Myths and Misunderstandings about Self-Harm

  • Myth 1: People who self-harm are attempting suicide
    • Fact: Self-harm is most often used as a way to keep living despite experiencing emotional distress, rather than a way to end their life
  • Myth 2: People who self-harm are just attention-seeking
    • Fact: In fact, they tend to keep their self-harming a secret as a result of feelings of embarrassment, shame or guilt as well as not expecting others to understand or that it is a deeply personal act. It is not ‘just attention-seeking’ however sometimes it can be a cry for help
  • Myth 3: Don’t approach a person who self-harms, leave it to the professionals
    • Fact: Taking time to listen without judging encourages people to get their problems out into the open; the first and essential step along the road to recovery. You don’t need to focus, or even discuss, the self-harming, rather focus on the distress that is underlying the need to harm
  • Myth 4: You will know if someone is self-harming if they have cuts on their arms
    • Fact: Cutting is one form of self-harm; others include burning, hitting, bruising, swallowing, poisoning, etc. There is usually a great deal of effort made to keep the injuries and scars hidden; including actions that leave no mark or a mark in an area hidden by clothing
  • Myth 5: Self-harming is just the latest fashion and young people will simply grow out of it
    • Fact: Self-harm is not a phase or a fashion; read our blog on the different functions of self-harming. Listening to certain music, or dressing in certain ways does not lead to self-harming. People of all ages, backgrounds and of both genders self-harm. Self-harm is always a signal that something is seriously wrong

What is Self-Harming?

In its broadest sense, self-harm describes a wide range of acts that people do to themselves in a deliberate and usually hidden way, which are damaging; includes cutting, burning, scalding, banging heads and other body parts against walls, hair-pulling, biting, swallowing or inserting objects as well as self-poisoning. It is a practice that has not fully settled on a name with other terms frequently being used; self-injury, self inflicted violence, self-injurious behaviour and self mutilation. Currently the phrase Deliberate Self-Harm (DSH) is being used in professional contexts.

Importantly, Self-harm in defined as inflicting immediate and direct physical damage or pain without the intent to kill oneself. The damage can be alarming with the uninformed not being able to understand and, therefore, making the assumption that the act was an attempt at suicide. Self-harming has many varied functions, but it is always a sign of emotional distress and that something is seriously wrong.

It is listed in the DSM-IV-TR (The Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association) as a trait for diagnosing Borderline Personality Disorder and often associated with mental illness, trauma & abuse, low self-esteem & perfectionism and eating disorders.

People self-harm for a number of reasons, for some people self-harm provides the means to cope with overwhelming emotions, a way to control feelings of helplessness and powerlessness. For others, self-harm temporarily combats feelings of numbness to the world around them. It is important to bear in mind that everybody’s experience is unique, and there are no universal rules or reasons for self-harm.

Read further about the different function of self-harming.

Borderline Personality Disorder in the Media

Many of my clients are devastated at the very suggestion that they have a mental health diagnosis, especially one as notorious as Borderline Personality Disorder. I have had patients in tears after looking up the diagnosis online where they have found a great deal of anger expressed against people that are supposed to be like them. And absolutely, both in and out of public life, there is a focus on the destructive elements. However, there are some key points to note about people that fall within this category:

  • they have positive and negative characteristics like everyone else, just more extreme
  • some are more extreme than others, like anything else
  • they make up a significant portion of the general population: between 1 in 20 to 1 in 50 people
    • they are not some strange outlying alien species, but part of your everyday life
  • the more extreme characteristics are stress related and not evident everyday
    • the more extreme behaviours relate to primary attachment figure, i.e. people close to them
  • treatment offers significant gains that make real differences

Below are some examples of borderline people or characteristics in popular media that we see every day. Hopefully, this will both normalise and show that these difficult traits can have positive aspects. These are intense people so they can be very charismatic, loyal, loving, intelligent, sensitive, humorous, among many other attributes.

Celebrities with BPD

The following have shown strong Borderline traits in their public life:

Amy Winehouse, Angelina Jolie, Kurt Cobain, Marilyn Monroe, Princess Diana, Heather Mills, Christina Ricci, Britney Spears, Winona Ryder, Megan Fox, Charlie Sheen, Courtney Love, Lindsey Lohan and Elizabeth Wurtzel.

Certainly I would not diagnose people whom I have never met; the purpose her is simply to highlighting that their public personas have elements that are clear representations of borderline characteristics. They may well be the result of a different underlying cause. Diagnosis is a complex and in-depth processes.

