Self-Injury Fact Sheet for Parents and Teachers

by Paul Rohling

 

What is self-injury?

These behaviors are called many things: self-inflicted violence, self-mutilation, self-harm, parasuicide, delicate cutting, self-abuse and self-injury (SI).

Broadly speaking, most researchers agree that self-injury SI is the act of attempting to alter a mood state by inflicting physical harm on one’s body serious enough to cause tissue damage or leave marks that last for several hours. This harm is typically done without suicidal intent and does not usually include body markings in the form of piercing and/or tattooing.

What is self- injurious behavior?

Although cutting is the most common form of SI, burning and head-banging are also very common. Other forms of SI include: carving, scratching, branding, burning/abrasions, biting bruising, picking and pulling the skin or hair, self-strangulation, hitting the body with objects and/or hitting objects with one’s body.Who is likely to self-injure?

The "portrait" of the typical self-injurer: female, in her mid twenties to early thirties, and has been hurting herself since she was a teen. She tends to be middle or upper-middle class, intelligent, well-educated, and from a background of physical and/or sexual abuse or is from a home with at least one alcoholic parent. Eating disorders are also often reported.

While many fall into the aforementioned category, it is important to remember that self-injurers come from all walks of life and socioeconomic brackets. People who harm themselves can be male or female; straight, gay or bisexual; Ph.D.s, high-school dropouts or high achieving high school students; rich or poor; from any country around the world. Some people who engage in SI manage to function effectively in highly demanding jobs and some are on disability. Their ages usually range from early teens to early sixties. SI has tended to be more common in girls and is somewhat rare in boys (7:1 female:male ratio). Some researchers hypothesize that as many as 1 teenager in 10 could be affected by this trend that many have labeled the "new anorexia".

Despite these differences, self-injurers tend to have a number of psychological traits in common. The overall picture seems to be of people who:

  • strongly dislike / invalidate themselves.
  • are hypersensitive to rejection.
  • have difficulty regulating their emotional states.
  • are chronically angry, usually at themselves.
  • are lacking in impulse control.
  • tend to be avoidant.
  • are depressed and self-destructive.
  • suffer chronic anxiety and irritability.
  • have high levels of aggressive, angry feelings that they often suppress or direct inward.
  • do not think they have much control over how / whether they cope with life.

Why do people deliberately injure themselves?

This may be the aspect that is most puzzling to those who do not do it. Studies have shown that when people who self injure are faced with strong emotions or overwhelming situations, an act of self-harm brings them a rapid release from their tension and anxiety. In other words, they feel a strong uncomfortable emotion, don’t know how to handle it (much less name), but they know that hurting themselves will reduce their emotional discomfort almost immediately. After this release, they may still feel bad (i.e., angry, guilty and/or afraid), but they no longer have that panicky jittery trapped feeling like they did before; it’s a calm bad feeling. While this explains the development of some self-injurious behaviors, there are clearly a number of additional subjective and objective motivations.

Subjective Motivations: What self-injurers say SI does for them:

  • Escape from emptiness, depression and feelings of unreality.
  • Expresses emotional pain.
  • Escape from numbness: many who self-injure say they do it in order to feel something, to know they’re alive.
  • To obtain a feeling of euphoria.
  • To continue abusive patterns: many self-injurers are abused as children. Sometimes self-mutilation is a way of punishing oneself for "being bad" or is a way to re-enact their trauma.
  • To relieve anger: many self-injurers have tremendous amounts of rage that they are afraid to express outwardly. SI can be a means of them venting these feelings.
  • To obtain or maintain influence over the behaviors of others.
  • To exert a sense of control over one’s body.
  • To ground themselves in reality; as a way of dealing with feelings of depersonalization and/or dissociation.
  • To maintain a sense of security or feeling of uniqueness.
  • To express or repress sexuality.
  • To express or cope with feelings of alienation.
  • For revenge against some they feel has wronged them in some manner.

Objective Motivations: Links researchers have found:

  • Difficulties in various areas of impulse control that frequently manifest in problems with eating behaviors and substance abuse.
  • Low capacity to form and sustain stable relationships.
  • A history of neglect or abuse – physical, sexual, and/or emotional.
  • The presence of traumatic losses, illnesses or instability in the family life (such as frequent moves).
  • A lack of self-esteem, coupled with a powerful need for love andacceptance from others.
  • An inability or unwillingness to nurture or take care of oneself.
  • Overly rigid thought patterns: "ALL or NOTHING" thinking.

What can I do to help?

The reality is that SI is a crude, ultimately self-destructive coping mechanism, but it works. Anyone who is harming themselves is struggling to cope and needs help. If the self-injurer does not get help when they need it, the problems are likely to continue, if not worsen over time. Frequently self-injury is kept secret from family and friends. While anger or concern on the part of parents, friends and/or teachers is a normal response, this often leads the self-injurer to feel ashamed and/or guilty about their actions. Individuals should not be coerced or "guilted" into stopping their self-injurious behaviors. Any attempts to reduce or control the amount of self-harm a person does should ideally be based in the individual’s willingness to undertake the difficult work of controlling and/or stopping self-injury. It is important to make sure that the young person feels that they have someone they can talk to and get support from when they need it. They are most likely to share their upset feelings with friends their own age or adults they know well and trust. Friends often worry about betraying the self-injurer’s confidence, you may need to explain that self-harm can be dangerous. For this reason it should never be kept a secret. Ultimately, it is better to get them help than to allow them to suffer in silence.

If you are a parent or a teacher, you can help by:

  • Recognizing signs of diress and finding some way of talking with the individual about how they are feeling.
  • Listening to their worries about the problems without passing judgment upon them.
  • Offering empathy and understanding.
  • Staying calm and constructive – however upset you feel about the self-harm.
  • Being clear about the risks of self-harm – making sure they know that, with help, it will be possible to stop once the underlying problems have been sorted out.
  • Making sure that they get the right kind of help as soon as possible.

    Specialist help available:

    Many young people who harm themselves do ultimately need specialist help. Psychological treatment can make all the difference. There are different approaches, depending on the underlying cause of the problem. Often this involves both individual and family work. Individual work focuses on help the self-injurer learn to cope with the difficult emotional issues that lead to self-harm. Families often need help working out how to make sure that the dangerous behavior doesn’t happen again and often need assistance as to how to give the support that is needed. If depression or anxiety are a part of the problem, medication may be helpful. Occasionally, intensive help may be needed. Sometimes recovery from very traumatic experiences happens slowly. Then specialist help may be needed over a longer period of time.