Why People Self-Injure

For many people, the thought of self-injury is shocking; an incomprehensible thought. Here are the reasons why people self-injure, engage in self-injurious behaviors, and commit acts of self-harm.

For many, self-harming behavior starts in childhood, disguising scratches and bumps as accidents and progressing to more systematic cutting and burning in adolescence.

There are different theories as to why people self-mutilate. One is that because victims of childhood sexual abuse were forbidden to reveal the truth about their abuse, they use self-mutilation or self-cutting to express the horror of their abuse to the world.

Another theory is that sexual abuse in early childhood leads to extremely low self-esteem. If very low self-esteem develops, self-harm as an expression of self-hatred is understandable.

One research finding is that self-harmers tend to grow up in an 'invalidating environment' - one where the communication of private experiences is met with unreliable, inappropriate or extreme responses. As a result, expressing private experiences is not validated, instead it's trivialized or punished.

The problem with these theories is that (in the case of the sexual abuse theory, for example) not everyone who's been sexually abused starts to self-harm, and not everyone who self-harms has been sexually abused.

Pain and Pleasure of Self-Injury

Another theory for self-cutting is that it triggers release of the body's natural opiate-like chemicals to reduce the pain. Perhaps self-cutters have become addicted to their body's heroin-like reaction to cutting, which is why they do it again and again. They may also experience withdrawal if they haven't done it for a while.

Drugs used to treat heroin addicts may be helpful with self-cutters, but mostly for those who describe a 'high' after they've cut themselves.

Another theory, which in-patient units often use, is based on the psychological principle that all behavior has consequences that are somehow rewarding. Cutting usually leads to a sequence of behavior - increased attention, for example - that may become the rewarding reason to repeat the behavior.

Staff in hospital specialist units are specially trained to ensure that no consequences follow from an episode of cutting that could be rewarding. Instead, when the patient stops cutting themselves they're rewarded with increased attention from staff.

Sources:

  • Favazza, A. R. (1989). Why patients mutilate themselves. Hospital and Community Psychiatry.
  • Solomon, Y. & Farrand, J. (1996). "Why don't you do it properly?" Young women who self-injure. Journal of Adolescence, 19(2), 111-119.
  • Miller, D. (1994). Women Who Hurt Themselves: A Book of Hope and Understanding. New York: BasicBooks.

next: Cutting: Self Mutilating to Release Emotional Stress

Last Updated: 24 June 2011

Reviewed by Harry Croft, MD

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