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The Questions We Never Ask: ‘Why Did They Cut Themselves?’

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Self-harm, like the word suggests, is an act to harm oneself physically and/or emotionally. In its most general form, self-harm may constitute acts of making cuts on wrists, arms, legs and perhaps even stomach. Such acts may also include burning oneself with boiling hot water or cigarettes, holding one’s breath or suffocating oneself with a pillow and so on. The less-obvious forms of self-harm include the excessive consumption of any intoxicant like alcohol, cigarettes or drugs, the sudden and extreme display of promiscuous behavior, and deliberately putting oneself in dangerous situations.

Teens and young adults are more prone to self-harm. Now, you may ask why. Adolescence, the teen years and young adulthood is a phase of transition, which entails a lot of changes, decisions and choices to be made. These may or may not always be the way the individual prefers the situation. On the other hand, they may not even know what they prefer. This stage of ambiguity causes feelings of unrest and emotional turmoil which most young adults fail to comprehend. Feelings of sadness, loneliness, anger and a sense of loss of control may all seem overwhelming – therefore, leading to the urge for avoidance or to search for meaning and understanding.

At such a stage, the act of self-harm provides a clarity as to the source of pain for these individuals. They are aware that the pain is being caused by cutting, which they are inflicting on themselves. Furthermore, that also gives them a false sense of control over their feelings and emotions. For some individuals, the process of watching their blood flow also provides them a sense of instant relief from pain, which can be temporarily gratifying in its own way. Additionally, it is important to understand that self-harm is more a form of reducing tension rather than of ending life. However, self-harm is usually taken seriously as it may be a precursor to suicidal ideations or attempts.

Alcohol, drugs and sex give a false sense of control to cause pain to oneself on demand. They also provide an affirmation of where the pain is stemming from.

Furthermore, it is important to understand the cause(s) of self-harm or the symptoms accompanying it. This would help us determine the underlying problem and how the therapy/treatment needs to be undertaken. The possible causes could be depression, anxiety, a personality disorder, or neuroticism (a relatively mild mental illness that is not caused by organic diseases – involving symptoms of depression, anxiety, obsessive behavior, hypochondria but not a radical loss of touch with reality). Some individuals also cause self-harm out of anger and frustration, without realising the degree to which they are hurting themselves.

As a mental health professional, the importance of understanding the reasons to why someone would inflict pain on themselves is immense. Therefore, I also feel the importance of educating others about the same. This insight can not only help the loved ones understand the proplr suffering, but also replace maladaptive coping mechanisms (like self-harm) with more adaptive strategies.

In order to identify the urge to self-harm, it is important to be insightful about one’s feelings and emotions. Most teen transitioning from 19-20 start developing good insights; however, this can happen sooner as well. The feelings of being impulsive, immense anger, restlessness, or the inability to stay calm are either due to a particular triggering event or loneliness.

Once the urge has been identified, the act can be nipped in the bud. Of course, it takes effort and patience, but it is very much possible. For me, the first step is the acceptance that something may be wrong with me – and therefore, I am looking for an outlet. Even recognising that self-injury is an attempt to soothe oneself – and that you need to develop other, better ways to calm and soothe yourself – is a very helpful technique. More often than not, it is extremely helpful talking to someone you trust about your urges to self-harm.

A technique that helped me was reminding myself that “this is just a momentary urge and it will pass if I wait it out.” Counting backward or listening to soothing music at that moment can help you take your mind off the urge, and even take the feeling away.

Some professionals suggest that if this initial step isn’t possible, then perhaps taking a red felt pen and drawing marks (where one usually makes the cuts) can also prove to provide similar relief. Sometimes, in order to reduce the intensity of self-harm, professionals initially suggest reducing the impact of the harm and probably hurting oneself in ‘harmless ways’ – like holding a cube of ice or dipping one’s hands into a bowl of ice or stomping your feet on the ground. During one of my group therapy sessions in Mumbai, few adolescents revealed that punching a boxing bag helped them deal with their urges to good effect. Their depressive and anxiety symptoms also seemed to have reduced.

For those who struggle with substance abuse or promiscuity as a form of self-harm, studies and experiences show that having a ‘buddy’ to warn you each time you may be going overboard may be helpful. Setting small limits for yourself on a night may also do the trick. Additionally, one could also use a vape instead of smoking cigarettes or illicit drugs. As mentioned above, realising the urge and being wary of the same is the key to adopting these adaptive strategies.

