the facts

Self injury can be referred to in a number of ways:   'self harm', 'self injury', 'self mutilation', 'cutting' 'si'.  Many self injurers refer to their actions as 'cutting' or 'si' - these are far more informal terms.   'Self mutilation' as a term is often avoided by self-injurers, due to the graphical quality of the description.

Self injury is the deliberate damaging of body tissue without the eventual intention of suicide.  Self injury is often mistaken as a failed suicide attempt, and while there are many self injurers who are also suicidal, research shows that by far the majority of self injurers have not considered suicide.   This is one false assumption that seems to naturally occur amongst people who are unaware of self injury.

In 1993 self injury was classified into three categories by psychiatrists Favazza & Rosenthal:

1) Major self-mutilation: This is the most extreme and uncommon form of self-injury. It consists of infrequent acts in which a great deal of tissue is destroyed (castration, limb amputation etc...) It often results in permanent disfigurement and is most often associated with psychotic or acute intoxicated states.

2. Stereotypic self-mutilation: This form of injury consists of fixed, often rhythmic patterns such as head banging (the most common), eyeball pressing, and finger or arm biting. It is most commonly seen in institutionalized mentally retarded people, but also occurs in autistic, psychotic, and schizophrenic people as well as those with Lech-Nyhan and Tourette Syndromes.

3. Superficial or moderate self-mutilation: This is described as "a common behavior" by many of the writers listed in the reference section and is the primary subject of this article. Although a significant indicator of emotional distress, this kind of injury is not highly lethal and results in relatively little tissue damage. It often occurs sporadically and repetitively. It sometimes develops an "addictive" quality and becomes an overwhelming preoccupation for some people. Cutting the skin with razor blades or broken glass is the most commonly seen method, and skin carving, burning, interference with wound healing, needle sticking, self-punching and scratching are among other examples.

It must be stressed that category three is the most common form of self injury, and the form which is chiefly dealt with on this website.

'Moderate self-mutilation' is often linked with a number of additional disorders, including:

• Posttraumatic Stress Disorder (PTSD) after rape or combat
• Depersonalization
• Multiple Personality Disorder (Dissociative Identity Disorder)
• Eating disorders
• Characterological traits or disorders
• Addison's Disease
• Benign intracranial hypertension
• Substance abuse
• Clinical depression

However, self injury does occur without symptoms of the above. 

The 'technical stuff' aside, self injury is not the 'problem' for many injurers.  It is the feelings and reasons behind the cutting that are the main problems.  Many self injurers find it extremely difficult to express their reasons for self injury to any specific level, which is why counseling and therapy can be so beneficial to self injurers. 

Self injury is often combined with feelings of guilt, helplessness, rejection, self-hatred, anger, failure and loneliness.  Often - although not always -  these feelings stem from past or present influential events (e.g. domestic violence, divorce of parents, death of loved ones, lack of care as a child, parental depression, alcoholism or critical behavior...).  It must be stressed though, that often the reasons for self harming are not as easy to pinpoint as these causes.

Self injurious behavior does NOT categories a person as psychotic, suicidal or mentally disturbed. 

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