Cutting is not a trend, it’s an addiction. It’s like screaming , but no one can hear. It is an every day battle. It can best be defined as an act of violence (cutting, burning, etc.) that is done to oneself, by oneself, without the intent of suicide. Sometimes self-injury is called self-inflicted violence, self-harm, self-mutilation or cutting.
Self-harm is an unhealthy way to cope with emotional pain, intense anger or frustration by injuring your own body by cutting, burning, biting, hair-pulling or starving. It is not meant as a suicide method. They want to feel better, not end it all. Initial feelings of pleasure are however soon replaced by guilt, shame or the return of painful feelings afterwards.
It can feel to other people that these things are done calmly and deliberately – almost cynically. But we know that someone who self-harms is usually in a state of high emotion, distress and unbearable inner turmoil. About 1 out of every 10 people self harm.
Why do people self-harm?
Self-harm is a way of expressing and dealing with deep distress and emotional pain. As counter-intuitive as it may sound to those on the outside, hurting yourself makes you feel better. In fact, you may feel like you have no choice. Injuring yourself is the only way you know how to cope with feelings like sadness, self-loathing, emptiness, guilt, and rage.
Relief is short: The problem is that the relief that comes from self-harming doesn’t last very long. It’s like slapping on a Band-Aid when what you really need are stitches. It may temporarily stop the bleeding, but it doesn’t fix the underlying injury. And it also creates its own problems.
It’s a secret: If you’re like most people who self-injure, you try to keep what you’re doing secret. Maybe you feel ashamed or maybe you just think that no one would understand. But hiding who you are and what you feel is a heavy burden. Ultimately, the secrecy and guilt affects your relationships with your friends and family members and the way you feel about yourself. It can make you feel even more lonely, worthless, and trapped.
Unbearable inner turmoil: Many people who harm themselves are struggling with intolerable distress or unbearable situations. A person will often struggle with difficulties for some time before they self-harm. People who self-harm, may have feelings of worthlessness, loneliness, panic, anger, guilt, rejection, self-hatred or confused sexuality. Through self-harm they may try to cope with stress, numb emotional pain, feel a sense of control, cry out for help, or punish themselves for things they think they did wrong. Self-injury generally provides temporary relief to intense emotional pain.
Self-harm & Anhedonia (the inability to feel pleasure)
There has been a sharp increase in people who self-harm in the past few years. It seems to have become a trend, a coping mechanism of the youth today. During a recent survey, secondary schools pupils in South Africa were asked if they know of someone who self-harms , and 70 -80% have indicated that they do know of someone who does. It also seems to be a predominantly teen thing. Reasons for self- harm are most of the time a chaotic home environment, sexual abuse and overuse of internet technology.
You may ask why internet technology? If you spend time texting or surfing or playing games on the internet , your brain releases pleasure chemicals (dopamine) all the time which makes you feel good. Have you noticed how time flies when you do this? Have you noticed how a click on an app with a red icon sends a rush of excitement through you? You might discover an interesting email, an avalanche of “likes”, or nothing at all. Even swiping becomes addictive because it releases dopamine all the time. It was designed to hook you. The dopamine release is more than the usual amount that is released by for example eating when you are hungry. Teens who are on their phones most of the day, ends up with dopamine being blocked in their brains, because the brain tries to lower the release. Low levels of dopamine are associated with lethargy and chronic fatigue.
When you feel no pleasure anymore, because too little dopamine is released it is called anhedonia. When kids start cutting, to try and feel something, another neurotransmitter is released – endorphin. The pain from cutting makes the brain sense injury and floods their system with endorphin’s, which acts as natural pain reliever. It is not as powerful as dopamine and the high they get, quickly dissipates. Then they have to cut again, and again, and again. Cutting eventually becomes more extreme, deeper and they draw blood. Some cut all the way to the bone after a while to get the endorphin release. The top three reasons for digital anhedonia is watching pornography, playing social video games and internet surfing.
The are certain people who often self harm, for example teens, young women, prisoners, people who have been abused in any way, refugees, people who have experienced trauma (rape/war), people who are discriminated against (homosexuality/ albinism), and young people who self harm as a group.
What is the effect of self harm?
For persons with emotional problems, self-injury has an effect similar to cocaine and other drugs that release endorphin’s to create a feel-good feeling. Self-harm can become impulsive behavior that is difficult to control or stop. You can get addicted to self-harm. A behavior that starts as an attempt to feel more in control can end up controlling you.
The arms, legs and front of the torso are the targets of self-injury because these areas can be easily reached and easily hidden under clothing. Persons who self-harm often use more than one method to injure themselves.
Methods of self harm are
- cutting your body with sharp objects
- swallowing poison
- overdose on pills/drugs
- burning your skin
- skin picking or scratching
- banging your head / or limbs against a wall
- sticking objects in your body
- punch your self
- pulling out hair/ eyebrow hairs
- starving or binge eating
Injuries can be so bad that the person needs medical assistance, for example misjudging the depth of a cut might require stitches.
