When some people picture self-harm, they may envision a teenage girl cutting herself. This sort of scenario certainly does occur, but it’s important to recognize that self-harm in adults and among males happens too and is more common than you might realize. Self-harm also takes a variety of forms, not just cutting. It can be bruising, burning, hitting, and breaking bones. Even severe scratching and skin picking can be forms of self-harm.
Why Do People Self-Harm?
Self-harm in adolescents and adults tends to be a way for them to cope with emotional pain. It is not done out of a desire to get others to help them. Otherwise, the people who self-harm would not make such an effort to hide the behavior and the marks it leaves. In some cases, these adolescents and adults may believe that they deserve to be punished, and self-harm is one way to punish themselves.
Michael Hollander, a psychology assistant professor at Harvard Medical School and McLean Hospital, explained some of the reasons behind self-harm to U.S. News: “Self-injury helps with modulation of emotions. Many of these people have a hard time identifying and labeling their emotions and feelings. Others experience self-loathing and want to escape the emotional experience because it’s so painful.”
When people self-harm, the physical pain serves as a distraction from the emotional pain, self-hatred, and self-criticism. For some people, it’s possible that the physical pain is so intense they feel relief (a positive emotion) when it ends. For others, the endorphins released as they self-injure can have a soothing effect. In any case, they turn to self-harm again and again because it’s the most effective of all the methods they have tried to cope with confusing, negative emotions.
Self-Harm Can Be a Sign of a Behavioral Health Condition
Some people who have conditions such as borderline personality disorder, post-traumatic stress, bulimia, binge eating, anxiety, or depression engage in self-harm. They may also be at risk of other unhealthy coping mechanisms such as substance use.
With that in mind, self-harm treatment must be comprehensive and address any behavioral health conditions. Take someone who has been abused emotionally and physically. This person might turn to self-harm to find an outlet for the emotional pain experienced. His or her spouse finds out about the self-harm and encourages treatment. However, as long as the underlying causes of the emotional pain remain unaddressed, the self-harm behavior could continue.
The Big-Picture Treatment May or May Not Involve Medications
The treatment for self-harm itself usually does not involve medications. Instead, dialectical behavior therapy takes place in both individual and group settings. This type of therapy is based on cognitive behavioral therapy, and DBT focuses on four main areas:
- Emotional regulation
- Interpersonal skills
- Distress tolerance
People can start seeing quality results as early as four months into DBT.
Now, if a person who self-harms also has a behavioral health issue such as anxiety or depression, medication might be used to help treat the behavioral health issue. However, as mentioned above, the self-harm behavior itself does not require medication.
What to Do If You Suspect Self-Harm in Adults or Adolescents
It can be beyond upsetting to suspect or find out that a loved one engages in self-harm. These tips should help you respond appropriately.
- Think before reacting. Avoid shaming or judging. If you react on the spur of the moment, it is likely that fear, not reason, is driving your behavior.
- Learn the various reasons why people self-harm. This also helps you to be able to differentiate between self-harm behaviors and suicide attempts.
- Work with your loved one to come up with a list of alternative behaviors. Examples include using a pen to draw a wound instead of actually inflicting a wound or waiting one day for each cut made (three cuts means waiting three days before the person can cut again). Also work with your loved one to create action steps to take when he or she wants to self-harm. Your loved one could reach out to you or to a therapist, for instance.
- Understand that your loved one might be coping with or processing some sort of trauma.
- Get rid of items such as knives, razors and lighters.
- Listen to your loved one and validate his or her feelings.
For many, self-harm is a behavior they have been doing for a long time. As a result, it can take time to build new thought patterns and coping skills, but patience, understanding, and therapy can help them get back on track.
If you or someone you know experiences mental health issues, it is important to seek help from a qualified professional. Our Resource Specialist can help you find expert mental health resources to recover in your community. Contact us now for more information on this free service to our users.
Tom Connell, Executive Director at Pyramid Family Behavioral Healthcare, has over 30 years of experience working in the behavioral health field in the Atlanta market. He has worked in a variety of settings as well as from different ends of the care-spectrum, from prevention through population management programs to providing treatment in residential and acute care hospitals.
The opinions and views expressed in this guest blog do not necessarily reflect those of www.rtor.org or its sponsor, Laurel House, Inc. The author and www.rtor.org have no affiliations with any products or services mentioned in this article or linked to herein.
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