Accountability in Self-Harm Recovery

self acceptance my experience (1)

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The best decision I’ve made during my recovery process was choosing (and continue to choose) to be accountable to other people about my self-harm.

It was a hard thing to do, especially since for me, self-harm carried a stigma and a shame that hit deep in my soul. But even with my shame, there is an element of wanting someone to know and of not wanting to struggle through the pain alone.

I want it to be clear from the beginning–being accountable to others is never easy and most often hurts like hell.

To me, being accountable means I am “required to explain actions or decisions to someone.”* In my recovery journey from self-harm, it is crucial for me to be accountable to two groups of people: my team of treatment professionals and my non-professional support network.

Let’s talk about my treatment team first.

It is made up of a therapist, psychiatrist, and medical doctor. My accountability with my medical doctor means telling her if I have self-harmed since the last time I saw her and allowing her to check for infection and appropriately treat me, if necessary.

My psychiatrist and my therapist play a more active role in working to figure out my triggers and why I am self-harming. My therapist and I work closely on this. In order for her to be helpful, it is important I am able to recount what led up to my self-harm. We often discuss what made me vulnerable to the behavior, the trigger(s), and the residual effects of engaging in self-harm behavior.

The second group of people I need to be accountable with is my non-professional support network.

This group includes friends, family, and various faculty members at my college. It is important to have people easily accessible to you for accountability purposes when you are struggling, especially when you cannot communicate with your treatment team.

One method of accountability I have found to be effective is to text someone when I am having self-harm urges. In a message, I will say I am having self-harm urges and before acting on them, I am going to do X, Y, and Z for 15 minutes each (I usually go with at least three things). It doesn’t matter if I receive a response because having committed to coping skills and distractions gives me the accountability I need.

Another way I hold myself accountable is to physically go and be with one of my support people.

I don’t always tell them about my self-harm urges, but sitting with someone most likely will drastically decrease my likelihood of self-harm. A friend had someone hold her hands when she was having urges.

When I am in public and anxious I tend to scratch at my skin and I found holding someone’s hand will prevent me from scratching.

I also try to be honest with my support network about my behaviors.

I have one or two specific people who I make myself call or text if I have a behavior. This accountability is important because it helps me when they check in about my abilities to keep myself safe and how I am feeling. It also helps me to feel less alone and ashamed of my actions.

Another purpose of this check-in is to make sure I am seeking proper medical attention if it is needed. As a lifeguard with my history of self-harm, I have a good idea of when a laceration requires stitches or other more serious medical attention than I can give it. But because of the shame that comes with self-harm, I generally do not seek it. However, if I know I need more serious medical attention, I inform the person I usually text. This holds me accountable to going to the doctor or the ER for medical assistance.

It is impossible for me to hold myself accountable on my own for my self-harm, which is why I need other people to help me.

It is excruciatingly painful to admit to having dealt with an emotion by hurting myself, but I do it.

Accountability with even one person breaks the cycle of shame and feelings of failure that can perpetuate my self-harm behaviors. But I have slowly discovered those with whom I am safe to rely on for accountability when things get hard (and they will get hard).

By being accountable to others, the truth is revealed to me in my weakest moments–I am valued and worth loving regardless of what I have done and I do not have to fight for my freedom from self-harm alone.

*definition from Webster’s Dictionary


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