What is self-injury?

[David Baxter PhD]

What Is Self-Injury?
by Desirea Black, 2001

Everyone develops ways to deal with the pain they experience, whether it is physical or emotional. Self-injury is one method that some people use. It is a practice that is largely misunderstood by doctors, the public, and family members of those who engage in self-injury. People may react to the self-injurer with disgust, anger, or fear. This may cause the self-injurer to become ashamed and to hide his or her practices rather than seeking help.

What is self-injury?
Self-injury is the act of hurting oneself on purpose. Most self-injurers engage in the behaviour as a method of coping with feelings, such as depression or hopelessness. It is not an attempt to kill oneself. Self-injury takes many different forms, including cutting, burning, scratching, hair pulling, breaking bones, hitting, head banging, and interfering with wound healing. Depending on the person, self-injurers may or may not actually feel the pain they are inflicting on themselves. For this reason, some people may injure themselves more severely than they intend.

Who self-injures?
Many different types of people use self-injury as a way to cope with emotions. Often the practice begins in the teen years. Some people believe that the practice is becoming more widespread. Self-injury is seen in patients with different psychiatric disorders, such as depression, substance abuse, post-traumatic stress disorder, and eating disorders. Many self-injurers are diagnosed as having borderline personality disorder. This diagnosis may or may not be relevant to the self-injurer and should only be made if the person exhibits additional symptoms of this disorder. However, many people are diagnosed with this disorder based on the presence of self-injury alone.

Why do people self-injure?
Many self-injurers use self-injury as a coping mechanism, a way to deal with stressful emotions or events. Often the emotions they feel are extreme and cannot be expressed verbally by the self-injurer. Some people self-injure to punish themselves, to show people how much they are hurting, or to calm themselves. Some people use it as a method of stopping disassociation, while others may use it to induce this state.

Self-injury is not a suicidal act, though many people around the self-injurer may think so. It is also not a cry for attention or an attempt at manipulation. It is believed that the act of self-injury may cause the release of certain chemicals in the brain that help to calm people.

Desirea Black is a freelance writer in Ottawa, Ontario, Canada.

 

[Gayalondiel]

As a person with a long history of self harm, I should like to expand on the reasons why a person might commit harm. In my own specific case, the cutting was often because I felt strongly out of control, and cutting was one of the few things over which I had sure and certain control, knowledge that this action would lead to the same result.

Of course this often combined with other reasons, but I find that this idea is often overlooked and should be borne in mind.

 

[David Baxter PhD]

As a person with a long history of self harm, I should like to expand on the reasons why a person might commit harm. In my own specific case, the cutting was often because I felt strongly out of control, and cutting was one of the few things over which I had sure and certain control, knowledge that this action would lead to the same result.

Hi, Gayalondiel - welcome to the forum.

You make a good point: "cutting" can be about more than one thing and trying to find a way to exert some control over what often seems to be an uncontrollable and unpredictable or uncertain world is one of the reasons. Interestingly, it is also an important component in eating disorders and obsessive-compulsive disorder.

It's not about controlling other people, by the way - that's something quite different. It's about controlling your own life and your own world, making those things more predictable. And the fact that life today is so much more stressful and "uncontrollable" and unpredictable for many people (especially young people, I think) is probably one of the reasons we are seeing an increase in the frequency of these problems or disorders.

 

[Cat Dancer]

It's not about controlling other people, by the way - that's something quite different. It's about controlling your own life and your own world, making those things more predictable. And the fact that life today is so much more stressful and "uncontrollable" and unpredictable for many people (especially young people, I think) is probably one of the reasons we are seeing an increase in the frequency of these problems or disorders.

I worry A LOT about other people thinking that I cut and burn to manipulate. I don't think I do. I go to great lengths to hide it, wear long sleeves all the time and no one ever sees my wounds except sometimes my husband. He says it is manipulation, but he really only sees it about 1 time out of every ten times that I do it. He's actually forced me down to look at my arms. He's in the medical profession so he says that is why. I'm really not sure, but it is humiliating. Of course if I didn't do it to myself nothing like that would happen.

 

[Cat Dancer]

Wow, I did the quote thing right. :O

 

[David Baxter PhD]

Yes you did, Janet... )

He says it is manipulation, but he really only sees it about 1 time out of every ten times that I do it. He's actually forced me down to look at my arms. He's in the medical profession so he says that is why. I'm really not sure, but it is humiliating.

I must say that I am surprised that someone "in the medical profession" would have so little insight or understanding... or compassion for that matter.

Of course if I didn't do it to myself nothing like that would happen.

