Self-harm

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Self-harm is deliberate injury to one's own body. (In the past this term has also been used to refer to masturbation, although it is now generally accepted that this practice is not harmful; this article is not about that usage).

This injury may be aimed at relieving otherwise unbearable emotions, sensations of unreality & numbness, or for other reasons. Self-harm is socially taboo. It is often (but not always) associated with mental illnesses such as bipolar disorder, anorexia; with a history of trauma and abuse; and with mental traits such as perfectionism.

Self Harm (SH) is also known as Self Injury (SI), Self Inflicted Violence (SIV), Self Injurious Behaviour (SIB) and also Self Mutilation, although this last term has connotations that perturb some people. It is suggested that when discussing self harm with someone who relies on it, to use the same terms and words as they do, rather than insisting on labeling it 'self harm'.

People who self-harm are not usually attempting suicide, but are trying to relieve the unbearable emotional pressure they are feeling. However, self-injury is a strong predictor for future suicide or suicide attempts. A self-injurer is significantly more likely to attempt or complete suicide in the year after an incident of self-injury. Self-harm is very rarely attention-seeking behaviour. Many self-injurers are ashamed, embarrassed, and attempt to conceal their behaviour from others.

Strictly, self-harm is a general term for self-damaging activities (which could include alcohol abuse, bulimia etc.); self-injury refers to the more specific practice of cutting, bruising, burning or otherwise directly injuring the body. A common form of self-injury is shallow cuts to the skin of the arms or legs, or less frequently to other parts of the body, including the breasts and sexual organs.

Table of contents

1 Demographics
2 Psychology
3 References

Women and Parasuicide: a Literature Review, Women's Health Council">3.1 1. World Health Organisation Europe Multicentre Study of Suicide, retrieved Jul. 20, 2004 from Women and Parasuicide: a Literature Review, Women's Health Council
Hospitalisation for intentional self-harm, New Zealand Health Information Service">3.2 2. Retrieved Jul. 20, 2004 from Hospitalisation for intentional self-harm, New Zealand Health Information Service

4 See also
5 Readings
6 External links

Demographics

The average European rate of self-harm and attempted suicide for persons aged over 15 years is 0.14% for males and 0.193% for females. For each age group the female rate exceeds that of the males, with the highest rate among females in the 15-24 age group and the highest rate among males in the 12-34 age group. Recently, however, it has been found that the female to male ratio, previously thought to be around 2:1, is diminishing ÃÂ in Ireland it has been close to parity for a number of years.1

More females are hospitalised for intentional self-harm than males. Females more commonly choose methods such as self-poisoning that generally are not fatal, but still serious enough to require hospitalisation.²

Psychology

One theory states that self-injury is a way to "go away" or disassociate, separating the mind from the feelings that caused the anguish. This is done by tricking the mind into believing the pain felt at the time is caused by self-injury instead of the issues they were facing before. The physical pain may also act as a distraction from emotional pain in a similar way to a hot water bottle reducing the pain of a stomach ache.

Alternatively self-injury may be a means of feeling something, even if the sensation is unpleasant. Those who self-injure sometimes describe feelings of emptiness or numbness, and physical pain may be a relief from these feelings. Self-harm may also give a feeling of being in control of one's own body, which could be especially important for victims of sexual abuse.

Self-injury may also be a means of communicating distress. This motivation is sometimes dismissed as "attention seeking" and has often been seen as the primary motivation. However, for many, the act of self-harm fulfils a purpose in itself and is not a means of communicating with or influencing others. Many who self-injure keep their injuries secret, while those who do disclose their injuries may be embarrassed and ashamed of their actions.

Those who engage in self-harm face the contradicting reality of harming themselves while at the same time feeling a relief from this act. This feeling of relief comes from the beta endorphins released in the brain. These act to reduce tension and emotional distress and may lead to a feeling of calm.

It is a coping mechanism which becomes highly addictive because to the self-injurer, it works; it enables him/her to deal with stress there and then. Therapy for self-harmers only works when it is focussed on finding alternative coping methods before giving up the self-harm behaviour. Instead of tackling the behaviour itself, therapy and treatment concentrates on the underlying cause.

References

Women and Parasuicide: a Literature Review, Women's Health Council">

1. World Health Organisation Europe Multicentre Study of Suicide, retrieved Jul. 20, 2004 from Women and Parasuicide: a Literature Review, Women's Health Council

Hospitalisation for intentional self-harm, New Zealand Health Information Service">

2. Retrieved Jul. 20, 2004 from Hospitalisation for intentional self-harm, New Zealand Health Information Service

Readings

Favaro, A. & Santonastaso, P. (2000). Self-injurious behavior in anorexia nervosa. The Journal of Nervous and Mental Disease, 188(8), 537-542.
Favazza, A.R. & Rosenthal, R. J. (1993). Diagnostic issues in self-mutilation. Hospital and Community Psychiatry, 44, 134-140.
Levenkron, S. (1998). Cutting. New York, NY: W. W. Norton and Company.
Stanley, B., Gameroff, M. J., Michalsen, V., & Mann, J. J. (2001). Are suicide attempters who self-mutilate a unique population? American Journal of Psychiatry, 158(3), 427-432.
Suyemoto, K. L. & MacDonald, M. L. (1995). Self-cutting in female adolescents. Psychotherapy, 32(1), 162-171.
Zila, L. M. & Kiselica, M. S. (2001). Understanding and counseling self-mutilation in female adolescents and young adults. Journal of Counseling & Development, 79, 46-52.