Warning signs that someone is self-harming
- Unexplained wounds or scars from cuts, bruises, or burns, usually on the wrists, arms, thighs, or chest.
- Blood stains on clothing, towels, or bedding; blood-soaked tissues.
- Sharp objects or cutting instruments, such as razors, knives, needles, glass shards, or bottle caps, in the person’s belongings.
- Frequent “accidents.” Someone who self-harms may claim to be clumsy or have many mishaps, in order to explain away injuries.
- Covering up. A person who self-injures may insist on wearing long sleeves or long pants, even in hot weather.
- Needing to be alone for long periods of time, especially in the bedroom or bathroom.
- Isolation and irritability
Why should you stop self-harm?
- The relief is short lived, and is quickly followed by other feelings like shame and guilt. Meanwhile, it keeps you from learning more effective strategies for feeling better.
- Keeping the secret of self-harm is difficult and lonely. And it can have a detrimental effect on your relationships with friends and family members.
- You can hurt yourself badly, even if you don’t mean to. It’s easy to misjudge the depth of a cut or end up with an infected wound.
- You’re at risk for bigger problems down the line. If you don’t learn other ways to deal with emotional pain, you increase your risk of major depression, drug and alcohol addiction, and suicide.
- Self-harm can become addictive. It may start off as an impulse or something you do to feel more in control, but soon it feels like the cutting or self-harming is controlling you. It often turns into a compulsive behavior that seems impossible to stop.
People who have stopped cutting often say the first step is the hardest — admitting to or talking about cutting. But they also say that after they open up about it, they often feel a great sense of relief. Choose someone you trust to talk to at first (a parent, school counselor, teacher, coach, doctor, or nurse). If it’s too difficult to bring up the topic in person, write a note.
Identify the trouble that is triggering the self harm
Cutting is a way of reacting to emotional tension or pain. Try to figure out what feelings or situations are causing you to cut. Is it anger? Pressure to be perfect? Relationship trouble? A painful loss or trauma? Mean criticism or mistreatment? Identify the trouble you’re having, then tell someone about it. Many people have trouble figuring this part out on their own. This is where a mental health professional can be helpful.
How do I identify emotions that can lead to self-harm?
Take note of the following acronym “BEHALTED,” which spells out high risk times when one is tempted to start self-harming:
- B o r e d
- E x c i t e d
- H u n g r y
- A n g r y
- L o n e l y
- T i r e d
- E x c l u d e d
- D e p r e s s e d
* When you experience one of these conditions, make sure to get busy doing something else to prevent you from falling into the trap of trying to self sooth through self-harm.
Ask for help
Tell someone that you want help dealing with your troubles and the cutting. If the person you ask doesn’t help you get the assistance you need, ask someone else. Sometimes adults try to downplay the problems teens have or think they’re just a phase. If you get the feeling this is happening to you, find another adult (such as a school counselor or nurse) who can make your case for you.
Work on it
Most people with deep emotional pain or distress need to work with a counselor or mental health professional to sort through strong feelings, heal past hurts, and to learn better ways to cope with life’s stresses. One way to find a therapist or counselor is to ask at your doctor’s office, at school, or at a mental health clinic in your community.
What can you do instead of self-harming?
If you self-harm to express pain and intense emotions
- Paint, draw, or scribble on a big piece of paper with red ink or paint
- Start a journal in which to express your feelings
- Compose a poem or song to say what you feel
- Write down any negative feelings and then rip the paper up
- Listen to music that expresses what you’re feeling
To calm and soothe yourself
- Take a bath or hot shower
- Pet or cuddle with a dog or cat
- Wrap yourself in a warm blanket
- Massage your neck, hands, and feet
- Listen to calming music
Because you feel disconnected and numb
- Call a friend (you don’t have to talk about self-harm)
- Take a cold shower
- Hold an ice cube in the crook of your arm or leg
- Chew something with a very strong taste, like chili peppers, peppermint, or a grapefruit peel
- Go online to a self-help website, chat room, or message board
To release tension or vent anger
- Exercise vigorously—run, dance, jump rope, or hit a punching bag
- Punch a cushion or mattress or scream into your pillow
- Squeeze a stress ball or squish Play-Doh or clay
- Rip something up (sheets of paper, a magazine)
- Burst blown-up balloons by jumping on them or hitting them with a racket
- Make some noise (play an instrument, bang on pots and pans)
Substitutes for the cutting sensation
- Use a red felt tip pen to mark where you might usually cut
- Rub ice across your skin where you might usually cut
- Put rubber bands on wrists, arms, or legs, and snap them instead of cutting or hitting
1. Avoid High-Risk Situations
Some common high-risk situations are described by the acronym, BEHALTED:
Bored Excited Hungry Angry Lonely Tired Excluded Depressed
How do you feel at the end of the day? You’re probably hungry because you haven’t eaten well. You’re probably angry because you’ve had a tough day at work or a tough commute home. You may feel lonely because you’re isolated. You don’t have to be physically alone to feel lonely. And you’re tired. That’s why your strongest cravings usually occur at the end of the day. Here’s another way of looking at high-risk situations:
- People. (People who you use with or who are related to your cutting habit. People who you have conflicts with, and who make you want to self-harm. People who you celebrate with by self-harming. People who encourage you to self-harm either directly or indirectly.)
