Self-Injury Cutting Yourself to Relieve Emotional Pain

What do these high-profile individuals have in common?

Singer, Fiona Apple; Comedian, Russell Brand; Actress, Drew Barrymore; Actor, Johnny Depp; Actor, Colin Farrell; Actress, Megan Fox; Actress, Angelina Jolie; Singer, Demi Lovato and Princess Diana

Before finding emotional health, they struggled with self-injury.

Self-Injury is a deliberate, non-suicidal behavior that inflicts physical harm on one's body to relieve emotional distress. Self-injury has a paradoxical effect in that the pain self-inflicted actually sets off an endorphin rush, relieving the self-harmer from deep distress. It's important to note that self-injury does not involve a conscious intent to commit suicide—and as such, the clinical term for this behavior is called Non-Suicidal Self Injury (NSSI). This kind of self-injury can take many forms from cutting, picking, burning, bruising, puncturing, embedding, scratching or hitting one's self, just to name a few.

In its simplest form, NSSI is a physical solution to an emotional problem. Generally, it is a deliberate, private act that is habitual in occurrence, not overtly attention-seeking behavior, nor meant to be manipulative. Self-injurers are often secretive about their behaviors, rarely letting others know, and often cover up their wounds with clothing, bandages, or jewelry.

Symbolically speaking, deliberately injuring one's self can be viewed as a method to communicate what cannot be spoken. With self-harm, the skin is the canvas and the cut, burn or bruise is the paint that illustrates the picture. Most individuals who self-injure have difficulties with emotional expression. This clinical experience is known as Alexithymia—the inability to recognize emotions and their subtleties and to understand or describe thoughts and feelings. Many other self-harmers are struggling with internal conflicts, may have anxiety, depression, experienced physical or sexual abuse, or other more serious psychological concerns.

Statistically speaking, approximately 4% of the population in the United States uses NSSI as a way of coping. Individuals who self-injure are represented in all SES brackets in the United States with the behavior usually starting in adolescence. Girls and women tend to self-injure more than boys and men, but this may be represented by the fact that females tend to turn to professional help more than males.

Children and Adults Who Self-Injure Are Often Trying To:

* Distract themselves from emotional pain
* End feelings of numbness
* Offset feelings of low self-esteem
* Control helplessness or powerlessness
* Calm overwhelming or unmanageable feelings
* Maintaining control in chaotic situations
* Self-punish, self-shame or self-hate
* Express negative thoughts or feelings that cannot be put into words
* Self-nurture or self-care

Psychiatrists believe that, for people with emotional problems, self-injury has an effect similar to cocaine and other drugs that release endorphins to create a feel-good feeling. Yet self-harm is different from taking drugs. Anybody can take drugs and feel good. With self-injury, if it works for you, that's an indication that an underlying issue needs be dealt with -- possibly significant psychiatric issues. If you're a healthy person, you might try it, but you won't continue.

Forms of self-injury

Self-injury usually occurs in private and is done in a controlled or ritualistic manner that often leaves a pattern on the skin. Examples of self-harm include:

·         Cutting (cuts or severe scratches with a sharp object)
·         Scratching
·         Burning (with lit matches, cigarettes or hot, sharp objects like knives)
·         Carving words or symbols on the skin
·         Hitting or punching
·         Piercing the skin with sharp objects
·         Pulling out hair
·         Persistently picking at or interfering with wound healing

Most frequently, the arms, legs and front of the torso are the targets of self-injury, but any area of the body may be used for self-injury. People who self-injure may use more than one method to harm themselves.

Becoming upset can trigger an urge to self-injure. Many people self-injure only a few times and then stop. But for others, self-injury can become a long-term, repetitive behavior.

Although rare, some young people may self-injure in public or in groups to bond or to show others that they have experienced pain.

10 Tips for Reducing Self-Injury

1) Create an emergency kit. Place positive things in your kit like photos of things or people you love, notes to yourself or from friends or family, a journal for writing, markers or art supplies for artistic expression, an inspirational poem, beloved stuffed animal, upbeat music, favorite scents, and other things like that to help you dilute the urge to self-harm.

2) Use positive imagery. Visualize yourself moving through your painful moment without self-harming. Research shows that using positive visualization can keep you in-the-moment which is a key tool for recovery.

3) Hold your ground. Sensory Grounding Experiences like holding something soft, listening to soothing music, drawing or writing, for example, can interrupt the trance-like state that often comes with self-harm, shifting you towards more positive behaviors.

4) Reboot your mind. Reframe your thoughts toward helpful statements, also known as Cognitive Grounding Skills, like "Who am I really mad at?"...."What is setting me off?"....  "I am safe because I can take control." These can re-orient you to the here-and-now.

5) Know your triggers. Become aware of what issues bend or break you. Try to dilute your exposure to them, call upon others to help you move through them and remind yourself that you can emerge from triggers successfully.

6) Take a detour. Re-route self-harm by using less severe forms of sensations. Holding an ice cube, tearing paper, shredding a sheet, snapping a rubber band against your skin, sucking a lemon peel, pounding a pillow are ways to diminish the need to self-injure.

