The ICD 10 CD-10 (International Classification of Diseases, Tenth Revision) for intentional self- harm varies depending on your chosen method but in general if you have a history of self-harm it is ICD.10 Z91.5. There are multiple codes under this classification with multiple methods and patterns identified to discern one type of harm from another.
The rates of self- harm and the mortality rates for self-harm are alarmingly high and rising.
It seems many of us carry around wounds so agonizing that they demand to be resurfaced and healed with anything we can find; a razor in a hand, a gun on a lap; a rope around a neck, the bottles in the bathroom cabinet or in the fridge or in the cleaning cupboard. Strange items to heal a deep wound, but ultimately they are analgesic.
There are treatments of course; pharmaceuticals naturally and a psychiatric diagnosis (even your own detailed code), 50 minutes weekly talks with a Therapist, Cognitive Based Mindfulness, Meditation, yoga exercise and diet and so on.
All meant to heal, most healing in some way.
Like any injury when you turn up seeking help or others notice you need help, a short developmental history is taken, a look at the visible damage and then a plan is set to fix the injury; usually including medicine for the pain. The care plan is set and all eyes are on future actions.
The top down mechanics of modern psychiatry get the machine moving for the most part and there is solid evidence that it reduces successful suicide rates; but if that is enough why do the behaviours recur?
Clearly the mechanized behaviours are not the problem in self harm or suicide. Maybe these breakdowns are just the bodies way of screaming at you to look deeper for the wound and please stop the pain.
What if the original wound is too painful, too shameful, or complicated or traumatizing to talk about once a week for what is left of 50 minutes; after you have discussed the week and measured how effective the current strategies are and thought up new ones; or discussed medication and homework or ‘to do lists’ and set up next week’s appointment? What if it happens that the strategies you learn help you the least when you need them most?
What if you need to examine the wound from the bottom up, in depth, not just what is regulating these shifts in mood and action but where did the cuts on your arms or the urge to die or to just not be here really originate from?
What if the part of you that is deeply wounded needs to die?
What if you need to scream in pain? What if the communication of that pain is primal not to be dampened but to be felt and heard?
The scars we see are not the wound; they are merely the cover-up of a deep wound. The not uncommon belief that scar tissue is stronger than normal tissue, is untrue; it is weaker, less flexible and much more sensitive to pain.
Likewise; those other things that hurt us can make us weaker and less flexible, they can heighten our sensations of pain and leave us much more vulnerable to even minor injury emotional or physical. This makes us hyper-vigilant to danger and so all the stress hormones in our systems are at battle stations; already preparing to grab what we can for when the fight or the flight or the freeze of the sympathetic nervous system (which is really just rounding up the troops to protect you) kicks in.
So we ask ‘what is it that will get me out of this place of danger?’ We find these weapons in pills, in booze, in razor edges, in lighters, in rope, in isolation.
If you are one of the millions of people who have experienced self-harm, you will always be in that much maligned statistical group because this has happened to you; but take time to find and heal the original wound. Then swim with all your might away from the growing statistical whirlpool of death by self harm.
Whatever it is that has happened to you needs to be examined in detail, fully addressed and healed at a deeper level. Commit to a deeper examination and walk towards a happier life.
Healing trauma fully requires work to discover in more depth the wounds that keep reopening within you and instead of stocking you with band aids or giving you pain relief we need to help the mind, body and spirit heal to the core of the wound.
Unlike the scar tissue you may have formed that will never go away, we want to help you build inner resilience, lesson your sensations of pain and make you less vulnerable to injury from self or others.
Through in depth exploration of your life story we can start to understand the core of you; we take time to feel the story fully, to feel the pain and to let it be heard. Then we find out who it is you think you are? Who do you think other people are? What kind of place has the world been for you?
These beliefs whatever their cause are the original wound. So we seek out the original wound and work to heal it.
Through deep acknowledgement of the pain and an intricate understanding of the underlying wound we can begin changing beliefs and behaviours, instill self- compassion, introduce new ways for the body to release trauma and help your sympathetic nervous system quiet down, call back the troops and let the wound heal.
It is possible to recover; whatever it is you use to hurt yourself, they are all just pain relief, heal the wound and the pain will ease.
This Blog is dedicated to my beautiful brother Conor; who did not survive his depression.