What Helps and Harms at the Same Time
On Survival Strategies, Self-Protection, and the Difficult Path Towards Change
Some actions appear only harmful when viewed from the outside.
Washing the skin until it becomes sore.
Controlling food.
Working until one can barely continue.
Keeping other people at a distance.
Harming oneself.
Leaving the body when closeness becomes too intense.
It is easy to respond to such actions with a single question:
How can this be stopped?
But in the conversations that formed the foundation of my doctoral dissertation, A Study of Shame, another question becomes at least as important:
What has the action helped the person to do?
This does not mean that what is harmful should be defended. Nor does it mean that serious actions should be romanticised. But if we see only the harm, we risk overlooking the function. And if the function is not understood, help may remove the only protection the person still has before anything safer has been put in its place.
Something can harm and help at the same time.
That is the paradox explored in this essay.
The Strategy That Emerged Before Language
Many survival strategies emerge before the person can explain them.
The body finds a solution.
The child withdraws from its feelings.
It becomes quiet.
It watches the adult’s mood.
It washes.
It eats or refuses to eat.
It harms the body.
It makes itself unnoticed.
It learns to be capable and compliant.
No one necessarily describes this as a strategy. The action simply exists, is repeated, and gradually becomes part of everyday life.
Only later may the person look back and ask:
What was I actually doing?
Why did I have to do it?
Why did I not stop?
But the strategy was not created in a calm room. It emerged in a situation in which something had to be managed quickly, often without help and without language.
It should therefore not be judged as though it were primarily a poor choice.
It was a response to an impossible situation.
When Self-Harm Provides a Form of Control
Self-harm is a clear example of something that can both help and injure.
From the outside, one sees the wound.
The blood.
The scar.
The danger.
From within, the action may carry several meanings.
It may divert an indistinct inner pain by making it concrete.
It may break through numbness.
It may punish a body experienced as dirty or guilty.
It may create calm after intense distress.
It may provide a sense of control:
This is a pain I determine myself.
When emotions are chaotic, physical pain may have a beginning and an end. It can be located. It can be seen. It can be treated.
This does not make the action safe. But it makes it understandable.
If the helper simply says, “You must stop,” the person may hear:
You are taking away what currently makes life possible.
Change therefore requires more than prohibition. It requires that the task performed by the action is recognised.
What happens immediately before it?
What becomes easier afterwards?
What does the action protect against?
What need is it trying to meet?
Only then can something else gradually begin to take over the same function.
When Pain Is Moved
Shame can be difficult to contain.
It is often diffuse.
It exists in the body, in thoughts, and in the way one sees oneself. It may be without form and without clear boundaries.
A physical action can give it form.
The inner wound becomes an outer wound.
The invisible becomes visible.
What cannot be told is written into the skin.
In this way, the body may come to carry the language the person lacks.
But what gives form also creates new pain.
Scars may appear.
Secrets.
Fear of discovery.
New shame about the action.
The strategy that initially reduced shame may later create more shame.
I am ashamed of what happened.
Then I harm myself in order to endure the shame.
Afterwards, I am ashamed that I harmed myself.
In this way, the person may become trapped in a cycle in which help and harm continually replace one another.
Washing as Relief and Imprisonment
Washing may contain the same duality.
For someone who experiences the body as unclean, a shower may provide a moment of relief.
The water runs.
The skin is scrubbed.
Something is being done.
The feeling of uncleanness may lessen for a while.
But because what is being washed away does not truly exist on the skin, the need returns.
Another shower.
Another washing.
Another check.
What began as relief gradually becomes a demand.
The person no longer washes because she chooses to, but because she cannot refrain.
The strategy protects against a feeling, while at the same time narrowing life.
It takes time.
It damages the skin.
It governs the day.
It also indirectly confirms shame’s claim:
If I have to wash again, it must mean that I am still unclean.
In this way, the action intended to correct shame may instead keep it alive.
Food as Protection and Punishment
The relationship with food may also take on a double function.
Eating may calm.
It may fill emptiness.
It may reduce distress and give the body weight and substance.
Not eating may provide control.
It may make the body less visible.
