What is self-injury? It is the deliberate mutilation of your own body, with the intent to cause injury or damage, but without the intent to kill yourself. It includes:
1. Sudden and recurrent intrusive impulses to hurt oneself, without the perceived ability to resist.
2. A sense of being “trapped” in an intolerable situation that one can neither control nor cope with
3. An increasing sense of agitation, anxiety, and anger
4. When in this state, a constricted ability to problem-solve or to think of reasonable alternatives for action
5. A sense of psychic relief after the act of self-harm
6. A depressive or agitated-depressive mood, although suicidal ideation is not typically present (Pattison &Kahan, 1983)
Broad estimates are that about one percent of the total U.S. population, or between 2 and 3 million people, exhibit some type of self-abusive behavior. But that number includes those with eating disorders like anorexia, as well as those who self injure. In the U.S., it’s estimated that one in every 200 girls between 13 and 19 years old, or one-half of one percent, cut themselves regularly. Those who cut comprise about 70 percent of teen girls who self injure. Treatment visits for teens who self injure have doubled over the past three years. And those numbers are expected to grow as life becomes more complex for teenagers. Directors at self-injury treatment programs refer to this growth trend as an epidemic that reaches even into middle schools.
The profile of a typical self-injurer looks like this. She’s female in her mid-20’s to early 30s, and has been cutting herself since her teens. She’s intelligent , middle or upper-middle class, and well educated. She also comes from a home where she was physically and/or sexually abused and has at least one alcoholic parent.
The most frequent methods of self-injury include:
· Cutting the skin with a knife or razor blade
· Burning (e.g. with a cigarette or heated metal)
· Scratching the skin with fingernails hard enough to draw blood
· Biting yourself, including extreme episodes of nail biting
· Interfering with the healing of wounds (e.g. compulsively picking at scabs)
· Scalding hot showers
· Head banging
· Ingesting sharp or toxic objects (e.g. razor blades, pines, cleaning fluids)
Self-injurious behavior should be viewed as well as treated as an addiction. Actually, it may be the root to understanding all other addictions. According to Webster’s dictionary, “addict” is to “devote or surrender (oneself) to something habitually or obsessively.” “Addiction” is “compulsive need for and use of a habit-forming substance.” Addictions can be categorized as the following:
1. Alcohol and drug addictions
2. Behavioral addictions, which involve compulsive and obsessive thought processes. (includes self-injury, anorexia, bulimia, compulsive overeating, over exercising ,etc.)
Someone who self-injures typically engages in a behavior that is habit forming and that takes on an obsessive quality, with repetitive behavior of increasing frequency and intensity. Many who self-injure also struggle with alcohol, drugs, and/or eating disorders. Self-injury is usually not learned by direct observation, but rather by picking up on subconscious cues in the environment. For example, a young girl who is being physically or sexually abused may subconsciously learn that when someone inflicts pain on her body, she can escape for a while. Therefore, whenever she wants to escape again, she inflicts pain on herself. The issues or feelings which are usually especially hard for people who self-injure to tolerate without escaping are:
· Sexual arousal
· Mixed messages from other people, which cause frustration and confusion
Favazza (1998 ) writes that “SM (self-mutilation) can best be understood as a morbid self-help effort providing temporary relief from feelings of depersonalization, guilt, rejection, and boredom as well as hallucinations, sexual preoccupations, and chaotic thoughts.” He also states that self-mutilating behaviors provide temporary relief from the distressing symptoms of mounting anxiety, racing thoughts and rapidly fluctuating emotions. Among the effects of self-mutilating behavior are tension release; termination of depersonalization; euphoria; decreased troublesome or enhanced positive sexual feelings; release of anger; satisfaction form self-punishment; a sense of security, control, and uniqueness; manipulation of others; and relief from feelings of depression, loneliness, loss, and alienation.
Briere and Gil (1998 ) suggest that any effective treatment interventions would include the following:
1. Most immediately, exploration of alternate methods of reducing distress that are less injurious or shame-inducing (e.g. physical exercise, distraction, changing environments, or contacting friends or hotlines)
2. Teaching cognitive and behavioral strategies for dealing with stressful situations and painful emotional states
3. Strengthening internal emotional regulation capacities and strategies (ability to control internal emotional ups and downs), so that external methods life self-mutilation become less necessary
4. Ultimately, reducing the distress and dissociative symptoms that may underlie and motivate self-mutilation
If you have a problem with this, let me encourage you to get help from a professional. Someone who is warm, supportive, and knowledgeable about this would be best.
This is just a little information on this topic. If there is more interest, I’ll be glad to pursue this topic in further detail.
Briere, J. and Gill, E. 1998. Self-mutilation in clinical and general population samples: Prevalence, correlates, and functions. American Journal of Orthpsychiatry 68 (4): 609-20
Favazza, A. 1998. The coming of age of self-mutilation. The Journal of Nervous and Mental Disease 186, no 5 (May): 259-68
Pattison, E. and Kahan, J. 1983. The deliberate self-harm syndrome. American Journal of Psychiatry 140, no. 7 (July) 867-72.