The fundamental differences between self harm & eating disorders – vital in helping students with these conditions
One of the keys to helping in any situation is awareness and understanding. So what is it about when someone chooses to harm themselves? This can be through starvation, cutting themselves or purposely making themselves sick. All of these behaviours can seem extreme and difficult to relate to for many parents, teachers or friends.
All of these actions are firstly about control. You have lost control in some way in your life. Everything just seems to be out of your grasp and you need something to focus your attention on and have control over. Eating, food, routines and exercise are all very easy to control. There are no external factors and so these become the focus for you. The first time I ever came across Anorexia was when I was still in school myself. Oddly there were a number of female students in the same year who were all experiencing eating disorders. Their behaviour stuck in my head and when I later started university I was exposed once again to people around me with the condition, especially through my work in the students union. All of the people either controlled how much they ate, over exercised compulsively or took some sort of solace in making themselves ill after eating.
I wasn't exposed to self harm until much later when I became an educational mentor and education administrator. From a distance this looks to be a very different condition and in the same way as my school days I saw there was a tendency for there to appear to be groups of students with the same behaviour patterns. This made me ask is it fashionable? Is it something you do because others around you do it? What are the reasons and the triggers? How different are these actions? Is cutting yourself the same as starving yourself and most importantly what are the keys to helping someone?
So aside from control or loss of it what else do these conditions have in common? The simple answer is self image. But the self image is not created in the same way and this is vital to understanding the difference in helping people with eating disorders and self harm.
The classic picture of self image for a person with an eating disorder is that they will stand in front a mirror and see a much fatter, heavier and unpretty image of themselves. This can be very hard to understand from the outside. How can they see something that is so distorted?
This important point is that the "self image" they have of themselves is created from inside. My experience has always been that they have developed an image of themselves that is untrue and doesn't easily seem to have stemmed from anyone else. There may in fact be a deep trauma or experience that has happened to them that has led them to think very badly of themselves and hence see themselves in a very negative way and especially in a very physically unattractive way. Getting to the route of this trigger that has lead to their own self image is key to solving the condition.
With self harm there is also a poor self image but this has been created in a slightly different way. There is always an external pain that the student is trying to drain away very literally. There will be someone in the background who is making them feel very bad about themselves. They will be bullied either directly by someone or through an indirect way. I have seen a huge correlation between academic achievement and self harm. If there is a sense that you are doing very poorly in school or not keeping up with others expectations of you this can make you feel very bad about yourself. I have seen that students with learning difficulties very often don't feel they are good enough in school. There can be a huge pressure that builds up. There is a great fictional example of this in the book Casual Vacancy by J.K Rowling. Parminder Jawanda is in a very high achieving family and as a culture educational achievement is given a huge priority and status. As she is dyslexic and misunderstood in the family she never feels that she comes up to the mark. This in itself would probably not be enough for her to resort to self harming but as she is being anonymously cyber bullied it's all too much! She doesn't have a way to express all that is happening to her and so she finds control in cutting the pain away. I have seen many examples where people self harm because they don't feel they come up to other peoples mark or expectations coupled with an inability to express what is happening in their world.
If we go back to one of my earlier questions - why is there a tendency for groups of students to self harm in the same schools? Well one of the correlations that I have seen is that schools that are not seen as centers of excellence but would like to be higher on the league tables put their students under enormous pressure to achieve academically. Schools that are consistently doing well have an expectation but it's almost taken for granted that a certain type of student is going to do very well. So there is often not the same pressure as a whole on the class. Schools from disadvantaged areas unfortunately often behave as if they don't have any great expectations. So schools that are middle ground and striving to be better are the ones where students often feel under huge pressure - I have even seen this from the time of the entrance exams. In these schools I have seen pockets of self harm. It's like it is a way to alleviate the pressure cooker effect and yes of course when one person does it then others follow.
So in summary - understanding that these actions are about control and expression is vital. There is always a trigger for poor self image which is key. In the case of eating disorders this can be hard to trace back as it is a very internal bench mark of self image that the person has created for themselves. With self harming the self image is created externally by someone else making us feel like we are not good enough or causing us to feel a pain that we need to get out of our systems.
Finally the key to all of this is expression. Being able to unravel the triggers. When you can truly create your own self image and feel good about yourself you will no longer have the need to cause yourself pain in any way. This is the process I have taken many people through.
Dr. Naoisé O'Reilly, Expression Developist.™