Why do people hurt themselves?

Self-mutilation or self-harm can manifest itself in different ways, such as scratching, cutting, or hitting oneself. Sometimes self-mutilation is an expression of stress or unspoken feelings, but it can also be the symptom of an underlying disease. Recent research shows that as many as one in ten young adults between the ages of fourteen and seventeen has committed self-harm sometimes in their lives. Females, by the way, do it more often than males. Self-mutilation is a complex behavior that can be challenging for those who don’t experience it to understand. It often serves as a coping mechanism for individuals trying to manage overwhelming emotions. While it might seem counterintuitive, the physical pain can often provide a temporary release or distraction from emotional distress.

Understanding Self-Mutilation

Common Misconceptions

There are several misconceptions about self-mutilation that can hinder understanding and support. One common myth is that self-harm is always a suicidal gesture. However, many individuals who self-harm do not have suicidal intentions. Instead, they use it as a way to cope with life’s challenges. Another misconception is that self-harm is simply a bid for attention. While some individuals may exhibit their injuries, many go to great lengths to hide their actions due to shame or fear of judgment.

Deepening Understanding

To better understand self-mutilation, it’s essential to consider the perspective of those who engage in it. Many individuals describe the act as a way to externalize their internal pain, making something intangible more concrete and, therefore, more manageable. For others, self-harm can be a grounding experience, pulling them away from dissociative episodes or intense emotional numbness.

Symptoms of Self-Mutilation

The symptoms of self-mutilation include the following:

• Scratching oneself
• Biting oneself
• Cutting oneself
• Burning oneself
• Hitting oneself
• Head banging against the wall
• Pulling out hairs (trichotillomania)
• Poisoning oneself (auto-intoxication)
• Sticking or putting objects into oneself
• Causing bone fractures to oneself

While these symptoms are the most common, they are not the only ones that can indicate self-mutilation. Sometimes, individuals may engage in less obvious forms of self-harm, such as neglecting their physical health or engaging in risky behaviors.

Identifying Hidden Signs

Some individuals may not display visible injuries or wounds. Instead, they might exhibit behavioral changes such as wearing long sleeves in warm weather, frequent unexplained injuries, or displaying signs of depression or anxiety. It’s crucial for friends and family to be observant and approach the topic with sensitivity and understanding.

Causes of Self-Mutilation

There can be several reasons why people, consciously or not, hurt themselves: to punish themselves, to turn inner emotional pain into physical pain, or to forget other painful things. Trauma victims sometimes use self-mutilation to stop moments of ‘re-experiencing’ the trauma. Sometimes self-mutilation is a way to deal with an inner emptiness or to manipulate the environment. The signs of self-mutilation are often located in visible places of the body. In this way, self-mutilation becomes a form of language, a way to convey a message.

Psychological Underpinnings

• Emotional Regulation: Self-harm may help regulate intense emotional experiences. For some, it is easier to manage physical pain than emotional pain.
• Expression of Anguish: It can be a non-verbal way to express feelings of anger, frustration, or deep sadness.
• Sense of Control: When life feels overwhelming, self-harm can provide a sense of control over one’s body and pain.

Biological Factors

Self-mutilation also has an addictive effect. By hurting oneself, endorphins are released, acting as a natural painkiller that also causes a feeling of euphoria. This biochemical release can be reinforcing, making it difficult for individuals to stop the harmful habit on their own.

Self-Mutilation and Mental Health Disorders

Keep in mind that self-mutilation is not a mental illness in itself; it is rather a symptom of another disease or condition such as borderline syndrome or autism. It is often associated with the following mental health conditions:

• Borderline Personality Disorder (BPD): Individuals with BPD may use self-harm as a coping mechanism to deal with intense emotions or feelings of emptiness.
• Depression: Self-harm can sometimes be a symptom of depression, serving as a release or distraction from persistent negative thoughts.
• Anxiety Disorders: The compulsion to self-harm may arise from overwhelming anxiety or panic attacks.
• Eating Disorders: There is a significant overlap between self-harm behaviors and eating disorders, as both can involve issues related to control and self-perception.

