These acts often serve to relieve intense emotions that are unbearable for the person to cope with. They can also serve to turn around a feeling of numbness that arises during a dissociative episode in which the person feels out of touch with their own sense of self. While not characterized in the Diagnostic and Statistical as an individual disorder, self injury is characteristic of other mental illnesses like Borderline Personality Disorder, Post Traumatic Stress Disorder and Major Depressive Disorder.
How the Tendency to Self Mutilate Arises
There are a variety of reasons that psychologists think the tendency to self mutilate manifests itself. For some people it is the result of severe trauma associated with sexual assault, child abuse, child sexual assault or emotional abuse. The act is a signal that the person is unable to cope with either memories, experiences or emotions that are triggered in daily life. Often the person who self mutilates expresses a sense of low self esteem and is very isolated from others. Sometimes the act exists in concert with an eating disorder which is in itself a very self destructive behavior.
It is important to remember that these acts of self injury are not in reality suicide attempts, they are instead coping strategies. Neither are these behaviors attention seeking behaviors. Most self injurers are humiliated and feel very guilty about the wounds and scars they bear. This is often why the injuries happen on the bodily in places not readily accessible. Thus, it becomes very hard to record and understand the scope of self mutilation because it remains unreported and hidden.
Who Hurts Themselves
It has been suggested in numerous journals that four times more females than males self mutiliate. This is in keeping with the idea that when women become depressed they are internalizing their own anger at their lives and situations. Men are more likely to act out in anti-social ways and thus are less likely to self injure. Often times the tendencies to self injure are an indication of an underlying more serious disorder that is hidden by the symptom of self injury, leaving the more serious disorder untreated.
What is the Purpose of the Injury
Self injurers who are willing to talk about their experiences often report that there is a positive purpose to the act. This makes the act a positive coping strategy that most people would see as negative. Some self mutilators report a feeling of relief that keeps them calm in a situation they see as out of control. This sense of being out of control can be either real or imagined, but for the mutilator it is very real. The act allows the person to gain back control by releasing the emotions leading to a sense of control over the emotions and the situation that triggered the emotions.
Many times other self injurers report feeling disassociated from their own sense of self. Some believe they have no sense of their real selves and feel that they are watching themselves live. This sense of disassociation if often relieved for self injurers because the injury and associated results, either blood, vomiting or pulling out their own hair for example, gives them a sense of feeling real, alive and able to function.
What to Look For
Since injurers most often hide their injuries one must look carefully to see the signs of self mutilation in a person. Wearing long sleeve shirts or long pants in the summer is often a dead give away. Refusing to disrobe at the beach and wear a bathing suit is yet another sign of something to hide.
Intervening is often more difficult. Self injurers will deny that the injuries were self inflicted and in keeping with their secrecy come up with very creative excuses for the wounds they are trying to hide.
It is also important when confronting someone you suspect to be a self mutilator to do so in a gentle manner that indicates that you understand that these actions are coping strategies for situations that the person cannot deal with. It is also important to recognize that often those who self injure are suffering from an underlying disorder that needs professional help.
As with any mental illness, the self injurer needs to be encouraged to seek professional help in a non threatening way in order to help them come to terms with what they are dealing with and learn to develop better coping strategies. This can be done through diagnosis of the underlying disorder and treatment that leads to a change in the behavior.
Self mutilation does not have to be a life time experience. There are better, healthier ways to cope with intense emotions and these can be taught. There is above all hope for repairing the tendency.
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