I’ve been haunted by the accusation that I am ‘just doing [whatever] for attention’ since I first heard it levelled at people who self harmed, and then my fear deepened when a friend at school accused me of it in response to my not eating.
Fear of being thought of as ‘attention seeking’ as a teenager meant I hid every element of my unhappiness. I was petrified that someone would discover my self harm and call me an attention seeker, so I painstakingly covered. For a decade. And I was afraid I would be called attention seeking for not eating, so even when the school nurse cautioned I was ‘under weight’ I didn’t say a word – and publicly laughed at such an absurd assessment.
The difficult thing is, I think, that these actions are attention seeking. But bear with me: probably not quite in the way you’re thinking.
Teenagers, in particular, are going through unparalleled emotional, bodily, and cognitive/intellectual changes. Their social relationships are radically rearranging themselves as they re-orientate themselves around peers rather than family, their bodies are changing in very obvious ways in terms of puberty and hormones, but they are also changing into the shape that will likely determine how they experience much of their rest of their lives. More than this, they are exploring increasingly intense and sometimes romantic relationships, and learning about the pleasure their bodies can achieve in consent with others. They are coming to terms with ideas like mortality, and able for the first time to take responsibility for assessing risks and gambling their own safety.
Looking back on who I was as a deeply unhappy 14-18 year old, I still don’t know how to fully articulate that experience, or how I could have communicated the sense of being lost in my own body, baffled by my new and changing emotions, isolated from my [seemingly] entirely-heterosexual surroundings, and the fear and exhilaration I was encountering as I began taking risks with drugs and alcohol.
What I can see when I look back, is a young woman trying to ask people around her to help. I did want attention – I wanted someone to show me how to navigate that transition in my life, I wanted someone to tell me my feelings were as significant and life-altering as they felt, I wanted someone to validate the depth of the things I felt without calling me “dramatic” (another favourite accompaniment to ‘attention-seeking’). In a sea of other teenagers, all struggling to find themselves and each other, I wanted to be seen. I needed attention that distinguished me from the crowd (‘bloody teenagers’) and reassured me I was valuable.
My heart aches for how isolated and lost I was at this time – how desperately I wanted someone to notice the physical actions I was taking to ask for help, and how entirely unable I was to do that verbally. Ultimately, two parents of my friends, two of my best friends, and a girlfriend, helped me in the ways I needed.
Subconsciously, I think altering your body through self-harm and disordered eating are, ultimately, actions which some part of your mind knows will draw attention. Faced with a total lack of language for those feelings, or the skills of reflection and introspection we develop into adulthood, how else can young people communicate their need for care, for guidance, for help, for attention?
As adults, we’re expected to move away from these actions, to develop different strategies, to recognise that harming ourselves as a cry for help is ’emotionally manipulative’. As I understand it, one criteria which is used to identify and diagnose borderline personality disorder relates to ‘manipulative’ or ‘attention seeking’ behaviour and I know a number of people with symptoms/moods similar to mine who have been diagnosed with BPD, apparently largely because of their long term self harm. I also know many of these people have repeatedly sought psychiatric help, have repeatedly asked, calmly, clearly and with specific evidence of need and defined goals, for emotional support from the appropriate health care providers; and they have been turned away. What can you do when expressing in words, in ‘acceptable’ ways, your need for help is unsuccessful?
I know someone who works as a NHS Psychiatrist and is called to A&Es to assess people in crisis – usually at the point they are expressing suicidal impulses or engaging in actions of self harm. This psychiatrist can only recommend people are admitted, but cannot create the NHS beds for them to be accommodated. These people are also, ultimately, turned away. They might return, ever more desperate, ever less able to communicate, ever more extreme in the physical actions they take. The chronically underfunded NHS, teetering on the point of collapse, ends up labelling these people “attention seekers”. And, implicitly, that means ‘not in need of attention’.
Attention seekers, in an age of YouTube and Facebook and make-your-own-celebrity, who instead chose to endanger their lives and permanently alter their bodies rather than start a blog (hey-oh!) or a YouTube channel or an Instagram account? Something doesn’t add up there, does it? If this was about seeking ‘attention’ there are a hundred easier routes to it. Self harm, suicidal gestures, and disordered eating, and a hundred other self-injurious actions are about seeking attention, but not any kind of attention. Attention – help – for chronic, overwhelming, unmanageable experiences of fear, pain, anxiety, loss or some other catastrophic emotional state. They are the last refuge of people who either cannot discover the words to convey their emotional state and their need for support, or who have communicated their desperate need for help and not been heard.
Why else seek attention through actions, unless because nobody is listening?
My conclusion is two-fold.
On a personal note, I remind myself of all of this as I wrangle self-harm impulses. I don’t want to self harm, what I want right now is help with these unmanageable emotions of stress, anxiety, and fear.
More generally; that attention-seeking is not bad, or wrong, or evidence that there is not a mental health condition, an emotional need underlying it. That we must care for, and be patient with teenagers in particular and be cautious not to dismiss their actions as dramatic or (most hated of words) ‘angst’.
People ask for help in many ways – often it is not with words because those words are either not available, or not heard.