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"Self-harm" refers to the deliberate,
direct destruction of body tissue that results in tissue damage. When
someone engages in self-harm, they may have a variety of intentions;
these are discussed below. However, the person's intention is NOT to
kill themselves. You may have heard self-harm referred to as
"parasuicide," "self-mutilation," "self-injury," "self-abuse,"
"cutting," "self-inflicted violence," and so on.
Common
myths about SI:
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self-injurers have a death wish.
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self-injury is a failed suicide attempt.
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self-injury is done for attention or to
manipulate others. |
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self-injury is a teenage fad.
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self-injurers are freaks, etc. |
Some reasons why people engage in self-harm:
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To distract themselves from emotional pain by causing physical pain
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To punish themselves |
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To relieve tension |
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To feel real by feeling pain or seeing evidence of injury
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To feel numb, zoned out, calm, or at peace
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To experience euphoric feelings (associated with release of
endorphins) |
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To communicate their pain, anger, or other emotions to others
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To nurture themselves (through the process of healing the wounds) |
Who engages in self-harm?
Only a handful of empirical studies have examined
self-harm in a systematic, sound manner. Self-harm appears to be more
common in females than in males, and it tends to begin in adolescence or
early adulthood. While some people may engage in self-harm a few times
and then stop, others engage in it frequently and have great difficulty
stopping the behavior4. Several studies3,5,6 have found that individuals
who engage in self-harm report unusually high rates of histories of:
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Childhood sexual abuse |
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Childhood physical abuse
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Emotional neglect
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Insecure attachment
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Prolonged separation from caregivers |
At least two studies have attempted to determine
whether particular characteristics of childhood sexual abuse place
individuals at greater risk for engaging in self-harm as adults. Both
studies reported that more severe, more frequent, or a longer duration
of sexual abuse was associated with an increased risk of engaging in
self-harm in one's adult years7,8.
Also, individuals who self-harm appear to have higher
rates of the following psychological problems2,4,6:
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High levels of dissociation
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Borderline personality disorder
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Substance abuse disorders
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Posttraumatic stress disorder
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Intermittent explosive disorder
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Antisocial personality
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Eating disorders
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If you have a friend
or relative who engages in self-harm:
It can be very distressing and confusing for you. You may feel guilty,
angry, scared, powerless, or any number of things. Both of the books
mentioned above contain chapters for friends and family members. Some
general guidelines are:
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Take the self-harm seriously by expressing concern and encouraging
the individual to seek professional help.
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Don't get into a power struggle with the individual-ultimately they
need to make the choice to stop the behavior. You cannot force them
to stop. |
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Don't blame yourself. The individual who is self-harming initiated
this behavior and needs to take responsibility for stopping it.
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If the individual who is self-harming is a child or adolescent,
make sure the parent or a trusted adult has been informed and is
seeking professional help for them. |
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If the individual who is engaging in self-harm does not want
professional help because he or she doesn't think the behavior is a
problem, inform them that a professional is the best person to make
this determination. Suggest that a professional is a neutral third
party who will not be emotionally invested in the situation and so
will be able to make the soundest recommendations.
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2.
Zlotnick, C., Mattia, J.I., & Zimmerman, M. (1999). Clinical correlates
of self-mutilation in a sample of general psychiatric patients. The
Journal of Nervous and Mental Disease, 187, 296 - 301.
3. Gratz, K.L., Conrad, S.D., & Roemer, L.
(2002). Risk factors for deliberate self-harm among college students.
American Journal of Orthopsychiatry, 72, 128 - 140.
4. Simeon, D., & Hollander, E. (Eds.).
(2001). Self injurious behaviors: Assessment and treatment. Washington,
DC: American Psychiatric Press.
5. Van der Kolk, B.A., Perry, J.C., &
Herman, J.L. (1991). Childhood origins of self-destructive behavior.
American Journal of Psychiatry, 148, 1665 - 1671.
6. Zlotnick, C., Shea, M.T., Pearlstein, T.,
Simpson, E., Costello, E., & Begin, A. (1996). The relationship between
dissociative symptoms, alexithymia, impulsivity, sexual abuse, and
self-mutilation. Comprehensive Psychiatry, 37, 12 - 16.
Excerpts taken from
http://www.ncptsd.va.gov/facts/problems/fs_self_harm.html
by
Laura E. Gibson, Ph.D., The University of Vermont
Links:
National
Mental Health Association
Fact sheet on Self-injury
http://www.nmha.org/infoctr/factsheets/selfinjury.cfm
Secret shame
Is a comprehensive website with links to research, self-help
information, referral information, and information for families and
friends.
http://www.palace.net/~llama/psych/injury.html
BUS Web Board - Bodies Under
Siege
An online forum for people who self-harm and friends and family.
I've joined up years ago there is a section for adults past
college age along as a section for younger self-harmers.
http://buslist.org/phpBB/
Self-Injury.net
Gabrielle – A young and talented web mistress has put together one of
the best web sites on self-injury and writes of her own battles.
She has one of the best FAQ sections I have found at one place. I
suggest anyone interested in Self-injury/self-harm to explore this web
site. Friends and family should also read the info found @
http://self-injury.net/familyandfriends/
SIARI Self-injury and Related Issues
A large self-injury resource.
http://www.siari.co.uk/
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