The Ghost of Self-Harm: A Tale of Psychotic Depression

Trigger warning for in-depth, no filter self-harm/suicide descriptions.

I co-founded an organization and support group called SHARE (Self-Harm Anonymous and Recovery Education). By no means do I support self-harm; that’s why I actively work to promote self-care and support for those struggling with it. But I also believe in the harm reduction model; this is the empirically validated idea that abstinence is not always the best way to go about solving a problem, to put it simply. And I also believe in being open about my experiences with self-harm for two reasons: 1) To let people know they’re not alone, and 2) to reach under the carpet and drag out this much needed conversation.

The SHARE philosophy — and, indeed, what research we are supported by — is that self-harm isn’t akin to self-injury (i.e. cutting, scratching, burning). Self-harm is anything that someone does to intentionally harm the body; anything from overmedicating to reckless driving to disordered eating is part of the spectrum of behaviours. There’s also a myriad of conditions that self-harm occurs under. This post will speak to my personal experience that I separate into different categories. Psychosis-related self-harm is the one I want to talk about right now.

Psychosis-related self-harm is the most interesting to me. Here’s my anecdote for that:

I’m sitting on the floor of my bedroom, bare legs extended in front of me — bent at the knees. I’m wearing an oversized black t-shirt with only panties underneath to cover myself; after all, I’m alone and no one’s coming to save me. I’ve been thinking about death and dying all day. My skin feels tight, tingling with a sense of dread; I realize I’m shivering, but it’s not because the room is cold. I want to cry, but I can’t find it in myself to do so. There’s a ghost in the room. It fills the air; it wants to suffocate me. Without words, it calls to me to end it all. It puts thoughts in my head about running out to my car and driving to the mountains. Just jumpit tells me, and think about how freeing the fall with feel. This is what it wants. It wants me dead. But I don’t think I want to die. I know I don’t want to die. But how do I make the ghost go away? How do I silence its presence? How do you make something go away when it can touch me but I can’t touch it?

The instinct is there. I feel the wave of certainty, of the knowledge of what I must do to calm the demon in the room who is trying to kill me. All the while I’ve been staring at a box of pins on the floor. I can’t think; the ghost is in my head, and if I don’t act now it will take over my body. I grab a pin and drag it across my thigh, gasping as it carves a shallow wound. Again and again and again I break my flesh and watch the blood creep out of the slivers of damaged skin. A shock wave bursts through me and sends a ripple of pain through my body. The pain explodes in me and I weep, tears trailing down my cheeks, sliding down to my chin where they drip onto some forsaken part of me. And suddenly the ghost is gone. Suddenly the room is quiet and I am truly — truly — alone. I cry until the numbness takes over.

Harm reduction is the part where I eventually find a first aid kit to clean the wounds, bandage them (and using clean instruments to start with). This is the reality I’ve faced on more than a few occasions. This is one of my mental health experiences I’ve never needed to question in terms of validity. It happened so lucidly that I could write about the fine details — the beads of blood, the wrinkles in my shirt, the way my hair fell over my face. And I wasn’t alone. I will never question the power of the nameless force that surrounds me on such occasions.

We don’t like talking about self-harm. We dislike talking about it even more so than suicide. Why is this? Why do we stray from moments of brutality in the mind? And how to do we have these conversations in a way that opens doors instead of closing them? I don’t have answers for these questions — just hypotheses. This is one of the few times when I’ve considered not writing this in terms of social responsibility. I want to encourage critical thought about oneself and one’s journey through life, but I want to encourage it in a way that’s safe for every individual. It’s in the name — these are harmful, sometimes tragically so, experiences. But we need to talk about them for the same reason we need to talk about suicide. Talking about it saves lives and bodies from scars that don’t need to be there (both physically and mentally). Talking about it empowers us to explore our identities and inform better practices in mental health treatment. Talking about self-harm gives me protection from my ghosts. Talking about self-harm respects the ghosts of people who only exist in memory.

Let us engage in this conversation for a future where there are fewer ghosts.