And if he were a more compassionate and caring person it wouldn't happen either.

 

[Gayalondiel]

He says it is manipulation, but he really only sees it about 1 time out of every ten times that I do it.

If my own experience is anything to go by, then he's just plain wrong. "Attention seeking" is so often used by people who just don't understand as a way of dismissing people who ned help. Case in point: I moved to a completely new area a few months ago, and in the past weeks I've fallen back on bad habits. The community I work in is loving and caring and 100% there for each other, and I've kept it hidden. I'm actually terrified of letting anyone on the island know, for a variety of reasons (well, fears really) but uppermost is the idea that they'll think I'm doing it for attention. Surely that fear, in of itself, shows that I'm not?

Now, I don't know you, but I think I can safely say that for me its about me, not about manipulating others, and it sounds like that's the same for you. At least we know there *are* people out there who understand, right?

 

[haunting]

I would like to add something here. For myself, SI is a warning sign. Often it is something I begin to do when nothing else works. I do cut, not a lot granted. The times I have, I can't stand seeing it everyday.

The comments on how SI is not a way to attempt suicide, I have to disagree just slightly. And this is only my view. I start the process of SI as a way of punishing myself, but really, its the direction that I am considering on taking next. Its partly my way of telling myself, "Okay, do this to yourself to reinforce how unworthy you really are, then soon take the next step to complete the harm in the sense of committing that final act."

Anytime I have done SI, I have attempted suicide shortly after. I do feel that SI can be broad, its so different for everyone. By me starving myself, yes to me this is SI. I have no plan of attempting suicide; please don't get me wrong. I have thought of it day in and day out. But no plans. But recently I have cut, not bad, but have taken a razor to myself. The ED is a way of hiding it better, nobody can see that. Yes, this is a warning to my own self. But I do feel that SI can be an alarm bell going off.

Just a thought to ponder,

Haunting

 

[David Baxter PhD]

We call people "individuals" because they are... I don't doubt what you say about your own situation, Haunting, but it is nonetheless true that most "cutters" are not suicidal or intending to kill themselves, or even to punish themselves necessarily.

Generally speaking, for most people, it's about expressing something that the individual doesn't know how to express very well any other way...

 

[haunting]

Yes Dr. Baxter I do agree. I wanted to add this point in, simply because this holds true for me. I do know what you have said here and don't agrue this at all.

I have known many people who battle with SI in their daily lives. What is said here holds true for about 90% of these friends. I just know that for maybe a small percentage, my point of view is also similar for them as well.

I have never cut myself to actually kill myself, like I say, its a warning sign that suicide ideation is most likely going to take over at some point. I had this friend that was like a "twin" in our thought process. She cut so badly that she lost almost the full use of her hand. She ended up in surgery. Shortly after, she attempted suicide, thankfully she was not sucessful.

Haunting

 

[David Baxter PhD]

Your post hints at another significant problem, Haunting: sometimes cutters, even those who are NOT suicidal, unintentionally go too far... and that can cause death. That is of course one of the dangers of this disorder.

 

[haunting]

not sure

Of course SI can be accidently taken too far, without the intentions of ending ones life. This is what happened to my friend. She did try to take this further but this did not happen.

I am not hinting at a suicide plan. I wanted to share my point of view. I have no intention of commiting such an act. No plans.... really. I would not say such a thing on here. And its not allowed. I would never do that to others.

I don't agrue that suicide ideation is part of my daily life, but thinking and doing is not the same. I don't ever want to attempt this again. I keep other things in mind when the urge seems strong, and if this were the case, I would get help.

My ED is destroying me. I know this and I also am aware that my views on this are clear. I am not using this ED as a way of "exiting" purposely. There is a great deal of pain behind my ED, this is my way to deal with the pain. As odd as this may sound. I know full well if I continue, I will die. The drop by 10lbs in 5 days reminds me of this when I step on the scale for the 40th time in one day.

Haunting

 

[HA]

This article made the issue of self injury more understandable to me. I have worked with many children & adults who had severe intellectual deficits and would harm themsleves by hitting themselves or hitting against something.

Is that similar at all? Is there a physiological drive that may not be connected to an emotional drive for some people?

I have done some reading on this but do find it difficult to understand. I have never known or met anyone that self injured that I know of.

How prevalent is it? Does it begin in early adolescence? Does it occur equally in both males and females?

Thanks for letting me ask these questions.

Cheers
Judy

 

[Ash]

Judy, there are many forms of SI. Hitting is definitely one of them. I've done that before instead of cutting. At least it doesn't leave any lasting marks.

