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What is Self-Injury?

Self-Injury is the act of purposely causing harm to one’s own body in order to cope with emotional pain, anger, or frustration. It is not typically associated with suicidal thoughts or attempts. The injury brings a temporary relief of the emotional pain; however, it is often followed by guilt or shame and a return of the emotional distress it was meant to relieve. The impulsive nature of self-injury creates an extremely dangerous situation during which an injury could be more severe than intended and cause serious harm. Often, self-injury is a symptom of or associated with other mental illnesses such as depression, personality disorders, PTSD, or eating disorders. There are many forms of self-injury ranging in severity:including, burning, cutting, carving words or symbols into body, breaking bones, hitting, punching, piercing, head banging, biting, hair pulling, picking, and scratching. In most cases extreme attempts to hid injuries will be made, which can either be by wearing full covering clothes, injuring on parts of the body that are hidden, or making excuses.

Symptoms and Warning Signs:

  • Scars
  • Fresh wounds (cuts, burns, scratches, bruises, etc)
  • Broken bones
  • Keeping tools, such as sharp objects
  • Wearing clothing to cover wounds that may be inappropriate for weather
  • Claiming frequent accidents
  • Spending excessive time alone
  • Difficulties in relationships
  • Questioning their role in the world, reason to live
  • Impulsive or unstable behavior
  • Mood instability
  • Feelings of helplessness, hopelessness, or worthlessness
  • Low self-esteem
  • Expressing negative feelings towards self

Why Would Someone Self-Injure?

There is no one single reason why a person would harm themselves. In most cases self-injury is the result of not being able to effectively cope with distressing emotions. The self-injury may be an attempt to manage or reduce distress, find a sense of relief, distract from pain of emotions, gain perceived control over emotions or situations, regain feelings after a feeling of numbness, expressing internal emotions in an external way, to bring attention to ask for help when they cannot verbally, or to punish their self for their faults.

How to Treat Self-Injury:

Psychotherapy is vital to recovery. Depending on the severity there are differing levels of therapy from outpatient individual, to intensive outpatient, to partial hospitalization, to inpatient. Since self-injury is often a symptom of another mental illness or an outlet for emotional distress, it is important to work towards finding triggers and identifying that underlying emotional pain and address that in therapy. The focus is also to find healthy and appropriate coping skills to replace the need to injure when confronted with those distressing emotions. Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT), Mindfulness, and talk therapy are all useful tools in identifying the thoughts and emotions behind the self-injury and working towards replacing them with positive thoughts while instilling the skills to cope with the negative.

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