“I cut myself because you wouldn’t let me cry.
I cried because you wouldn’t let me speak.
I spoke because you wouldn’t let me shine.
I shone because I thought you loved me…”
The Asylum for Wayward Victorian Girls
It’s important to remember that self-harm, such as cutting or burning, is not simply a trend or a phase.
It’s a serious addiction and a harmful way to cope with emotional pain, intense anger, or frustration.
Self-injury, also referred to as self-inflicted violence, self-harm, or self-mutilation, is an act of violence done to oneself without the intent of suicide.
People who engage in self-harm usually do so to cope with negative emotions and do not want to end their lives. However, the initial relief or pleasure from self-harm is often followed by feelings of guilt, shame, or the return of painful emotions. It may seem to others that self-harm is done calmly and deliberately, but in reality, individuals who self-harm are often in a state of high emotion, distress, and inner turmoil. It’s important to note that approximately 1 out of every 10 people engage in self-harm.
Why do people engage in self-harm?
Self-harm is a way of expressing and coping with deep distress and emotional pain. Despite sounding counter-intuitive to those who are not experiencing it, hurting oneself provides a sense of relief. It may feel like the only available coping mechanism. Self-injury may seem like the only way to deal with emotions such as sadness, self-loathing, emptiness, guilt, and rage.
Short-lived relief: The issue is that the comfort gained from self-harming is temporary. It’s similar to applying a Band-Aid when stitches are genuinely needed. While it may temporarily stop the bleeding, it doesn’t address the root problem and can create additional problems.
Kept in secret: Like many who self-injure, you may try to keep your actions hidden. This could be fueled by shame or the belief that no one would understand. However, keeping your actions and feelings concealed can become a heavy burden. Ultimately, secrecy and guilt can impact your relationships with friends and family and your self-perception. This can lead to increased feelings of loneliness, worthlessness, and entrapment.
Unmanageable inner turmoil: Many individuals who engage in self-harm are grappling with unbearable distress or challenging circumstances. Often, a person may struggle with difficulties before turning to self-harm. People who self-harm may experience emotions such as worthlessness, loneliness, panic, anger, guilt, rejection, self-hatred, or confusion about their sexuality. Through self-harm, they may attempt to cope with stress, numb emotional pain, exert a sense of control, seek help, or punish themselves for perceived wrongdoings. Self-injury typically offers temporary relief from intense emotional pain.
You hold the power
“People say things
meant to rip you in half
but you hold the power to not
turn their words into a knife
and cut yourself”?
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 for youth today. During a recent survey by the Bureau of Youth Research at UNISA, secondary school pupils in South Africa were asked if they knew of someone who self-harms, and 70 -80% indicated that they did know someone who does. It also seems to be a predominantly teen thing. Reasons for self-harm are a chaotic home environment, sexual abuse and overuse of internet technology.
You may ask why internet technology? If you spend time texting, surfing, or playing online games, your brain releases pleasure chemicals (dopamine), which make 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. Even swiping becomes addictive because it releases dopamine all the time. Research has shown people, on average, touch, swipe or tap their phone 2,617 times a day. It was designed to hook you. The dopamine release is more than the usual amount released by, for example, eating when you are hungry. Most of the day, teens on their phones end 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 the system with endorphins, which act as a 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 and more profound, and they draw blood. Some cut to the bone after a while to get the endorphin release. The top three reasons for digital anhedonia are watching pornography, playing social video games and internet surfing.
Source: Digital Cocaine: A Journey Toward iBalance Book. Brad Huddleston.
Who self-harms?
Some individuals who frequently engage in self-harm include teenagers, young women, prisoners, individuals who have experienced abuse, refugees, those who have undergone traumatic experiences such as rape or war, individuals facing discrimination based on their sexual orientation or albinism, and groups of young people involved in self-harm.
What is the effect of self-harm?
For persons with emotional problems, self-injury releases endorphins to create a feel-good feeling, similar to the effects of cocaine and other drugs. Engaging in self-harm can develop into impulsive behaviour that is challenging to control or halt, and it can lead to addiction. What initially begins as an effort to feel more in control can ultimately take over a person’s life.
The arms, legs, and front of the torso are self-injury targets 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.
- 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 a cut’s depth might require stitches.
- Unexplained wounds or scars from cuts, bruises, or burns, usually on the wrists, arms, thighs, or chest.
- Bloodstains 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 to explain away injuries.
- Covering up. Self-injuring people may insist on wearing long sleeves or long pants, even in hot weather.
- Need to be alone for long periods, especially in the bedroom or bathroom.
