Healing through pain: Silent sufferers

Published: November 24, 2013
A step into the world of silent sufferers who resort to dangerous coping mechanisms . DESIGN: KIRAN SHAHID

A step into the world of silent sufferers who resort to dangerous coping mechanisms . DESIGN: KIRAN SHAHID

It is a pretty dark place when the only way to ease pain is to increase it. Commonly known as self-harm, it is a condition in which physical harm is deliberately inflicted on one’s own body to relieve emotional distress. The behaviour may take various forms such as poisoning, skin burning, hair pulling, skin-cutting, eating disorders and drug and alcohol abuse.

People who resort to deliberate self-harm can be divided into two broad categories — those who are attempting suicide and those who are using self-harm as a survival strategy to gain temporary relief from emotional pain. For the latter, it develops into an addiction as the pain provides them temporary release. The physical injury releases beta endorphins into the brain, which reduces tension and creates a feeling of temporary calm and control.

“My parents’ marriage was not a happy one and often, they would involve me in their arguments. At the age of 14, I started cutting myself using my father’s razor blades and [the pain] brought me instant relief,” admits Hassan, a former self-injurer.

The behaviour can be triggered due to anything from family disputes to conflict with the opposite sex, marital problems, chronic illness or financial difficulties.

“Research indicates that people who have been abused sexually in childhood feel a lot of guilt [and] feel responsible for the abuse against them. Harming themselves is an attempt to punish themselves, which is soothing in the moment,” says Tabassum Alvi, a psychiatrist at the Jinnah Medical College. Life Signs, a UK-based user-led voluntary organisation states that there is a strong link between self-injury and low self esteem.

A study conducted by the Rawalpindi Medical College in 2006 shows that the reported incidents of deliberate self-harm in Pakistan is about eight persons per 100,000 men and women. However, updated data on cases of deliberate self-harm in Pakistan is not available as it can be seen as a suicide attempt, which by law is a criminal offence punishable by a jail term or a fine. Most cases also go unreported due to fear of bringing shame to the family, or being subjected to a police inquiry.

The easy availability of medicines makes self-poisoning one of the easiest and most common methods of self-harm in the country. Drugs like benzodiazepines or aspirin, bleach, bathroom cleaners, rat-killing pills, lice powder and varnish are frequently used.

According to research conducted by Dr Muhammad Shahid at the Aga Khan University, impoverished married housewives, less than 35 years of age, are at the greatest risk of self-harm in Pakistan. Alvi attributes this trend to stress, having too many children in quick succession and hormonal changes which lead to depression. However, in recent years, an increasing number of men in the country are also self-harming due to frustration, abuse and poverty.

Even though the road seems dark, it is not hopeless and complete recovery is possible. One of the most effective ways is to seek help through therapy and develop alternative coping methods of dealing with the pain.

“I really wanted to stop cutting because I was tired of having to hide my scars and being in constant physical and emotional pain. So whenever I felt the urge to cut, I would instead try to express my pain by drawing and writing. Gradually, my sketchbook replaced my razor blade,” says Sheela, a former self-injurer.

A common misconception about self-harm is mistaking it as an attention-seeking tactic. In most cases, people who engage in this behaviour are very self-conscious and wary of asking for help. Hence, a strong support network of family and friends can play a critical role in recovery.

Rakshanda Khan is currently under training for humanistic integrative counseling. 

Published in The Express Tribune, Sunday Magazine, November 24th, 2013.

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Reader Comments (6)

  • Stranger
    Nov 25, 2013 - 12:59PM

    My parents were caring in their individual ways but they both left myself and my brother ‘wanting’ in many aspects. Those days we didn’t have these things like cutting ourselves with a razor but yes I remember quietly suffering like not eating fully , wearing torn undergarments (which only I knew ) etc., It was not a nice feeling to know that parents are ‘there’ but ‘not there ‘. U grow up thinking no one cares so why bother to speak up .whats the point anyway ?


  • Nov 27, 2013 - 1:44PM

    I have also observed that other than physically, people also like torturing themselves mentally. They get involved in situations which they are already aware of and will lead to distress or hurt. They feel sorry for them all the time. Its like having a Jaundice personality. Its sad how people do this to themselves but I am glad there can be a solution to most of it.

    This was a very enlightening article. I liked it!


  • Rakshanda Khan
    Nov 27, 2013 - 2:32PM

    @Stranger: I’m sorry you had to go through that. All parents to be should really be taught basic child psychology in my opinion. Parenting is not easy but as long as you understand your children’s basic developmental and psychological needs and meet those needs, you’re a good enough parent. Tragically, not many people do.


  • Mariya
    Dec 5, 2013 - 9:43PM

    My friend had a problem cutting herself. She had gone through a lot and she just needed someone to listen to her. Thank God I found her cause now shes much better and I dont even want to think what would have happened if I hadn’t found her.
    I have realized that peole like her are not trying to drown themselves in self pity they are actually trying to cope with something they think no one else understands


  • Esha
    Dec 5, 2013 - 11:35PM

    ur article is great, i myslef cut myself alot bt nw for 3 months i ve stoped it. wid refernce to stranger i ve same story bt different in many ways tht i alwys feel like unwanted, misfit. i been through al kinds of abuse from sexual to mental torture, cuttng nd takng slpng pils was my only way through… i alwys hide my scars hate ppl whn thy stare!!!
    bt thing is nw i realised cutng is nt worth it,, so stay bsy alot in dis way i dnt ve to stay home i study nd do job, nd also realised face thngs thn hurtng myself cux its not my body fault so y it shud suffer..


  • Rakshanda Khan
    Dec 24, 2013 - 12:59AM

    @Mariya: Your friend is lucky to have someone understanding like you in her life.

    @Esha: I’m sorry for what you’ve been through and it’s amazing how you managed to survive it all and are now coping without self harming. You are so strong and brave, I really respect your resilience heart


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