Although National Self-Injury Awareness Day (NSIAD) is on March 1, I am offering some information to my readers today. Just because it's important and close to my heart.
INFORMATION
Approximately 1% of the US population has self-injured at some point in time.
Self-harm, also known as self-injury, self-inflicted violence, self-injurious behavior, or self-mutilation, can be defined as the deliberate, direct injury of one's own body that causes tissue damage or leave marks for more than a few minutes and that is done in order to deal with an overwhelming or distressing situation.
It's important to remember that, even though it may not be apparent to an outside observer, self-injury is serving a function for the person who does it. Figuring out what functions it serves and helping someone learn other ways to get those needs met is essential to helping people who self-harm. Some of the reasons self-injurers have given for their acts include:
- Affect modulation (distraction from emotional pain, ending feelings of numbness, lessening a desire to suicide, calming overwhelming/intense feelings)
- Maintaining control and distracting the self from painful thoughts or memories
- Self-punishment (either because they believe they deserve punishment for either having good feelings or being an "evil" person or because they hope that self-punishment will avert worse punishment from some outside source
- Expression of things that can't be put into words (displaying anger, showing the depth of emotional pain, shocking others, seeking support and help)
- Expression of feelings for which they have no label -- this phenomenon, called alexithymia (literally no words feeling), is common in people who self-harm
See Osuch, Noll, & Putnam, Psychiatry 62 (Winter 99), pp: 334-345
Zlotnick et al, Comprehensive Psychiatry 37(1) pp:12-16.
People who self-injure often never developed healthy ways to feel and express emotion or to tolerate distress. Studies have shown that self-harm can put a person at a high level of physiological arousal back to a baseline state.
It's natural to want to help people who self-injure develop healthier ways of coping when they feel overwhelmed, but it's important not to let your discomfort with the concept of self-harm cause you to issue ultimatums, punish self-harming behavior, or threaten to leave if the person self-harms again. Ideally, you should set boundaries to keep yourself feeling safe while respecting the person's right to make his or her own decisions about how to deal with stress.
MYTHS
Self-harm is usually a failed suicide attempt.
This myth persists despite a wealth of studies showing that, although people who self-injure may be at a higher risk of suicide than others, they distinguish betwen acts of self-harm and attempted suicide. Many, if not most, self-injuring people who make a suicide attempt use means that are completely different to their preferred methods of self-inflicted violence.
People who self-injure are crazy and should be locked up.
Tracy Alderman, Ph.D., author of The Scarred Soul, addressed this:
"Fear can lead to dangerous overreactions. In dealing with clients who hurt themselves, you will probably feel fear. . . . Hospitalizing clients for self-inflicted violence is one such form of overreaction. Many therapists, because they do not possess an adequate understanding of SIV, will use extreme measures to assure (they think) their clients' best interests. However, few people who self-injure need to be hospitalized or institutionalized. The vast majority of self-inflicted wounds are neither life threatening nor require medical treatment. Hospitalizing a client involuntarily for these issues can be damaging in several ways. Because SIV is closely related to feelings of lack of control and overwhelming emotional states, placing someone in a setting that by its nature evokes these feelings is very likely to make matters worse, and may lead to an incident of SIV. In addition, involuntary hospitalization often affects the therapeutic relationship in negative ways, eroding trust, communication, rapport, and honesty. Caution should be used when assessing a client's level of threat to self or others. In most cases, SIV is not life threatening. . . . Because SIV is so misunderstood, clinicians often overreact and provide treatment that is contraindicated.
People who self-harm are just trying to get attention.
A wise friend once emailed me a list of attention-seeking behaviors: wearing nice clothing, smiling at people, saying "hi", going to the check-out counter at a store, and so on. We all seek attention all the time; wanting attention is not bad or sick. If someone is in so much distress and feels so ignored that the only way he can think of to express his pain is by hurting his body, something is definitely wrong in his life and this isn't the time to be making moral judgments about his behavior.
That said, most poeple who self-injure go to great lengths to hide their wounds and scars. Many consider their self-harm to be a deeply shameful secret and dread the consequences of discovery.
Self-inflicted violence is just an attempt to manipulate others.
Some people use self-inflicted injuries as an attempt to cause others to behave in certain ways, it's true. Most don't, though. If you feel as though someone is trying to manipulate you with SI, it may be more important to focus on what it is they want and how you can communicate about it while maintaining appropriate boundaries. Look for the deeper issues and work on those.
Only people with Borderline Personality Disorder self-harm.
Self-harm is a criterion for diagnosing BPD, but there are 8 other equally important criteria. Not everyone with BPD self-harms, and not all people who self-harm have BPD (regardless of practitioners who automatically diagnose anyone who self-injures with BPD).
