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In the United States approximately 2-million people inflict some form of self-injury on themselves. Around 1% of the population has injured themselves at some point in time, with the most common age groups being 14-30 years of age.

Self-injury is more popular among teenage girls and young adults, however there is statistical information that suggests people as old as 60 years of age have participated in the behavior.

Different Types of Self-Harming

 “Self-injury,” is a general term that references self-inflicted violence, self-mutilation or self-injurious behaviors.  Intentional self-injury involves a deliberate act of damage to the skin, done for a period of minutes, with the intent of coping with an overwhelming situation or stress.

There are many different ways a person can self-harm, which include the following:

  1. Branding:  burning of the skin with a hot object.
  2. Friction burning:  rubbing of a pencil eraser against the skin.
  3. Cutting:  this involves making cuts or scratches on parts of the body with a sharp object. Objects used might include knives, razors, needles or fingernails.  The arms, legs and front of the body are oftentimes the most common areas to cut because they are easily accessible.
  4. Hair-pulling:  medically known as Trichotillomania, is an impulsive, obsessive-control disorder which is likened to an addiction.  A person has an unyielding urge to pull out hair from parts of the body.  Pulling hair from the head often leaves bald patches on the head which pullers will try to disguise will hats, scarves and wigs. 
  5. Hitting: with either a hammer or some other object.
  6. Multiple piercings or tattooing (Body Modification):  can also be classified as a form of self-injury, particularly if done to relieve pain or stress.
  7. Picking at the skin:  is known as Dermatillomania, is an impulsive disorder which is marked by the repeated urge to dig or pick at the skin.  Often the damage caused is a form of stress relief or self-gratification.
  8. Biting
  9. Ingestion of harmful chemicals

Because self-injury and cutting is a “hidden affliction,” it is hard to determine accurate statistical data as to how many people actually participate in the act.  At one time, researchers believed that incidents of “cutting,” were higher among females than males.  However, recent medical findings state that more males in their mid-30's were treated for self-injuring than females of the same age group.

Why Do People Self-Harm?

For people who practice cutting and other forms of self-harm, suicide is not the intention they are going for.   Acts of self-harm are oftentimes done at times of emotional upset or overwhelming stress, and people who engage in self-harm are sometimes unaware of the correlation between the events.

Self-harmers often have not learned how to describe or express stressful feelings in a healthy way.  Oftentimes, a person who self-harms believe in the act itself, which involves outward feeling instead of inward feeling, the damages will be seen and allow them the chance to heal.

Those who self-harm may think that the injuries, which are now in physical form, will somehow provide tangible evidence that the inner emotional pain is real.  Through the physical pain they feel may be the catalyst that allows release of inner pain, the release is only short-lived.  For self-harmers, this coping mechanism is ineffective because the pain eventually returns without any actual healing occurring.

Self-inflicted harm or violence is used as a way of expression for situations that cannot be described in words.  People who engage in self-harm often feel a sense of power over their body, when they feel powerless in other areas of life.  Sometimes the self-harmer might think harming themselves will prevent them from doing something worse. 

Some people who self-injure have a history of sexual, emotional or physical abuse in childhood.  They mistakenly blame themselves for having caused the situation and deserved what happened, and now as a way of punishment, they cut, burn or maim themselves.  The reasoning used by abuse victims is that they must be punished, because of self-hatred or low self-esteem issues.

Forms of self-abuse can also be a means of self-soothing for a person who has not learned other methods to calm stressful, intense, emotional situations.  A person who cuts, burns or otherwise injures themselves might follow up the incident by tending to the wounds as a way to express self-caring and nurturing.

People who engage in self-harming have some common traits exhibited:

  • Any form of expressing anger was frowned upon in childhood
  • Oftentimes they have other issues that exist such as obsessive-compulsive disorder (OCD), a history of alcohol or substance abuse and possibly eating disorders, though this is NOT always the case.
  • They do not possess the skills needed to express strong emotions in a positive way
  • They have a limited social support system
  • Unstable living conditions

Forms of self-harm serves a purpose for those who do it.  If the person who does it can figure out some other way of functioning, emotional needs can  be met and thus the desire to self-harm will diminish greatly.

Self-Harm as an Addiction

For people who self-harm, the behavior can become a sort of addiction that occurs in gradual steps. A first time incident of self-harming might not be intentional, or could be a result of finding a peer group who demonstrates this sort of behavior pattern.  As a result of the first incident, the next time a similar situation arises, a person may be conditioned to seek self-harming to relieve the the feelings.

A person who cuts, burns or engages in some other form of self-injury may be feeling anger, fear or anxiety prior to an event of self-harming and the person feels compelled to repeat the behavior, which in time will increase in both frequency and severity.  These types of feelings will build up over time and the person has no other way of expressing or handling them, and hiding the objects used to self-harm is common.

Cutting and other forms of self-harm provide a sense of relief, a way to get rid of mounting stress or inner tension.  During episodes of self-injury, endorphines are released by the body in response to pain, contributing to the addictive feeling of cutting or self-harm.  Often after an episode of self-injury, feelings of guilt and shame will follow and the behavior becomes an addiction, because the self-harmer learns to associate the act with positive feelings, which occur because of the endorphines released.