It may reduce sexuality.
It may be a way of punishing oneself.
It may also express:
This body shall receive nothing.
Or:
This body shall become so small that no one sees it any longer.
Both strategies may create a temporary sense of control. At the same time, they can harm the body and make the relationship with it even more conflicted.
It is not enough to ask how much the person eats.
One must also ask:
What does food mean?
What does hunger mean?
What becomes possible when the body is empty?
What becomes unbearable when it is full?
Without such questions, the body once again becomes merely an object to be corrected.
Leaving the Body
Disconnection may be one of the most effective strategies during the violation itself.
The child is physically present but mentally elsewhere.
It looks at the ceiling.
Counts patterns.
Thinks about something else.
Disappears into an imagined place.
Experiences the body as distant or unfamiliar.
This may be a way of surviving when escape is impossible.
But the strategy may later accompany the person into situations in which it is no longer needed.
The person disappears during intimacy.
Loses contact with the body.
Cannot remember parts of conversations.
Experiences herself from outside.
What once protected against being overwhelmed may later make it difficult to be present in one’s own life.
Yet disconnection cannot simply be commanded away.
Saying “stay here now” is of little help if the body still experiences presence as danger.
The person needs gradually to discover that it is possible to remain present while also retaining control over the boundary.
That she can return without becoming trapped.
That she can feel the body without being taken over by the past.
The Usefulness of Not Feeling
Emotional numbness may also be helpful.
It makes it possible to get out of bed.
Go to work.
Care for children.
Buy food.
Function in meetings.
Others may perceive the person as calm and resilient.
But the calm may have been purchased through absence.
Grief is kept away.
Anger is subdued.
Joy also becomes weaker.
What protects against pain simultaneously protects against life.
This is a recurring feature of many survival strategies: They do not always distinguish between dangerous and welcome feelings.
When the door is closed against grief, joy may also remain outside.
When the body is subdued to avoid memories, the capacity for presence is also subdued.
When relationships are kept at a distance to avoid betrayal, the possibility of belonging is also kept at a distance.
The strategy works.
But it works more broadly than the person wishes.
Work as Rescue
Working excessively may be a socially accepted survival strategy.
The person who washes too much may cause concern.
The person who works too much may be admired.
Work provides structure.
Identity.
Distance from memories.
The opportunity to be useful.
It creates a world in which effort produces visible results.
Here the person can be competent and valued. Here rules, expertise, and tasks have greater authority than the body, shame, and unpredictable closeness.
Work may have saved a life.
But it may also wear that life down.
Rest becomes dangerous.
Inactivity creates space for memories.
Personal worth becomes tied to performance.
When the person can no longer continue, shame may return with full force:
Who am I if I do not function?
What carried the person forward may therefore also make it difficult to stop before the body collapses.
The Capable Helper
Some enter caring professions or become the person who always helps others.
This may be a deeply meaningful path through life. The experience of pain may create particular sensitivity to the vulnerability of others.
But helping may also serve a double function.
When I help you, I do not have to feel myself.
When you need me, I have value.
When I carry your pain, my own can wait.
The care may be genuine while also protecting against something.
One does not cancel the other.
The problem arises when the person is permitted to exist only as a helper.
When personal needs feel like betrayal.
When receiving care becomes more difficult than giving it.
Then the good action may become another way of abandoning oneself.
Anger as Protection
Anger can damage relationships.
It can frighten others.
It can make a conversation difficult.
But anger may also be an important protection.
It says:
This was wrong.
Do not come any closer.
You have no right.
A person who has long lived without effective boundaries may need anger in order to feel that a boundary exists.
If the helper only tries to calm the anger, she may end up diminishing the force that is finally protecting the person.
The task is not necessarily to remove anger, but to help it find a form that does not destroy the person it is trying to protect.
From explosion to clarity.
From self-punishment to protest.
From directionless rage to a language for injustice.
Anger can be dangerous.
But the absence of anger may also be dangerous if it means that the violation is still not allowed to be called wrong.
Isolation as Safety
Withdrawing from other people reduces the risk of further violations.
No one comes close enough to betray.
