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Self-Injury: Types, Causes and Treatment
There is no simple portrait of a person who
intentionally injures him/herself. This behavior is not limited
by gender, race, education, age, sexual orientation, socio-economics,
or religion. However, there are some commonly seen factors:
Self-injury more commonly occurs in adolescent
females. Many self-injurers have a history of physical, emotional
or sexual abuse. Many self-injurers have co-existing problems
of substance abuse, obsessive-compulsive disorder (or compulsive
alone), or eating disorders. Self-injuring individuals were
often raised in families that discouraged expression of anger,
and tend to lack skills to express their emotions. Self-injurers
often lack a good social support network. What are the types
of self-injury?
The most common ways that people self-injure
are:
cutting burning (or "branding" with hot objects)
picking at skin or re-opening wounds hair-pulling (trichotillomania)
hitting (with hammer or other object) bone-breaking head-banging
(more often seen in autistic, severely retarded or psychotic
people) multiple piercing or multiple tattooing Throughout
history, various cultures have intentionally created marks
on the body for cultural or religious purposes. Some adolescents,
especially if they are with a group engaging in such practices,
may see this as a ritual or rite of passage into the group.
However, beyond a first experiment in such behavior, continued
bodily harm is self-abusive. Most self-injuring adolescents
act alone, not in groups, and hide their behavior. There are
also some more extreme types of self-mutilation, such as castration
or amputation, which are rare and are associated with psychosis.
How does self-injury become addictive?
A person who becomes a habitual self-injurer usually follows
a common progression:
the first incident may occur by accident, or
after seeing or hearing of others who engage in self-injury
the person has strong feelings such as anger, fear, anxiety,
or dread before an injuring event these feelings build, and
the person has no way to express or address them directly
cutting or other self-injury provides a sense of relief, a
release of the mounting tension a feeling of guilt and shame
usually follows the event the person hides the tools used
to injure, and covers up the evidence, often by wearing long
sleeves the next time a similar strong feeling arises, the
person has been "conditioned" to seek relief in the same way
the feelings of shame paradoxically lead to continued self-injurious
behavior the person feels compelled to repeat self-harm, which
is likely to increase in frequency and degree Why do people
engage in self-injury? Even though there is the possibility
that a self-inflicted injury may result in life-threatening
damage, self injury is not suicidal behavior. Although the
person may not recognize the connection, SI usually occurs
when facing what seems like overwhelming or distressing feelings.
The reasons self-injurers give for this behavior
vary:
self-injury temporarily relieves intense feelings,
pressure or anxiety self-injury provides a sense of being
real, being alive - of feeling something injuring oneself
is a way to externalize emotional internal pain - to feel
pain on the outside instead of the inside self-injury is a
way to control and manage pain - unlike the pain experienced
through physical or sexual abuse self-injury is a way to break
emotional numbness (the self-anesthesia that allows someone
to cut without feeling pain) self-abuse is self-soothing behavior
for someone who does not have other means to calm intense
emotions self-loathing - some self-injurers are punishing
themselves for having strong feelings (which they were usually
not allowed to express as children), or for a sense that somehow
they are bad and undeserving (an outgrowth of abuse and a
belief that it was deserved) self-injury followed by tending
to wounds is a way to express self-care, to be self-nurturing,
for someone who never learned how to do that in a more direct
way harming oneself can be a way to draw attention to the
need for help, to ask for assistance in an indirect way sometimes
self-injury is an attempt to affect others - to manipulate
them, make them feel guilty or bad, make them care, or make
them go away What is the relationship between self-injury
and suicide? Self-injury is not suicidal behavior. In fact,
it may be a way to reduce the tension that, left unattended,
could result in an actual suicide attempt. Self-injury is
the best way the individual knows to self-sooth. It may represent
the best attempt the person has at creating the least damage.
However, self-injury is highly linked to poor sense of self-worth,
and over time, that depressed feeling can evolve into suicidal
attempts. And sometimes self-harm may accidentally go farther
than intended, and a life-threatening injury may result.
