Self injury is any deliberate, non suicidal behavior that inflicts physical harm on your body and is aimed at relieving emotional distress. Physical pain is often easier to deal with than emotional pain, because it causes ‘real’ feelings. Injuries can prove to an individual that their emotional pain is real and valid. Self injurious behavior may calm or awaken a person. Yet, self injury only provides temporary relief, it does not deal with the underlying issues. Self injury can become a natural response to the stresses of day to day life and can escalate in frequency and severity.

Self injury may be inflicted upon the self in many ways, such as cutting oneself, banging limbs, burning / branding oneself, overdosing on medication, and other methods.

Medical Diagnosis

Self injury is not a distinct syndrome according to current diagnostic criteria, it is often a behavior associated with syndromes such as Personality Disorders, Anxiety Disorders, Compulsive Disorders, Post Traumatic Stress Disorder, Dissociative Disorders, Eating Disorders, Impulse Control Disorders and forms of Depression.

People who self injure may not have a diagnosed disorder; in fact, they may be mentally healthy, and even outwardly happy. There is a strong link between low self esteem and self injury.

Self injury is a maladaptive coping mechanism, and health care workers may offer to teach new coping strategies to people relying on self injury.

Incidence

Studies in 1998 stated that 160,000 people said that they had self injured. A recent study by the Samaritans states that 1 in 10 teenagers have self injured. Self injury is the ‘hidden affliction’ though; estimates of incidence can not be relied upon, as self injury is private and secret.

In the 1990’s it was assumed that more females (teenage to 30 years of age) self injured than males, however, more recent studies and anecdotal information shows that the incidence is similar in males. It could be that males are less likely to seek support and so remain hidden.

Age of onset ranges from pre-teen to teenage, and many self injurers find that they lose the urge to harm themselves around their early thirties. There is a growing number of older self injurers seeking support as they gain confidence with the medical establishments’ acceptance of self injury.

Why Self Injury Helps People

When a person hurts himself or herself, it is because they are undergoing immense emotional distress, and their everyday ability to cope and function have failed. They may feel distressed, upset, uncomfortable, claustrophobic, anxious, depressed, helpless, powerless, out of control, or worthless. When under such pressure, any task, even simple tasks are impossible to perform; so, to regain their composure, and to find some small area of control, they hurt themselves.

It is not always the pain that is sought; physical pain is easier to deal with than the emotional pain being experienced. The physical pain may not even be fully felt, as some people disassociate from the pain and even from their bodies, and it takes self injury for them to ‘wake up’.

Self injury provides a very real focus; it quietens the mind, creates space to think clearly, and is a small area of life that can be controlled.

Many people who self injure feel that their life is not under their control, there are ‘powerful others’ with authority over them. People who are constantly invalidated by people in positions of respect or authority lose their self esteem. Self injurers often have to deal with being chronically ignored or being made to feel inadequate. Self injury provides a release for pent up frustrations, it takes the emotional hurt inflicted upon them and transforms it into something ‘real’.

Self injury may protect a person from thoughts of suicide; it may reduce anxiety, relieve distress, awaken a person from sloth or depression, or reduce the hearing of hallucinogenic voices. Self injury is a personal coping mechanism, relied upon for often personal reasons.

What Self Injury Is Not

It is sad to think that people suffering trauma, anxiety and depression can be told that they are using their self injurious behaviour to manipulate people, or just as a ‘cry for attention’.

Self injury may be used to garner attention, but this is not the focus of chronic, repetitive self injury. The fact is that people who self injure make a great effort to hide their bruises and scars, and are loath to discuss their inner or outer pain. Self injurers rarely seek medical attention for their wounds, and are wary of seeking support from the mental health services. Self injury is private and personal; it is hidden from family and friends.

Self Injury Is Not:

• Attention Seeking;
• Manipulation;
• For Pleasure;
• A Group Activity;
• Cool, a trend;
• An Adrenaline Rush;
• Tattooing, Body Piercing or part of BDSM sexual activities;
• A failed Suicide Attempt.

Suicide

While it is true that people who consider suicide and take their own life may also be involved with self injury, it is commonly accepted that self injury is not about dying.

Self injurers may be desperate to end the distress they are suffering, but self injury is thought of as a survival strategy, that is to say, self injurers feel that their use of self injury keeps them alive.

Self injurers generally do not fantasise about death, and they may be positive about their futures and their future happiness. It is depression and other mental health issues that lead to suicide ideation and acute self-hatred.

When talking to a person who self injures, it may be necessary to address concerns about suicide, but assumptions should not be made.

Words

Self Injury may be referred in many ways, if a self injurer labels their behavior in a different way to your expectations, do not correct their terminology, instead, adapt your own.

Self Injury (SI); Self Harm (SH); Self Inflicted Violence (SIV); Self Injurious Behavior (SIB); Self Mutilation (SM); Cutting; Burning; Branding; Over Dosing (OD).