Self-harm refers to the behaviors associated with intentionally injuring one’s own body without suicidal intent (though it may seem like a suicide attempt). These behaviors are most commonly associated with cutting, burning, scratching, ripping skin or hair, and self-bruising and are usually performed on hands, wrists, stomachs, and thighs.
While some have reported self-harming earlier than age 7, most individuals who self-harm typically begin between the ages of 12 and 15 (early adolescence). Self-harming behaviors are sometimes performed only once, but in more severe cases can last for years into adulthood. While there are currently no known gender or race differences between those who self-harm, some risk factors may include belonging to a sexual minority group or having an early experience of trauma (e.g. physical or sexual abuse). Other psychological factors may also influence the likelihood of self-harm. Those at increased risk may suffer from an eating disorder, PTSD, borderline personality disorder, substance abuse, and anxiety or depression.
What are the signs & symptoms of self-harm?
- dressing inappropriately according to the weather (e.g. wearing long sleeve shirts and long pants when it is hot out)
- injury to arms & wrists that are opposite of the dominant hand
- excessive and frequent use of wrist bands or bandages
- discovery of sharp objects in one’s possession
- refusal to participate in activities that may expose skin such as working out or swimming
- withdrawal from friends, family, and enjoyable activities
- having friends who self-harm (current research suggests that self-injury may be socially contagious)
- low self-esteem
- irritable or impulsive behaviors
- a sudden increase in the number of skin injuries
- skin injuries that are performed in secret or are tried to be kept secret
- injuries that appear cyclically rather than constantly
Why do people self-harm?
- as a way to manage intolerable or negative feelings
- to feel something in the presence of nothing
- to punish oneself for feeling inadequate or worthless
- as a way to cope with some negative emotion, anxiety, stress, or pressure
- for feelings of euphoria or an “energy rush”
- to reenact an unresolved trauma
- to communicate needs
- to distract oneself from other problems
- to express one’s emotional pain
- to feel or restore a sense of control over one’s mind & body
How common is self-harm among the adolescent/young adult population?
Among the population of high school children and young adults in the United States, approximately 12-24% self-harm. Of this population, approximately 75% have self-harmed more than once. About 6-8% of the entire adolescent/young adult population reports frequent and chronic self-harm.
Is self-harm addictive?
Current research has suggested that self-harm does possess some addictive qualities similar to drug addiction. The experience of self-injuring is thought to release endorphins and stimulate the body’s endogenous opioid system. Both are thought to modulate the body’s pain response to evoke feelings of euphoria or pleasure. This might explain why constant self-harm may feel less painful over time and may increase one’s pain tolerance. Additionally, it might explain one’s repetitive and cyclic urge to repeat self-harming behaviors after periods of cessation.
How is self-harm related to suicide?
While 60% of those who self-harm report never having thoughts of suicide, the emotional distress that leads one to perform self-harming behaviors may increase the likelihood of suicidal ideology or attempts among these individuals. Generally, self-injury therefore is used as a maladaptive mechanism for coping with negative emotional experiences and is usually performed in order to avoid acts of suicide. However, if these negative coping skills have gone untreated for a long span of time, self-injury may then be preliminary to suicidal behaviors.
What are the long-term effects of self-harm?
Because chronic self-injurers often build a tolerance to pain over time, an episode of self-harm may lead to an accidental suicide or other medical emergency. Often times, those who inflict major wounds on their body do not seek medical help. Therefore, severe injury or unintentional death may be a few serious effects of chronic self-harm. Additionally other effects may include:
- scarring and blisters (including keloids)
- numbness and loss of feeling in injured skin areas
- severed nerves
- decreased sensitivity
- random pain
What can parents and friends do to help one suffering from self-harm?
- do not approach your loved one with anger or avoidance; instead, be direct and express concern
- pay attention to the underlying feelings that your loved one is facing and listen to them in a supportive and respectful way
- do not be judgmental, do not give ultimatums, and do not try to make your loved one feel guilty
- do not equate self-harm with suicidal behavior, however, do be aware for signs of suicidal ideology
- keep educated on self-injury
- be supportive and let your loved one know that you understand the journey to recovery may be long and difficult, but that you are with them every step of the way
- when your loved one is ready for treatment, find a psychotherapist who is comfortable in dealing with self-harm