My son, who at 26 suffers from paranoid schizophrenia with voices, attempted suicide twice this spring and has been self harming for years. He is unmedicated (stops taking medication as soon as he is out of the hospital). He has never shown the least sign of aggression towards me or anyone else, but I am concerned that self-harm could turn into other harm. Does anyone have experience with their loved one self-harming and that changing into harming others?
From a DXed perspective, I think it’s unlikely. The internal dynamics of self harm center around release, relief or escape from sensation or mental pain. I had a therapist tell me once (or I may have read it) depression is anger directed within.
A shift of anger toward other people and the outside world would likely manifest outwardly first and escalate before shifting to violence of revenge, “defense” or retribution toward others. Talk of conspiracies, shouting and arguing, threats, agitation, destruction of property, trespass, physical confrontations short of contact usually precede violence toward others. There are rare people who quietly plot and plan and write notes and manifestos, but they’re often too tied up in their egos and quick to blame others to contemplate or commit self harm.
The same sorts of precautions and mitigation strategies with instruments of harm apply in both cases, but I’d look to past history and deviations from it to predict the future. Drug and alcohol use throws a bit of a wildcard into behavior, but in my experience users follow similar escalation patterns. My brother would get angry and shout about ending people for years until he was drinking with my brother and started to choke him. Months later he did something similar to my mother which led to police being called, a restraining order, being banned from my parents house, getting set up in a house of his own, and strict rules about visiting my parents.
His diagnosis is bipolar disorder, and to my knowledge he hasn’t attempted self harm. My thought is he thinks too much of himself to consider it.
Thanks so much for your well reasoned response Maggotbrane. I’ve been feeling afraid at times because I hear so much about violence from people suffering from schizophrenia. It is good to know that there is perhaps a build up, it doesn’t just appear out of nowhere. I’ve made some changes in the household to mitigate self-harm opportunities, but unfortunately even a toothpick can be a problem. Getting rid of all alcohol definitely helps.
In my experience schizophrenics are much more a danger to themselves than others.