Finally, if you feel the need to self-injure, try asking yourself these questions first:

1. Why do I harm myself? Why do I feel I must injure myself? What has driven me to cut (or burn) myself?

2. Have I done this before? How did I cope then? Did I feel the same way?

3. What other paths have I pursued to ease my pain prior to this? Is there something else I can do – an alternative to self-harming that won’t hurt?

4. How am I feeling now?

5. How will I feel later, when I am injuring myself?

6. How will I feel afterwards? How will I feel the next morning?

7. Can I avoid the problem that has driven me to this point? Is there a better way I can handle it the next time?

8. Must I injure myself?

Write them down so you can refer to them later and analyse your reasoning. Answering these can really help you understand the underlying issue and help develop more adaptive coping mechanisms. These responses may further help one’s therapist in providing more specific coping aids.

 The author is the co-founder of Invisible Illness.

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Featured image used for representative purposes only.

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An ambassador and trained facilitator under Eco Femme (a social enterprise working towards menstrual health in south India), Sanjina is also an active member of the MHM Collective- India and Menstrual Health Alliance- India. She has conducted Menstrual Health sessions in multiple government schools adopted by Rotary District 3240 as part of their WinS project in rural Bengal. She has also delivered training of trainers on SRHR, gender, sexuality and Menstruation for Tomorrow’s Foundation, Vikramshila Education Resource Society, Nirdhan trust and Micro Finance, Tollygunj Women In Need, Paint It Red in Kolkata.

Now as an MH Fellow with YKA, she’s expanding her impressive scope of work further by launching a campaign to facilitate the process of ensuring better menstrual health and SRH services for women residing in correctional homes in West Bengal. The campaign will entail an independent study to take stalk of the present conditions of MHM in correctional homes across the state and use its findings to build public support and political will to take the necessary action.

Saurabh has been associated with YKA as a user and has consistently been writing on the issue MHM and its intersectionality with other issues in the society. Now as an MHM Fellow with YKA, he’s launched the Right to Period campaign, which aims to ensure proper execution of MHM guidelines in Delhi’s schools.

The long-term aim of the campaign is to develop an open culture where menstruation is not treated as a taboo. The campaign also seeks to hold the schools accountable for their responsibilities as an important component in the implementation of MHM policies by making adequate sanitation infrastructure and knowledge of MHM available in school premises.

Read more about his campaign.

Harshita is a psychologist and works to support people with mental health issues, particularly adolescents who are survivors of violence. Associated with the Azadi Foundation in UP, Harshita became an MHM Fellow with YKA, with the aim of promoting better menstrual health.

Her campaign #MeriMarzi aims to promote menstrual health and wellness, hygiene and facilities for female sex workers in UP. She says, “Knowledge about natural body processes is a very basic human right. And for individuals whose occupation is providing sexual services, it becomes even more important.”

Meri Marzi aims to ensure sensitised, non-discriminatory health workers for the needs of female sex workers in the Suraksha Clinics under the UPSACS (Uttar Pradesh State AIDS Control Society) program by creating more dialogues and garnering public support for the cause of sex workers’ menstrual rights. The campaign will also ensure interventions with sex workers to clear misconceptions around overall hygiene management to ensure that results flow both ways.

Read more about her campaign.

MH Fellow Sabna comes with significant experience working with a range of development issues. A co-founder of Project Sakhi Saheli, which aims to combat period poverty and break menstrual taboos, Sabna has, in the past, worked on the issue of menstruation in urban slums of Delhi with women and adolescent girls. She and her team also released MenstraBook, with menstrastories and organised Menstra Tlk in the Delhi School of Social Work to create more conversations on menstruation.

With YKA MHM Fellow Vineet, Sabna launched Menstratalk, a campaign that aims to put an end to period poverty and smash menstrual taboos in society. As a start, the campaign aims to begin conversations on menstrual health with five hundred adolescents and youth in Delhi through offline platforms, and through this community mobilise support to create Period Friendly Institutions out of educational institutes in the city.

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A student from Delhi School of Social work, Vineet is a part of Project Sakhi Saheli, an initiative by the students of Delhi school of Social Work to create awareness on Menstrual Health and combat Period Poverty. Along with MHM Action Fellow Sabna, Vineet launched Menstratalk, a campaign that aims to put an end to period poverty and smash menstrual taboos in society.

As a start, the campaign aims to begin conversations on menstrual health with five hundred adolescents and youth in Delhi through offline platforms, and through this community mobilise support to create Period Friendly Institutions out of educational institutes in the city.

