Many people on this forum self-injure (cutting being the most common form). Many more people misunderstand what self-injury is, and why people do it. This post is to point those who self-injure toward places to get help and information, and to help both self-injurers and those who know self-injurers to better understand why, and how they can help.
What is Self-Injury?
Self-injury is an expression of acute psychological distress. It is an act done to oneself, by oneself, with the intention of helping oneself rather than killing oneself. In other words, damage is done to the body in an attempt to preserve the integrity of the mind.
Self-injury is not attention seeking. It is not a failed suicide attempt, or “parasuicidal behavior.” It does not infer a weakness of character. It is not something that most people can “just stop.”
Self-injury is a coping mechanism. When things become too much, impossible to handle, people need a way to release their overwhelming feelings of anxiety, depression, fear, unreality, or pain. Despite all of the negative side effects, for some people, self-injury does temporarily relieve their problems. Yes, it’s a maladaptive coping mechanism, but it’s no different from using alcohol or drugs, over or under eating, becoming a work- or sex-oholic, or having any other “socially acceptable” problem.
Forms of self-injury include cutting, burning, hitting, bone breaking, pulling out hair, interfering with wound healing, and picking at one’s own skin excessively. For an action to be considered self-injury, it must leave a mark that lasts for an hour or longer, and must be done with the intent of hurting one’s self. Overdosing (without suicidal intent) can also be a form of self-injury for some people.
Why do people self-injure?
There are many reasons that people self-injure. Some of the more common ones include:
- relieving stress or anxiety
- combating depression and emptiness
- punishing oneself for a perceived wrong
- warding off feelings of unreality or disconnection from one’s self (dissociation)
- biochemical relief
- physical pain as a distraction from psychological pain
- preventing suicide
These are only a few of the more common reasons, there are many more. Every self-injurer has their own reasons for hurting them self. Like any other coping problem, people usually self-injure because they never learned other, more effective ways of dealing with problems.
Who self-injures?
About 50-60% of self-injurers were abused either physically or sexually as children. Nearly all self-injurers have suffered through chronic invalidation and have low self-esteem. Current estimates project that approximately 1% of the population self-injures (about three million people in the US).
Contrary to popular misconception, self-injury is not only seen in adolescent girls. Self-injurers can be any age, any IQ, any sex, and any social class. There are doctors, lawyers, church school teachers and grandparents who self-injure. Self-injurers frequently suffer from serious disorders such as Bipolar, Depression, Schizophrenia, Post Traumatic Stress Disorder, personality disorders, eating disorders, substance abuse disorders, dissociative disorders, Obsessive Compulsive Disorder, and anxiety disorders, amongst others.
Why can’t I just stop?
Self-injury is highly addictive. There are several theories as to why this is, ranging from endorphin release (the body’s natural pain killers; Morphine works by imitating endorphins) to malfunctions in the nervous system. Though the reason is still unclear, major studies have backed fully the theory that self-injury is addictive. How addictive? About as addictive as crack cocaine or heroin, and like any other addiction, people build tolerance to it. Over time, the self-injury becomes more severe to get the same results. Eventually, this can lead to accidental suicide.
How can I stop?
Since self-injury is a coping mechanism, new coping mechanisms will probably be needed before stopping will be possible.
There are a lot of resources out there that can aid you in getting new coping mechanisms.
- http://www.selfharm.net (Secret Shame) is the first place to look. Most of the information in this article was paraphrased from Secret Shame. It’s very comprehensive, and has both a message board and a mailing list for self-injurers and their friends/family.
- Tracy Alderman’s The Scarred Soul is a book that has much more information, and activities that can help you to develop new coping mechanisms.
- Marilee Strong’s A Bright Red Scream has an enormous amount of information on self-injury. It’s generally considered the most comprehensive book on self-injury that’s currently out. This book is particularly helpful in teaching non-self-injurers about self-injury.
WARNING: Reading this material can be triggering. You should make yourself safe before reading any of it, and stop reading if you begin to feel triggered. You can always resume reading later.
Telling a close friend or family member can frequently be helpful. Having someone to talk to who will really listen can do wonders. Before telling them, you should have information on hand to help them learn about self-injury; remember, it will probably be a shock for them. Make it clear that the cutting is the symptom rather than the problem, and that getting rid of it without dealing with the problem would be either impossible, or would lead to other forms of maladaptive coping (eating disorders, substance abuse, etc).
If they already know but haven’t been helpful at all, consider trying to educate them. There’s a good chance that they’re scared and don’t know what to do. The more they know about self-injury, the less scared they’ll be, and the more likely they’ll be able to help you.
In most cases, therapy is very helpful toward stopping. I strongly recommend that you look into getting therapy. http://www.golivewire.com/forums/topic.cgi?topic=35004 provides useful tips in selecting a therapist. Lists of local therapists are usually available from your insurance company (if you have one) and your doctor. You should try to make sure that your therapist is knowledgeable about self-injury before setting up an appointment. Also, if one therapist isn’t working for you after a session or two, try another. Different therapy styles work better for different people. Therapy in itself isn’t a “cure,” but it can be very helpful, IF you get a good therapist. If you get a poor therapist, don’t hesitate to discontinue treatment and find a new, better therapist.
Medications can sometimes be helpful (no one can force you to take medication if you don’t want to, not even your parents). Talk to your doctor or therapist if you’re interested in the possibility of going on medication.
It’s very important to keep in mind that self-injury itself is not the problem, but only a way to cope with the problem(s). Try to make sure those who want to help you know that too.
Even if you’re not ready to stop yet (not everyone is), I’d still recommend taking a look at the Secret Shame site.
How can I help my friend/family member/significant other who self-injures?
