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Harm reduction is usually thought of in terms of supplying clean needles to drug addicts. The idea is to lessen the transmission of blood-borne diseases such as HIV and hepatitis and to prevent bacterial infections. It works but unfortunately it has a bad rep. “OOOH! That means you are encouraging addiction!”
It has been proved, however, to be useful in working with drug addicts. Now only does it lower disease transmission, but it brings addicts into a setting where they are respected and their welfare is considered important. This is often a first step toward getting clean.
It’s a useful concept in many other areas, as well. I’ll write about cutting, a form of self-harm wwhich many ritual abuse survivors engage in at some point in their lives. It is often misunderstood by people in schools, medical settings, and even peer groups. Since the vast majority of us have DID, I’ll write from a multiple’s point of view.
A part cuts for a reason, and until you can understand that reason, contact the part, and negotiate another behavior, chances are the cutting will continue. Willpower only takes you so far: it becomes useless the moment you switch. A lot of people do not understand this, and any suggestion of reducing the harm of cutting to the body and to the system is usually met with the argument that you are encouraging cutting.
(Here is a nice article by Kerry Gutridge, “Safer Self-Injury or Assisted Self-Harm?” in The Journal of Theoretical Medicine and Bioethics. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2847158/)
Harm reduction techniques for cutting are done by parts of the system that do not want to self-harm. They plan ahead and buy blades, bandages, isopropyl alcohol for sterilization, and topical antibiotics. Equally important is understanding where major arteries, veins, and tendons are located. The part that cuts may be persuaded to avoid them, and if they are cut, plans have been made for this emergency. Preparations and care for the wound are both done by one or more parts of the system that do not want to self-harm.
If you are going to try this, be sure to talk to the part(s) that cut. Tell them that you are aware that they are trying to help and that you believe that they are trying to catch your attention and warn you of danger. Be sure and let them know that you aren’t telling them to go away and that you will take their message seriously. In actuality, you are spending more time attending to what they have to say, as preparations and wound care are time-consuming.
Perhaps, in return, they could cut fewer times, less deeply, or in less conspicuous places? Perhaps they could explain to you what they are trying to protect you from? Is it punishment from the perpetrator? Strong emotions that you aren’t ready to handle? Something else that you haven’t thought of?
(Here is an article was written by Amelia, who speaks from experience. https://imaginaryplaygrounds.wordpress.com/2013/05/09/a-harm-reduction-guide-to-cutting-an-early-version/ It covers medical issues in depth and social and legal issues as well. It probably doesn’t occur to many people that open wounds or even scars can get you court-ordered for evaluation and/or treatment. I really recommend it.)
When I was a practicing therapist, we used the term “turning down the volume.” We asked kids that were having tantrums to see if they could turn down the volume “just a little bit.” We also wondered what they wanted to say to their parents but couldn’t say in words.
Sometimes it worked. A couple of kids took the directions literally and didn’t scream as loud. If one of the parents needed the kid to act up for some reason, it didn’t work at all. We often had to find another way to phrase it or another approach altogether.
It worked brilliantly with my first adult RA client. The process made sense to her and she did a ton of internal work. It made me realize that everything I knew applied to RA survivors simply because they were people like everybody else. They were just more complicated due to the severity of their trauma.
Realizing that every symptom had a meaning and served a purpose also reassured me. Symptoms were a form of communication and wondering what they were saying that couldn’t be said in words helped translate them into a language the client and I had in common. We had a framework we could work within.
So I am all for harm reduction, not only to reduce harm but to explore what the self-harming behavior means and what purpose it is serving. Saying that the symptom should be given up all at once is like slamming a door in somebody’s face and shutting down all chance of communication. I find it disrespectful and counter-productive.
If you would like to explore more about this topic (not just cutting), ra-info.org (Ritual Abuse, Ritual Crime, and Healing) has a self-harm bibliography at http://ra-info.org/for-researchers/bibliographies/s/ It contains both websites and books. The first two websites are not currently active. Enter their URL in the Wayback Machine at https://web.archive.org/ Use early pages in the Wayback Machine for “Healing Self-Injury:” the later ones get squirrely.
If you want my opinion, the Wayback Machine is just about the best thing since sliced bread!
1/13 Satanic New Year
1/17 Feast of Fools/Old Twelfth Night/Satanic and demon revels
1/20 St. Agnes’ Eve
1/20 Full moon
1/21 Martin Luther King Day
1/20 – 21 Total lunar eclipse. Visible in North and South America and partially visible in Europe.
2/2 S Candlemas/Imbolc/Satanic Revels
2/14 Valentine’s Day
2/18 President’s Day/Washington’s Birthday
2/19 Full moon
2/25 Walpurgis Day
3/1 St. Eichstadt’s Day
3/5 Shrove Tuesday/Mardi Gras
3/6 Ash Wednesday/Beginning of Lent
3/17 Str Patrick’s Day
3/20 Full moon
3/20 Spring Equinox
3/24 Feast of the Beast/Bride of Satan
Dates Important to Nazi and Neo-Nazi groups
1/20 – 1/21 Tu B´Shvat (Celebration of spring)
1/30 Hitler named Chancellor of Germany
3/20 – 3/21 Purim (Deliverance of the Jewish people from Haman in Persia)
(Not all groups meet on Jewish holidays. Some groups also mark Candlemas, Beltane, Lammas, Halloween, the solstices and the equinoxes)