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People who self-harm are not usually seeking to end their own life; it has been suggested instead that they are using self-harm as a coping mechanism to relieve emotional pain or discomfort or as an attempt to communicate distress.
About half of 'Alternative' adolescents' self-injure, primarily to regulate emotions and communicate distress.
Alcohol and drugs may not only have interfered with the ability of the deceased to communicate distress effectively.
While Alternative teenagers are more likely to use self-injury to communicate distress or seek help they frequently self-injure to regulate their emotions.
Several accounts suggest that the deceased may have tried to communicate distress but failed to do so effectively or gave oblique and ambiguous signals.
Over time, significant others may come to disregard talk induced by drink, so that further attempts to communicate distress and even suicidal ideation are ignored: Father: "She said, if you don't get him out Dad, I'll top myself.
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Therefore, communicating distress towards other individuals (e.g. pair-partners) may be important in order to prepare for action, namely to actively support the partner in an encounter.
NSSI has autonomic (it reduces negative emotions) and social (it communicates distress or facilitates group 'bonding') functions.
Alluhire should thus not only be understood as a local syndrome, but also as an 'idiom of distress': a culturally prescribed way of communicating distress.
These fell into three broad categories: difficulties faced by the suicidal person in effectively communicating distress, difficulties experienced by significant others in interpreting and heeding distress signals, and difficulties experienced by significant others in taking action.
A code word ("fireplace") was in place if they had to communicate genuine distress to visitors.
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