Find out more about the campaign here.

A native of Bhagalpur district – Bihar, Shalini Jha believes in equal rights for all genders and wants to work for a gender-equal and just society. In the past she’s had a year-long association as a community leader with Haiyya: Organise for Action’s Health Over Stigma campaign. She’s pursuing a Master’s in Literature with Ambedkar University, Delhi and as an MHM Fellow with YKA, recently launched ‘Project अल्हड़ (Alharh)’.

She says, “Bihar is ranked the lowest in India’s SDG Index 2019 for India. Hygienic and comfortable menstruation is a basic human right and sustainable development cannot be ensured if menstruators are deprived of their basic rights.” Project अल्हड़ (Alharh) aims to create a robust sensitised community in Bhagalpur to collectively spread awareness, break the taboo, debunk myths and initiate fearless conversations around menstruation. The campaign aims to reach at least 6000 adolescent girls from government and private schools in Baghalpur district in 2020.

Read more about the campaign here.

A psychologist and co-founder of a mental health NGO called Customize Cognition, Ritika forayed into the space of menstrual health and hygiene, sexual and reproductive healthcare and rights and gender equality as an MHM Fellow with YKA. She says, “The experience of working on MHM/SRHR and gender equality has been an enriching and eye-opening experience. I have learned what’s beneath the surface of the issue, be it awareness, lack of resources or disregard for trans men, who also menstruate.”

The Transmen-ses campaign aims to tackle the issue of silence and disregard for trans men’s menstruation needs, by mobilising gender sensitive health professionals and gender neutral restrooms in Lucknow.

Read more about the campaign here.

A Computer Science engineer by education, Nitisha started her career in the corporate sector, before realising she wanted to work in the development and social justice space. Since then, she has worked with Teach For India and Care India and is from the founding batch of Indian School of Development Management (ISDM), a one of its kind organisation creating leaders for the development sector through its experiential learning post graduate program.

As a Youth Ki Awaaz Menstrual Health Fellow, Nitisha has started Let’s Talk Period, a campaign to mobilise young people to switch to sustainable period products. She says, “80 lakh women in Delhi use non-biodegradable sanitary products, generate 3000 tonnes of menstrual waste, that takes 500-800 years to decompose; which in turn contributes to the health issues of all menstruators, increased burden of waste management on the city and harmful living environment for all citizens.

Let’s Talk Period aims to change this by

Find out more about her campaign here.

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A former Assistant Secretary with the Ministry of Women and Child Development in West Bengal for three months, Lakshmi Bhavya has been championing the cause of menstrual hygiene in her district. By associating herself with the Lalana Campaign, a holistic menstrual hygiene awareness campaign which is conducted by the Anahat NGO, Lakshmi has been slowly breaking taboos when it comes to periods and menstrual hygiene.

A Gender Rights Activist working with the tribal and marginalized communities in india, Srilekha is a PhD scholar working on understanding body and sexuality among tribal girls, to fill the gaps in research around indigenous women and their stories. Srilekha has worked extensively at the grassroots level with community based organisations, through several advocacy initiatives around Gender, Mental Health, Menstrual Hygiene and Sexual and Reproductive Health Rights (SRHR) for the indigenous in Jharkhand, over the last 6 years.

Srilekha has also contributed to sustainable livelihood projects and legal aid programs for survivors of sex trafficking. She has been conducting research based programs on maternal health, mental health, gender based violence, sex and sexuality. Her interest lies in conducting workshops for young people on life skills, feminism, gender and sexuality, trauma, resilience and interpersonal relationships.

A Guwahati-based college student pursuing her Masters in Tata Institute of Social Sciences, Bidisha started the #BleedwithDignity campaign on the technology platform Change.org, demanding that the Government of Assam install
biodegradable sanitary pad vending machines in all government schools across the state. Her petition on Change.org has already gathered support from over 90000 people and continues to grow.

Bidisha was selected in Change.org’s flagship program ‘She Creates Change’ having run successful online advocacy
campaigns, which were widely recognised. Through the #BleedwithDignity campaign; she organised and celebrated World Menstrual Hygiene Day, 2019 in Guwahati, Assam by hosting a wall mural by collaborating with local organisations. The initiative was widely covered by national and local media, and the mural was later inaugurated by the event’s chief guest Commissioner of Guwahati Municipal Corporation (GMC) Debeswar Malakar, IAS.

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