If the wounds aren't "bad enough," self-harm isn't serious.
The severity of the self-inflicted wounds has very little to do with the level of emotional distress present. Different people have different methods of SI and different pain tolerances. The only way to figure out how much distress someone is in is to ask. Never assume; check it out with the person.
Only teen-aged girls self-injure.
In five years of existence, the bodies-under-siege email list has had members of both genders, from six continents, and ranging in age from 14-60+. It's a person-who-has-no-other-way-to-cope thing, not a teenage (or female or American or whatever) thing.
INFORMATION
Self-injury is a coping mechanism. An individual harms their physical self to deal with emotional pain, or to break feelings of numbness by arousing sensation.
People can feel the
urge to self-injure for hours, and it can feel like there is nothing else to relieve the distress, other than to hurt one's self.
A
trigger is an event that pushes a person over the edge and leads them to seek immediate relief through self-harm.
A trigger can be an external event, such as an argument, or an internal event, like remembering a traumatic time.
DID YOU KNOW?
Self-harm includes many harmful behaviours such as self-injury, but includes such diverse matters as eating disorders, risk taking behaviour, drug and alcohol misuse.
We might describe a massive acute drug overdose as suicidal behaviour, but if someone is self-medicating in a chronic manner (over a period of time) then we're more likely to describe it as self-injury, especially if the person explains their actions are to 'help them cope' or 'help them forget'.
When a person is told that their ideas, desires and thoughts are wrong, stupid or not worth considering, that person can feel invalidated, i.e. they can feel unheard and discounted.
When a person finds that all their thoughts are always judged to be silly or not worth consideration, they can be said to be experiencing chronic, or long-term invalidation.
If a person's self expression is inhibited, or even forbidden, then it may lead to such a crisis that they turn inwards, only expressing themselves internally, and this might manifest as self harm.
Self harm can be seen as 'communication to one's self'; a person who self harms may feel that the only way to have a voice, is to keep it silent and private, to express their feelings directly on their own body.
If there is no one who will listen to the emotional outbursts of a frustrated and distressed person, they may turn to self harm as a form of emotional expression. By creating physical harm to themselves, they seek relief from the emotional distress# that they are forbidden to express publicly.
Physical pain can seem easier to deal with than the emotional pain that is trapped inside an invalidated person, and it detracts from the emotional distress therefore offering some kind of temporary relief.
Chronic invalidation is not only experienced by young people, it can effect people of any age, in situations where a person in power, or a group of people, continuously discount and ignore a person. This sort of passive bullying can often be seen in the work place*.
WHO SELF-INJURES?
Self-injury can affect anybody, at any time in their lives. Gender, age, sexual orientation, race, religion, background – they are all irrelevant. If, rather than considering who might turn to self-injury, we instead focus on who could possibly suffer from the emotional distress that can lead to self-injury, it’s much easier to imagine that self-injury really can affect anyone.
Self-injury is a coping mechanism. Anyone who has anything distressing to cope with might potentially turn to self-injury.
So instead of looking at who self-injures in terms of such things as gender and age, we might consider that there are certain characteristics that some people who self-injure share. These include, but are not restricted to, low self-esteem, perfectionism and high achievement, poor body image, trauma and abuse. Of course, a person who self-injures may experience all, some, or none of these characteristics, as may a person who doesn’t self-injure.
Many people who self-injure often talk about intense negative feelings towards themselves. A significant cause of low self-esteem is chronic invalidation by others.
Perfectionists may be very successful in their every-day lives, but it often comes at a personal cost. Perfectionism simultaneously pushes people to succeed to the highest standards, but it also inevitably causes a person to feel they could have done better, or even that they have failed. Similarly to invalidation, this may lead eventually to low self-esteem.
Some people who self-injure have a poor body image. This may, again, be due to invalidation (i.e. consistent comments about weight, looks etc) or may even be due to the media’s attention on the ‘beautiful people’. A person can feel inadequate, or even ugly or inferior. Self-injury may be a way of coping with these feelings by ‘punishing’ the body.
Some people self-injure to cope with traumatic life events, either currently or in the past. These may include bereavement, bullying, break-up of relationship, financial crisis, or physical, emotional or sexual abuse.
Self-injury may also be associated with mental health issues such as depression, anxiety, eating disorders, schizophrenia, borderline personality disorder, etc.
Resource:
http://www.lifesigns.org.uk/ (TONS of info here, please go to the website and download the appropriate pdf file..ex. info for teachers, for parents, for friends, for males and so on)
This information could save someone you know so please read!
