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The Silent Epidemic is an Australian documentary about self-harm. Self-harm is an unrecognized threat to our entire modern society, it is claimed in the documentary.

Image: by Mathieu Stern on Unsplash

Self-harm is about people who experience such high levels of stress that they do not know how to deal with it in any other way, says Professor Nick Allen at the University of Melbourne.


Self-harm - a silent epidemic

In 2008, the University of Queensland conducted the first national survey to identify the problem of self-harm in Australia, and 12.000 people answered the survey by telephone. The results showed that 8% of the sample had had deliberately self-harming behavior.

Professor Graham Martin Dam talks about the study:

We were shocked by the high numbers of people who at one time or another had deliberately injured themselves. We did not expect 8% of the population to have self-harming behavior. It is almost - I would venture to say - an epidemic.

The numbers were scary. They mean that every month there are over 200.000 people in Australia who deliberately injure their own bodies. They cut themselves, scrape themselves up, burn themselves, and sometimes even break their own bones. 

Many of the young people who struggle with self-harm keep their self-harm behaviors hidden. It's so hard to talk about, there's a lot of shame in the picture, and they fear not being understood.

Self-harm is not about a desire to die, but is an attempt to survive.


Here you can watch the documentary 


Part 1 (of 4) of the documentary on self-harm


Part 2 (of 4) of the documentary on self-harm



Part 3 (of 4) of the documentary on self-harm


Part 4 (of 4) of the documentary on self-harm


A desperate situation for both the victim and the family

The problem of self-harm is most prevalent among teens and young adults. One of the young people in this documentary, Alison, has been hurting herself for seven years. She tells:

The first time I hurt myself was after an argument with my parents. It happens when I get angry and overwhelmed by emotions, and need something else to focus on. There is so much going on in my head, there are a hundred thoughts raging around in my head, and everyone makes me stressed.

Her mother says:

We were in shock. We did not know how to help her. I think self-harm is a way for people in deep pain to get away from the pain for a short period of time, but I think I will never fully understand it. I have not yet found a satisfactory answer.

I feel that we as parents could not have given her more help, we have done everything we can, but we did not succeed. It gives an overwhelming feeling of having failed as a parent.


Emotional reactions that can lead to self-harm

For many self-injurious people, life is full of anxiety - an sometimes almost incomprehensible anxiety. Often there is only one way out: self-harm. Self-harm thus becomes an attempt to deal with a very difficult emotional state.

Self-harm involves a failure to regulate one's own emotions. When our "fight-or-flight system", which is a natural part of the brain, is activated, we feel fear, stress and unrest. These are completely normal reactions in the face of situations or impressions that we perceive to involve a danger or threat. The challenge when you have had the fear reaction triggered, then lies in calming down again. When the person is unable to do this - when there is a failure in the ability to regulate themselves - self-harm can be the only solution the person seems to have from the difficult feelings.

Professor Nick Allen explains:

People who engage in self-harm seem to have stronger negative emotions in the first place, and in addition they seem to have greater difficulties than other people in relation to regulating these emotions.

Many of those who struggle with self-harm are looking for something that can break the vicious circle, to put an end to the difficult feelings, and they are then happy to look for something that is powerful. 

Thus, self-harm can become a "solution" for people struggling with emotional regulation - in that it provides a temporary experience of control over the emotional chaos. 


Dissociation, trauma and attachment difficulties

In the documentary, we meet Alisa, who is also struggling with self-harm. She has a different starting point than Alison. Alisa has experienced several years of sexual abuse in childhood, and in other words has been through serious trauma. She tells in the documentary about a pervasive emotional numbness - a feeling of not being in contact with one's own body, of not feeling anything. She has so-called dissociative experiences. For her, self-harm becomes an attempt to feel something at all.

The documentary emphasizes that it has previously been assumed that trauma has been the only way into self-harm, but that researchers today say that there are several factors that can affect the way into self-harm.

Not least, people today have become more concerned with attachment difficulties as a risk factor for developing self-harm. Children who form a secure connection with their caregivers will to a greater extent also develop the ability to regulate their own emotions. When an insecure attachment occurs, emotion regulation will often be difficult.


Self-harm as an addictive behavior

Self-harm can be difficult to treat. The documentary tells that Alison has been going to a psychiatrist for six years, but without gaining control of her self-harm. 

Some of the explanation for why self-harm can be difficult to treat is explained by the fact that self-harm can be understood as an addictive behavior.

One of the characteristics of addiction is that you have to drink more or use more drugs to get the same effect. It may seem to be the same in relation to self-harm. You have to injure yourself more seriously to have the same emotional calming effect, says one of the researchers interviewed in the documentary.

Self-harm can thus develop into the only way you experience that you can master difficult emotions.


Mindfulness-based stress management course had an effect on self-harm

Almost every day, Alison experiences such strong and overwhelming emotions that it can lead to self-harm. In this documentary, she tries out a course with mindfulness-based stress management over 8 weeks. Before the course, Alison has maintained a very high level of activity through the weeks to try to keep the anxiety away. Through the course, she will learn to calm down in another way, which can help her both to calm down her activity level, and to refrain from engaging in self-harming behavior.

Prior to the course, Alison was examined by brain researchers who determined that she had a very high level of brain activity in the front, right parts of the brain - while there was a low activity in the front, left parts of the brain. Activity in the right parts of the brain is associated with negative emotions, and activity in the left parts is associated with positive emotions. In other words, Alison had a pattern in her brain activity that indicated a lot of negative emotions and little positive. 

After completing the 8-week course, the researchers again examined Alison's brain activity. They determined that there had been a change in Alison's brain after completing a stress management course: There had been an increase in brain activity in the areas involved in positive emotions, and a decrease in brain activity in the areas involved in negative emotions.

Researchers interpreted this as a hope that we can change our brains, and that there are coping techniques that can be effective also in relation to gaining control of self-harm.


Self-harm in a societal perspective

Finally, the documentary asks some critical questions about how we are doing in our modern society. It is emphasized in the documentary that it seems that children who grow up today come to school with poorer abilities for self-confidence and self-regulation than children of previous generations, and questions are asked as to what the reasons may be.

The question is whether the widespread spread of self-harm can be a symptom of a society in crisis - a symptom of a society that has had a cultural and technological development that is miles ahead of the people who will live in this society.

- Has the world become more chaotic, more stressful? Has society developed so rapidly that we humans do not keep up? Could this explain some of the explosive development of self-harm, such as an attempt to calm down and regain control?



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