Can personal training be used to reduce self harm?
Today's blog is about self-harm, I won’t be going into details or methods of deliberate self-harm but I will be talking about if exercise is an effective strategy in reducing self-harming behaviour.
It seems strange to me that I have not written about self-harm before. Every day at least twice a day in work I talk and support someone who deliberately self-harms, I have had friends struggle with their own behaviours and tell be about the shame that they feel. But today's blog has been triggered by today’s news story “alarming rise in self harm but only half get care” . “self harm risks being normalised”
So today the news headlines are reporting an increase in the number of young people, particularly women and girls who are self-harming. This news story has been triggered by a very robust scientific study publish in the lancet. The media are portraying the conclusion inaccurately as the study is unable to tell is there is an increase in self-harm and it’s also likely that the prevalence is higher than the study concludes due to the exclusion of researching people in hospital or prison. But the study is interesting as it is not looking at population of people accessing mental health services but across a sample of the English population.
The media is clear with one helpful message. It’s OK to seek help and if you are concerned about someone ask how they are. If you are the person wanting to seek help and don’t know were to start , if you can identify someone that you think will be helpful speak to them, if not talk to your GP. Your G.P may not be an expert in mental health but they will have had the conversation at least once today and they can be the gateway into getting some support. If you are the friend or family member concerned about someone else Mind have some useful resources.
Some experts within today’s news have talked about self-harm as a way of coping with strong emotion and trauma. In the last few years there has been evidence that self-harm is not just about regulating and coping with emotion. Coping with emotion assumes that you have noticed the emotion and have been able to identify what it is, there is now evidence that suggests that there may also difficulties understanding interoception (The internal senses). This would indicate that self-harm could be a response to a difficulty in noticing and interpreting responses. Within my career often the people I have worked with have described feeling numb.
The news articles I have read have mentioned it can be helpful to distract yourself and one person speaking on the radio spoke out about how they used holding ice cubes or doing star jumps as coping strategies. I would suggest that exercise and ice cubes are more than a distraction method of coping, they are creating different sensations and may help a person make sense of their emotions. They can also be helping with the parasympathetic nervous system as they can utilise the stress hormones and make it easier to return to a feeling of calm. So I decided to have a look at the research to see if there is any evidence around if self-harm can be reduced by exercise. Interestingly within my literature search I couldn’t find any studies that have even asked the question about what the impact of exercise may have on self-harm behaviours. (If you happen to find any please send them my way).
So as I couldn’t find this research I explored what the evidence based “protective factors” would be. The things in a persons life that are likely to keep people safe from harm were speculated on during some academic appears on self-harm however there were very few studies on the role of these protective factors in helping people recover. I hope the more we write and speak and ask questions the more evidence there will be in what can help with recovery.
In the meantime, whilst there is not the evidence out there I will continue to ensure that when I offer personal training to anyone who self-harms I will do this in a trauma informed way. I will support my client in identifying the internal signals and emotions from the body and use their feedback and experience to help physical activity be safe and enjoyable experience. Whilst we do not know if exercise can help with the behaviour of harming we do know that it can help reduce stress and improve mental health in other ways.