What is Self-Injury? | Focus Adolescent Services

Many people have misconceptions about self injury, what it is, who does it, and why. Here, Deb Martinson, author of Bill of Rights for People Who Self-Harm, presents the reality of self-injury..

What is self-injury?

It’s called many things ― self-inflicted violence, self-injury, self-harm, parasuicide, delicate cutting, self-abuse, self-mutilation (this last particularly seems to annoy people who self-injure).

Broadly speaking, self-injury is the act of attempting to relieve emotional pain by inflicting physical harm serious enough to cause tissue damage to one’s body.

The forms and severity of self-injury can vary, although the most commonly-seen behavior is cutting, burning, and head-banging.

Other forms of self-harming behavior include: carving, scratching, branding, burning/abrasions, biting, bruising, hitting, picking/pulling skin and hair, embedding objects under the skin (e.g., glass fragments, pencil lead, staples, paper clips).

It’s not self-injury if the primary purpose is body decoration (e.g., piercing, tattooing).

Why does self-injury make people feel better?

It reduces physiological and psychological tension rapidly.
Studies have suggested that when people who self-injure get emotionally overwhelmed, an act of self-harm brings their levels of psychological and physiological tension and arousal back to a bearable baseline level almost immediately. In other words, they feel a strong uncomfortable emotion, don’t know how to handle it (indeed, often do not have a name for it), and know that hurting themselves will reduce the emotional discomfort extremely quickly.They may still feel bad (or not), but they don’t have that panicky jittery trapped feeling; it’s a calm bad feeling.

Some people never get a chance to learn how to cope effectively.
One factor common to most people who self-injure, whether they were abused or not, is invalidation. They were taught at any early age that their interpretations of and feelings about the things around them were bad and wrong. They learned that certain feelings weren’t allowed. In abusive homes, they may have been severely punished for expressing certain thoughts and feelings. At the same time, they had no good role models for coping. You can’t learn to cope effectively with distress unless you grow up around people who are coping effectively with distress. Although a history of abuse is common about self-injurers, not everyone who self-injures was abused. Sometimes invalidation and lack of role models for coping are enough.

Problems with neurotransmitters may play a role.
Just as it’s suspected that the way the brain uses serotonin may play a role in depression, so scientists think that problems in the serotonin system may predispose some people to self-injury by making them tend to be more aggressive and impulsive than most people. This tendency toward impulsive aggression, combined with a belief that their feelings are bad or wrong, can lead to the aggression being turned on the self. Of course, once this happens, the person harming himself/herself learns that self-injury reduces his level of distress, and the cycle begins. Some researchers theorize that a desire to release endorphins, the body’s natural painkillers, is involved.

What kinds of people self-injure?

Self-injurers come from all walks of life and all economic brackets, although most come from a middle-income to upper-income background. People who harm themselves can be male or female; straight, gay, bisexual, or transgender; Ph.D.s or high-school dropouts or high-school students; rich or poor; from any country in the world.

Their ages range from early teens to early 60’s. Though uncommon, children as young as preschool age have intentionally hurt themselves. Children who self-injure usually have experienced abuse, neglect, violence, abandonment.

Nearly half of self-injurers report physical abuse and/or sexual abuse during his or her childhood. Many self-injurers report that they were discouraged from expressing emotions, particularly anger or sadness.

The incidence of self-injury is about the same as that of eating disorders, but because it’s so highly stigmatized, most people hide their scars, burns, and bruises carefully. They also have excuses ready when someone asks about the scars.

Aren’t people who would deliberately cut or burn themselves psychotic?

No more than people who drown their sorrows in a bottle of vodka are. It’s a coping mechanism, just not one that’s as understandable to most people or as accepted by society as alcoholism, drug abuse, overeating, anorexia and bulimia, workaholism, smoking cigarettes, and other forms of problem avoidance.

Okay, then isn’t it just another way to describe a failed suicide attempt?

NO. Self-injury is a maladaptive coping mechanism, a way to stay alive. People who inflict physical harm on themselves are often doing it in an attempt to maintain psychological integrity ― it’s a way to keep from killing themselves. They release unbearable feelings and pressures through self-harm, and that eases their urge toward suicide. And, although some people who self-injure do later attempt suicide, they almost always use a method different from their preferred method of self-harm.