Hi, my name is Sarah, I am part of the Telehealth team here at EDV. Before we get started, I want to acknowledge today’s recovery newsletter is going to cover a big topic, self-harm and eating disorders. Before reading on, maybe take some time to check in with yourself and just see whether you’re up for this conversation right now or whether it might be best to wait until you are in a better physical or emotional place.

Something lots of people talk to us about is self-harm either alongside the eating disorder or when they are recovering from an eating disorder.

So, what are we talking about when we say self-harm?

When we talk about self-harm we are talking about any act to cause physical harm to yourself. This could take many different forms and is a short-term way of someone managing intense emotional distress.

There are many reasons why someone might self-harm. Some of the things we hear about include someone wanting to feel something when they feel numb, feeling so much emotional distress that physical pain is a way of releasing this or helping it to feel ‘real’. Having thoughts of self-harm does not necessarily mean you want to end your life or experience thoughts of suicide, although people can experience both.

What about self-harm and eating disorders?

We know many people who experience an eating disorder also experience other forms of self-harm. In some ways this makes sense, as the behaviors of an eating disorder could also be considered a form of self-harm.

The eating disorder behaviors cause physical harm to our bodies, although it may not be as visible as other forms of self-harm, and the eating disorder behaviors are also a way of managing intense emotional pain or distress. The difference sometimes is the intentionality. Self-harm is an intentional act of physical harm whereas the eating disorder isn’t always about causing intentional harm to ourselves.

It is really understandable that if you are trying to challenge eating disorder behaviors or manage intense feelings, that other ways to cope (like self harm) might come up, as a different way of managing the same intense thoughts or feelings.

It is also really understandable that they might come up at the same time or one after the other. For example, you might experience an eating disorder behavior, like a binge or purge, and then afterwards feel intense feelings of shame or guilt which can lead to thoughts or urges to self-harm. If any of these things or similar things happen for you, please know you are not alone in this experience.

What can you do to manage when experiencing thoughts of self-harm?

In lots of ways, tools to manage the eating disorder thoughts and urges can also be used to manage thoughts and urges to self-harm. The thoughts and feelings will often come in a wave that gets really intense and then subsides. The length of the wave can be different for different people, for some it is quite short and for others it can last a while. This wave can also change in length at different days and times in your recovery.

Short-term management

In the short term, it is important to find ways of riding the wave in the moment. Different things will work for different people. For some, it might be reaching out to friends to chat, breathing, mindfulness or finding something different like using ice on your skin that helps you get through the moment with a reduced impact on your physical health. Lifeline describe some of the different ways to manage in the moment here.

Long-term management

In the longer term, it is really important to take some time to understand what the role of the self-harm or the eating disorder is for you. If we can do that, we can start to address the distress and manage the intense feelings in a different way. This is often not an easy thing to do and can take some time. It is also a good idea to do this with your support people, both professional, like a mental health worker, and personal, like your friends and family.

The most important thing you can do if experiencing any of this is to reach out and talk to someone about what is happening for you; this can often feel like the hardest thing to do too. We can often feel like we don’t want to burden others with this information or that we feel like we ‘should’ be able to manage distressing thoughts and emotions on our own. Figure out who might be the safest person to start with – maybe a friend or family member or maybe a professional or helpline of some description.

If this has brought up any intense feelings for you then please reach out for the appropriate support. It might be a call with a support person is enough, you might like to book in for an EDV Telehealth Counselling appointment here or if you are needing more immediate support please contact Lifeline here or call them on 13 11 14.  If you are in immediate danger call 000 or go to your local emergency department.