Harm reduction was initially first used in the contest of substance use as an alternative to abstinence. It is about reducing the physical and mental harm done to an individual when they engage in a potentially risky activity. A person can still engage in the activity but they do so as safely as possible. Within the context of substance abuse, harm reduction could mean that a person who uses IV drugs has access to and uses clean needles and they do not share needles with others. By using clean needles they are greatly lowering their risk of transmitting or becoming infected with diseases such as HIV and Hepatitis C. Harm reduction has branched out and being used in behaviours such as drinking, smoking and self harm.
Harm reduction is described as “realistic” by Fred Victor, a Toronto organization that supports people experiencing homelessness or have a low income status. I would agree that harm reduction is realistic because the approach does not expect abstinence. Harm reduction recognizes that abstinence is not something everyone can or wants to do. Completely eliminating the behaviour (abstinence) can be the potential end result, something that an individual decides they want and works up to but it is never expected.
When I think of harm reduction I am reminded of something I read in The Hurt Yourself Less Workbook:
“…there is no way forward unless we all accept a fundamental fact: that for many people self-harm is an essential coping mechanism, and we have no right to demand that people stop it, unless we have something better to offer them.” (pg. 6)
For me, this statement explained exactly why I could not abstain from harming myself. It is the same for many people. We can’t find anything better so we keep going with the behaviour that both lifts us up and brings us down.
I first started using harm reduction to cope with my self harm when I was around 18 years old. I had already been self harming for 5 years and had been fortunate enough to never need medical attention for my wounds. I was not taking care of myself. I did not care. I struggled desperately to eliminate the behaviour as the threats of friendships and intimate relationships ending if I did not stop cutting piled up in front of me. I felt like I was drowning. I was shocked when my counsellor at the time told me that I could still self harm but that I should do it safely.
My harm reduction looks like this:
- Having tools specifically for the behaviour
- Wash tools before and after (I at the least do after because in the moment things can be too intense)
- Wash wound with soap
- Cover wound with bandage
- Use antibacterial cream to kill bacteria and promote faster wound healing
- Use a scar reducing oil/cream to help with the appearance of scars
- Talk to someone you trust about it
Doing these simple tasks helped me prevent possible infections, helped me get my body back, showed me how to care for myself and eventually that caring allowed me to find successful alternatives to self harm. It took a few years and I’m still working eliminating the behaviour if that is what happens (it is what I’m aiming for). If I am completely honest, I believe that if I had not had someone in my life who knew that abstinence wasn’t an option for me I may not have been able to develop the coping skills I have. Harm reduction worked and still works for me.
I am currently 3 months self harm free, have reached 7 months self harm free in 2012 and before that reduced the behaviour to once or twice a month. Recently, even in the moments were I found myself holding my blade in my hand I chose to do something else because I now care about the marks I leave on my body. I take care of myself.
(Photo credit: renjith krishnan, freedigitalphotos.net)