Understanding Self -Injurious Behaviors

Statistics vary as to the number of individuals who engage in self-injurious behaviors. Conservative estimates are that about 1% of the general population will self-injure. What is self- injury? Self-injury is defined as deliberate self-harm to one’s body. It can include cutting, bruising, burning, excessive body piercings/tattoos and fracturing bones. Of the above mentioned, most commonly seen is cutting, particularly in youth.  Although there is research suggesting that self-injury rarely represents a suicidal gesture, self-injurious behaviors should always be taken seriously. It can be a strong predictor for future suicide or suicidal attempts (often within 1 year of the self-injurious behaviors) and also lead to accidental death. Contrary to popular belief, self-injurious behaviors are not always a means of gaining attention. Even if the goal was to obtain attention, self-injurious behaviors communicate distress and a need for help. Primarily self-injury serves the purpose of expressing and managing painful thoughts and emotions such as anger, sadness or anxiety. Self-injurious behaviors can also be a means of distraction or a means to gain a sense of control due to feeling powerless in other areas in life. Several effective treatments are available to assist those who self-injure. Treatment strategies may include:

• Counseling using Dialectical Behavior Therapy (DBT): DBT is a form of treatment that assists people in identifying, labeling and expressing emotions. One of the many goals is to learn ways to better tolerate distress and acquire new coping skills through techniques such as mindfulness. One of the several goals in DBT is to be able to identify and reduce stress and tension before incidents of self-injury.

• Group therapy will allow for a healthy expression of emotions and allow people to share their experiences and decrease any shame that may be associated with self-injurious behaviors. 

•  Family therapy addresses any history or family dynamics that may be related to the self-injurious behaviors. Family members will learn to communicate more directly and openly with each other.

• Medications: Antidepressants or anti-anxiety medication may be used to reduce the initial impulsive response to stress.

If you know someone struggling with self-injurious behaviors, be supportive, encourage them to talk about their feelings and don’t expect them to simply stop self-injuring. A variety of alternative coping strategies will be necessary before one will be able to stop using self-injury as a coping method. Try not to judge or criticize for this may increase the risk of self-harming behavior. Encourage them to talk to a mental health professional so that the underlying causes of the self-injurious behaviors can be explored and healthier coping strategies are developed.