Understanding the Reasons Behind
Aren't people who would deliberately cut or burn themselves psychotic?
No more than people who drown their sorrows in a bottle of vodka are. It's a coping mechanism, just not one that's as understandable to most people and as accepted by society as alcoholism, drug abuse, overeating, anorexia, bulimia, workaholism, smoking cigarettes, and other forms of problem avoidance are.
| Explaining Self Harm |
Okay, then isn't it just another way to describe a failed suicide attempt?
NO. People who inflict physical harm on themselves are often doing it in an attempt to maintain psychological
integrity -- it's a way to keep from killing themselves. They release unbearable feelings and pressures through self-harm, and that eases their urge toward suicide. And although some people who self-injure do later attempt suicide, they almost always use a method different from their preferred method of self-harm. Self-injury is a maladaptive coping mechanism, a way to stay alive. Unfortunately, some people don't understand this and think that involuntary commitment is the only way to deal with a person who self-harms. Hospitalization, especially forced, can do more harm than good.
Why would someone Self-Harm?
Self harm provides a solution, a remedy for how they are feeling. Most Self Harmers have clinical or undiagnosed depression or mental problems. Self Injury helps them to cope by :
Releasing intense feelings/emotions
Physically expressing pain
Self-punishment
Establishing control
Enjoyment of feeling - adrenaline rush
Erotic pleasure in some people
A huge number of individual with self-injury have suffered some form of childhood abuse. 'Significant correlations exist between both sexual and physical forms of childhood violence and SI. Other violence within the home has also been determined to be related to self-injury, as has emotional abuse.' SI has also been linked to having witnessed or been part of ritual abuse. 'The short- and long-term effects of abuse are far reaching and severe, impacting emotions, memories, relationships, self-esteem, behaviors, and even identity.'
In some ways self-injury may be a reaction to abuse. 'If you have endured and survived trauma or abuse, you can attest to the horror of these events.' During episodes of abuse you have probably felt feelings of violation, helplessness, and powerlessness- as if you have little or no control over your environment or even your own body. You may be confused by the way in which you were treated. You may have felt even guilty. The psychological effects of trauma are so intense and severe that it became essential that you find a way to cope. Self-Injury may have helped you cope or deal with the aftereffects of your past traumatic experiences by giving you a way to escape negative feelings and to feel in control for once.
SI can be used for many uses. It may be a way of recreating some of the abuse you went through or witnessed as a child, allowing you to reenact the trauma through self-injury. Recreating previous traumatic experiences can be used as a way to symbolically alter the original course of the abuse, because when you hurt yourself, you are the one in control. This feeling of control can help change your reaction to these past abuses. By hurting yourself to recreate trauma, you are able to change from a situation where you felt helpless and powerless to one where you were in complete control, and had complete power.
Self-injury may also be used to relieve psychological tension. This extreme form of tension may directly result from past traumas ('as in the case of memories or flashbacks') or may indirectly result from past traumas ('such as an extreme reaction to loss or isolation'). You may experience moments when you are unable to get rid of painful images or memories of the trauma. At these times you may use self-injury as a way to get rid of these overwhelming memories.
Abuse and trauma both have so many related consequences, it is likely that you have used self-injury to cope with some of these. For example: if the people who were hurting you were the people who were the closest to you, you would not have been able to trust them. Or, because of the abuse you may have had to keep secrets from other friends and family members, which also interferes with your ability to connect with other people. You may also have used SI as away to lessen emotional pain related to the abuse. The lack of connection with other people, and the difficulty in trusting fosters the same feelings that lead to self-injury. 'Because of the patterns set up in your abusive past, you may used SI to both replicate these patterns as well as control and relieve the accompanying intense emotional pain.'
An area that is damaged by abuse, especially sexual abuse, is that of boundaries. 'Boundaries are limits we place on ourselves and others that help us to maintain our sense of separateness and independence.' When we are children we learn to separate ourselves from other people and to experience ourselves as a single, independent human being. A part of learning boundaries is determining what is ours and what is not ours. One of the things that children own is their body, they learn to believe that it is their own, and that no one else is allowed to touch, use, or disturb it without permission. These rules, or boundaries are often carried into adulthood. But children who have been abused often are not allowed or haven't had the chance to learn their boundaries. 'Sexual or physical abuse leads to confusion over these very basic rules of ownership.' Children who have been abused may learn that their body is to be hurt and abused or manipulated by others. They learn that their bodies are not their own. Their boundaries are variable or nonexistent.
Self-Injury allows people to experience their body as their own. In some way, it helps 'illuminate or restore some basic boundaries lost due to childhood trauma.' Hurting yourself may make you feel more real, more separate, more whole. You are the person who is hurting yourself. You are the one who is changing your body. 'You, and you alone, are in charge of your body.'
