Self- injures are those behaviors that involve self-inflicted physical damage, usually cuts (85%), burns (30%), blows (32%), punctures, scratches, pinching, hair pulling, etc. In many cases several simultaneous forms of self-injury are used.
The self-injurious behavior appears especially in young and young adults, and its tendency decreases as the age advances. A study carried out by Roulade Brunner found that of 5,000 pupils between the ages of 14 and 15, 2% of boys and 6% of girls carried out self-injurious behavior.
People who hurt themselves often feel sad, empty, with many difficulties in identifying their own feelings and expressing them. Doubts invade his mind, and cause a desperate search to control that cascade of unidentifiable feelings.
For many people, self-harm can lead to being seen as a friend, since it ends up being a tool to exit these uncontrolled emotions, allowing this intense and heavy sensation to be tolerated.
We could say that the person who is injured has not learned adaptive behaviors to control stress, and resorts to this action because it is actually easier for them to try to understand and express what they feel. In fact, they will hardly be able to explain what happens to them inside because they do not understand it themselves, nor why they feel what they feel so intensely.
How is the profile of people who self-harm?
The Personality Limit Disorder (TLP) is the most pervasive disorder of self-harm . This disorder is classified into group B of personality disorders, the so-called “dramatic-emotional” in the DSM-IV-TR.
This disorder is characterized mainly by great emotional, behavioral and social instability. They tend to have serious self-injurious behaviors, and have a highly impulsive and aggressive behavioral pattern. This causes their interpersonal relationships to be difficult, unstable and unsafe. Moreover, it is the most common among personality disorders (it suffers between 0.2% and 1.8% of the population).
In addition to people with BPD, other psychopathological disorders are also sensitive to self-harm, such as mood disorders, anxiety, post-traumatic stress disorder, eating disorders, dissociative disorders, and obsessive-compulsive disorder.
Although we discussed above the reasons why a person decides to self-harm, the truth is that they are accompanied by frustrating interpersonal experiences. Situations that the person experiences as difficult, with feelings of humiliation or over-emphasis can lead a person to self-harm.
These people learn very early on that the interpretation of their feelings and emotions is wrong or bad. When this happens, you do not know what you should feel or whether it is okay for you to feel it.
In fact, it is possible that many of these people learned that certain feelings were not allowed; receiving in some cases, even punishment for it.
It is important to note that self-injurious behavior is “contagious”. This is because this phenomenon, when it is shared by someone else we know, creates a sense of belonging to a collective, which reinforces behavior.
However, only those people who are under strong emotional tensions due to personal problems will be those who self-injure to overcome stress.
Warning signs of self-injurious behavior
- Frequent scars not explainable or for no apparent reason, cuts, burns and bruises; especially in the arms thighs, belly and hips.
- Blood stains on clothing.
- Frequent accidents.
- Clothing to hide, such as long pants or jerseys in times when it is already hot.
- Negative to undress in the presence of someone, and avoidance of all those situations that require it: go to the doctor, go to the beach, the pool …
- Saving blades, crystals, and useful things to control what can happen to self-injury.
- Some not so specific signs that go unnoticed, such as sudden and very obvious mood swings, low self-esteem, impulsivity, isolation, irritability.
- Need to be alone for a long time.
Self-harm from the point of view of those affected
Then, you can read some testimonies of people who present self-injurious behaviors that we have selected from the book Self-harm: the language of pain, which we hope will help you better understand those affected.
“I do not know why I’m self-injurious. Some professionals have told me it’s to attract attention, but I do not think that’s the reason. The only thing I have clear is that after making cuts I feel much better, calmer. Sometimes I think that I do to myself what I would like to do to others, but neither do I think that is the explanation because I would not hurt anyone. I do not know, I cannot answer your question. “A 19-year-old patient.
“Sometimes I feel like I’m in a kind of trance … I feel like I’m going crazy, I do not exist, I’m not real, it’s like I’m dead … Sometimes I burn myself to see if I’m alive and I still feel something.” A patient of 34 years.
