The Counselling Centre

Self-Injury

Self-injury (SI) – also known as self-harm or self-mutilation – is defined as any intentional injury to one's own body. It usually either leaves marks or causes tissue damage. It is hard for most people to understand why someone would want to cut or burn himself/herself). The mere idea of intentionally inflicting wounds to oneself makes people cringe. Yet there are growing numbers of young people who do intentionally hurt themselves. Understanding the phenomenon is the first step in changing it.

Who engages in self-injury?

There is no simple portrait of a person who intentionally injures him/herself. This behaviour is not limited by gender, race, education, age, sexual orientation, socio-economics, or religion. However, there are some commonly seen factors:

  • Self-injury more commonly occurs in adolescent females.
  • Many self-injurers have a history of physical, emotional or sexual abuse.
  • Many self-injurers have co-existing problems of substance abuse, obsessive-compulsive disorder (or compulsive alone), or eating disorders.
  • Self-injuring individuals were often raised in families that discouraged expression of anger, and tend to lack skills to express their emotions.
  • Self-injurers often lack a good social support network.

The most common ways that people self-injure are:

The most common ways that people self-injure are cutting, burning (or “branding” with hot objects), picking at skin or re-opening wounds, hair-pulling (trichotillomania), hitting (with hammer or other object), bone-breaking, and head-banging (more often seen in autistic, severely retarded or psychotic people). Multiple piercing or multiple tattooing may also be a kind of self-injury, especially if pain or stress relief is a factor.

How does self-injury become addictive?

A person who becomes a habitual self-injurer usually follows a common progression:

  • The first incident may occur by accident, or after seeing or hearing of others who engage in self-injury
  • The person has strong feelings such as anger, fear, anxiety, or dread before an injuring event
  • These feelings build, and the person has no way to express or address them directly
  • Cutting or other self-injury provides a sense of relief, a release of the mounting tension
  • A feeling of guilt and shame usually follows the event
  • The person hides the tools used to injure, and covers up the evidence, often by wearing long sleeves
  • The next time a similar strong feeling arises, the person has been “conditioned” to seek relief in the same way
  • The feelings of shame paradoxically lead to continued self-injurious behaviour
  • The person feels compelled to repeat self-harm, which is likely to increase in frequency and degree

Why do people engage in self-injury?

Even though there is the possibility that a self-inflicted injury may result in life-threatening damage, self injury is not suicidal behaviour. Although the person may not recognize the connection, Self injury usually occurs when facing what seems like overwhelming or distressing feelings. The reasons self-injurers give for this behaviour vary:

  • Temporarily relieves intense feelings, pressure or anxiety
  • Provides a sense of being real, being alive – of feeling something
  • A way to externalize emotional internal pain – to feel pain on the outside instead of the inside
  • A way to control and manage pain – unlike the pain experienced through physical or sexual abuse
  • A way to break emotional numbness (the self-anaesthesia that allows someone to cut without feeling pain)
  • Self-soothing behaviour for someone who does not have other means to calm intense emotions
  • Self-loathing – some self-injurers are punishing themselves for having strong feelings (which they were usually not allowed to express as children), or for a sense that somehow they are bad and undeserving (an outgrowth of abuse and a belief that it was deserved)
  • Self-injury followed by tending to wounds is a way to express self-care, to be self-nurturing, for someone who never learned how to do that in a more direct way
  • A cry for help, to ask for assistance in an indirect way
  • An attempt to affect others – to manipulate them, make them feel guilty or bad, make them care, or make them go away

What is the relationship between self-injury and suicide?

Self-injury is not suicidal behaviour. In fact, it may be a way to reduce the tension that, left unattended, could result in an actual suicide attempt. Self-injury is the best way the individual knows to self-sooth. It may represent the best attempt the person has at creating the least damage. However, self-injury is highly linked to poor sense of self-worth, and over time, that depressed feeling can evolve into suicidal attempts. And sometimes self-harm may accidentally go farther than intended, and a life-threatening injury may result.

How can a self-injuring person stop this behaviour?

Self-injury is a behaviour that becomes compulsive and addictive. Like any other addiction, even though other people think the person should stop, most addicts have a hard time just saying no to their behaviour – even while realizing it is unhealthy.

There are several things to do to help yourself:

  • Acknowledge that this IS a problem, that you are hurting on the inside, and that you need professional assistance to stop injuring yourself.
  • Realize that this is not about being bad or stupid – this is about recognizing that a behaviour that somehow was helping you handle your feelings has become as big a problem as the one it was trying to solve in the first place.
  • Find one person you trust – maybe a friend, teacher, minister, counsellor, or relative – and say that you need to talk about something serious that is bothering you.
  • Get help in identifying what “triggers” your self-harming behaviours and ask for help in developing ways to either avoid or address those triggers.
  • Recognize that self-injury is an attempt to self-sooth, and that you need to develop other, better ways to calm and sooth yourself.
  • Try some substitute activities when you feel like hurting yourself.
  • If cutting is a way to deal with anger that you cannot express openly, try taking those feelings out on something else – running, dancing fast, screaming, punching a pillow, throwing something, ripping something apart.
  • If cutting is a way to feel something when you feel numb inside, try holding ice or a package of frozen food, taking a very hot or very cold shower, chewing something with a very strong taste (like chili peppers, raw ginger root, or a grapefruit peel), or snapping a rubber band hard on your wrist.
  • If cutting is a way to calm yourself, try taking a bubble bath, doing deep breathing, writing in a journal, drawing, or doing some yoga.
  • If cutting involves you having to see blood, try drawing a red ink line where you would usually cut yourself, in combination with other suggestions above.

What can you do to help a friend or family member who is a self-injurer?

  • Understand that self-harming behaviour is an attempt to maintain a certain amount of control, and that it is a way of self-soothing
  • Let her or him know that you care and that you will listen
  • Encourage expression of emotions, including anger
  • Spend time doing enjoyable activities together
  • Offer to help find a therapist or support group
  • Do not tell the person to stop the behaviour or make judgmental comments – people who feel worthless and powerless are even more likely to self-injure

Adapted from Helpguide.org

The Counselling Centre offers individual and couples counselling to help with these issues. For more information, call The Counselling Centre at 902-420-5615 or drop by our office on the 4th floor of the Student Centre.