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Main Page....Mental Health...Self-Injury

Self-Injury: Inside Pain Turned Inside Out

days 'til National SI Awareness Day, March 1 2004.

"We are male and female. We are artists, athletes, students, and business owners. We have depression, DID, PTSD, eating disorders, borderline personalities, bipolar disorder, or maybe no diagnosis at all. Some of us were abused, some were not. We are straight, bi, and gay. We come from all walks of life and can be any age. We are every single race or religion that you can possibly think of. Our common link is this: We are in pain. We self-injure. And we are not freaks."

Though the issue might not get as much attention as eating disorders, some figure skaters do also have problems with self-injury. And once again, many non-skaters face the exact same issue.

What is self-injury? Who does this, and why If you self-injure... Friends and family
Books on SISI in the spotlightSelf-injury links Mental health links

What it is

Self-injury involves deliberate harm to oneself without conscious suicidal intent and not for sexual pleasure. Primarily, it is used as a coping mechanism. It is sometimes called self-harm, self-abuse, self-mutilation (a term which most self-injurers HATE), or self-inflicted violence. The preferred term, however, is self-injury. Common forms of self-injury include, but are not limited to: cutting, burning, picking at the skin, hitting, and biting. Sometimes it is difficult to determine where to draw the line between self-injury and "body modification." It is generally accepted that it depends on the person's reason for the act. (For example, getting a tattoo or a piercing because it "looks cool" is different than having it done because the act itself causes pain.)

A person who self-injures is very, VERY rarely a danger to anyone else (an exception being violent criminals who, when jailed, turn to self-harm when they can no longer outwardly express their rage on others). Sometimes people become frightened when they find out that a person they know deliberately inflicts harm on themself. "Wow, if he/she is willing to that to themself, imagine what he/she might do to someone else!" But a person who self-injures is almost never a threat to others... the only person they would even think about harming is his or her own self. The internal pain is turned inside out, but never goes any further than the person's own skin.

Self-injury is NOT "attention-seeking." On the contrary, people who self-injure are often very clever in hiding their wounds, and equally clever at making excuses when their wounds are discovered... feline members of households really get a bad rap! Skaters especially can pull lots of clever and seemingly plausible excuses because of the nature of the sport (You'd be surprised at how long I fooled my parents by claiming that my synchro team mates had accidentally kicked my legs or scratched my arms.) Because of the stigma attached to SI, they may even be ashamed of what they are doing. People who are either "careless" in letting their wounds show or who confide in others about their self-harming behaviors are merely asking for help...probably in the only way they know how.

Who does this...and why

The exact statistics on SI may never be known, because there is so much stigma attached to the behavior. However, it is estimated that 1% of Americans engage in this behavior. That may not sound like a lot, but it is. That's at LEAST two million people in the United States who cannot find a way to ease the internal pain they feel, and so they seek out the knife, the razor blade, the cigarette lighter, or the wall, to help them. That's two million too many.

Self-Injury is not in itself a diagnosis, but it may be found in people who have other "labels" (whether such labels are really warranted or not). Borderline Personality Disorder is the only psychological disorder which lists "self-mutilation" as one of the possible criteria, but self-injurious behavior doesn't automatically mean that a person has BPD (even if that is a common assumption among less-educated therapists). Self-injury may also be found in patients diagnosed with mood disorders such as depression or bipolar disorder (a.k.a. manic depression), dissociative disorders, eating disorders, or anxiety disorders such as generalized anxiety, panic attacks, or Post-Traumatic Stress Disorder. For more information on these disorders, please see the mental health page.

There are many different reasons why a person might turn to self-harm. Studies have shown that the brain releases endorphins when a person is injured, which may explain the feelings of calmness commonly experienced after self-injury. Some people do it for the pain, either because they feel numb and just want to feel something, or simply to punish themselves. Some are comforted by the sight of their own blood...maybe they weren't allowed to cry when they were younger, and blood has replaced tears for this person, or it is otherwise symbolic somehow of "getting rid of the pain." For people who are victims or survivors of physical or sexual abuse or molestation, it may be a way to "reclaim" their body, a pain that they can control, or a way to stop flashbacks or keep themself from disocciating. It may also be used as a way to release tension when a person feels anxious, angry, scared, stressed out, or any other "negative" emotion.

