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Understanding Self-Harm

Understanding Self-Harm, self-injurious behaviors, How Self-Harm is Treated,

Self-harm, which is sometimes referred to as self-injury or self-mutilation, is the act of intentionally inflicting pain and physical damage on oneself. It is something that can be confusing and upsetting to loved ones of the person who self-harms. 

At Carolina Dunes Behavioral Health, we want to give loved ones the tools to understand and support people who are struggling with self-harm behaviors. Although self-harm is generally not meant to result in lethal injury, the people who engage in this behavior are at higher risk of attempting suicide if they do not receive help. 

Examples of Self-Harm

There are a variety of different ways that people engage in self-injurious behaviors, and some people exhibit more than one behavior. 

A few of the most common types of self-harm include:

  • Cutting – this method is utilized by about 80 percent of people who self-harm.
  • Head banging
  • Burning
  • Hitting/punching
  • Inserting objects into body openings
  • Ingesting harmful substances
  • Intentionally breaking bones

Intention Matters

There may be times when someone engages in one of the behaviors listed above without it being considered self-injurious behavior. For example, if the action occurs as part of a spiritual or religious custom, or if the person only harms themselves accidentally, this would not be considered self-mutilation.

Understanding Self-Harm

Around five percent of adults, 17 percent of teenagers and 17-35 percent of college students are believed to engage in self-injurious behaviors. While engaging in these behaviors sometimes brings short-term relief, this tends to give way to feelings of shame, guilt and regret. 

Some of the reasons people give for engaging in self-mutilation include:

  • Feeling empty inside
  • Inability to express feelings
  • Loneliness
  • Fearfulness of responsibilities
  • Distraction from difficult feelings
  • A sense of control over something in their lives
  • Punishing themselves for something they feel they have done wrong

Risk Factors for Self-Harm

Certain groups of people are more likely than others to engage in self-injurious behaviors. These include:

  • People with friends who self-mutilate
  • Individuals who have had difficult life experiences, such as:
    • Neglect
    • Sexual, physical or emotional, abuse
    • Trauma
    • Unstable family life
    • Questioning personal or sexual identity
    • Isolation
  • People who are diagnosed with mental illness
  • Individuals who misuse alcohol or other drugs
  • People living in poverty

Indications of Self-Harm

If someone engages in self-injurious behaviors, their loved ones might notice the following:

  • Scars – often including patterns, words or symbols, usually located on the forearms, belly, chest, or thighs, in areas that can be covered with pants or long sleeves
  • Wearing clothes that are too warm for the current season to hide burns, scabs, cuts, scratches, or scars 
  • Frequent injuries, such as cuts and burns that are unexplained or don’t match the explanation given
  • Self-esteem issues
  • Difficulty processing emotions
  • Expressing hopelessness, helplessness, or worthlessness
  • Poor functioning in various life domains, including work, school, or relationships

The Link Between Self-Harm and Suicide

Although self-mutilation is not typically done for the purpose of killing themselves, the people who engage in it are nine times more likely to make suicide attempts. Clearly, self-harm indicates struggles with mental health and lack of healthy coping skills. Acts of self-injury can also become addictive and increase in severity over time. Sometimes self-harm injuries go further than expected and lead to medical complications and accidental death. For these reasons, if someone you know is struggling with self-harm behaviors, it is important to get them help right away.

How Self-Harm is Treated

Self-harm is addressed in several ways, most commonly through the following:

  • Medications – while there are no pills prescribed for self-harm specifically, people who engage in self-harm are often diagnosed with depression, anxiety, obsessive-compulsive disorder, or other medical conditions that can benefit from medication. Once these conditions are well-managed, it will likely be far easier for the person to refrain from hurting themselves.
  • Therapy – cognitive behavioral therapy, dialectical behavior therapy, and interpersonal therapy are all modalities that can help people who engage in self-destructive behaviors develop new coping skills that don’t involve self-injury.
  • Services – individual and family support groups, substance abuse treatment, and family therapy may also prove helpful to people who struggle with self-harm and to the people who support them. 
  • Contracts, journals, and behavior logs – these may help the person regain control.

How Parents Can Help

If you believe your child may be engaging in self-injurious behaviors, it is important to address your concerns in a calm, respectful manner. Do not insist that your child show you their injuries. Instead, try mentioning what you noticed, that you are worried, and that you wonder how they are doing. It is also a good idea to ask if they are having any thoughts of ending their life.

At Carolina Dunes Behavioral Health in Leland, North Carolina, we support people with a wide range of behavioral health concerns, some of whom have engaged in self-harm. We provide a safe, stable environment where they and their families can learn new ways to cope and thrive.

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