Borderline Characteristics in Film and Television

In line with the outdated clichés, the earlier films show the destructive potential of these personality traits in their full cinematic glory. After “Girl, Interrupted”, a more realistic and mixed narrative started showing the characters as full rich and diverse people.

Fatal Attraction (1987)

In “Fatal Attraction,” the infamous femme fatale character played by Glenn Close displays the emotional instability and fear of abandonment that are symptomatic of someone with Borderline Personality Disorder. Her character also exhibits symptoms of self-harm, obsession, intense anger and manipulation as she stalks her former lover and his family.

Single White Female (1992)

Jennifer Jason Leigh’s character in “Single White Female” exhibits fear of abandonment, identity confusion, impulsivity and mirroring as she attempts to take over the life of Bridget Fonda’s character.

Girl, Interrupted (1999)

This autobiography in diary format tells the story of Susanna Kaysen’s experiences as a patient with Borderline Personality Disorder in a psychiatric hospital in the 1960’s. The film (1999), which stars Winona Ryder and Angelina Jolie, centres around Kaysen’s 18-month stay at a mental hospital as a young adult. Both stars struggle with features of this disorder themselves.

Monster (2003)

Charlize Theron transformed into the role of female serial killer Aileen Wuornos in “Monster.” Wuornos was diagnosed with Borderline Personality Disorder, which may have contributed to the unstable and angry behaviours that led to her killing at least six men.

My Super Ex-Girlfriend (2006)

A comedy in which Uma Thurman portrays a woman with superpowers and a secret identity who also displays the BPD symptoms of impulsivity, unstable interpersonal relationships and poor self-image.

Battlestar Galactica (2004–2009)

The central character of Captain Kara “Starbuck” Thrace played by Katee Sackhoff shows many Borderline traits, including unstable emotions, behaviours and relationships, self-destructive behaviours, boundary diffusion, identity confusion, impulsivity and intense attachments. Starbuck is a richly diverse and nuanced character which shows both the destructive and heroic sides of a Borderline Personality that typifies these engaging and powerful people.

Katee Sackhoff also plays another character, Sarah Corvus, with Borderline traits in the American TV series Bionic Woman (2007).

Dexter (2006 – 2013)

In the American TV series Dexter’s his adoptive sister Debra Morgan, played by Jennifer Carpenter, is a well-developed character that consistently and accurately portrays a comprehensive span of Borderline features; lack of boundaries, intense attachments, erratic relationships, impulsivity, self-destructive behaviours, balanced with great loyalty, drive and compassion. Conversely, one of Dexter’s girl-friends Lila Tournay, portrayed by Jaime Murray, equally fits the diagnosis only in a dramatically different with a focus on self-centred behaviours, lack of containment and destructiveness directed outward at others. Although, not exact opposites these two characters show the wide range of expressions possible within this diagnosis.

Brooklyn Nine Nine (2013)

This 2013 American offbeat police sitcom starts Andy Samberg as Officer Jake Peralta who is erratic, unboundaried, self-focused and self-destructive; but equally exciting and endearing.

Taxi Brooklyn (2014)

Chyler Leigh plays determined and passionate, but chaotic Detective Caitlyn Sullivan who has broken the rules so many times the Captain won’t even let her drive. She forms a close attachment with taxi driver Leo Romba played by Jacky Ido who provides her stability and perspective.

Murder in the First (2014)

Homicide detectives Terry English and Hildy Mulligan investigate two murders that outwardly appear to be unrelated. As the investigation proceeds, they find that both murders have a common element – that being Silicon Valley rising star Erich Blunt. The show examines the crime through the investigation, arrest and trial. Hildy is played by Kathleen Robertson to show a dedicated mother and detective contained by her work role, but with a strong underlying self-destructive drive. Her loyalty, authenticity, and passion are evident through story times where her struggle with boundaries can be admired even whilst getting her into trouble. Again the show provides the chaotic character with a stabiliser and sensible perspective in her partner played by Taye Diggs, an example of a Dependent Personality Disorder. Their antagonist is an Antisocial character being investigated for murder, played by Tom Felton.

Although all played a little close to cliché, this story does provide an excellent illustration of a Borderline/Dependent/Antisocial triangle at a sub-clinical intensity. All the characters demonstrate a limited range of life strategies definitive of a Personality Disorder, but all are functional and contributing members of society.