No one sees what the person is ashamed of.
No one asks questions.
No one can demand anything.
Isolation works.
It creates a form of calm.
But it also creates loneliness.
The person is protected from dangerous relationships by being cut off from good relationships.
This is not a simple choice between solitude and community. The person who isolates herself often does so because experience has taught her that community can be dangerous.
Breaking isolation therefore requires more than encouragement to be sociable.
It requires relationships that prove reliable over time.
Closeness that does not intrude.
Distance that is not punished.
A community in which the person may come and go without having to explain everything.
When the Strategy Becomes an Identity
A strategy used for a long time may come to be understood as personality.
I am simply someone who needs control.
I am cold.
I am difficult.
I cannot tolerate closeness.
I am self-destructive.
I am someone who always helps others.
In this way, what the person did in order to survive becomes a claim about who she is.
This can make change threatening.
If the control disappears, who am I then?
If I am no longer the strong one, what remains?
If I stop punishing the body, do I deserve care?
Change therefore involves more than giving up an action. It may involve losing an identity that has provided coherence.
Help must make room for this loss.
The strategy was not only a problem.
It was part of the way the person knew herself.
The Helper’s Desire for Rapid Results
Within helping systems, there may be strong pressure towards visible change.
The self-harm must stop.
Eating must stabilise.
Absence must decrease.
Control must be challenged.
The person must participate more.
These may be necessary goals. But if the goal comes before understanding, the help may be experienced as another struggle over control.
The helper sees the risk and wants to act.
The person knows the function and holds on.
Both may be right.
The action is dangerous.
And it helps.
The ethical task lies in holding both truths at the same time.
We must protect you from what harms you.
And we must understand what you risk losing if it is taken away.
This duality requires patience.
It does not tolerate moral shortcuts well.
Asking Before Removing
An important question may be:
What would happen if you stopped tomorrow?
Not what ought to happen.
But what the person fears would happen.
I would not be able to calm myself.
The memories would come.
I would feel the body too strongly.
I would lose control.
I would not know who I was.
The answers reveal what the new solution must be able to contain.
It is not enough to replace self-harm with “think positively.”
It is not enough to replace control with spontaneity.
It is not enough to replace isolation with a social demand.
A new strategy must be able to offer some of what the old strategy provided:
calm,
boundaries,
control,
distraction,
protection,
language,
belonging.
Otherwise, it remains merely advice.
Harm Reduction as Respect for Reality
Sometimes a harmful strategy cannot stop immediately.
In such situations, harm reduction may be a more realistic and respectful approach.
Not because the harm is accepted as desirable, but because the person is met where she actually is.
How can the situation become slightly safer?
How can the risk be reduced?
What can be postponed?
Who can be contacted?
What can be done before the action?
What can help afterwards?
In this way, complete change does not become a condition for receiving help.
The person does not first have to succeed in order to deserve support.
Small shifts may be significant.
A little more time between impulse and action.
A little less harm.
One person who knows.
One alternative way of calming oneself.
One experience of choosing something different.
Change is not always a clean break.
It may be a gradual transfer of function from one strategy to another.
The New Must Be Strong Enough
It is easy to suggest gentle alternatives.
Take a bath.
Go for a walk.
Call a friend.
Breathe slowly.
Sometimes these things help. At other times, the suggestions are far too weak in relation to what the strategy is actually regulating.
An action that has kept powerful memories, bodily distress, and self-hatred at a distance cannot necessarily be replaced by a cup of tea.
The alternative must be strong enough.
It must be available when the crisis comes.
It must withstand repetition.
It must provide a real experience of influence.
It must be usable without shame.
For some, this may be contact with another person.
For others, physical activity, cold, rhythm, writing, sleep, meditation, or clear agreements.
There is no single replacement suitable for everyone.
The point is not that the strategy should be exchanged for something more respectable.
The point is that the person should gradually gain more possibilities.
From One Necessary Solution to Several Possible Choices
A survival strategy becomes especially dangerous when it is the only one.
If self-harm is the only way of regulating distress, the action gains enormous power.
If isolation is the only form of safety, loneliness becomes almost unavoidable.
