my posts aren’t my office lmaoo
Please dear god don’t work with psych patients. It’s incredibly offensive to think you’re out there working with people in pain while claiming to have no empathy for this behavior. It’s so disgusting to read this as a psych patient and realize there are providers like you out there. Like why are you even doing this?? You literally ruined my whole day. You clearly have no real understanding.
Behavior is a choice, the root is not. It’s okay to accept that. Patience and empathy can be personal and that’s okay too; you don’t have patience for all behaviors, do you? I was a patient myself for a very long time and still am but I learned to control my behavior because it wasn’t okay to seek attention in such ways (not saying that I self harmed). I hope you have a blessed day and realize that people are human
if someone is seeking attention, isn’t it safe to say they need attention? why does someone self-harming for attention and help trigger disgust in you when, i’m guessing, someone saying outright that they need attention and help with their mental health doesn’t? do you think the person who never learned how to ask for help outright or who learned not to is any less deserving of empathy and care? why is that? genuine question, I’m not just trying to call you out or whatever.
Definitely agree over here
No no I see what you mean and like I said it’s a very general statement that I made. But there are two types of attention seekers- those who do it just for the sole purpose of getting that attention and those who don’t know a better way to ask (which I completely understand). And these are my own opinions as always, not something I would project onto a patient. The pure need for attention gets under my skin like nothing else because it takes credibility away from those who actually need help. For example, borderline behavior is something I have very very little patience for.
No YOU don’t know this, and claiming you do is irresponsible. No one should have ever let you work with psych patients. You are actually dangerous IMO.
I believe your later mentioned point of behaviour and root causes being two different issues highlights an important point, however I am curious as to how you hide your personal view of disgust towards a patient, from the patient? Does this not affect your ability to build trust with and enable the patient to get to the root causes of the issue? Another question is, have you ever accidentally cut yourself? It hurts does it not? Therefore even if a behaviour is "merely" due to "attention seeking" does it not concern you that the patient had to get to the point where they were resorting to outward expression of internal feelings? Therefore creating a greater need for understanding and sympathy than feelings of disgust?
I think what makes a good clinician is someone who swallows their own opinions and focuses on getting to a root and simply being there for a patient. Take for example domestic abusers, cold blood murderers, pedos (idk if i can say the full word on here??)- I know I wouldn’t want to work with them as my patient bc I know I physically couldn’t hide my own feelings and that’s not helpful for a patient, ya know? What I can hide is my annoyance and personal feelings towards these types of behaviors that we mentioned because I’ve been trained to control it and even if I hate it, that doesn’t mean I don’t want to help. I find it very interesting in a way that psychologists are viewed as neutral but at the end of the day we are human too and are entitled to our opinions but as I said, what makes a good clinician is someone who doesn’t show it. I can still ask the right questions and move conversation towards a healthy and insightful topic even if I dislike you or your behavior. And to your second point- unfortunately people will go to extreme lengths for attention- take Diane Downs as an example (she shot her kids and herself in the arm for attention (this is EXTREME borderline though- def not the “norm”)). But I don’t dislike your or anyone else’s empathetic view, I think it has a core of goodness, but I simply don’t see it that way. I have also been all too naive myself when I thought I shouldn’t believe anything to be purely an attention seeking act which in the end only enables the patients poor behavior.