- Isolation and irritability
- The relief is short-lived and quickly followed by 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 more significant 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 as an impulse or something you do to feel more in control, but soon, it feels like cutting or self-harming controls you. It often turns into a compulsive behaviour that seems impossible to stop.
Get help
Step 1
Tell someone
People who have stopped cutting often say the first step is the hardest — admitting to or talking about cutting. But they also say that they usually feel great relief after opening up about it. Choose someone you trust to talk to at first (a parent, school counsellor, teacher, coach, doctor, or nurse). If discussing the topic in person is too difficult, write a note.
Step 2
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? The pressure to be perfect? Relationship trouble? A painful loss or trauma? Mean criticism or mistreatment? Identify the problem 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-soothe through self-harm.
Step 3
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 teens’ problems or think they’re just a phase. If you feel this is happening to you, find another adult (such as a school counsellor or nurse) who can make your case.
Step 4
Work on it
Most people with deep emotional pain or distress need to work with a counsellor or mental health professional to sort through strong feelings, heal past hurts, and learn better ways to cope with life’s stresses. One way to find a therapist or counsellor is to ask at your doctor’s office, school, or community mental health clinic.
Reference: Counseling / Cutting. https://www.everettsd.org/Page/41477
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 robust taste, like chilli 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)
Reference: How to Stop Cutting and Self-Harming | Novni. https://novni.com/articles/171/how-to-stop-cutting-and-self-harming-
- 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
The acronym, ”B-E-H-A-L-T-E-D” describes some common high-risk emotions:
Bored Excited Hungry Angry Lonely Tired Excluded Depressed
You may feel hungry from not eating well, angry from a demanding workday or commute, lonely even if you’re not alone, and tired, leading to intense cravings.
Here’s another way of looking at high-risk situations:
- People: People you use with or are related to your cutting habit. People with who you have conflicts 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 cravings from turning into primary urges.
Take better care of yourself. One practical approach is to prioritize self-care, which includes consuming nutritious meals to stave off hunger throughout the day, joining a supportive 12-step group to combat feelings of isolation, acquiring relaxation techniques to manage anger and resentment, and establishing healthy sleep patterns to minimize fatigue.
Avoid your self-harm friends. Moreover, it’s essential to abstain from environments, individuals, and paraphernalia that are linked to self-harm. Engaging in recovery isn’t centred around a single momentous alteration but encompasses numerous minor modifications. By steering clear of high-risk situations, you’re actively constructing a new lifestyle that reduces the likelihood of self-harm tendencies surfacing.
Recovery isn’t about one significant change. It’s about lots of minor changes. A practical step involves compiling a list of potential high-risk scenarios, as addictions can be deceptive, and awareness often only dawns when you find yourself immersed in such situations. Hence, it’s advisable to maintain this list with you and periodically review it with a trusted individual in recovery to identify any overlooked triggers. This proactive strategy may prove indispensable and potentially life-saving in the future.
- 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 behaviour.
- Try not to judge or criticize. Criticism, yelling, threats or accusations may increase the risk of self-injuring behaviour.
- 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 behaviour, 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 experiences with trusted family members or friends and keep in close touch with the professional caring for 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. Do what you enjoy, get adequate rest, and engage in physical activity.
Reference: Self-injury/cutting – Augusta Health. https://www.augustahealth.com/disease/self-injury-cutting/
QUIZ
You can do a self-test quiz on self-harm to learn more about it:
References
SELF- HARM – Knowledge Bridge Consulting Inc Blog. https://blog.kbcinc.cloud/self-harm/
How to Stop Cutting and Self-Harming | Novni. https://novni.com/articles/171/how-to-stop-cutting-and-self-harming-
Things You Need to Understand about Self-Harm. https://www.psychotherapykuchenna.com/2020/06/28/things-you-need-to-understand-about-self-harm/
Counseling / Cutting. https://www.everettsd.org/Page/41477
Cutting & Self-Injury (for Teens) – Cook Children’s. https://www.kidshealth.org/CookChildrens/en/teens/cutting.html
addiction Archives – Therapy SRQ. https://therapysrq.com/tag/addiction/
How to Stop Cutting and Self-Harming | Novni. https://novni.com/articles/171/how-to-stop-cutting-and-self-harming-
Self Harm – Counselling Alliance. https://counsellingalliance.com/self-harm-2/
Self-mutilation in children and teens – Childpsych. https://www.childpsych.co.za/selfmutilation-children-teens/
Self-injury/cutting – Augusta Health. https://www.augustahealth.com/disease/self-injury-cutting/