 

[David Baxter PhD]

I'm not an expert in developmental delayed/disaabled issues but in that population it may be less about SI and more about sensory stimulation, somewhat like what you may see in autism. To a lesser degree, you may see similar behaviors in ADHD and "non-disordered" young children.

 

[HA]

Hello Ash,

Thanks for your reply. I will understand more as I get to know you and others that are struggling with this issue. It must be very difficult. I do understand (from what I read) that it is a coping mechanisim for dealing with emotions that are overwhelming.

I was wondering if for some people it was more of a stimulation versus a release. But as David pointed out SI and Self Injurious Behaviour (SIB) are completely different issues.

What is so wonderful about the internet is the ability to ask such a question and get an answer instead of wondering about it. Who better to ask than those who are dealing with it.

Thanks again for being patient with my questions and giving me a better understanding.

Cheers
Judy

 

[Ash]

Thanks for your reply. I will understand more as I get to know you and others that are struggling with this issue. It must be very difficult. I do understand (from what I read) that it is a coping mechanisim for dealing with emotions that are overwhelming.

Sure thing. Most of us did not learn healthy coping mechanisms while growing up. Most of us went through a lot of trauma that brought up overwhelming emotions. I consider myself to be very strong (after all I'm still around!) but there are times when I become so overwhelmed that I have no idea how to cope. In the past I've cut, hit myself, thrown things (at least that's not self-destructive), drank, done drugs, just to get by. I'm doing my best to figure out the best way of dealing with life.

I was wondering if for some people it was more of a stimulation versus a release. But as David pointed out SI and Self Injurious Behaviour (SIB) are completely different issues.

Oh, most definitely! There are many reasons for SI, one of which is release.

What is so wonderful about the internet is the ability to ask such a question and get an answer instead of wondering about it. Who better to ask than those who are dealing with it.

We'll help where we can.

Thanks again for being patient with my questions and giving me a better understanding.

It's in everyone's best interest that people gain a better understanding!

 

[Cat Dancer]

I know it serves many purposes for me. I mostly cut and burn, sometimes other stuff. I do it when emotions are too overwhelming, but sometimes I do it when there is no emotion. And sometimes, and this is sad to me, when I'm feeling ok I want to do it.

I started when I was about 9 or 10. I'm not really sure, but I know it was before we moved when I was in the fifth grade. I remember accidentally stapling my fingers together and thinking it was ok to be hurt like that. (Ok, I'm not the most graceful person. LOL.) And it just got worse over the years. I was always so embarrassed and ashamed of it and had no idea that other people did it too.

For me I think a huge thing is invalidation. If you go to a website called Secret Shame (it's about self-injury) there's a paragraph there under "causes" that just clicked in my mind when I read it. It's about growing up in an environment where your feelings and thoughts are rarely recognized or you're told you are wrong for what you think and feel. Growing up we were not allowed to be mad, sad, scared, even too happy. No crying, no laughing, no expressions of emotion whatsoever. It just wasn't acceptable. The odd thing is that I've chosen to be in a relationship with someone who does exactly the same thing to me so I'm just basically a very confused person.

 

[Ash]

I know it serves many purposes for me. I mostly cut and burn, sometimes other stuff. I do it when emotions are too overwhelming, but sometimes I do it when there is no emotion. And sometimes, and this is sad to me, when I'm feeling ok I want to do it.

I mostly do it when I'm too overwhelmed (sad, angry) to know what to do, or when I feel like punishing myself. I don't mind so much the times when I have no emotion. Well, usually. It's better than having TOO much!

For me I think a huge thing is invalidation.

Do you mean not feeling validated?

It's about growing up in an environment where your feelings and thoughts are rarely recognized or you're told you are wrong for what you think and feel. Growing up we were not allowed to be mad, sad, scared, even too happy. No crying, no laughing, no expressions of emotion whatsoever. It just wasn't acceptable.

Right on. That really hit home with me!

The odd thing is that I've chosen to be in a relationship with someone who does exactly the same thing to me so I'm just basically a very confused person.

There's really nothing odd about that! You're doing what you're used to. I think it makes sense in it's own way.

 

[Cat Dancer]

Do you mean not feeling validated?

Yes, that's it exactly. And you have felt that way too? It really stinks.

And it's so frustrating because I have such a strong desire to stop, but every few weeks I just lose it and cut myself or burn myself and then it seems it's all for nothing. Plus I'm already so scarred up I never wear short sleeves so no one sees and I figure what difference does it make anyway. But I'm not giving up. Every day that I DON'T do it is a small triumph, I suppose?

Janet