- Places. (Places where you self-harm.)
- Things. (Things that remind you of your self-harm.)
How can you avoid high-risk situations?
Of course, you can’t always avoid these situations. But if you’re aware of them, they won’t catch you off guard, and you can prevent little craving from turning into major urges.
Take better care of yourself. Eat a healthier lunch so you’re not as hungry at the end of the day. Join a 12 step group so that you don’t feel isolated. Learn how to relax so that you can let go of your anger and resentments. Develop better sleep habits so that you’re less tired.
Avoid your self-harm friends, your favourite hang-out, and having self-harm utensils in the house. Avoid people who you used to self-harm with.
Recovery isn’t about one big change. It’s about lots of little changes. Avoiding those high-risk situations helps you create a new life where it’s easier to not harm your self.
Make a list of your high-risk situations. Addiction is sneaky. Sometimes you won’t see your high-risk situations until you’re right in the middle of one. That’s why it’s important that you learn to look for them. Make a list of your high-risk situations and keep it with you. Go over the list with someone in recovery so that you can spot any situations that you might have missed. Make the list and keep it with you. Some day that list may save your life.
2. Be Honest
An addiction requires lying. You have to lie about self-harm, doing it, hiding its consequences, and planning your next relapse. An addiction is full of lying. By the time you’ve developed an addiction, lying comes easily to you. After a while you get so good at lying that you end up lying to yourself. That’s why addicts don’t know who they are or what they believe in.
The other problem with lying is that you can’t like yourself when you lie. You can’t look yourself in the mirror. Lying traps you in your addiction. The more you lie, the less you like yourself, which makes you want to escape, which leads to more self-harming and more lying.
Nothing changes, if nothing changes. Ask yourself this: will more lying, more isolating, and more of the same make you feel better? Nothing changes if nothing changes. If you don’t change your life, then why would this time be any different? You need to create a new life where it’s easier to not self-harm.
Recovery requires complete honesty. You must be one-hundred percent completely honest with the people who are your supports: your family, your doctor, your therapist, the people in your 12 step group, and your sponsor. If you can’t be completely honest with them, you won’t do well in recovery.
When you’re completely honest you don’t give your addiction room to hide. When you lie you leave the door open to relapse.
One mistake people make in the early stages of recovery is they think that honesty means being honest about other people. They think they should share what’s “wrong” with other people. But recovery isn’t about fixing other people. It’s about fixing yourself. Stick with your own recovery. Focusing on what you don’t like about others is easy because it deflects attention from yourself.
Honesty won’t come naturally in the beginning. You’ve spent so much time learning how to lie that telling the truth, no matter how good it is for you, won’t feel natural. You’ll have to practice telling the truth a few hundred times before it comes a little easier. In the beginning, you’ll have to stop yourself as you’re telling a story, and say, “now that I think about it, it was more like this…”
Show common sense. Not everybody is your best friend. And not everybody will be glad to know that you have an addiction or that you’re doing something about it. There may be some people who you don’t want to tell about your recovery. But don’t be reluctant to tell the people close to you about your recovery. You should never feel ashamed that you’re doing something about your addiction.
Coping tips if your loved one self-injures
- Get informed. Learning more about self-injury can help you understand why it occurs and help you develop a compassionate but firm approach to helping your loved one stop this harmful behavior.
- Try not to judge or criticize. Criticism, yelling, threats or accusations may increase the risk of self-injuring behavior.
- Let your loved one know you care no matter what. Remind the person that he or she is not alone and that you are available to talk. Recognize that you may not change the behavior, but you can help the person find resources, identify coping mechanisms and offer support during treatment.
- Share coping strategy ideas. Your loved one may benefit from hearing strategies you use when feeling distressed. You can also serve as a role model by using appropriate coping strategies.
- Find support. Consider talking to other people who’ve gone through the same thing you’re going through. Share your own experiences with trusted family members or friends and keep in close touch with the professional taking care of your loved one. Ask your friend or loved one’s doctor or therapist if there are any local support groups for parents, family members or friends of people who self-injure.
- Take care of yourself, too. Take some time to do the things you enjoy doing, and get adequate rest and physical activity.
Cutting down worksheets
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Self Harm Quiz
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