Skaters especially are subject to a lot of pressure from coaches, judges, parents, their peers, and even themselves. They may turn to SI as a way to cope with all of the stress and anxiety that comes with the sport, if they have no other "outlets" which work for them. I know that when I had a very hard time keeping my own SI under control, it was the worst during the competition season. Now, however, I am learning to use more constructive coping mechanisms to deal with the stress. See my page on stress management for some ideas, or add some of your own.

If you self-injure...

...I think the best place you can go right now is Secret Shame, a site maintained by Deb, coordinator of the Bodies Under Siege mailgroup (and a really wonderful woman!). It helps to know that you are not alone. While you are there, check out the various other resoources offered there, especially the BUS mailing list (it's high in traffic, but even higher in support). You can also visit another site from the Bodies Under Siege webring by going to the bottom of this page and clicking on the icons.

There are sometimes doubts about whether or not you should tell anyone about it. It's often very hard to come forward and talk about self-injury with other people, simply because it's hard to know how anyone is going to react. Voices of those who self-injure can also provide you with some information, but really, everyone's situation is different. Same goes for the decision of whether or not you wish to stop. Strategies to stop self-harming by Brandon (another really awesome guy) is definitely a must-visit site, even if you harbor any sort of ambivalence toward stopping.

I will be the first to admit that it is definitely difficult to stop SI, and went through periods of time where the prospect of not cutting was unfathomable, even impossible. But as I and countless other people can tell you... if you really want to stop, as hard as it might be, it is definitely possible. As of June 2003, it's been almost three and a half years since I have cut. Other people I know who used to self-injure have managed without it for five, ten, and even twenty years.

If you are having urges to self-harm RIGHT NOW, I encourage you to call a trusted friend, or do something to distract yourself. If mere distraction is not effective, it is important to assess why you want to harm yourself, and do something else to serve that purpose. For example, if you are angry, you might instead try throwing ice cubes into your bathtub. You won't damage yourself, or anything else for that matter, and there's no cleanup afterwards. If you are having trouble handling stress, some relaxation activities might be a good idea. (I always used to bake when I got stressed... but this is not something I would recommend if you are prone to burning yourself.) If you wish to see blood, try taking a red magic marker and drawing on yourself instead. Kel's alternatives page has tons of other ideas on how to cope with urges to self-injure.

For treatment of injuries already there, it is absolutely essential to know basic first aid. Infections, broken bones, and loss of blood are especially serious potential consequences. Going to a hospital for treatment of self-inflicted injuries may be awkward at times due to the stigma of SI and the fact that they may recommend psychiatric evaluation, but use your good judgement. If you have even the slightest concern about needing to go to the emergency room, it's better to err on the side of caution.

Special: Coping With the Attacks of September 11

If you know someone who self-injures...

...the worst thing you can do is ignore the problem. First off, educate yourself! As much information I have tried to include here, this page is just a start.. A Bright Red Scream by Marilen Strong gives the voice of self-injurers as to why they do it, and Deb's Secret Shame site also gives a wonderful explanation as to the "who, what, and why" of it all. Her page for family and friends is especially thorough and informative. Next: don't judge your friend or family member. That is the last thing he or she needs. Self-injury might be scary to you, but it's probably just as scary for him or her.

The best thing you can do for someone who self-injures to BE THERE for them. Set up a support system. Offer to let them page or call you if they get the urge to self-injure, if you feel like you can handle talking about it with them. You don't necessarily have to accept phone calls from them at three in the morning (though that would be nice), but let them know that they can e-mail you late at night or when you are not available to talk on the phone. In the meantime, encourage them to seek professional help from a psychiatrist or therapist. It's sometimes a difficult balance between helping a friend and maintaining healthy boundaries, but in the long run it's best to do whatever makes you the most comfortable.

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