Dissociation is a big part of self-injury. But dissociation is also related to trauma or abuse. To survive abuse situations some people have to use dissociation as a tool. Dissociating from the physical or emotional pain may have helped you cope with the trauma. But, as an adult you have difficulty in regulating your dissociative states. SI is an effective way to control dissociation, letting you enter or end a dissociative state.
The relationship between SI and eating disorders is interesting and complex. Research has shown that most women who hurt themselves also have some type of eating disorder.
As in SI, childhood trauma has often been experienced by those with eating disorders. An estimated one-third of people with eating disorders have experienced some type of trauma as a child. Like SI, eating disorders may be a coping mechanism where you gain control. But there are many other factors that can lead to the development of an eating disorder. But this represents the most frequent roots of eating disorders.
Dissociation is also more common is people with eating disorders. If you have an eating disorder you may experience dissociative states similar to the ones felt when you hurt yourself. Actually, the overall pattern of an eating disorder is similar to that of self-injury. The cycle of bulimia is similar to the 'Addiction model'. Negative emotions produce a state of tension, which leads to a state of dissociation, which then lead to an act of binging or purging, which then induces feelings of euphoria, which dissipates and leads to feeling of guilt, shame, or regret. Then the cycle continues.
If you have an eating disorder you may alternate between self-injury and the eating disorder. Or the two may occur simultaneously. Both may be used as a way of coping with great internal pain. And both can provide a way to relieve or release tension, a way to communicate to others your emotional state, to control dissociative states, and to physically express your internal pain. Eating disorders and self-injury have a great deal in common.
Trauma > Dissociation > Eating Disorder or Self-injury
Trauma or abuse leads to a tendency to dissociate, a coping mechanism that may have been crucial to survive the event physically and psychologically. The dissociation can, but doesn't always, lead to an eating disorder behavior or self-injury or both. Trauma is the common source for both these behaviors 'and is responsible for the apparent relationship between eating disorders and self-injury.' This does not mean that everyone that experiences trauma or that is abused will develop an eating disorder, or develop SI. And eating disorders and self-injury can develop without the presence of trauma. 'It seems that both of these behaviors, while often stemming from common sources, also provide similar functions as coping mechanisms.'
Substance abuse can mean the abuse of any drug (over-the-counter, prescription, or illegal), which includes alcohol, nicotine, and caffeine. These substances may be inhaled, ingested, or injected. It includes chemicals that are purposely inhaled with the intention of getting high.
Substance-related disorders is the general term that includes a wide variety of specific uses of substances and pattern of involvement with them. The terms that refer to the different degrees or impact that drugs have or your life are: substance use, substance abuse, and substance dependence. Also, the drugs may cause many side effects, such as insomnia and brain damage, that lead to other problems. Like self-injury, drugs are used to change our psychological or physical state. SI is typically used to change the way you feel: To decrease tension, increase euphoria, or alter you state of dissociation. And in this way, self-injury has similar effects to some drugs. Even though the two may serve a similar function they are not closely related.
Many people begin and continue using drugs as a way of regulating their moods. When you feel angry, or depressed, you may wish you had a way to change how you feel. Drugs do this effectively, although they have a large number of sometimes dangerous or lethal side effects. Many of us use one chemical or another at a time to regulate our moods and physical state.
The use of substances such as caffeine, alcohol, and/or nicotine is widely accepted by society and is more common than the use of other drugs, such as marijuana, cocaine, etc. Most of us have a type of substance to help us get through the day. However, most of these substances are legal and 'culturally sanctioned,' which makes them more difficult to identify, accept, understand, or recognize as a problem.
The relationship between self-injury and substance abuse has not been identified or understood very well. In part, this is because a lot of substance abuse goes unrecognized. You probably don't think of yourself as a drug addict, or dependent on drugs. And you may not even realize that you are changing your state of being with chemicals, such as drinking coffee to stay awake in class or at work.
Most people who hurt themselves do not use or abuse illegal substances. Fewer than one-third of people who hurt themselves have ever tried street drugs. In fact, the majority of acts of self-injury do not occur under the influence of any substance, legal or illegal. The reason for this is that substances and self-injury are both short-term ways of coping. Different people have different ways of coping. And some ways work better than others on different occasions. Using drugs and hurting yourself at the same time is unnecessary because both present a temporarily effective way to cope. If you have found something that works you don't need to use another coping mechanism because the immediate problem is solved.
Suicide is the ending of life. Chronic feelings of depression and anxiety can lead to someone deciding to end their life. Suicide is often the result of overwhelming feelings of hopelessness and helplessness and of great psychological discomfort. Suicide is used to end psychological pain, people who attempt or succeed in killing themselves are not looking for a way to adapt to their psychological state. 'In contrast, self-injury is used to cope - to adapt to severe psychological discomfort.'