Self-Harming and Risk of Suicide

People who self-harm are usually not doing so out of a desire to commit suicide.  Infliction of physical  harm to oneself is a learned behavior and coping mechanism, which is used to express feelings and as a form of self-soothing.  Self-injury is strongly associated with those who suffer from self-esteem issues, which over time, the depression experienced may graduate into suicidal tendencies.

Sometimes the act of self-injury can extend farther than the person intended.  A life-threatening injury could occur, which is why intervention and professional medical help is necessary in situations such as this. 

How To Help Someone Who Self-Harms

Self-harming is an act that frightens others, it is a situation that is hard to accept and conceptualize.  People have a difficult time coming to terms with the fact that someone they love is physically hurting themselves. 

Listed is some helpful information about how to help someone who self-injures:

  • Gaining a clear understanding about why a person cuts or self-harms is imperative.  It is done as an act done to maintain self-control, which is a form of self-soothing for some.
  • Give the person emotional support and let them  know you care about them and  are ready to listen, when and if they need to talk.
  • Spend time with the person and engage them in activities they enjoy.
  • Offer to assist them in  finding a therapist or support group to help them work through their feelings.
  • Do not pass judgment or instruct the person to stop the self-injuring behavior.
  • If a family member or child is engaging in self-injurious behavior, be prepared to address the situation with the family.  Begin with expressing feelings, do not blame them and learn about new ways to deal with family situations and communication, which can be beneficial to the whole family.

How the Person Who Self-Harms Can Stop the Behavior 

Bear in mind that the propensity to engage in forms of self-harming behavior is compulsive and highly addictive.  Like with any other form of addiction, people who self-injure have a difficult time curbing the urge, even though they know deep down it is unhealthy.

There are many ways a person who inflicts self-harm can help themselves:

Acknowledge the behavior is an issue:  someone who self-harms is hurting on the inside and would benefit greatly from seeking professional help to alleviate the behavior.

Realizing that self-harm does not make them a bad person:  recognize that self-harm is a learned behavior in response to stressful situations.

Find someone to trust and get professional help:  this person could be a sibling, parent, friend, family member, clergy or counselor, talking to someone about serious issues is important.

Become aware of what “triggers” episodes of self-harm:  seek help and find ways to avoid or handle the “triggers” that makes one want to cut or self-harm.

Realize that self-harming is another way to self-soothe:  learn more positive and productive methods for calming and soothing.

Find out why self-injury is fulfilling a certain need in life:  replace acts of self-harm with learning how to effectively express emotions in a healthy way.

Effective Methods for Treatment of Self-Harm

One of the many dangers contributed to self-harm is the tendency for it to become an addiction, a harmful habit which is extremely difficult to stop, even when the person wants it to cease.  As with any other type of addiction, intervention with a qualified professional is almost always needed.

It is very important to find a therapist or counselor who understands this type of behavior and does not become emotional or repulsed.  Many physician referral lines can provide a list of qualified  professionals who specialize in the field of self-harming behavior.

The following is a list of treatment methods one might employ for the treatment of self-harm:

  • If the self-harmer has a past history of abuse, therapies similar to those used for post-traumatic stress disorder are often useful.
  • Hypnosis and self-relaxation methods are also helpful in reducing stress levels and tension that often occur prior to incidents of self-injury.
  • Sometimes family therapy can be helpful in both dealing with family stress that may be related to the behavior.  Family therapy can also be a useful tool in helping other family members learn better communication methods.
  • In severe cases of self-harming behavior, an in-patient hospitalization program with a team of specialists could be necessary.

Viable Options Other Than Self-Harming

If a person uses self-injury as a way of dealing with anger issues that cannot be expressed, they might try working through the strong emotions and doing something different.  Many times running, screaming, exercise and other types of activities can alleviate the urge to self-harm.

If self-harm is done in order to “feel something,” a person might try holding ice cubes in one hand while trying to crush them, taking a cold shower and wearing a rubber band around the wrist and snapping it, can also provide the same type of mental release experienced while cutting or self-harming.

When a person cuts or self-harms in an effort to self-sooth, they might try taking a warm bath, doing yoga or deep breathing, writing in a diary, listening to music or painting to provide a sense of calm and to alleviate the desire to self-injure.

If self-mutilation is done in an effort to see blood, try drawing a red line on skin which would normally be cut, using this technique in conjunction with the other methods mentioned, can be enough to quell the urge to cut or self-harm.

Long-Term Prognosis

Self-harm is a very real mental health issue and not a form of attention seeking in an individual who exhibits the behavior.  If someone has the courage and strength to admit to self-harming, it is important to realize they are expressing a desire to receive help, so do not ever pass judgment or ridicule them.

Making the decision to stop self-injurious behavior is an extremely personal decision.  It is not uncommon for people who have engaged in this type of behavior, to think about it obsessively and to have to fight the urge to do it over and over again. 

The scars of self-injury will fade over time, but unless the underlying reasons and issues are addressed, the possibility of the behavior subsiding are unlikely.  However, with the intent to curb the behavior, combined with therapy and other forms of intervention, a person who self-harms can successfully recover.