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Understanding Self Injury (Cutting)

Most people with self injury disorder harm themselves as a way to cope with emotional pain, using mild physical injury as a way to manage problems and distress in life. As emotional pain builds, a person might cut or burn themselves as a way of dealing with this pain and after the cutting or the burning, the emotional pain would subside for a while.

However, since cutting or burning yourself does nothing to solve genuine problems in life, emotional pain inevitably resurfaces, and with it comes the urge to harm yourself again as a way to manage that pain, if only for a short while.

Self injury is also commonly known as self harm, self mutilation and self abuse. People often use self harm, by cutting themselves, for example, as a way to handle strong emotions that aren’t manageable in other ways. Although people engaging in self harm are not trying to kill themselves or inflict severe injury, accidents can happen and so people who harm themselves are at risk of serious injury or even death.

Behaviors are considered to meet the criteria for self injury when:

  • They are repeated, they are done impulsively and with intent, and they are not intended as suicidal acts.

More common types of self injury include:

  • Cutting
  • Scratching
  • Burning
  • Biting oneself
  • Sticking oneself with a needle
  • Punching self or other objects
  • Intentionally infecting oneself
  • Inserting objects into bodily orifices
  • Hair pulling
  • Drinking something harmful, like detergent
  • Breaking bones or bruising oneself1

Who Gets Self Injury Disorder?

  • It is estimated that about 2 million Americans engage in self harm behaviors.
  • People who self harm are more likely teenagers or young adults and more likely women than men.
  • According to the International Society for the Study of Self Injury, between 12% and 24% of adolescents have harmed themselves at some point and between 6% and 8% of adolescents suffer from a current chronic condition of self injury.2

People from all races, socioeconomic statuses and backgrounds will harm themselves, but there are certain types of people who are at increased risk to harm themselves, including:

  • People who have suffered sexual, physical or emotional abuse
  • People who grew up in families where anger could not be openly expressed
  • People with substance abuse problems, eating disorders or obsessive compulsive disorder
  • People who cannot express emotions easily and who lack close friends and family3

Why Do People Hurt Themselves on Purpose?

Some common reasons why people engage in self harm include:

  • As a way to regulate or manage emotional pain or anxiety
  • As a way to feel anything at all when feeling numb
  • As a way to exert control over your body
  • To communicate with others to show others your pain (even if you can’t put it into words). Self harm could be a way to ask for the help that you want, but cannot ask for verbally
  • To influence the behaviors of others (to get someone to stop ignoring you, for example, or to make someone feel guilty)4
  • To feel physical pain for a while, instead of the emotional pain

What Are the Risks and Dangers of Self Harm?

  • People tend to use self harm as a way to manage emotional distress. Of course, this does not solve any underlying  problem that are causing this pain and unresolved emotional pain can lead to other problems, such as substance abuse etc.
  • People who self injure may not intend to do significant harm, but when cutting or burning, accidents can happen that result in serious trauma.
  • People who self harm are at greater risk of suicidal thoughts, having a suicide plan and suicide attempts. The link between self harm and suicide is not clearly understood, but it is hypothesized that though self harm is not about suicide, it is about dealing with emotional pain and distress. When emotional pain and distress overwhelms, suicide may become an option for consideration. Some research suggests that people with a history of self harm are as much as 9 times more likely to attempt suicide than people without such a history.5

What Are the Warnings Signs of Self Harm?

Worried that someone you love may be harming themselves (cutting, burning, banging their head etc.)? Learn the warning signs of self injury so that you can recognize the behavior when you see it and intervene at the earliest opportunity.

People who engage in self injury typically harm themselves severely enough to leave marks or scars. While this is hardly ‘good news’ it at least provides evidence of the behavior and enables watchful loved ones to recognize the problem.

Are you worried that someone you love may be harming themselves? Look for these warning signs that may point to the existence of a self injury problem:6 7

  • Wearing long sleeves or long pants all the time, even in very hot weather
  • Refusing to participate in activities that would require revealing parts of the body (going swimming, for example)
  • Having frequent excuses for small injuries (a cat that scratches all the time)
  • Experiencing small injuries with unusual frequency
  • Having blood stains on clothing or bedding
  • Not letting anyone else do personal laundry (to hide blood)
  • Having tools of self harm without good reason, for example, a non smoker carrying around a cigarette lighter for no apparent purpose
  • The person becomes very defensive when asked about injuries or behaviors
  • The person chooses to spend an inordinate amount of time alone
  • The person has low self esteem
  • The person has problems handling intense emotion and dealing with interpersonal relationships
  • The person is having troubles at work or at school

What Do I Do If Someone I Love Is Harming Themselves?

If you discover that someone you love is engaged in self harm, it’s important that your reaction to the situation not make the situation worse than it already is – and hysterics, anger and threats won’t help and may very well hurt!

People who self harm tend to try to hide their behaviors and may feel guilt and shame about what they do. If you turn a discussion on their self harm into a very negative experience they may be less willing to reveal the truth of their behaviors at present and in the future.

When you discover the behavior:8

  • Make sure you are calm and collected and ideally informed when you go ahead and bring the subject up
  • Do not react to self harm with anger or threats of punishment or judgment. If a person is cutting as the only way they know how to handle emotional pain – then creating more pain for them is not an optimal solution.
  • Do not belittle or minimize the problem – do not say they are only doing it, “to get attention”
  • Do not attempt to fix the problem on your own – this is a situation where professional help is needed.
  • Do ask them calmly about how often they are harming themselves and do tell them that you are happy to now be aware of the situation and that you want them to feel better so that they won’t need to do this anymore.
  • Do encourage them to talk to a counselor who is experienced in dealing with people who self harm
  • Do ask them if they are feeling suicidal. If they say that they sometimes have suicidal thoughts then take them to a counselor for help. If they say that they sometimes have suicidal thoughts and have a plan ready for a suicide attempt then take them immediately to an emergency room for a psychiatric evaluation.

How Is Self Harm Treated?

Self injury is a tool used to handle emotional pain. What needs to happen is not only that the self harm behaviors come to an end, but that those things in life which cause such strong emotional pain also be dealt with. Since self injury is associated with a number of other conditions, such as depression, OCD and anxiety as well as with things like a history of abuse or trauma, there is no one-size-fits-all therapeutic solution.

What’s important is that you find a therapist that’s experienced in dealing with self harm and with people of your age group. From there, a better diagnosis of the problem can be made and an appropriate plan of action developed.

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