My Experience of Self-Harm as a Physically Disabled Person

by Katy Evans

A quick Google search for self-harm and disability leads to many links, all of which are centred around learning disability. This blog is not to dismiss the very real challenges of people with learning disabilities who use self-harm to cope with the often frustrating and difficult situations they find themselves in. However, my experiences as a physically disabled woman does not fit within these links. Neither do they fit within information for non-disabled people whom have privacy and control over what happens to their bodies.

Self-harm means different things to everyone. The problem is we are rarely given the freedom to define our lived reality for ourselves. I am a survivor of childhood abuse and my need to self-harm largely arises from a requirement to punish myself and as an attempt to alleviate some of the shame I feel, as if by cutting my skin I am bringing this to the surface. I realise this self-blame is misplaced and I know I will probably be working for the rest of my life to place this where it belongs: with the abusers.

While the abuse laid the foundations for self-harm, living with disability has certainly sustained it. Feeling overwhelmed and lacking in control are big factors which contribute to my need to self-harm and these are part and parcel of living as a disabled person. I often feel at the mercy of others’ decisions: how much support I will get, what I can spend my money on, how many pets I can have, what work I can do – are all decisions that have been made for me just in the last year with little to no acknowledgement of my thoughts. Added to this is the lack of control I have had over my body since birth. Disability has given professionals the green light to touch me, prod me, mark me, cut me and restrain me with me having no say in when it will end. These painful invasions of my body make me want to take back the control of the pain my body feels because that feels safer than being at the mercy of the abusers and professionals who, whilst poles apart in their intentions, both stole the ownership over my body which I had so little of in the first place.

As an adult, my encounters with mental health professionals have been just as harmful, leaving deep, invisible injuries. At times, these interactions themselves have proved to be a source of self-harm. For the last year I have been searching for a therapist to work with me. I want to see someone face to face and I have now contacted 150 therapists, the majority of whom turn me down on the grounds of not having wheelchair access or viewing my trauma to be ‘too complex’. One even stated they could make easier money by seeing someone else. I have times when I self-sabotage and contact therapists and use their very probable rejection as proof I’m unworthy and beyond help.

Like many survivors, I have experienced the superficial suggestions and throwaway comments from crisis teams. During risk assessments they regularly place me at low risk of self-harm or suicide because they assume my physical disability makes these options impossible. However, this doesn’t account for how good at problem solving I, and many disabled people, have been forced to become as a necessity to living in an inaccessible and ableist world. If one option is shut to me, I’m already formulating the next plan, meaning there is a never-ending array of possibilities. Professionals do not see these as they fail to see past my visibly obvious disability and cannot envisage how I can self-harm.

Mental health services view of what constitutes self-harm and neglect is too narrow to acknowledge that not all self-harm is physical. Whilst not doing physical self-harm avoids the immediate physical danger from injury, the google binges where I spend hours reading everything about my abuser further impounds the trauma which fuelled the self-harm need and often heightens the level of physical injury I feel compelled to do following this.

Instead of giving me the support I need, mental health services have often expected my personal assistants (PAs) to fulfil this role. As I am their employer this presents numerous boundary complications. In addition, they have no training in this area and have nowhere to go for support or supervision other than to me. Even without this aspect, it can be difficult to have PAs involved in my personal life because I cannot hide my injuries from them when I am naked in their presence and in need of their physical support for personal care. Some PAs ask what happened and with others the silence feels stifling because we both see it but no one wants to voice it. My inner pain becomes visible in ways I feel too vulnerable or not ready to disclose to them. It’s difficult enough to be an employer of people who see me naked on a daily basis without explaining my internal turmoil.

Pain is an expected part of my impairment and I have often used this to invisibly meet the urge to self-harm by purposely doing things which aggravate muscle spasms and skipping pain medication. This pain leaves no visible marks and if people are aware of it, they are quick to accept it as part of my condition. Although this has been an easily achievable and discreet way to self-harm, it denies the benefit I get from physical self-harm; watching my injuries heal gives me hope that I can heal too.

Many of the disability related assessments I have are traumatic and invasive with a strong focus on evidencing my need because my word isn’t enough. One assessor wanted to see visible proof that I self-harm. This wasn’t for therapeutic reasons or to check I was medically safe but simply a tick box on her form. I felt forced into showing her the scars because I was desperate for the support that she was the gatekeeper to. Her cold manner left me feeling humiliated and judged. I self-harmed that night as an attempt to physically demonstrate the contempt I felt the assessor had towards me and to regain some control.

It is my experience that the needs of physically disabled people who use self-harm are frequently overlooked, especially when my limited ability means I often use other methods of self-harm which stray from the established stereotypes. The challenges of living as a disabled person drives my need to self-harm yet this very same disability also makes my self-harm invisible to many professionals. We need to broaden our understanding of what constitutes as self-harm and the support people need, especially the unique aspects for disabled people. When self-harm experiences are widely silenced already, I would argue the experiences of people with a physical disability are even more hidden. Organisations raising awareness of this reality could shift away from individual disabled people having to educate and instead receiving the support they need in the moment they need it.

Katy can be found on twitter @KatyRoseEvans