There are many things that you can do. The most important thing is to ask them what you can do. They’re the ones that know best. Listen if they need to talk, and only offer advice when asked. Avoid judging them (“attention whore,” “faker,” etc), and remember that they are not going to tell you everything right away. Do not assume that you know everything about them, and do not blame either them or yourself for their pain. Remember that they are a person beyond their self-injury. Keep an open line of communication with them.
Do not demand that they stop self-injuring. Self-injury isn’t something that one can “just stop.” Yes, it can be scary to see a loved one in that much pain, and the natural reaction is to want to protect them from getting hurt. However, if you want them to be able to stop hurting, new coping mechanisms will be needed. You can offer them a way to cope by listening when they want to talk, and by encouraging them (NOT forcing them) to try new coping methods.
Make sure to clarify whatever boundaries you have. Let your loved one know exactly what they can expect from you as far as support goes. If you can’t take a crisis call after 10 PM, say so. If you can’t handle talking about self-injury, but are still willing to talk about the issues, let them know that too.
For ideas on what to say/do, check out http://www.golivewire.com/forums/topic.cgi?forum=1&;topic=32176. Remember though, everyone is different. Talk to them about what’s on the list before just assuming its all true. It will probably need to be modified a bit to fit both them and you.
Encourage (do NOT force) them to get a therapist. The one exception to this rule is when there is an immediate risk of suicide or a suicide attempt; that means that they need help now. If/when they do decide that they want therapy, be supportive and offer to help them look. If they don’t like a therapist, encourage them to find another rather than just giving up. Therapists are people too; they’re all different. Some are really, really bad, but some are awesome. The awesome ones are worth finding.
Become educated on self-injury. Visit the Secret Shame site ( http://www.selfharm.net ) and read A Bright Red Scream (reading additional books would defiantly not hurt!). Share the information with the self-injurer in your life and anyone else who’s trying to help them. If they suffer from co-occurring disorders, become educated on those too.
Remember is to take care of you. This is very important. You need sleep. You need food. You need time for yourself. That may all seem obvious, but a lot of people try to take on more than they can handle. You cannot be there 24/7. You will not be any use to your loved one if you don’t take care of yourself first. It would also be a good idea to look into getting support for you. As willing as you may be to help them, their problems will take their toll on you in time. You’ll help them best when you’re at your best.
Most importantly: Do not try to “save” them. They are the only ones who can save themselves. Instead, help them by listening, distracting, or doing whatever else you can within reason. Keep up an open line of communication with them.
Links to information on commonly co-occurring problems
Eating disorders:
Introduction article - http://www.hampsteadhospital.com/Media/Guide.pdf
More detailed information – http://www.something-fishy.org
Depression:
http://www.depressionalliance.org/
Suicide:
Suicide hotline – 1-800-SUICIDE
Feeling suicidal? Read this first - http://www.metanoia.org/suicide/
Suicide information - http://www.save.org/
Borderline Personality Disorder:
http://www.bpdcentral.com
Schizophrenia:
http://www.schizophrenia.com/index.html [haven’t extensively checked it out]
Bipolar:
http://www.dbsalliance.org/ [haven’t extensively checked it out]
Sexual abuse/assault (PTSD):
http://www.rainn.org/
Grief:
http://www.counselingforloss.com/
Basic information on many disorders:
http://www.nimh.nih.gov/publicat/
Anyone who would like to suggest a link, PM me and I’ll check it out and add it if it looks good.
[The specific definition of self-injury which is the first paragraph comes from Jan Sutton ( www.siari.co.uk ) and Deb Martinson ( www.selfharm.net ).
The rest of the information comes mostly from Deb Martinson’s site ( www.selfharm.net ).]
[Edited 12/14/03. Added onto both "How can I stop?" and "How can I help my [loved one] who self-injures?" Also added "Links" section and edited several minor details.]
Why people, especially teens don't want to get help, and how to encourage them to get help. - trackster32
1. Peers
"No one else sees a psychiatist?"
"What if people find out"
Teens think they are alone in a lot of their problems. In reality a lot of teens each year are seeing a counselor or somebody. They dont want to embarrass themselves if someone finds out.
How to encourage them: Explain that many people at your school are on meds or see a counselor.IF you can, name examples but tell her to keep quiet. She isnot going to be alone. Besides, if her true friends find out they will be happy that she is getting help. You could also have a counselor try to tell them this.
2. "I'm not crazy"
"Only crazy people get help"
This is part denial and part shame. So often, psychiatric help is made out for the crazy. Only murderers ect are crazy, right?
How to help: Explain that murders have a different kind ofmental problems. She's perfectly sane but jsut needs some help dealing witha few things. There is nothing wrong with asking for help
3. "I'm fine,"" I can handle it."
This is denial. They probably know inside they need help they just dont want to admit it. It could also stem from embarrasment of admiting a problem and the other reasons discussed above.
How to help " I 've seen you had a lot of trouble recently. I'm concerned you have more than you can handle. Maybe you should talk to a professional"
4. About Parents
They know they need help but they are afraid their parents wont take them seriously, wont believe them, or get angry. In a few cases yes. In those cases, an adult should get involved.
Most parents woul dbe glad that their teens came to them and would help them.
How to help: offer talk to her parents with her, " they just want the best for you. They prolly dont know how to approach this themselves.
(Edited by XxCrazyDawg69xX at 7:51 pm on Oct. 28, 2003)
(Edited by Tempral at 9:21 pm on Jan. 27, 2004)
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i USED 2 CUT MYSELF BUT i EVENTUALLY GAVE IT UP BY BECOMING A CHRONIC STONER AND A BORDERLINE ALCOHOLIC
