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Judge Less & Understand More: Self-Injurious Awareness


Self-harm is a symptom that signals emotional distress and can be associated with many other mental health disorders such as depression, bipolar disorder, schizophrenia, anxiety, PTSD and borderline personality disorder. Self-injurious behaviors differs from the definition of mental illness which is defined as conditions that affect your thinking, mood, and behavior whereas the self-injurious behavior is simply a behavioral act. Mental disorders are may be occasional or long lasting in duration. They affect the ability to relate to others and often impair one’s functioning in everyday life. Acts of self-harm differ in that they are behaviors that are a way of relieving some type of emotional distress. These acts can be isolated or can be ongoing for many years.

There is no specific treatment or medication for self-injurious behaviors. Instead, the treatment is targeted towards the underlying causes for the self-harm which can present in the form of mood disorders, borderline personality disorder, impulsivity, life stressors and the development of inadequate coping skills. When treatment with medications for underlying conditions are effective, the urge or need to self-harm may even diminish. Dialectical behavioral therapy has been shown to be highly effective as an evidenced based treatment for self-injurious behaviors. This form of therapy can help a person tolerate the distress and regulate their emotions without turning to self-harm as a coping mechanism.

Categorically, females tend to engage in self-harm behaviors more frequently than males. These behaviors often develop between the ages of 12 and 15, studies also suggest that 40% of college age students who engage in acts of self-harm began at the age of 17 or older. Overall, among college students, 17% tend to engage in acts of self-harm. The prevalence among the general adult population is estimated to be up to 4% and at least 1% of these experience chronic or severe self-injurious behaviors. With these numbers of prevalence, it is likely that you know someone who is or has acted upon urges toward self-injurious behavior either currently or in the past. For this reason, those who act upon their urges to self-injure are likely to do so in secretive. It can be difficult to detect the injuries without being aware of some of the signs or symptoms.

  • Unexplained injuries can be in the form of burns, cuts, bruises, scars healing or healed wounds. Often people tend to inflict small, linear cuts on their arms, legs and inner thighs.

  • The individual may offer up stories as to how they get these scratches, cuts or burns. “I’m just clumsy, I just scratched up my arms while moving some furniture in the house”.

  • The individual may wear long sleeves or pants at times when they would be inconsistent with the season or time of the year.

  • Wearing large bangle bracelets, oversized watches, or jewelry to cover their wrists.

  • Observing frequent bandages, band aids or other methods of covering a wound.

  • Having razor blades, needles, scissors, or other sharp items in their bag, purse, or room.

  • Refusing to participate in activities such as swimming or dressing out for sports activities.

  • Since individual use self-injurious behavior to express their emotional distress, it is likely that family and friends will also observe other problems such as mood change, difficulty with interpersonal relationships, difficulty with work relationships, etc…

There are numerous factors that can play a role in the development of self-injurious behaviors but most often it is due to the development of inappropriate ways of expressing painful emotions. Cutting behaviors are often linked to a history of childhood abuse, sexual abuse and are more commonly associated with borderline personality disorder. With the issue of bullying among young people today, it can also contribute to the inappropriate expression of painful emotions. The presence of non-suicidal self-injurious behavior can also be found among individuals who are suffering from mental illness and substance abuse. Unlike persons who make suicidal attempts to end their lives, people who exhibit self-harming behavior are not trying to end their lives but simply trying to express overwhelming feelings that they are trying to cope with.

Some people cut or harm themselves to change or distract themselves from their feelings. The harmful acts are an attempt to exchange the intolerable overwhelming feeling that they are experiencing with the feeling of physical pain. Others self-harm to feel any emotion at all. When a person feels numb, the ability to feel pain can feel like a form of relief and feel that the expression of the self-harm gives an outward expression of their inner pain. Once a person develops a pattern of using self-harm as a coping mechanism, it can become a compulsive, habitual behavior that is difficult to stop.

Some of the common methods of self-harm include cutting, burning, hitting, head banging, hair pulling, picking, scratching and excessive piercing. The unfortunate thing is that there are many healthy alternatives to expression one’s inner pain that do not involve self-harm. Below is just a few of the ways that one could choose to express their feelings of inner pain in a more appropriate, healthy manner.

  • Scream loudly!

  • Have a pillow fight with a wall

  • Pop Bubble Wrap

  • Go for a run

  • Learn to Swear in another language

  • Get out of the location where you are and take a walk

  • Take a cold shower

  • Hold ice in your hands, against your arm, or in your mouth

  • Snap a hair band against your wrist

  • Get washable markers and draw on yourself

  • Bite into a hot pepper or eat some ginger root

  • Rub Icy Hot on the area that you want to cut

  • Say out loud, “I’ll self-harm in 15 minutes if I still want to” and set a timer and keep going for periods of 15 minutes until the urge fades

  • Count backwards from 1000

  • Play with fidgets or a slinky

  • Call up an old friend

  • Color a picture in a coloring book

  • Get a paint by number picture to work on

  • Go to the zoo and name all the animals

  • Blow Bubbles

  • Pull weeds in a garden

  • Call a friend/buddy and ask for some company

  • Remember every happy moment and relive it for a while in your head

  • If you are religious, read the bible or pray

  • Carry tokens to remind you of peaceful comforting things/people

  • Do yoga or exercise

  • ____________________ fill in the blank

As you can see from the list from above, this is just a noticeably short list of ideas that could be used whenever one experiences thoughts of self-harm. More importantly, I hope that you will reach out for professional help!

Set up an appointment with a mental health provider to work with you to help you to overcome some of the reasons that self-injurious acts appear to be a viable solution. You are worth giving yourself the gift of healing.

Whatever the painful memories, events, or traumas that you have experienced are, they can improve or at least the way that they affect you can improve with effective treatment and time. We may not can take away the pains of the past, but we certainly do not have to allow them to steal away our future.

Call the office today to get started at 901-232-1956.

Article prepared by: Judy P. King, LCSW, BCD

Licensed Clinical Social Worker

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