Self-Injury: Understanding and Responding to It
by
Karen Carr, Mobile Member Care Team-West Africa
Terms: Self-injury, self-harm, self-mutilation, or self-inflicted violence
What is it? The intentional harm of one’s own body without conscious suicidal intent.
Why Do We Need to Know About it? Self-injury is something that is more common than we realize and that often is covered in secrecy and shame. An estimated 8 million Americans are currently self-mutilating. Chronic acts of self-injury usually begin in adolescence and may last for 10-15 years before ending. Kids in boarding schools may be more vulnerable to this method of coping because of feelings that they do not have enough control or freedom in their lives. There seem to be an equal number of males and females who self-injure.
Methods often used:
- Cutting (with razor blades, pins, knives)
- Burning (with cigarettes, matches, lighters)
- Reopening wounds (picking at scabs)
- Biting fingernails excessively
- Pulling out hair
- Hitting or bruising self
- Breaking own bones
Reasons for Self-Injury:
1) Relief from feelings: Person has trouble identifying, expressing, and releasing emotions. May express feeling isolated, alienated, depressed, frustrated, disorganized, tense, fragmented, or empty. Self-injury provides a sense of immediate relief from these feelings by producing a flooding of endorphins and providing a tangible wound that can be nurtured and healed.
2) Method of Coping: A person feels overwhelmed and unable to tolerate intense feelings and has found this method to be a kind of coping that brings relief and lowers stress when other methods have failed.
3) Physical Expression of Pain: Person feels internal conflict and this act brings validation and tangible reality to the pain.
4) Revenge: Person is expressing anger or resentment at someone and so the injury is a way of communicating those feelings to another person.
5) Self-punishment: Person may have been abused and does this because they think they deserve it. Strong feelings of self-criticism and unworthiness are present.
6) Re-enacting Previous Abuse: If person was injured or abused by another they may replicate the abuse in order to gain a sense of control or to bring relief of tension.
7) Self-Protection: Person may fear sexual victimization and produce scars in order to scare away anyone who may approach them.
8) Establishing Control: Although a person may feel they have little or no control over their environment or others, they can control their own body, thoughts, behaviors, and emotions. Self-injury gives a sense of increased control and strength as they endure the pain that they have inflicted on themselves.
9) To Reduce Feelings of Numbness: Person may perceive that they are not feeling anything and will injure themselves in order to reassure themselves that they can feel pain and that they are “alive.”
Reasons it is difficult to stop:
Because self-injury provides an immediate sense of release and relief for the person who is experiencing emotional pain, the act then becomes associated with something very positive, even if there are negative consequences later on. The act of self-injury can become addicting and unless an alternative form of coping that is just as effective is found, it will be very hard for the person to let this method go. Also, this behavior can be associated with feelings of shame and secrecy. This means that the person may not tell others about the behavior and may stay in an isolated place which will only aggravate the feelings that have led to the self-injury in the first place.
How to help someone who is self-injuring:
Perhaps the most important thing is to focus first on why the person is hurting themselves as opposed to how to get them to stop. Remember that self-injury is usually a symptom of a deeper emotional issue and the person has not figured out how to talk about it or how to cope with it. Because feelings of loss of control are a common factor in self-injury, taking a controlling, dominant stance to get the person to stop is generally ineffective. It will need to be the person’s choice to stop and they will have great difficulty doing this until they have discovered alternative means of coping with emotional stress. Anything that the helpers can do to help the person identify feelings, talk about them, and discover effective problem solving strategies for them, will divert the focus away from self-injury and onto the source of the problem.
Remembering that shame is often a core part of self-injury, helpers need to find ways to communicate care and concern without communicating judgment, criticism, or disgust in response to self-injury. Sometimes the fear and concern of the helpers translates to a judging urgency that can make the problem worse. Most self-injury is not life threatening even if it is harmful and therefore a patient, thorough approach is more effective than a quick, harsh one.
Never hesitate to consult with a mental health professional when you become aware that someone is engaged in self-injury. Self-injury can also be occurring in conjunction with other types of problems such as sexual abuse, depression, suicidal thoughts, eating disorders, or substance abuse. Be sure to ask the mental health professional if they have any experience in working with self-injury. If you are in West Africa, you can contact the Mobile Member Care Team for consultation by Clicking HERE.
Suggested Ways to Use This Handout:
This handout can be distributed toBoarding school staff (dorm parents, administrators, teachers, nurses, chaplain, etc) as well as parents in order to raise awareness and to educate. Inservices can be held to have further discussions about how to recognize this problem and respond to it. Also consider having discussions with kids in the dorms to encourage them to let an adult staff know if they or someone they know is self-injuring so that they can get some support and help.
References and Reading Resources:
"The Scarred Soul: Understanding and Ending Self-Inflicted Violence" by Tracy Alderman
"A Bright Red Scream: Self-mutilation and The Language of Pain" by Marilee Strong
"Bodies Under Siege" by Armando Favazza
Websites:
 www.webring.org/cgi-bin/webring?ring=bus;list
www.palace.net/~llama/selfinjury
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