SI is not used to make life-threatening injuries. You hurt yourself so you can feel better. This is a goal that is infinitely different from that of suicide, which is to feel nothing at all. 'The means, intent, and often the result of self-injurious acts are vastly different than those of suicide.' Self-injury is not a mild form of suicide, nor is it a suicide attempt gone awry. Instead, SI is a means of coping during a time of intense or overwhelming distress.
Of the large variety of psychiatric diagnoses self-injury is most often associated with borderline personality disorder (BPD). Borderline Personality Disorder is the only psychological diagnosis that specifically identifies self-injury as a criteria for diagnosis, with the exceptions of trichotillomania (the pulling out of hair) and sexual masochism (which can involve SI activities). Because of this some psychologists might diagnose some self-injurers with borderline personality disorder, only because of this one behavior. Because of the lack of diagnoses you may have been incorrectly diagnosed with BPD.
Borderline personality disorder has many criteria for diagnoses other than self-injury. 'Personality disorders - whether borderline or another type - are characterized by long-term patterns of behavior that leads the person to feel distressed or impaired in some matter. Usually these patterns of behavior will affect functioning in several areas of life, including employment or school, social relationships, and/or personal well-being. In general terms, BPD is characterized by chronic, intense instability and chaos. This instability can present itself in the realms of identity, relationships, moods, and impulsivity.'
People with BPD fluctuate between extremes. Unlike most people, people with BPD view the world in terms of black-and-white, all-or-nothing experience. They usually feel life is either great or terrible, effortless, or hopeless; but nothing in the middle of these two extremes.
Also, people with BPD do things to undermine their own success. Just before completion, goals are thrown aside. Graduation, relationships, and promotion may be tossed aside before successful completion. Behaviors that are self-defeating such as substance abuse, overspending, and physical altercations are common.
Lives of people with borderline personality disorder are chaotic. When life gets too calm or stable, they will begin to experience feelings of tension, vulnerability, and anxiety. Rather than experience these negative feelings they will seek out new chaos. So their life is a cycle of creating and repairing chaotic situations.
For people with BPD self-injury is a direct response to overwhelming psychological pain. It is a way of relieving and releasing intense emotions they experience at calm times in their lives. Also, SI is a way of releasing the feelings of fright they get from thoughts, memories, and emotions during their moments of calm. It also keeps these feelings at bay. Dissociation that may come with the self-injury may end those overwhelming emotional states.
Also, the injuries produced by self-injury are another chaos to focus on for those with BPD. These wound allow the attention of the person to be transferred from the original, distressing emotions to the new emotions and experiences that stem directly from the self-injury. Basically, self-injury plays a complex and interesting role within people with borderline personality disorder. "Self-injury, for a variety of reasons, acts as an agent for producing internal states which are better able to be tolerated.
HOW DOES SHAME PLAY A PART?
One of the most common factors connected to Self Injury is shame. 'Shame is a powerful emotion, able to alter thoughts, feelings, and even behaviors.' Any shame or embarrassment that comes from Self Injury can have a big effect on all parts of a self-injurers life such as friendships, school, and job performance. Also, shame is often a feeling that precedes Self Injury, coming from events that happened earlier in the individual's life. As has been stated earlier there is a obvious relationship between self-injury and child abuse. For many self-injurers, Self Injuring is connected with a traumatic childhood. Feelings of shame and embarrassment often follow the traumas they have experienced. Many people who have been abused feel that it is their fault, that they somehow encouraged, initiated, or/and deserved the abuse. These thoughts and feelings become connected with the memories of abuse, and then are transferred to SI behaviors. So, possibly if you feel shame or guilt or think you deserved to be punished, then you might act in ways that correspond those beliefs. You might hurt yourself if you feel that you deserve to be punished, for example.
The punishment or Self Injury act then implies that you are at fault (because generally you are punished when you have done something wrong), which then fosters feelings of shame or guilt. So an Self Injury act often can cause the feelings of shame that before preceded the act of self-injury. Also, the shame from Self Injury "breeds secrecy." Many people keep their self-injury secret because of their shame, and their fear of being judged or looked down upon by others. The stigma in our society placed on SI makes many people afraid to tell others about their SI behavior. The secretive nature of Self Injury also increases the feelings of shame and isolation, which continues the cycle of self-injury.
The feeling of shame and embarrassment can result from many different parts of Self Injury, such as scars, wound, bruises, cuts, feelings from past traumas, emotions, etc.
Some info taken from RYL (RecoverYourLife.com)