According to international trauma expert Janina Fisher, self harm can have many layers, purposes and meanings. Is it a way of escaping pain, boredom, emptiness or threat? Is it a way of punishing or controlling ourselves? Do we use it to give us energy or forestall dread? Are we reliant on self harm because we have no better strategies to manage frightening or overwhelming emotions?

Janina suggests that not all self harm has the same meaning. We should therefore be curious about the FUNCTION of the self-harm behaviours. What does it protect us from? How does it help us in our valiant efforts to survive?

Her idea is breathtaking because the current medical model treats most self harm as a problem and blames patients for this behaviour. Patients are typically judged rather than being understood or acknowledged for trying to utilize a(n admittedly imperfect) survival strategy.

Lisa Ferentz, a colleague of Janina,  has recently published a workbook called “Letting Go of Self Destructive Behaviours” which includes many strategies to help people who self harm. We will preview some suggestions in a forthcoming blog.