Self-harm is defined as the intentional, direct injuring of oneself in an attempt to deal with emotional pain, anger, or frustration. Sometimes the individual believes that they deserve to be injured as self-punishment. Most of the time individuals who are engaging in self-harm are not doing so with the intention of suicide. Self-harm may also be referred to as “self-mutilation,” “self-abuse,” or “self-injury.”
The most common form of self-harm involves cutting oneself, but other self-harm behaviors may include: burning, scratching, hitting body parts, hair-pulling, or ingestion of poisonous substances. While self-harm may result in a sense of calm and release of tension, those feelings are short lasting. After the initial feelings have subsided the individual is often consumed with guilt and the painful emotions they were trying to escape. As the behavior continues to occur a man or woman may begin to crave self-harming, resembling an addiction. This can result in deeper wounds as well as an increase in the number of wounds.
Objects such as knives, needles, razors, or other sharp objects may be used to inflict these self-injuries, most often on the thighs and forearm. During a self-injury session an individual may cut a series of parallel cuts separated by a few centimeters. Eventually this will result in a characteristic pattern of scars.
Statistics
Non-suicidal self-harm usually begins in the early teen years and can continue for many years. It often reaches its peak at 20-29 years of age and declines from there. It’s estimated that this behavior occurs in about 1%-4% of the adult population; although the prevalence of chronic self-harm is estimated to occur in approximately 1% of the adult population. Self-injury rates are especially high among adolescents at about 15%. College students make up the highest number of reported cases at 17%-35%.
Self-harm rates are consistent among the sexes, however the manners in which they engage in self-mutilation is different. Women most often cut themselves, while men are more likely to hit themselves.
Co-Occurring Disorders
Self-harm is a very serious condition that generally occurs in the presence of other mental health disorders. Disorders that are associated with more dangerous and higher rates of self-injurious behaviors may include:
- Borderline personality disorder
- Dissociation and dissociative disorders
- Autism spectrum disorders
- Major depressive disorder
- Eating disorders
- Trauma
- Post-traumatic stress disorder
- Substance abuse
Causes of Self-Injury
The exact cause of self-harm behavior is not known, but there are a number of factors that may contribute. Some of these include:
- Avoidance/Distraction – individuals who are experiencing intense emotional pain may use self-harm as a way to distract themselves from painful emotions
- Cause sensations – individuals who are emotionally numb may self-harm in an attempt to just feel anything at all. Pain is better than no feelings at all.
- Control – people who feel that they have no control in their life often seek out things that they can control, such as self-harm behaviors.
- Coping mechanisms – when certain situations are overwhelming an individual may use self-harm as a coping mechanism when they have no idea what else to do.
- Emotional Expression – some people do not grow up to learn to properly identify and express their emotions. For some, self-harm may be used as a way of expressing negative emotions or moods.
- Punishment – certain men and women grow up being told there is something wrong with them. Over time, these individuals internalize their feelings and believe this about themselves. These incorrect perceptions may cause some to punish themselves for their perception of their worthlessness.
Symptoms of Self-Harm
There are many signs and symptoms that may indicate that an individual is self-harming. These may include:
Mood:
- Relief from a highly distressing mood
- Irritability
- Isolation
- To feel a positive mood state, like peacefulness
- Interpersonal conflicts, negative emotions, guilt, and the belief that the individual is a bad person precedes the self-harm
- Depressed mood
Behavioral:
- Burning or scalding oneself
- Spending lots of time alone
- Hitting oneself
- Purposefully swallowing poison or other inappropriate objects
- Sticking objects into the skin
- Behavior causes much distress to the individual
- Inability properly cope
- Carrying sharp objects in the individual’s belongings
- Wearing long sleeves in warm weather
Physical:
- Unexplained wounds or scars, usually on the wrists, thighs or chest
- Blood stains on towels, tissues, or bedding
- Unexplainable, frequent self-report of accidents
Psychological:
- Expectation that the self-injury will only cause mild to moderate harm physically
- Frequent thoughts of self-harm even if there is no intent to execute at that time
- Feeling that self-harm is punishment
- Feeling in control of some aspect of life
- Relief from the tension and emotional pain
Effects of Self-Injury
Self-harm behavior can create a multitude of short-term and long-term effects. Effects of self-harm may include:
- Permanent scars
- Substance use and abuse
- Infected wounds
- Anxiety over someone discovering self-mutilation
- Depression regarding the inability to stop self-injuring despite the consequences
- Feeling worthless, helpless, or hopeless that an individual can stop the behaviors
- Broken bones
- The stress of providing many reasons for injuries
- Social isolation
- Stress of having to hide the self-abuse from others
- Failure to address reasons behind the self-injury that may worsen over time
- Long-standing problems cause decreased enjoyment from other areas of life
- Death