7) Move your body. Consider the adrenaline rush of running, dancing, holding a yoga pose, jumping rope to offset urges to self-harm. The rush of adrenaline of these positive behaviors has been known to produce the similar chemical surge that comes from self-injury.

8) Forgive yourself. As you try to interrupt your self-harming behaviors, know that it may not come as easily some days as others. Should you find that you've lapsed into self-harming, remind yourself that change is a process. Learn to forgive and be kind to yourself as you start anew.

9) Be supportive. If you know someone who may be self-injuring, offer support and try not to shame or criticize the NSSI behavior. Self-injury behaviors can be successfully treated, so help your friend or family member by encouraging them to seek help.

10) Consider calling a therapist. Remember that having an urge to self-harm is not the same as actually self-harming. If you can distract yourself from self-injury, you are well on your way to recovery. However, if the urges win out, not allowing you to reduce your self-harm behaviors, consider working with a professional therapist.

When to see a doctor

If you're injuring yourself, even in a minor way, or if you have thoughts of harming yourself, reach out for help. Any form of self-injury is a sign of bigger issues that need to be addressed.

Talk to someone you trust — such as a friend, loved one, health care provider, spiritual leader or a school official — who can help you take the first steps to successful treatment. While you may feel ashamed and embarrassed about your behavior, you can find supportive, caring and nonjudgmental help.

When a friend or loved one self-injures

If you have a friend or loved one who is self-injuring, you may be shocked and scared. Take all talk of self-injury seriously. Although you might feel that you'd be betraying a confidence, self-injury is too big a problem to ignore or to deal with alone. Here are some ways to help.

·         Your child. You can start by consulting your pediatrician or other health care professional who can provide an initial evaluation or a referral to a mental health specialist. Don't yell at your child or make threats or accusations, but do express concern.
·         Teenage friend. Suggest that your friend talk to parents, a teacher, a school counselor or another trusted adult.
·         Adult. Gently encourage the person to seek medical and mental health treatment.

Understanding why your loved one cuts or self-harms

Because cutting and self-harm tend to be taboo subjects, many people harbor serious misunderstandings about their friend or family member's motivation or state of mind. Don't let these common myths get in the way of helping someone you care about.

Myth 1: People who cut and self-injure are trying to get attention.

Fact: The painful truth is that people who self-harm generally hurt themselves in secret. They aren't trying to manipulate others or draw attention to themselves. In fact, shame and fear can make it very difficult to come forward and ask for help.

Myth 2: People who self-injure are crazy and/or dangerous.

Fact: It is true that many people who self-harm suffer from anxiety, depression, eating disorders, or a previous trauma-just like millions of others in the general population, but that doesn't make them crazy or dangerous. Self-injury is how they cope. Sticking a label like "crazy" or "dangerous" on a person isn't accurate or helpful.

Myth 3: People who self-injure want to die.

Fact: When people self-harm, they are usually not trying to kill themselves—they are trying to cope with their problems and pain. In fact, self-injury may be a way of helping themselves go on living. However, there is always the risk of a more severe injury than intended and, in the long-term, people who self-injure have a much higher risk of suicide, which is why it's so important to seek help.

Myth 4: If the wounds aren't bad, it's not that serious.

Fact: The severity of a person's wounds has very little to do with how much they may be suffering. Don't assume that because the wounds or injuries are minor, there's nothing to worry about.

Helping a someone who cuts or self-harms

Perhaps you've noticed suspicious injuries on someone close to you, or that person has admitted to you that they're cutting. Whatever the case, you may be feeling unsure of yourself. What should you say? How can you help?

·         Deal with your own feelings. You may feel shocked, confused, or even disgusted by self-harming behaviors—and guilty about admitting these feelings. Acknowledging your feelings is an important first step toward helping your loved one.

·         Learn about the problem. The best way to overcome any discomfort or distaste you feel about self-harm is by learning about it. Understanding why your loved one is self-injuring can help you see the world through their eyes.

·         Don’t judge. Avoid judgmental comments and criticism—they’ll only make things worse. Remember, the self-harming person already feels distressed, ashamed and alone.

·         Offer support, not ultimatums. It’s only natural to want to help, but threats, punishments, and ultimatums are counterproductive. Express your concern and let the person know that you’re available whenever they want to talk or need support.

·         Encourage communication. Encourage your loved one to express whatever they're feeling, even if it’s something you might be uncomfortable with. If the person hasn’t told you about the self-harm, bring up the subject in a caring, non-confrontational way: “I’ve noticed injuries on your body, and I want to understand what you’re going through.”

·         If the self-harmer is a family member, prepare yourself to address difficulties in the family. This is not about blame, but rather about communicating and dealing with problems in better ways that can benefit the whole family.

When to get emergency help

If you've injured yourself severely or believe your injury may be life-threatening, or if you think you may hurt yourself or attempt suicide, call 911 or your local emergency number immediately.

Also consider these options if you're having suicidal thoughts:
·         Call your mental health specialist.
·         Call a suicide hotline number — in the U.S., call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255).
·         Seek help from your primary doctor or other health care provider.
·         Reach out to a close friend or loved one.
·         Contact a spiritual leader or someone else in your faith community.

Sources and Additional Information:


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