By Pat Somers*, M.A., LCPC
Reports from hospital emergency rooms, inpatient psychiatric facilities, private counseling agencies and high school counselors and social workers describe increasing rates of self-injurious behavior. Parents and professionals alike often misunderstand this behavior, which is defined as the deliberate effort to harm oneself physically, but not lethally.
Methods of self-injury are varied and limited only by the victims’ resources and imagination and may range from superficial scratches to the skin to lacerations deep into muscle. The wrists and forearms are the most frequently reported sites of injury, but injury to the face, genitals, abdomen, hips, legs and breasts also occurs. Cutting, scratching and burning are the most common methods.
Is self-injurious behavior usually associated with other problems?
Those who self-mutilate often experience intense distortion of body image and/or confusion about their sexual identity. Attempts to control these negative perceptions often result in behaviors designed to modify or correct the faulty body image. Some investigators have found a correlation between eating disorders, childhood abuse and neglect and self-mutilation. For example, as many as 26% of female patients with bulimia have been found to engage in cutting or burning behaviors.
Is most self-mutilation really a subtle attempt at suicide?
Self-mutilating behaviors do not generally reach the lethal levels of suicide attempts. Lader and Conterio, originators of the S.A.F.E Alternatives Programs, note that self-mutilation is usually a way to cope with distress, rather than a way to end one’s life. Also, overt suicide attempts typically bring a response from an individual’s environment which results in an offer of assistance. On the contrary, individuals who self-wound usually seek to conceal their behavior and as a result receive less aid.
How can cutting, burning, interfering with wound healing, and other forms of self-harm make a person feel better?
Self inflicted injuries are a way that individuals cope with overwhelming negative internal emotions, often feelings that are related to past trauma or abuse. A widely accepted explanation for self-injury is that the behavior brings immediate, though temporary, relief from intense emotional distress, perhaps due to a release of endorphins following the self-injurious act. To the individual, the behavior is a remedy for mounting anxiety or depersonalization and thus serves a “therapeutic purpose.” It is also believed that self-mutilation is used by some individuals to end a dissociative episode (a feeling of being “unreal”), bringing them back to an awareness of their bodies in the present time. Cutting or burning can also be a way of externalizing internal pain.
Isn’t self-mutilation just a “stage” that kids go through and if teachers and parents give kids attention for it, it will just make it worse?
Most self-mutilators try to keep their behavior a secret and do not use it as an attempt to seek attention. Research indicates that self-injurious behavior is higher among people who lack the emotional regulatory benefit that secure attachment provides. Thus, when parents, teachers or friends ignore their self-inflicted wounds it tends to reinforce their self-perception that they are insignificant and disposable. This may be experienced as further abandonment and lead to subsequent bouts of self-injury. Self-injury is not a problem that goes away if ignored.
Are people who harm themselves dangerous and likely to hurt others?
Like the unfortunate misconception often held regarding those suffering from any form of mental illness, people who self-mutilate are often thought to be dangerous. In fact most of them continue to engage in their daily activities and pose no threat of harm to others.