What can you do to help a friend or family
member who is a self-injurer? It is very hard to realize
that someone you care about is physically harming herself
or himself. Your concern may come out in frustration and even
comments that can drive the person farther away.
Some things that might be helpful are:
understand that self-harming behavior is an
attempt to maintain a certain amount of control, and that
it is a way of self-soothing let her or him know that you
care and that you will listen encourage expression of emotions,
including anger spend time doing enjoyable activities together
offer to help find a therapist or support group do not tell
the person to stop the behavior or make judgmental comments
- people who feel worthless and powerless are even more likely
to self-injure if you are the parent of a self-injuring child,
prepare yourself to address your family's difficulties with
expression of feelings, as this is a common factor in self-injury
- this is not about blame, but about a learning process that
will help the entire family How can a self-injuring person
stop this behavior? Self-injury is a behavior that becomes
compulsive and addictive. Like any other addiction, even though
other people think the person should stop, most addicts have
a hard time just saying no to their behavior - even while
realizing it is unhealthy.
There are several things to do to help yourself:
acknowledge that this IS a problem, that you
are hurting on the inside, and that you need professional
assistance to stop injuring yourself. realize that this is
not about being bad or stupid - this is about recognizing
that a behavior that somehow was helping you handle your feelings
has become as big a problem as the one it was trying to solve
in the first place. find one person you trust - maybe a friend,
teacher, minister, counselor, or relative - and say that you
need to talk about something serious that is bothering you.
get help in identifying what "triggers" your self-harming
behaviors and ask for help in developing ways to either avoid
or address those triggers recognize that self-injury is an
attempt to self-sooth, and that you need to develop other,
better ways to calm and sooth yourself try some substitute
activities when you feel like hurting yourself - there are
some examples here, and many more that can be found online
(links are provided below): if cutting is a way to deal with
anger that you cannot express openly, try taking those feelings
out on something else - running, dancing fast, screaming,
punching a pillow, throwing something, ripping something apart
if cutting is a way to feel something when you feel numb inside,
try holding ice or a package of frozen food, taking a very
hot or very cold shower, chewing something with a very strong
taste (like chili peppers, raw ginger root, or a grapefruit
peel), or snapping a rubber band hard on your wrist if cutting
is a way to calm yourself, try taking a bubble bath, doing
deep breathing, writing in a journal, drawing, or doing some
yoga if cutting involves your having to see blood, try drawing
a red ink line where you would usually cut yourself, in combination
with other suggestions above How is self-injury treated? One
danger connected with self-injury is that it tends to become
an addictive behavior, a habit that is difficult to break
even when the individual wants to stop. As with other addictions,
qualified professional help us almost always necessary. It
is important to find a therapist who understands this behavior
and is not upset or repulsed by it. Some of the online resources
below offer links for referrals to therapists experienced
with self-injury.
Cognitive-behavioral therapy may be used to
help the person learn to recognize and address triggering
feelings in healthier ways. Because a history of abuse or
incest may be at the core of an individual's self-injuring
behavior, post-traumatic stress therapies may be helpful.
Interpersonal therapy is also the main treatment for the underlying
issues of low self-worth that allowed this behavior to develop.
Hypnosis or other self-relaxation techniques are helpful in
reducing the stress and tension that often precede injuring
incidents. Group therapy may be helpful in decreasing the
shame associated with self-harm, and in supporting healthy
expression of emotions. Family therapy may be useful, both
in addressing any history of family stress related to the
behavior, and also in helping family members learn to communicate
more directly and non-judgmentally with each other. In some
situations, an antidepressant or anti-anxiety medication may
be used to reduce the initial impulsive response to stress,
while other coping strategies are developed. A recent treatment
involves an in-patient hospitalization program, with a multi-disciplinary
team approach.
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About the Author:
Listen to Arthur Buchanan on the Mike Litman Show!
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here to listen.
With Much Love, Arthur Buchanan
President/CEO Out of Darkness & Into the Light
43 Oakwood Ave. Suite 1012 Huron Ohio, 44839
www.out-of-darkness.com 567-219-0994 (cell)
Article Source, www.goarticles.com.
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