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Therapist's Comments on Self Injury

Depression is common in people who self-injure

Juliet is suffering silently from self-injury syndrome, something that most sufferers suffer alone, and in shame. While some experts have seen self-injury as similar to suicide, just stopping short of it, most see self-injury as a distinct entity. Why do people, and especially women and young women, engage in such activities ranging from hairpulling and cutting one's self to much more severe forms of self mutilation?

For those of us who don't engage in this kind of activity it seems bizarre bordering on crazy. The fact is, most people who self-injure are not "crazy" but they often do suffer from psychological problems. Depression is common in people who self-injure. People who self-injure have often suffered physical, emotional or sexual abuse as children.

So why is Juliet going to cut herself again? Self-abusers report feeling calm and peaceful after a certain amount of injury. Many report feeling little or no pain. Is she doing it for the attention that she will get after injuring herself? Perhaps.

Some experts suggest that self-injurers pursue this activity as a way of escaping severe emotional pain. The physical pain they inflict upon themselves allows them to escape, at least for awhile, the emotional pain they are experiencing.

The feeling of control that some self-abusers experience can explain in part, the motivation behind self-mutilation. Many self-abusers, like Juliet, are perfectionists, demanding a lot of themselves.

Juliet's your friend-how do you help her?

It's important to recognize that people who self-injure themselves on a regular basis need to get professional help. The first therapist you turn to is not always the right one for you. If Juliet feels that Doug is not a good therapist for her, it may pay to try a different one.

One of the things that both therapists and friends can help Juliet with is letting her know that she is okay, even if she isn't perfect. It sounds like she is setting up tremendously high standards for herself, and ends up creating a lot of tension and self-induced pressure. Learning how to let go a bit, relax, and unwind might be very helpful for Juliet.

As Juliet's friend, you could try to distract her when she begins to talk about self-injuring. Go for a walk, or see a movie together. Often the urge to self-injure will pass with time. But remember, you are not her therapist, you are her friend.

If you have a child that self-injures it is imperative to consult with a mental health professional, both to get a better understanding of what is going on and to get some help for your child. This is one symptom that cannot be overlooked, and shrugged off.

There are many treatments available for self-mutilators, and their families. There is light at the end of the tunnel.

About the author: Dr. Naomi Baum has been a child and family psychologist for the past 15 years.



next: Depression: Suicide and Self Injury

Last Updated: 01 April 2016
Reviewed by Harry Croft, MD

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