Tony White

Harm minimisation for the self harmer

As one wanders around the internet one stumbles onto some varying ideas. One the other day that I happened upon was someone who was suggesting some harm minimisation strategies for self harmers.

When you think about it that is almost an oxymoron. If a person sets out consciously to inflict physical harm on themselves why would they be thinking of harm minimisation techniques. But it does raise some pertinent questions about the whole area of self harm and could indeed even further our knowledge and understanding of the self harming individual.



So I have set my self a goal of coming up with a a set of harm minimisation strategies for self harmers. I have contacted a number of my medical colleagues to start to gather information on such harm minimisation information. I want to be cautious with this and cross check the information as I want the information to be based on sound medical knowledge. So this list I hope will come about some time later and I will place it on my blog

However as an example there are these things called Langer lines and here is a picture of some of them.



These were developed by Carl Langer, an anatomist. They are the structural orientation of the fibrous tissue of the skin, forming the natural cleavage lines that, though present in all body areas, are visible only in certain sites such as the creases of the palm. These lines are of particular importance in surgery. Incisions made parallel to them make a much smaller scar upon healing than those made at right angles to the lines.

Thus we have one possible harm minimisation strategy. If you cut along the lines then there should be less subsequent scaring. However one needs to be cautions with such information. Whilst it could be used for good it could also be used for evil.

In a previous blog post I wrote of the different reasons people self harm. Here is a list of them:

1. Gang behaviour tattooing type of self harm
2. To make self feel real. Dissociation, detached from reality. Cutting closes the gap.
3. To make self feel something. No feelings at all just numb
4. Tension relief and pressure stress build up
5. Physical expression of emotional pain. Cutting provides concrete evidence of pain
6. Cutting as self nurturing. Allows caring of self. Munchausen Syndrome
7. Self punishment and self hate
8. Manipulation and to get attention

With number 1 we can have the teenage girl who cuts her forearm because it is what her friends are doing and makes her belong with them. In such instances harm minimisation information could be useful as her goal in self harming is to belong to the group and not so much to actually damage self.



With number 7 there could be the opposite effect. A person who cuts their arm as an expression of self loathing may purposefully cut right across the Langer lines because it allows them to express more self hatred.

The other one of particular interest is that self harmer who says they get a feeling of relief or a sense of reality from seeing the blood flow from the cuts. Now one can make blood flow from such cuts if they go along the Langer lines or across the Langer lines. Which one would such a self harmer do if they they had such information prior to such cutting? An engaging question in itself which could indeed through more insight into the psyche of this type self harmer.

Then there is number 8. The person who cuts self and then goes and displays the cuts to someone so as to get a particular type of reaction. Harm minimisation information could be useful with this type one could surmise. Again it would be interesting to see if such a person actually used such harm minimisation information in their cutting of self.

Finally there are those where the scarring is very important. The more scars the better. So one would assume they might use such information to increase the scarring effect on the body.

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