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Self-injury is a maladaptive coping skill utilized by individuals, who lack more effective coping skills, to combat or avoid severe, intense emotional distress and unmanageable psychic pain. Self-injury is deliberate physical harm to oneself. Self-injury is also referred to as: self-inflicted violence, self-mutilation, self-harm or simply "cutting."

Types of self-injury:

  • Cutting
  • Burning
  • Excessive scratching
  • Interference with wound healing
  • Hitting or bruising
  • Excessive nail biting
  • Pulling out hair
  • Breaking bones

"Two million Americans cut or burn themselves every year. This is 30x's more than the rate of attempted suicides. 140x's more than the rate of successful suicides. There are more completed suicides each year in the United States than homicides."

"In a survey of 500 undergrad students in a required psychology class, 12%, 1 in 8, had self harmed at least one time during their lives; 4% in the last 6 months. If extrapolated to the American population as a whole, this means 8 million Americans may be currently inflicting self-injurious behavior."
                                                                                    from the book Bright Red Scream (see resources page)

Risk factors:

  • History of physical, sexual, or emotional abuse
  • Abandonment or neglect
  • Invalidating home environment
  • Psychiatric Diagnosis:
    • Affective disorders
    • Obsessive-compulsive disorder
    • Eating disorder
    • Anxiety disorder
    • Personality disorders
    • Dissociative disorders
    • Posttraumatic stress disorder
  • Age - most self-injurious behavior begins in adolescence

Individuals who engage in self-injurious behavior may share many common characteristics:

  • Drug and alcohol abuse
  • Perfectionism
  • Isolation
  • Inability to regulate or express emotions
  • Lack of social skills
  • Anxiety
  • Inability to set physical or emotional boundaries
  • Inability to tolerate distress
  • Mood swings

Motivations for Self-Injury:

Miller (1994) and Favazza (1986, 1996), among others, (modified) discuss several possible motivations:

  • Escape from emptiness, depression, and feelings of unreality.
  • In order to ease tension.
  • Relief: when intense feelings build, self-injurers are overwhelmed and unable to cope. By causing pain, they reduce the level of emotional and physiological arousal to a bearable one.
  • Expression of emotional pain - communicate pain to others.
  • Escaping numbness: many of those who self-injure say they do it in order to feel something, to know that they're still alive - to see the blood.
  • Obtaining a feeling of euphoria - release of endorphins - addiction
  • Continuing abusive patterns: self-injurers tend to have been abused as children. Sometimes self-mutilation is a way of punishing oneself for being "bad."
  • Relief of anger: many self-injurers have enormous amounts of rage within. Afraid to express it outwardly, they injure themselves as a way of venting these feelings.
  • Biochemical relief: there is some thought that adults who were repeatedly traumatized as children have a hard time returning to a "normal" baseline level of arousal and are, in some sense, addicted to crisis behavior.
  • Obtaining or maintaining influence over the behavior of others.
  • Exerting a sense of control over one's body - know how to nurture physical but not emotional selves. It's tangible, can see the hurt.
  • Grounding in reality, as a way of dealing with feelings of depersonalization and dissociation.
  • Maintaining a sense of security or feeling of uniqueness
  • Expressing or repressing sexuality
  • Expressing or coping with feeling of alienation

Has reported that she used to cut herself as a teenager, even keeping a Swiss Army Knife in her boots, and has since used her celebrity status to bring awareness to the dangers of self-mutilation.

   Shirley Manson - Garbage

"My upbringing made me as I am now. But I can become merry and happy at once. There were many years I was feeling at a loss about my life or how I grew up. I couldn't understand what is right or what is precious. At that time, I was miserable and self-defeating. I was feeling angry with various things. My anger came up to the surface then. I don't say such tendency has disappeared. Even now there is anger and the dark side in myself. But it's the first time I've been so close to the light."

    Johnny Depp

"You have so much pain inside yourself that you try and hurt yourself on the outside because you want help."

   Princess Diana

Self-Injury Reading List

Cobain, B. (1998). When Nothing Matters Anymore. A survival guide for depressed teens. Free Spirit Publishing Inc.

Alderman, T. (2000). The Scarred Soul: Understanding & Ending Self-Inflicted Violence. Youthlight, Inc.

Conterio, K. and Lader, W. (1998). Bodily Harm: The Breakthrough Healing Program for Self-Injurers. Hyperion.

Favazza, A. (1996). Bodies Under Siege: Self-Mutilation and Body Modification in Culture and Psychiatry (2nd ed).

Hyman, J. W., (1999). Women Living with Self-Injury. Temple University Press.

Johnson, K. (1989). Trauma in the Lives of Children. Hunter House Inc.

Kettlewell, C. (1999). A Memoir: Skin Game. St. Martin's Press.

Levenkron, S. (1998). Cutting: Understanding & Overcoming Self-Mutilation. Youthlight, Inc.

Levenkron, S. (1997). The Luckiest Girl in the World. Scribner.

Strong, M. (1998). A Bright Red Scream: Self-Mutilation and the Language of Pain. The Penguin Group.

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