Many years ago a woman told me of standing on a street and taking a razor blade out of her pocket to cut her arm. She had been hospitalised nearby and had swapped cigarettes for a blade with one of the male patients. This was when men shaved with those old Gillette blades. Some of the women wanted blades and some of the men wanted cigarettes so these transactions came into being.
She felt relief more than anything else because she had developed something of an addiction to the cutting; this can happen because of the release of endorphins to counteract physical pain.
But she knew it was no good for her, that it solved nothing and that it could lead ultimately to death by accident or suicide. So she learned healthy ways to deal with her emotional distress and gradually ended the self-harm.
Increasing incidents
Since that time, self-harm has not only not gone away but appears to be on the increase.
Twice in the past few months, teachers have told me of relatively high levels of self-harm among second-level students. These include both male and female students.
That's anecdotal but figures from the National Suicide Research Foundation show that the rate of self-harm was 9 per cent higher in 2015 than in 2007 though there is some evidence of a levelling-off towards the end of that period.
The highest rates of self-harm are in the young. I suspect that the reductions in the guidance counselling services in schools during the post-2008 crisis have contributed to this. Guidance counsellors provide psychological and emotional counselling as well as career advice.
The peak age for self-harm is the mid to late teens in females and the early to mid-20s in men but some people self-harm in age groups all the way up to the mid to late 80s.
Traditionally we have thought of self-harm as a female phenomenon and that is still true. In the most common age groups for self-harm, one out of every 139 females and one out of every 181 males have engaged in this behaviour.
St Patrick’s mental health hospital in Dublin noted recently that since 2007, the male rate has increased by 15 per cent, whereas the female rate is 3 per cent higher than in 2007.
One of the problems with these figures is that they are based on hospital admissions and some observers believe only 10 per cent of self-harm cases end up in hospital.
We also tend to think of self-harm as involving cutting and, indeed, it often does. However, drug overdose is the most common means of self-harm. Nonetheless, people in all age groups self-harm by cutting themselves and this is most prevalent among young teenagers. Males are more likely than females to cut themselves.
Seeking relief
Experts suggest that self-harm doesn’t usually involve an intention to die. It is done in a search for relief for very painful emotions.
This doesn’t mean it doesn’t lead to death. Drug overdoses are very high risk. For instance, people who take paracetamol overdoses need urgent treatment but may not experience strong symptoms of poisoning for 24 hours.
We also need to appreciate that about 80 per cent of people under 25 who take their own lives have engaged in self-harm within the previous 12 months.
So self-harm can lead to death either accidentally or, further down the line, deliberately.
If we are seeing a rising level of self-harm, we are seeing either a rise in the level of emotional distress in society or else a lack of knowledge of how to deal with emotional distress in a healthy manner.
And that, in turn, emphasises the need for an emotional education for young people especially. After all, the emotional distress experienced by young people is, to them, something new with which they need to learn how to deal.
That’s why it was so awful that school counselling services were cut in the financial crisis. It’s also why the emotional education I’ve referred to needs to become a highly valued part of the school curriculum.
Padraig O'Morain is accredited by the Irish Association for Counselling and Psychotherapy. His latest book is Mindfulness for Worriers. His daily mindfulness reminder is free by email.
pomorain@yahoo.com Twitter: @PadraigOMorain