Self-Injurious Behavior
What is it?
Self-injury, self-inflicted violence, self-injurious behavior, or self-mutilation is defined as “a deliberate, intentional injury to one’s own body that causes tissue damage or leaves marks for more than a few minutes, which is done to cope with an overwhelming or distressing situation.” Although self-harm is rarely a suicidal act, it must be taken seriously because accidental deaths do occur.
About two million people in the U.S. are self-injurers, and approximately 1% of the population has inflicted physical injury upon themselves at some time in their life as a way to cope with an overwhelming situation or feeling. Finding new ways of coping with feelings can help to tone down the intense urges one feels and which results in self-harm.
What does it look like?
The most common self-injurious behaviors are:
Cutting: involves making cuts or scratches on your body with any sharp object, including knives, needles, razor blades or even fingernails. The arms, legs and front of the torso are most commonly cut because they are easily reached and easily hidden under clothing.
Branding: burning self with a hot object.
Friction burn: rubbing a pencil eraser on the skin.
Multiple piercing or tattooing: may also be a type of self-injury, especially if pain or stress relief is a factor.
Why does a person do this?
- Self injurious behavior is usually a result of not having learned how to identify or express difficult feelings in a healthy way.
- Self-injury can regulate strong emotions.
- Deliberate self-harm can distract from emotional pain.
- Self-inflicted violence is a way to express things that cannot be put into words such as displaying anger, shocking others or seeking support and help.
- Self-injurious behavior can exert a sense of control over your body if you feel powerless in other areas of your life.
- Self punishment or self-hate may be involved. Some people who self-injure have a childhood history of physical, sexual and emotional abuse.
- Self-abuse can also be a self-soothing behavior for someone who does not have other means to calm intense emotions.
What can you do?
- Understand that self-harming behavior is an attempt to maintain a certain amount of control which in and of itself is a way of self-soothing.
- Let the person know that you care about them and are available to listen.
- Encourage expressions of emotions including anger.
- Spend time doing enjoyable activities together.
- Offer to help them find a therapist or support group.
- Don’t make judgmental comments or tell the person to stop the self-harming behavior; people who feel worthless and powerless are even more likely to self-injure.
- If your child is self-injuring, prepare yourself to address the difficulties in your family.
- Start with expressing feelings which is a common factor in self-injury – this is not about blame, but rather about learning new ways of dealing with family interactions and communications which can help the entire family.
How is it treated?
One danger connected with self-injury is that it tends to become an addictive behavior, a habit that is difficult to break even when the individual wants to stop. As with other addictions, qualified professional help is almost always necessary. It is important to find a therapist who understands this behavior and is not upset or repulsed by it. Call your doctor or insurance company for a referral to a mental health professional who specializes in self-injury.
- Cognitive-behavioral therapy may be used to help the person learn to recognize and address triggering feelings in healthier ways
- Therapies that address post-traumatic stress disorder such as EMDR may be helpful.
- Hypnosis or other self-relaxation techniques are helpful in reducing the stress and tension that often precede injuring incidents
- Group therapy may be helpful in decreasing the shame associated with self-harm, and help to support healthy expressions of emotions
- Family therapy may be useful, both in addressing any history of family stress related to the behavior, and also in helping other family members learn how to communicate more directly and non-judgmentally with each other
- In cases of moderate to severe depression or anxiety an antidepressant or anti-anxiety medication may be used to reduce the impulsive urges to self-harm in response to stress, while other coping strategies are developed.
- In severe cases an inpatient hospitalization program with a multi-disciplinary team approach may be required.
For more information
S.A.F.E. alternatives (Self-Abuse Finally Ends)
http://www.selfinjury.com/
American Association of Marriage and Family Therapists
http://www.aamft.org/families/Consumer_Updates/Adolescent_Self_Harm.asp
Help for family and friends
Lets self-injurers know that they are NOT alone, and provides information to help their friends and family (http://www.self-injury.net)