Caregiving: Self Harm

[Trigger warning for discussion of self harm]

Ever since reading Susan’s Fucking Perfect: On Loving and Being Helpless, I’ve thought about covering self harm in the Caregiving series. Given a resurgence of the topic on Persephone lately, I figured now might be the time.

Self harm is something I’ve mentioned in passing time and again during the Caregiving series, and a little more in depth in articles like Unexpected. In part, I’ve shied away from discussing self harm because it has featured in our lives more than suicide attempts. At least, that’s what I’m telling myself right now. And I don’t think that’s right. Okay, let me try again.

All right. I think I might have it. There’s even a parallel to draw.

Fear. That’s what I think it comes down to.

In the movies, when someone gets that call? You know The Call. The one from the hospital, or presuming the patient is in good enough shape, from the loved one saying, “Guess where I am?” The person starts flinging things into a rucksack or handbag, then runs out the door. They’re trying to hold together their composure as they get to the hospital. Then it gets harder. The hospital doors. Which ward? A maze of signs to navigate. “Hello? I’m looking for my husband?” It’s almost always a question. Knowing the person’s in the hospital somewhere. Half-hoping to be wrong. Wanting to know what’s changed since The Call. Eventually finding the ward. The alcohol hand gel by the door. The sign declaring visiting hours that goes ignored. Looking around for that familiar face. The approach that defies logic by slowing up. Reaching the bedside and choking out, “You stupid, stupid man.”

In my defence, I usually followed up that sentiment fairly quickly with, “I love you.”

The parallel comes in the form of Mr. Juniper’s bowel disorder. The time in which it took to diagnose his issues there were several hospital admissions. Ones that were last minute. Immediate. Of the “get there now” variety. There was fear there, too. A lot of fear. The same questions running through my head when I got to the hospital.

And those two causes of fear come from the same place. Fear of losing him. Even his suicidal ideation hasn’t brought about the same fear because the risk of losing him didn’t exist in the same way until he did something. But with the self harm and the bowel disorder, the risks were far closer. Far more possible. Far more immediate.

I spoke about this in Unexpected, that self harm and suicide attempts don’t necessarily hold the same risks:

Mr. Juniper is also someone who, in the words of many, does not do things by half measures. Important lesson here: an incident of self harm can have physically worse repercussions than a suicide attempt. Hence there are two major points to consider: the intention behind the action and the conclusion of the action. This is especially important with someone like Mr. Juniper because his actions of self harm would be considered by many to be suicidal, but they’re not. Which, in case it hasn’t been guessed, means his suicide attempts have been quite”¦? I don’t know, elephantine? I truly can’t think of the right word, but the difference matters because self harm and suicide are not the same. It is quite feasible that someone who has self harmed has never been suicidal and that someone who is suicidal has never self harmed. Self harm is a coping mechanism, albeit an unhealthy one, suicide is”¦ (for want of much better wording)”¦ in this context, often about bringing an end to pain.

And so it’s fear that does, I think, cause me to shy away from talking about self harm. Memories of trips to Accident & Emergency. Wrapping him up in hospital blankets as the tiredness gets to him. As the emotions that drove him to hurt himself ebb away. The nurses and doctors. Stitches being made. Drips hooked up. Watching the clock tick through to the early hours. Wondering if there’s enough money for a taxi, or if a visit to the ATM is in order. Listening to the monitor’s incessant beeping. Waiting for the colour to come back to his skin. Taking him home to bed. His skin cold, no matter the number of blankets. Both glad of another day.

The fear doesn’t go, I don’t think, but an objectivity comes. It all somehow balances out. It would be an exceptional incident that didn’t require medical attention. And there’s no denying the knowledge of what he’s capable of. There’s fearing the worst and there’s knowing very well one of the possible avenues the worst can take.

Then there is accepting that hospital treatment doesn’t have to mean the worst, it can be the way an incident needs treated. Nothing more, nothing less. It’s an acceptance that brought about Mr. Juniper going to hospital himself for incidents of self harm. It was also him being able to deal with his self harm. A step in the direction of recovery, too.

Self harm barely features in our lives as an active part of Mr. Juniper’s struggles these days. I still remember, though. And so does Mr. Juniper. Not just what he went through, but he remembers what I went through, too.

And the memories are there whenever the rare incident has occurred in recent years. There’s little that has to be said. We both know. “I love you,” we say. The front door closes, I turn the lock. See to day to day life. Shoot glances at the clock until I know he should be at the hospital. Tell our son that Daddy has a sore tummy and needs to see the doctor. It isn’t a lie. Tuck our darling boy into bed. Wait for a call. A text. Anything. Give up mid-evening and call the hospital. “Hello, my husband was admitted earlier this evening,” I say. The right ward. The nurse. Sometimes the doctor. Kind words. Yes, he’s okay. Thank you. Thank you. Thank you for my husband. Hanging up. Waiting. The evening passing with an unshakeable emptiness. On my own since the cat has decided to snuggle in with our son. A text. A call. He’ll be home soon. Opening the front door quietly so as not to disturb. The night time cold following him in. Saying little. Treading carefully up to bed. The light off. Pulling the duvet up around us. Remembering the darkness will pass. Remembering that the sun will come up in the morning.