Understanding Self-Harm

Understanding Self-Harm

Understanding Self-Harm is just the beginning.  Through continued education, our goal is to help reduce the stigma associated with issues related to mental health.  When we, as a society, seek to increase our understanding of mental health issues, it decreases the stigma and shame often associated with getting much needed help for the people who are struggling. The information provided below only provides a basic understanding.  It is not meant to be all-encompassing as the reasons and methods for self-harm are many.

Individuals who engage in non-suicidal self-harming behaviors are often surrounded by others in their life who have a difficult time understanding why they might be driven to such extremes, and may not fully be able to empathize with their behavior. Many people are left wondering why someone, anyone, would purposefully and intentionally cause their own body harm.

The oversimplified explanation is that every behavior persists because it meets a need, and for people who self-harm, a very precise, albeit difficult to understand, goal and need is being met.

Explaining Non-Suicidal Self-Harming Behaviors

Self-Harm, that is not considered to be overtly suicidal, refers to injuring one’s own body while avoiding fatal injury. The intent is not to not to end one’s own life, but instead to cause an injury that meets the complex psychological needs of the individual. Self-harming behaviors can include but are not limited to cutting, biting oneself, ingesting toxic substances, burning or carving into one’s body, creating and re-opening wounds, repeatedly punching walls or objects, or severe head banging and hair pulling (trichotillomania).

Many of the complex psychological needs that self-harm meets, focuses on the need to regulate emotions. These emotions may often feel out of the individual’s control. The ability to regulate one’s emotions refers to one’s ability, when presented with particular environmental circumstances, that bring with them various emotional experiences (i.e. stress), we are able to control and direct those emotions in ways that allow us to manage them effectively.

For some individuals, the skills of emotional regulation are underdeveloped, and thus certain emotions elicit an inability to effectively cope. For example, disappointment, frustration, shame, grief, guilt and other similar negative emotions can be overwhelming and out of one’s ability to manage. Research has demonstrated that self-harm brings relief from those negative emotions, even if only temporary. That relief is a means of coping; while misunderstood by others and seen as maladaptive, and it allows the individual to feel some semblance of control over themselves, their emotions, and the situation.

How can a self-harming behavior bring about relief and help someone to cope?

Theories that are offered to help explain how self-harm leads to the ability to cope and feelings of relief remain ambiguous; however, there is some data offering promising insights. It is important to remember though, the explanations offered may differ for different individuals.

Research has also demonstrated that when engaging in self-harming behaviors, certain chemicals in the body such as endorphins and other opioids that relieve pain are released.  Although the self-harming behavior appears to be painful, the neurochemicals being released during the process bring about a sense of relief that is greater than the pain being inflicted. The neurochemical effect can be so powerful that it leads to cycle typical of those struggling with a substance use disorder.

Additional research proposes that the pain brought about from self-harm serves the purpose of distracting the individual from an even greater pain. This can be explained through understanding very simple principles employed in pain management techniques. Think of the last time you were at the dentist and needed a painful shot of Novocain (a local anesthetic) to numb a certain part of your mouth. Very often just before the pain-causing-needle enters your mouth, the dentist strongly pinches the area. The pinch helps to distract you from the more severe pain of the needle. It is no secret that often those who self-harm are in great pain.

Individuals who engage in self-harming behaviors often report experiencing extreme feelings of self-loathing, shame, and self-deprecation. The minor injuries serve as a form of self-punishment to reprimand themselves as a perceived ‘bad’ or guilt-ridden person.  There have even been reports of some individuals saying that they use the wounds, scars and bruises as their language to communicate to others the depth and extent of their pain and self-loathing they either cannot express or feel unable to communicate.

What factors cause this type of coping strategy to develop?

Many factors can influence a person’s ability to effectively cope with stress and especially their ability to regulate emotions. Some of these factors include experiencing childhood trauma, and victimization.

However, even for those without notable traumatic experiences, witnessing self-harm in others who report back a feeling of relief and calmness, can make this coping style seem enticing. This is especially true if the individual is desperately seeking a way to relieve themselves from psychological pain and is unaware of other means of coping.

How Can I Help?

It is important to remember that self-harm is not a form of suicide. Primarily, self-harm is a means of meeting complex psychological needs; not a means of ending one’s life. Again, many individuals are seeking a way to cope with pain, distract themselves from deeper pain, communicate their needs, and/or punish themselves for a whole host of negative reasons.

Reaching out to understand and help someone who is injuring themselves can have a vital impact on that person’s well-being. Here are some important things to remember:

1. Educate yourself about self-harm. You are reading this article right now and that means you have started that process of educating yourself. The more you are aware of the condition, the better and easier it will be for you to communicate understanding and support.
2. Don’t be afraid to openly address the issue. It is very often the case that individuals engaging in self-harm are longing to share their feelings about the issue; sometimes even hoping someone would openly confront them. If at first, your approach is met with resistance, that’s ok. Let them know that you are willing and ready to discuss the issue when they are ready to talk.
3. Listen emphatically. This means that you listen to the person with an open mind. Without using words that make them feel judged, criticized or ashamed, it is your role to create a safe place to discuss and listen to the feelings being experienced. It is important to state that you are here to not only listen, but to truly understand.
4. Let them know there are alternative ways to cope with feelings. Suggest that you are willing to help them find a professional specially trained in helping people who self-harm. It is important to find a licensed masters or doctorate level, licensed mental health professional who is experienced with self-harming behaviors. An inexperienced individual can make matters worse. Professionals can help people develop new and better ways to manage feelings and emotions. There are many types of programs available to treat people who self-harm and many people experience long-term success following professional interventions.

Being available to understand and support someone who self-harms can very often be the first step in helping that person begin the process of change. It is important to remember however; that being that support person can have challenges of its own. Providing emotional support can be time consuming, frustrating, and emotionally draining at times. Watching someone hurt themselves can be painful and scary. Those are all normal and expected reactions. Be sure to take care of yourself too and if necessary seek out your own counseling to help you set healthy boundaries and manage your personal stress.