Self-injury, or self-harm, is an act in which an individual intentionally harms their own body through a number of different methods such as cutting or burning. This behavior is not typically meant as a suicidal act but is an unhealthy way in which an individual cope with emotional pain, intense anger, or serious frustration. However, there are times that some people unintentionally hurt themselves badly enough to cause death. While in the moment self-harm brings an individual a sense of calm and release of tension, after a short period of time those feelings are replaced by feelings of guilt and shame before the original painful emotions return. While the most common form of self-injury is cutting, other forms of self-harm may include:
- Hitting or punching
- Carving into the skin
- Breaking bones
- Piercing the skin
- Pulling out hair
- Constantly picking at or interfering with a healing wound
Usually individuals will target the legs, arms, and front torso for their mutilating behavior because these areas can be easily reached and hidden under clothing.
There are a variety of reasons why an individual may self-injure and the mixture of emotions that may trigger self-injury are very complicated. Some engage in cutting to cope with emotional pain and distress, especially feelings of self-hatred, worthlessness, loneliness, panic, rejection, confused sexuality, guilt, and sadness. It can be very confusing for someone who does not engage in self-injury to understand this behavior. Through engaging in self-harm, a person may be trying to:
- Provide a distraction from distressing emotions
- Manage or reduce severe distress or anxiety
- Feel a needed sense of control over his or her body, feelings, and/or life circumstances
- Punish him or herself for perceived faults
- Externally express internal emotions
- Feel anything at all – even physical pain – when he or she feels empty inside
- Communicate depression or other distressing feelings to the external world
Self-harm is most often a behavior that one engages in behind locked doors. While self-injury may help some people cope with their problems, unfortunately the relief they experience is short-lived and tends to eventually only make matters worse. The good news is that with the proper therapy, medication, and self-care, most people who engage in self-injury are able to recover.
Since most individuals who engage in self-injurious behavior keep their habit a secret, the statistics for self-injury are likely skewed. In the United States, each year approximately 2 million cases of self-harm are reported. Most people who cut begin to self-injure in the teen years— 90% of people who engage in this behavior begin during these years. Each year, one in five women and one in seven men engage in some form of self-injury.
Causes and risk factors for self-harm
It’s thought that self-harming behaviors are not the result of one single factor but rather a number of causes and risk factors. The most common causes for self-injury may include the following:
Genetic: Many mental illnesses that can trigger cutting urges, such as borderline personality disorder and depression, are thought to have genetic components. People who are born into families that have a history of mental illness are at a greater risk for developing the disorder themselves.
Physical: A great number of mental illnesses lead to imbalances in the levels of certain neurotransmitters in the brain that are involved in emotional regulation. People with these imbalances may self-injure in order to experience any emotions at all. Additionally, physical injury to the body results in a flood of pleasurable chemicals into the body.
Environmental: People who experienced abuse, especially as a child, are at a greater risk for self-injury later in life. These people may not have been able to express their emotions in a healthy way as children and use self-injury as a means to express their overwhelming emotions and cope with the trauma.
- Being female
- Being in teens and early 20s – most people who cut themselves often begin as teenagers and young adults
- Having friends who also self-injure
- Unstable personal identity or sexuality
- Mental health disorders
- Drug and alcohol abuse and addiction
Signs and symptoms of self-harm
Since the methods of self-injury vary, it can be hard to determine if your loved one is engaging in self-injury. Some common symptoms of self-injury include:
- Wearing long pants or long-sleeved shirts even in the summer
- Claiming to have frequent “accidents”
- Spending a lot of time alone
- Challenges with interpersonal relationships
- Keeping sharp objects on hand
- Withdrawing from social situations and other people
- Unpredictable behaviors
- Impulsivity and unpredictability
- Bloody clothing, towels, or bedding
- Scars from burns or cuts
- Fresh scratches or cuts
- Broken bones
- Patches of missing hair
- Persistent questions about personal identity
- Thoughts of helplessness, hopelessness, or worthlessness
- Emotional numbing
- Emotional instability
- Mood swings
- Increasing anxiety, especially when unable to self-injure
Effects of self-harm
Even though self-injury is not considered a suicidal act, it can still leave an individual with a vast number of long-term effects. The consequences associated with self-injury can range from minor irritations to extremely serious injury and death. It is extremely important that people who self-injure seek treatment from a qualified professional as soon as possible in order to reduce the risk of any further or permanent damage. Effects from self-harm will depend upon the way in which an individual has chosen to harm themselves, but the most common long-term effects include:
- Injured tendons, nerves, blood vessels, and muscles
- Permanent weakness or numbness in certain areas such as the hand
- Loss of a limb
- Brain damage
- Organ damage
- Broken bones
- Social isolation
- Feelings of shame, disgust, and guilt
- Poor self-esteem
- Worsening mental health conditions
- Worsening physical health
- Loss of interpersonal relationships
- Suicide or suicidal behaviors
- Accidental death
Types of self-harm treatment
Our treatment approach for self-harm acknowledges that each individual faces multiple pressures in life that are unique to him or her. We teach our clients that in order to become a healthier person, treatment must include developing healthy expression of emotions, community involvement, teamwork, openness to alternative viewpoints, and accountability for one’s own actions. Once an initial assessment has been completed to determine the patient’s presenting problem and potential level of care that will best fit their needs, a face-to-face assessment will be scheduled. Based upon the results of the assessment a treatment plan will be developed. Some of the treatment approaches we use to help treat your self-harming behaviors may include:
Individual therapy: All of our patients in our treatment center meet one-on-one with a therapist. During these sessions, individuals can take the time to delve deeper into the emotions that may have led to the development of self-harm. Therapists will often use cognitive behavioral therapy to help patients identify their negative thoughts and replace them with more positive ways of viewing the world.
Group therapy: Group sessions focused on coping skills, life skills, and mental health education.
Family involvement: Family therapy can be an essential part of the treatment process at for self-harm. Family members will get a chance to learn more about why their loved one self-harms and ways in which they can be more supportive.
In addition to traditional therapeutic methods we offer a number of experiential treatment options which you will most likely participate in.
Helping a loved one get treatment for self-harm
Finding out about a love one who self-injures can be upsetting and leave you at a loss for what to do next. Many individuals tend to experience feelings of shock, confusion, and frustration. Others may fear that their loved one will actually commit suicide. Here are some tips that can help you and your family cope with having a loved one who self-harms:
- Get educated: Take the time to educate yourself about self-injury so you can better understand why it occurs. This will help you develop a more compassionate approach to helping your loved one.
- Try not to judge or criticize: Yelling, criticizing, or being extremely angry at your loved one will only make the behavior worse.
- Let them know you are there no matter what: Remind your loved one that they are not alone and that you are always there for them to talk to.
- Share coping strategy ideas: It may be beneficial for your loved one to hear strategies you use in order to help cope with distressing feelings.
- Suggest they seek treatment: Talk to your loved one about how treatment may be beneficial to them and offer to help them find a program and go with them to all of their appointments.
- Take care of yourself: Remember that in addition to helping your loved one you also need to take time to do some of the things you enjoy. Make sure that you get enough rest and that you find someone you trust to talk to about what you are going through.
Most importantly remember to take all talk of self-injury seriously; it is a serious problem and should not be ignored.