Emerging Insights

Recent studies have begun to explore the neurological aspects of self-harm. Brain imaging technologies have revealed that individuals who self-harm may have differences in brain structure and function, particularly in areas related to emotional processing and regulation. Understanding these biological components can drive more effective treatment strategies.

Treatment

Sometimes self-mutilation can be treated with medication. If it is an expression of nervousness or tension, the doctor may prescribe a sedative. If the self-harm is a symptom of depression, antidepressants can help. If the patient suffers from psychosis, then antipsychotic medications may be provided. However, sometimes treatment may be needed for the underlying mental health problems. Then the doctor will refer the patient to a psychologist or psychiatrist. Based on the diagnosis, they can draw up an appropriate treatment plan, such as psychotherapy.

Therapeutic Interventions

• Cognitive Behavioral Therapy (CBT): CBT can help individuals recognize and change negative thought patterns and behaviors associated with self-harm.
• Dialectical Behavior Therapy (DBT): Particularly effective for those with BPD, DBT focuses on teaching coping skills to manage emotions and reduce self-harming behaviors.
• Mindfulness-Based Therapies: Techniques such as mindfulness meditation can help individuals become more aware of their thoughts and feelings, reducing the impulse to self-harm.

Building a Support System

A strong support network is crucial for recovery. Friends and family can play a significant role by providing understanding, encouragement, and support. Joining support groups can also offer a sense of community and shared experiences, which can be comforting and empowering.

Involving Friends and Family

Education for the support system is vital. Loved ones should be informed about the nature of self-harm and trained in how to respond appropriately. This might involve learning not to react with anger or frustration, but rather with questions that promote understanding and healing.

Practical Tips for Coping and Prevention

• Develop Healthier Coping Mechanisms: Engage in activities that promote emotional well-being, such as exercise, journaling, or art.
• Create a Safety Plan: Work with a therapist to develop a personalized plan that includes contacts, activities, and steps to take when the urge to self-harm arises.
• Practice Self-Compassion: Encourage a more compassionate view of oneself, recognizing that everyone struggles, and seeking help is a sign of strength.
• Limit Access to Means: Reduce the availability of items commonly used for self-harm, and seek immediate help if the urge becomes overwhelming.

Alternative Coping Strategies

For those struggling with self-harm, finding alternative ways to cope with distressing emotions is crucial. Some find relief in creative outlets like painting or writing, while others might benefit from physical activities such as yoga or running. The key is finding what uniquely resonates with the individual and offers a positive release.

Engaging in Community

Connecting with others can significantly aid in recovery. Volunteering or participating in community events can shift focus away from self-harm, providing both a sense of purpose and connection. Being part of a community where one feels valued and understood can help replace the need to express pain through self-destructive means.

The Road to Healing

The injuries of self-mutilation can sometimes be so severe that medical care is needed. This may be done via a referral to the emergency department of a hospital. However, emotional healing often requires a long-term commitment to therapy and self-care. Recovery is a journey, not a destination, and setbacks are a natural part of the process. With the right support and strategies, individuals can learn to manage their impulses and develop healthier ways to cope with life’s challenges.

Long-term Management

Maintaining recovery from self-harm involves ongoing management and adaptation. This might include regular therapy sessions, continuous monitoring of emotional triggers, and consistent practice of positive coping mechanisms. Over time, the intensity of the urges can decrease, but remaining vigilant is essential.

Learning from Setbacks

Setbacks can be disheartening, but they don’t signify the end of progress. They are opportunities to learn and grow stronger. It’s vital to reflect on what led to the setback and how it can be avoided in the future. Compassionate self-reflection can transform these moments into pivotal learning experiences.

By understanding the complexities of self-mutilation and addressing the underlying issues, individuals can find paths to healing and reclaim their lives from the grip of this challenging behavior. The journey is deeply personal and requires courage and resilience, but with the right help and support, a future without self-harm is possible.