SIB

This is a topic I’ve been thinking about writing for a while now, but it’s another one that is fairly challenging for me to write about, both in terms of my own history and in the fact that it’s a fairly delicate subject matter, and I hold unorthodox views.  It is also a potentially triggery subject matter for readers, but I will try to write it in as un-triggery a way as I can manage.

I grew up knowing it as self-injury.  Now it seems to be self injurious behavior (SIB), or sometimes self inflicted violence or self harm.  Possibly other words too, but those are the ones that I know about.  While it certainly isn’t a behavior exclusive to those on the autism spectrum, it is known to be a particular risk for us.  I certainly have my own rather tumultuous history with it.

It’s almost always challenging for me to listen to other people talk about it, or about how to fix it, because their approaches always seem so utterly wrong to me.  Let’s start with the usual go-to reason to not do it that I usually see people say.

“It doesn’t work.”

I really, seriously, hate this response.  Before getting into why, I want to dissect it a bit.  On the occasions that I ask why they say it doesn’t work, the answers are fairly consistent.

“Because it doesn’t fix anything.”

Ok, this is true.  SIB fixes absolutely nothing, and no problem will be solved with its application.  Of course, the exact same thing can be said for meditation, deep breathing, counting to 10, having a cry, hitting a punching bag, or any number of other coping mechanisms we have.  While I have seen people criticize any of these coping mechanisms for whatever reasons they have, the failure to actually fix a problem has never been among them.  So right off the bat, the most common reason given to not engage in SIB is invalid.  Coping mechanisms don’t exist to fix problems.  They exist to help us cope while we do whatever it is that needs done to fix the problem.  Or, if the problem can’t be fixed, to try to simply cope.

So here’s the thing.  SIB does work.  For me, at least, in terms of helping me to cope with challenging circumstances that I couldn’t change, or a constant feeling of chaos that I couldn’t fix, or feelings of being completely out of control of everything, SIB worked very, very well.  It worked better than any other coping mechanism I have ever since figured out.  (side note – for anyone who may be reading this and worried, I have not engaged in SIB in years.  My stressors are less and my coping mechanisms greater than either used to be.)

So anytime someone says “it doesn’t work” in reference to SIB, they are basically claiming that my history, my experiences, my reality don’t exist, as well as the history, experiences, and reality of anyone like me.  It’s belittling, it’s invalidating, and it tends to lead me to not want to listen to anything else whoever said it may have to say.

Also frustrating is how the usual response to SIB (aside from what has already been mentioned) is to find a way to eliminate the behavior.  It’s almost like people hyperfocus on it and simply try to get it to stop without thinking about why it’s there in the first place.  The problem is, this and “it doesn’t work” adds shame and fear to a behavior that probably already has plenty of both attached.  It leads people who are hurting, who may need help, to be more secretive.  To hide it away, not tell anyone, and not ask for help that they may need.  That is the opposite of helpful.  Why in the world would anyone who claims to want to help, choose instead to shame?  It makes absolutely no sense at all.

I have been on the receiving end of such things in my life.  I can tell you for definite – they never, ever worked for me.  I learned to hide, to feel ashamed, to lie.  Yet for some reason hardly anyone showed any interest in providing alternative coping mechanisms, and no one at all wondered what might be so wrong in my life that I was choosing SIB.  Instead, it was simply “stop, or be punished.”  Yeah, it didn’t work.

What really gets me is that if everyone really needs a go-to stock response for why to not engage in SIB, there are plenty of totally legitimate reasons to choose from.

• SIB carries a risk of infection.  The worse the SIB, the greater the risk
• SIB tends to be addictive, and can take over as the dominant coping mechanism, even over others that may be more useful in some situations
• SIB only works as a short term coping mechanism.  Others, that may be less immediately effective, will ultimately help for longer
• SIB can carry long term consequences, physically, mentally, and emotionally

But ultimately, none of these reasons will be worth anything if the underlying causes are not addressed.  Personally, I consider SIB to be a symptom and thus a secondary concern to whatever is causing it.

Now, while I cannot speak for anyone else and I am not a professional, I can talk about what worked for me.

• Importantly, a complete lack of shaming.  When I first got together with my current bf, it was still a problem.  He never judged me for it, never tried to tell me not to do it, never made a big deal out of it.  It was what it was.
• A strong focus on figuring out what my triggers were and learning to eliminate, avoid, or mitigate them if possible.
• Slowly but steadily building an internal reservoir of other methods of coping with life’s stresses.
• Deliberately pushing SIB down my list of coping mechanisms
• A deliberate refusal to decide that I’ll never do SIBs again

Before I wrap this post up, I want to talk about that last one for a bit.  It’s another really common thing, and early on with my current therapist she tried to say that I should make SIBs a “never ever” thing.  I refused quite adamantly.  I’ve tried that technique before.  It always had the same result – a spiralling increase in stress and anxiety, centered around the idea that now I can’t use my best coping mechanism.  I would start to worry about what to do if I was faced with a situation that I did not have any other method to deal with.  It would typically only take me a few days, maybe a week, to get so frantic that I wound up doing it just to calm myself down.  Talk about backfiring.

Now, I know not everyone reacts that way.  However, I do recall seeing, very often, people doing the “never again” thing, slipping and having a relapse (which it’s important to note, does happen) and promptly freaking out and declaring whatever time they’d managed to go without as “gone” or “wasted” and that now they had to start over.  THIS IS NOT HELPFUL, just as it wouldn’t be helpful to get upset at someone who’s trying to quit for having a relapse.  It happens.  Far better is to simply deal with it, figure out something else that could be done if that situation arises again, and move on.

In fact, I think that sums up all my advice quite nicely.  Deal with it, figure out alternatives and how they can be applied in the real world, and move on.

SIB is still on my list of coping mechanisms.  It’s so far down the list, and my other coping mechanisms are sufficiently good that I haven’t needed to use it in quite a few years.  Yet I don’t rule out the possibility that I may need it in the future.  If I do, I’ll deal with it, figure out what happened and find alternatives, and move on.  All I ask from other people is understanding and respect.