“I’ve had an internal struggle for many years. As time passed, as I did not find effective solutions, I began to self-injure and this was effective. I was feeling better; when he thought that he could no longer do it, that it was not worth fighting, and that life had no meaning, he resorted to the courts. It would seem strange, but I did not want to die, I wanted to stop suffering, I wanted to learn to tolerate the unforeseen, to live without so much pain … I wanted, but I could not, I did not know … Self-harm was getting stronger and I ended up hooked, I could not stop to hurt me, any situation or unforeseen was enough to hurt me. Nobody noticed until one day my hand went away and I needed an intervention. There was blood everywhere, I thought I was going to bleed into my room and I asked for help. “A patient of 29 years.
Reasons for self-harm
After reading these words, you can surely understand these people a little better. In any case, so that you can know even better what is happening to them, we teach you the reasons that lead these people to inflict damage.
- As a way of control and relief of very intense and negative emotions. These emotions are perceived as uncontrollable, highly unbearable and above all impossible to identify. The person feels overwhelmed and cannot do more. Self-harm is a tool that relieves this discomfort.
- As At other times, feelings are more related to guilt, mistakes that you have been able to commit and scorn yourself.
- How to feel something. In the last testimony we could see very well that he needed a sign that he was still alive, that he still existed despite feeling nothing.
- As a way of expressing anger and anger, also uncontrollable. These people may become afraid of hurting others, so the way they can avoid it is by being aggressive with them.
- Sometimes, by the general public, these people are considered searchers to attract attention. The truth is that they do not seek to draw attention to themselves, but to express what they do not know how to express in the most “easy” way they have
The real reason why these hurtful behaviors are carried out is very simple: it works.
It is important that you keep in mind that self-injurious behaviors are not an attempt at suicide, but quite the opposite: they try to avoid reaching that point by soothing that intense thing they feel.
Although it is true that there are some cases that end in suicide, it is a reality that either they did not seek it (and the planned self-harm went wrong), or they looked for the suicide looking for methods other than the habitual one used for the self-harm.
Sometimes self-injurious behavior can become a true addiction, leading to an endless vicious circle. This is something like:
The bodily response is what plays the central role of reinforcement: The inner emotional tension diminishes, the dissociative feelings disappear and the person finds the relief he needed.
Later, there are other feelings more related to shame and guilt, which together with the concern to hide bandages and scars, can lead to social avoidance and isolation.
If we see it from this point of view, it is logical that they try to dodge uncomfortable questions that they know will hardly be understood. However, sometimes attracting attention, provoking parents, or engaging in relationships with others may also reinforce self-injurious behavior.
This is not to say that they seek with their behavior to attract attention. We have already said that they try to hide their behavior. It means that by receiving attention (and with it, affection), self-injurious behavior may be reinforced.
In addition to these reasons, there is a neural substrate that explains them.
It is a fact that self-injuring people are more insensitive to pain than other people who do not hurt themselves. In a study by Martin Bonus at the University of Freiburg, he investigated the pain perception of self-injuring people.
The laboratory situation was as follows: The subjects had to put their hand in a bowl of ice water as long as they were able and assess the degree of pain that this supposed. Subjects with a diagnosis of BPD assessed their pain with a significantly lower score than control subjects (i.e., “healthy” subjects).
In addition, none of the people who participated in the study and had BPD withdrew their hand from the water before finalizing the experiment. However, all control subjects had to resign early because the pain was unbearable.
To make matters worse, people with BPD who participated in the study were asked to come back when they felt bad enough to inflict damage in normal situations, to repeat the same test. What was verified was that they still showed less sensitivity to pain.
Self-injuries are related to excessive control of the prefrontal cortex, which reduces sensitivity to pain, in addition to the amygdale, which is responsible for the processing of emotions.
In addition, in these patients, painful stimuli seem to inhibit emotional stress better than weak stimuli. In other words, it seems that self-harm has a role of emotional regulation in these patients.