Somehow, you love me.
Even when my bodies covered in scars.
Maybe I was meant to kill myself.
Maybe it was always in the cards.
Maybe I was created to die.
Maybe I will do it now.
Just saw this post on my ex-boyfriends wall about his current girlfriend..my cuts just started another fight…
Self -Harm Survey
How old were you when you started self-harming? [] Younger than 4 [] 4-5 [] 6-7 [] 8-9 [x] 10-11 [] 12-13 [] 14-15 [] 15-16 [] 16-17 [] 18-19 [] 20-21 [] Older than 21
How often do you self-harm? x[] Depending on what mood I’ve been in… [] More than once a day [] Once a day(usually) [] Several times a week [] Once a week [] Two or more times a month [] Once a month [] Several times in a year [] Once a year [] I have stopped [] I am trying to stop
3. What method of self-harm do/did you primarily use? [x] Cutting [x] Burning [] Hair-pulling [x] Scratching [] Interference with the healing of wounds [] Hitting or bruising [] Bone breaking [x] Cutting and Scratching [x] Cutting and Burning [] Hitting Head against walls [x] Binging [] Purging [x] Starving [x] Biting [x] rubber band slaps [] burning with hot water
If You Self Harm What Sexual Orientation Are You? [] Straight Male [] Straight Female [] Bi-Sexual Male [] Bi-Sexual Female [] A-sexual female [] A-sexual male [] Homosexual Male [] Homosexual Female [] Transgender Male [] Transgender Female [] Questioning Male [] Questioning Female [] Pan-sexual Male [x] Pan-Sexual Female (FAAB, Agender) [] Prefer not to answer [] Demisexual Female
Which Of These, If Any, Are Something You Struggle With Along With Self-harm? [] Anorexia [] Bulimia [x] Anorexia and Bulimia [] EDNOS [x] Suicidal [thoughts] [x] Various Psychiatric Disorders (i.e. Bi-polar,Borderline Personality, OCD, Panic, Anxiety, PTSD, Dissociative, Impulse Control Etc.) [x] Learning Disabilities []None of the Above ~Not Diagnosed with anything~
Do You Think That You (as An Individual) Need Professional Help To Stop Self-harming? [] Yes, The Only Way I Could Stop Is With Professional Help [] No, I Have Stopped On My Own Though I Still Struggle Often And Sometimes Mess Up [] I Have No Desire To Stop And Therefore Don’t Need Professional Help [] Yes, I Have Stopped With Professional Help [] I don’t think I could ever stop without Professional help [] Prefer not to answer [x] I don’t know
Are You Trying To Stop Self Harming? [] No, And I Don’t Want To Stop. [] No, But I Would Like To Be Able To Stop [x] Yes, But I Am Not Doing Very Well [] I Have Stopped But I Still Mess Up Every Once In A While [] I Am Completely Self Harm free [] Yes, but I don’t want to
8. Does Anyone Know About Your Self Harm? [] No. No One Knows [] Some People May Have A Vague Idea Of Something [] Yes, But Only My Closest Friend (s) [] Yes. But Only Some Of My Family Member(s) [x] Yes, Some Friend(s) And Family Member(s) Know []Yes, All (or Most Of) My Friends Know []Yes, All (or Most Of) My Family Know [] Yes, People that see my scars/cuts [] Just a couple of people I trust [] Yes, My Therapist, Psychiatrist, etc
How many years have you been self-harming? [] 1 year [] 2 years [] 3 years [] 4 years [] 5 years [] 6 years [] 7 years [x] 8 years []9 years [] 10 or more years
If You Self-harm, Were You Abused Or Neglected (either As A Child Or Later In Life?) [] No [] Yes, I Was Emotionally Abused [] Yes, I Was Physically Abused [x] Yes, I Was Sexually Abused [] Yes, I Was Emotionally And Physically Abused [] Yes, I Was Physically And Sexually Abused [x] Yes, I Was Sexually And Emotionally Abused [] Yes, I Was Emotionally, Physically And Sexually Abused []Yes, I Was Neglected [] Yes, I Was Neglected As Well As Being Abused [] Prefer not to answer
Would you label yourself as emo? [] Yes [] No [] I guess..? [x] Maybe?
12. Do others label you as emo? [] Yes [] No [x] Some People [] I don’t know
13.What would you or others label you as? (chose all that apply) . [] Prep [x] Goth [x] Emo [] Punk [] Nerd [] Hipster [x] Pothead [] Poser [] Skater [x] Druggie [] Normal [] I dont know [] I don’t believe in labels
- What is your reaction when you see other people’s self-harm scars/cuts/marks? (choose all that apply) [] I want to get to know them [x] I wonder what they went through to feel that was a way out [] I want to get as far as possible from them so no one will find out about my own self-harm [x] I will acknowledge them as someone who shares something in common with me [] I would never even acknowledge them [x] What happened for them to start cutting [] Fear [x] Interest [x] Sadness [] Happiness [] Don’t really care [] No reaction [x] Surprise [] Relief [] Jealousy (if anyone has more than me) [] Upset that nobody else cuts as bad as me [] Happy that nobody else cuts as bad as me (at my school at least)









