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Teen Health: What is Self-Injury?  Previous Next

What is Self-Injury?

by: Amy Otis, RN

What is Self-Injury or Self-Mutilation?

Self-injury is not something people talk about very often, but for an estimated 2 to 3 million Americans it is a serious problem. The majority of people who self-injure are women between the ages of 13 and 30, but there are "cutters" of every age, gender, and economic group.

People who "self-injure" are not usually suicidal. They do however, intentionally inflict injuries upon themselves, usually in response to stress or trauma. Their injuries may vary from minor cuts that heal quickly to very serious wounds that leave permanent scars. This is also known as "Deliberate Self-Harm Syndrome".

If you or someone you know self-injures, please get professional help right away. This is just an overview of a very complex myriad of syndromes.

Self-injury usually indicates that somewhere during development that person didn't learn good ways of coping with overwhelming feelings or stress. They’re not sick or insane; they just never learned positive ways to deal with feelings and emotions for various reasons. Positive coping skills can be learned at any point in life. People who self-injure can learn to use new and healthier coping mechanisms. This process may take years to develop with the help of a skilled therapist familiar with this condition.

The late Princess Diana's word's shocked the world when she admitted in a television interview that she intentionally cut her arms and legs and had thrown herself down a flight of stairs on more than one occasion. Finally, self-injury -- the practice of deliberately cutting, scratching, burning, or otherwise injuring one's own body -- was about to come out of the closet. After that interview thousands of self-injury survivors called or wrote the media in response to that interview in just the United States alone.

Cutting seems to be the most common type of self-injury. "Cutters" often use razors, utility knives, scissors, needles, broken glass, or whatever they find to make repetitive slices on their arms, legs or other body parts. Some people burn themselves with cigarettes or lighters, others pull out their own hair.

Many people who self-injure say they do it because they normally feel "numb" and cutting helps them to "feel alive." Others talk about the "sense of control" they may get from self-injury. This may be the first time or thing that they have felt a sense of control in their lives. Most agree that incidents of self-injury are triggered by stress and anxiety.

Self-injury is usually kept secret, and the "cutter" often feels deep shame and guilt from this ritual. People who self-injure are at risk for infections if their wounds are not treated properly. Permanent scarring can also result from self-injury and often does. Many people who self-injure wear long pants, long-sleeved shirts, and turtlenecks even in warm weather to conceal the marks they've left on their own bodies.

Why Do People Self-Injure?

This problem is not completely understood by health care professionals or psychologists. It seems to be most common among people who have been sexually abused as children, molested as children, or by survivors of incest.

Whatever the context or reason, self-injury seems to function as a coping mechanism. "Cutters" use self-harm to feel calm, "in control," or just to "feel something." However, self-injury is not a healthy coping mechanism - it is a self-destructive behavior that probably reflects deeper, more complicated mental health or personal problems. (See the end of this article for some quotes and "stories" of people who self-injure).

Some Common Factors of Self-Injury

* Age of onset between 10 - 16 years old
* There was a major change in the teen's life -- parents divorce or death
* There is a history of family violence, abuse or sexual abuse
* Intense feelings of fear, hurt, anger, rejection or abandonment
* Feelings of loss and or need for control

Some Common Reasons Why People Cut Themselves
These are some of the reasons our readers who "cut" shared with us.

They find it soothing:
* To feel pain on the outside instead of the inside
* To cope with feelings
* To express anger towards themselves
* To feel alive, instead of "numb"

A way of communicating what they can't say with words:
* To tell people they need help
* To get people's attention
* To tell someon they should be in hospital

An attempt to get people to react to their actions:
* To get people to care for them
* To make other people feel guilty
* To drive people away
* To get away from stress and responsibility
* To manipulate people or situations

Triggering Events Reported by Young Adults Who Self-Injure:

* Being rejected by someone who is important to them
* Being blamed for something over which they had no control
* Feeling inadequate
* Being "wrong" in some way


People who self-injure can learn to use new and healthier coping mechanisms. This process may take years to develop.

It also is important to get help from a therapist who specializes in self-injury. He or she can help the person figure out what lies behind the urge to cut or injure. New coping mechanisms may include exercising, painting, writing, yoga or dancing instead of hurting oneself. A process that involves self-expression is often helpful. Whatever works as an alternative method of coping with the feelings of anxiety or stress or "numbness" is often a good start toward recovery.

If you hurt yourself intentionally, remember you are not alone. You might think that this behavior makes you a "weird," but you can see from the statistics that it is more common than you thought. Talk to a counselor, therapist or your health care provider, chances are they've helped others with this same problem. Whatever pain or bad experiences underlie your urge to self-injure, a professional can help you to heal, both inside and out.

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