If work is the only source of value, rest becomes threatening.
Change may therefore be understood as expansion.
Not:
You are not allowed to do this.
But:
You should not have to depend on this alone.
One new way of asking for a pause.
One relationship in which a no is respected.
One bodily experience that does not require punishment.
One possibility of calming oneself without disappearing.
When more possibilities exist, the strategy can become a choice rather than a compulsion.
And what can be chosen may eventually also be left behind.
Gratitude Towards What Saved
It may seem strange to meet a harmful strategy with gratitude.
But for some, this may be necessary.
The action did not arise in order to destroy life.
It arose in order to make life possible.
Perhaps the person can say:
You helped me endure.
You gave form to something for which I had no words.
You protected me from more than I could bear.
You also harmed me.
And now I need other ways of living.
This attitude differs from self-contempt.
It makes it possible to say farewell without pretending that the strategy never mattered.
Some solutions must be honoured before they can be left behind.
When Protection No Longer Recognises Time
Survival strategies often have one fundamental problem:
They do not know that time has passed.
The body responds as though danger were still present.
Control works as though no boundary will ever be respected.
Isolation protects as though all relationships were dangerous.
Self-punishment continues as though the child still carried the guilt.
The strategy remains faithful to an old reality.
It attempts to protect the person today from something that happened before.
Change does not begin by calling the strategy irrational.
It begins by helping the body and the person discover the difference:
That was then.
This is now.
That person had power.
This relationship can be stopped.
That door was closed.
This one can be opened.
I was a child.
I have more possibilities now.
Help That Does Not Take the Person Away from Herself
Good help must be able to hold the paradox.
It must be clear about risk without turning the person into a problem.
It must support change without violating the function.
It must be able to say:
I see that this harms you.
I also see that it has helped you.
We will not tear it away before we understand what it is holding up.
And we will not leave you alone with the consequences.
This is a different form of help from one that merely corrects behaviour.
It meets the person as someone who has tried to survive, not as someone who has failed to live correctly.
A Sentence for the Strategy
Perhaps the old strategy needs to hear:
You came when I had nothing else.
You helped me endure what I could not understand.
You gave me control, distance, or calm.
But the price has become too high.
You do not have to disappear on command.
Nor do you have to remain my only possibility.
I will try to find other ways of protecting myself.
Ways that do not harm the body you were trying to save.
What Comes Afterwards
The way out of a harmful strategy is rarely straight.
The person may relapse.
Return to what is familiar.
Use the action on a difficult day.
This does not mean that all change was false.
It means that the strategy still exists as a well-worn path through pain.
An old path does not become overgrown because one chose a new one once.
The new path must be used many times.
And when the person returns to the old one, she does not need more shame.
She needs help to understand:
What happened?
What was missing?
What became too much?
What can be built more strongly next time?
In this way, relapse becomes not a verdict, but information.
Living Without Having to Harm Oneself in Order to Survive
The final aim is not merely to make a particular action stop.
It is to create a life in which the action is no longer necessary.
A life with boundaries that are respected.
Relationships that can bear truth.
A body that receives care.
Feelings that can come in tolerable amounts.
Rest without loss of worth.
Anger that can become language.
Closeness that can be stopped.
Help that does not take over.
Then what once helped and harmed at the same time may gradually lose its task.
Not because the person finally pulled herself together.
But because life became safer than the strategy.
That is an important distinction.
The survival strategy was never evidence of weakness.
It was an expression of a human being trying to continue.
But a human being deserves more than surviving through actions that repeatedly cause harm.
A person deserves a life in which protection no longer has to take the form of punishment.
Where the body does not have to be wounded for pain to become real.
Where calm does not have to be purchased through absence.
Where safety may come from relationships, boundaries, and a gradually reclaimed ownership of one’s own life.
The final aim is not merely to make a particular action stop.
It is to create a life in which the action is no longer necessary.
This essay was developed through a new reading of the focus-group discussions and in-depth interviews that formed the foundation of my doctoral dissertation, A Study of Shame (2009). The text is part of the series Conversations About Shame and was written in conversation with OpenAI/ChatGPT.
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