The "Why" Behind Self-Injury

(Ed. Note: This is a companion article to the HealthyPlace TV Show on Self-Injury. Our guest, Dana, shares part of her self-injury story here.)

Self injury refers to the act of consciously harming oneself by means of such behaviors as: cutting, scratching, burning, pinching, biting, head banging or other harmful physical behaviors. Interestingly, it is not done in an effort to kill oneself, but rather is an act designed to help the person to "cope" with negative emotional states such as: tension, loneliness, frustration, anger, rage, depression or a whole host of other negative, bothersome emotions.

Since most people who engage in self-injury do so in secret, and with a sense of guilt and shame, we have no idea just how common the behavior is, but recent information shows it to be more common than most of us previously believed. Rarely is the behavior voluntarily revealed to others. We used to believe self-harm was exclusively a female problem, but we now know it may be as common in males.

The Addictive Nature of Self-Injury

The behavior is often performed impulsively at first, and is followed by a relief of the negative emotions for which it was performed, accompanied by sense of calm and sometimes "numbness." However, rather shortly, these feelings are replaced by a tremendous sense of guilt and shame, and a return of many of the prior negative emotions "and then some." Over time, the self-injurious behaviors often take on an "addictive" quality making them even more difficult to stop.

The behavior generally starts in the pre-teen or teen years, but can continue for many years into adulthood.

Self injury is not a diagnosis, but rather a symptom of an emotional disturbance. Those engaging in the behavior may also have other psychiatric disorders including: borderline personality disorder (BPD), mood disorders, eating disorders, substance abuse disorders or anxiety disorders such as obsessive-compulsive disorder and/ or post traumatic stress disorder.

Treatment for Self-Injury

Getting help for self-injury, self-harm begins with and understanding of what it is, and that it is part of an emotional problem that can be helped. Just knowing that others do the same thing can be reassuring to the sufferer. The sufferer must, despite the guilt and shame begin to face and admit the behaviors (even if the scars, etc, are originally discovered by family members or others).

Treatment for self-injury is possible, and can be quite effective. Generally help involves psychotherapy (individually, family or group), and education about the condition. For some, medication can be useful. In severe cases, hospitalization may be required.

There is a great deal of information on self-injury on the HealthyPlace website, and I encourage you to watch the HealthyPlace TV Show on self-injury. Help is available.

Dr. Harry Croft is a Board-Certified Psychiatrist and Medical Director of Dr. Croft is also the co-host of the HealthyPlace TV Show.

next: Bipolar Disorder: Diagnosis and Treatment
~ other mental health articles by Dr. Croft

APA Reference
(2009, March 6). The "Why" Behind Self-Injury, HealthyPlace. Retrieved on 2024, July 16 from

Last Updated: January 14, 2014

Medically reviewed by Harry Croft, MD

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