What self-injurers say SI does for them
• Escape from emptiness, depression, and feelings of unreality.
• Easing tension.
• Providing relief: when intense feelings build, self-injurers are overwhelmed and unable to cope. By causing pain, they reduce the level of emotional and physiological arousal to a bearable one.
• Relieving anger: many self-injurers have enormous amounts of rage within. Afraid to express it outwardly, they injure themselves as a way of venting these feelings.
• Escaping numbness: many of those who self-injure say they do it in order to feel something, to know that they're still alive.
• Grounding in reality, as a way of dealing with feelings of depersonalization and dissociation
• Maintaining a sense of security or feeling of uniqueness
• Obtaining a feeling of euphoria
• Preventing suicide
• Expressing emotional pain they feel they cannot bear
• Obtaining or maintaining influence over the behavior of others
• Communicating to others the extent of their inner turmoil
• Communicating a need for support
• Expressing or repressing sexuality
• Expressing or coping with feelings of alienation
• Validating their emotional pain -- the wounds can serve as evidence that those feelings are real
• Continuing abusive patterns: self-injurers tend to have been abused as children.
• Punishing oneself for being "bad"
• Obtaining biochemical relief: there is some thought that adults who were repeatedly traumatized as children have a hard time returning to a "normal" baseline level of arousal and are, in some sense, addicted to crisis behavior. Self-harm can perpetuate this kind of crisis state
• Diverting attention (inner or outer) from issues that are too painful to examine
• Exerting a sense of control over one's body
• Preventing something worse from happening

These reasons can be broadly grouped into three categories:

Affect regulation -- Trying to bring the body back to equilibrium in the face of turbulent or unsettling feelings. This includes reconnection with the body after a dissociative episode, calming of the body in times of high emotional and physiological arousal, validating the inner pain with an outer expression, and avoiding suicide because of unbearable feelings. In many ways, as Sutton says, self-harm is a "gift of survival." It can be the most integrative and self-preserving choice from a very limited field of options.

Communication -- Some people use self-harm as a way to express things they cannot speak. When the communication is directed at others, the SIB is often seen as manipulative. However, manipulation is usually an indirect attempt to get a need met; if a person learns that direct requests will be listened to and addressed the need for indirect attempts to influence behavior decreases. Thus, understanding what an act of self-harm is trying to communicate can be crucial to dealing with it in an effective and constructive way.

Control/punishment -- This category includes trauma reenactment, bargaining and magical thinking (if I hurt myself, then the bad thing I am fearing will be prevented), protecting other people, and self-control. Self-control overlaps somewhat with affect regulation; in fact, most of the reasons for self-harm listed above have an element of affect control in them.

Q. What is Self Injury?

A. The practice of 'self mutilation.' Causing harm on purpose, inflicting injury on oneself.

Q. Why do people do this?!

A. Usually, this practice is not out of masochism, as real emotional pain. Those who practice SI are in deep emotional turmoil, and hurt themselves to cope with the pain inside. Following the injury, they feel relief, though only temporary. It has been suggested that these injuries are done to make the emotional pain and depression a reality, something tangible.

Q. Are they crazy?

A. No. They are in extreme emotional pain, perhaps deep depression. They may suffer from emotional or psychological disorders, but believe it or not, these are generally normal people with normal lives.

Q. What kinds of things do they do to themselves?

A. Most of those who SI cut themselves with sharp objects - glass, razor blades, shaving razors, exacto kives, kitchen knives and any other sharp object that could potentially break the skin. Burning is another commonly used SI 'technique.' Matches, lighters, hot stoves, and any heated objects are used. Not as common is self inflicted beatings. Some hit themselves with blunt objects, throw themselves against solid objects, use doors or heavy lids to cause pain. It's very similar to those who drink or do drugs to drown out pain.

Q. What causes this?

A. As stated before, depression and emotional pain. Many SI practitioners have been abused, neglected, sexualy abused, or lived through any other traumatic event.

Q. Do these people have a death wish? Are they suicidal?

A. Not necessarily. Though closely related, Suicide and SI are not the same thing. Certainly, these people probably experiance thoughts about Suicide, but it has been suggested that SI is an alternative to suicide. It takes much personal restraint NOT to cut too deep. SI practitioners do not want to 'end it all,' rather, they want to relieve the emotional pain by causing physical pain. Self injury is more than likely the PREVENTION of suicide, and a mechanism to survive, rather than a death wish.

Q. Are these people violent?

A. Not usually. The harm inflicted is to themselves, not others.

Q. Is this just a hysterical woman thing?

A. No, this happens in men as well in women, however it's not as common in men due to the fact that men are more likely to anger than women, and are likely to vent their aggression in other ways.

Q. Do they hurt themselves to get attention?

A. Yes and no (IMHO). It is a cry for help, to show themselves and others that they are in pain, whether they realize it is or not. However, it is not attention they crave, it is release from their emotional pain, not a demand for attention. There are much better ways to get attention than this.

Q. Do they enjoy pain?

A. Most don't enjoy pain. Most of the injuries made are superficial, and do not cause much physical pain. Though some do cause greater injuries (deeper wounds, more serious burns, etc.), it is not because they enjoy it. It is, as stated before, a coping mechanism.

Q. I have a friend who does this. What can I do to help?

It's shocking to see someone you love hurting themselves, and you might be angry or sad, confused or resentful, but remember that the person is in pain. He/She is hurting deeply inside, and the best thing you can do is to let them know you are there for them. If the person is ready to talk about what is wrong, listen without judgement. But try not to overextend yourself, either. You are not responsible for the SI, the person doing it is. If they're not already seeing a counselor, suggest this.

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