Self-Harm: A Symptom Not A Disorder
Self-harm, also called self-injury, is not an uncommon or new phenomenon. An estimated 2 million Americans engage in some form of self-injury. An analysis across 40 countries identified 17% of all people will self-harm during their lifetimes. The average age of first incident is 13 but individuals as young has 5 have been reported, and although young white women are the typical face of self-injury as many as 35% are men.
It can be very upsetting to learn a friend or family member has engaged in self-harm and difficult to understand. The purpose of this month’s blog post is to educate on what self-harm is and is not, separate the fact from the myths, and to provide some guiding resources on how to help a loved one who is self-harming.
What is Self-Harm?
By definition, self-harm is the deliberate act of harming one’s own body without suicidal intent. That is an important take away from this post: self-harm is not a failed suicide attempt. Self-harm, in many ways, is the anti-suicide. That being said, accidental suicide can happen particularly when an individual is under the influence of a substance. A common cause is cutting deeper than intended.
It is also important to understand that self-injury is not a mental disorder. It is a symptom of deeper distress and is a coping mechanism, which will be elaborated on below.
What are Common Myths about Self Harm?
I am starting off with the myths. I will explain some of these in further detail however, suffice to say, if it is on this list it is not true. For fuller explanations of each of these myths please visit The Recovery Village and this handout from Samaritans.org.
Specific self harm myths –
1) Self-harm is rare.
2) Young people self-harm to fit in.
3) It’s a way to manipulate others.
4) Only “emos” self-harm.
5) It’s just a phase that will soon be grown out of.
6) It’s just a bid for attention.
7) People who self-harm want to die.
8) Self-harm is a failed suicide attempt.
9) Only those who have been sexually abused self-harm.
10) All people who self-harm have been abused.
11) People who self-harm do not feel pain.
12) Self-harm is not treatable.
Why Do People Self-Harm?
In short, a person’s primary reason for self-harm generally fits into two rather broad categories:
1) Feeling too much emotion
2) Not feeling enough emotion
How either of these states comes into being requires a rather long answer. The summary is either a person does not know how to self-regulate their emotions (see point 1) and self-harm helps them with this, or, a person feels so numb inside that the pain from self-harm shows them “At least I’m still alive,” (see point 2) as one of my clients described it.
What Exactly is Self-Harm?
The general definition of self harm is any action deliberately harming oneself physically as a way of dealing with difficult or overwhelming emotions.
How do People Self-Harm?
There are a number of ways in which people can self harm. Cutting is the most common. However, other methods include burning, scratching, hair pulling, biting, picking at skin and wounds, and hitting one’s self and/or head.
Self-Harm as a Coping Tool
I tell all my clients the brain’s number one concern is our immediate survival. This is where I marvel at our brains. Our brains work so hard to protect us that they will come up with anything, do anything, as long as it works to protect us right here, right now. Because if we do not survive right now we are not going to be alive later to decide whether or not we regret what we just did.
The mind—which I conceptualize as our logical part with our critical thinking and problem-solving parts—decides whether or not something is a good idea. The problem is, even if the mind knows self-harm is a bad idea, as most who engage in self-harm know this, it needs to come up with a better alternative in order for the brain not to choose self-harm. Simply knowing “This is a bad idea” is not enough.
How many times have we heard dialogue like this in a movie?
“This is crazy!”
“Do you have a better idea?”
A similar conversation goes on between the brain and the mind.
Why is Self-Harm a Coping Tool?
First, why it works. Harm to the body increases adrenaline and endorphin production. This induces both a greater sense of control and a relaxation effect. These, in turn, help to tolerate one’s emotions and regulate the nervous system.
There are many reasons why a person may not have learned how to regulate their emotions and nervous system:
· It can be due to trauma throughout childhood.
· It could be due to parents who likewise do not know how to regulate their emotions and thus never modeled it for their child.
· It could also be a child getting lost in the shuffle of family life. Think “middle child syndrome.”
· It could also be a person who, for one reason or another, finds intense emotion distressing.
For those who feel numb and dead inside severe depression and trauma are frequently the root causes.
How Do I Help Someone Who Self Harms?
There is a lot of information out there on how you can help your loved ones if you suspect they are self-harming. Below is a few suggestions. For more information on each them please visit Banner Health and Mental Health First Aid.org. There are also more resources as the bottom of this post.
1) Avoid judgement
2) Reassure and be supportive
3) Express your concern comes from caring
4) Provided educational information/resources
5) Seek understanding
6) Do not dismiss
7) Do not ask for promises
8) Try to be accepting and normalize
9) Encourage professional help
Counseling & Help For Self Harm in the Chicago Area
As a therapist, I have worked with many, many clients who do or have self-harmed. If you like to speak to me or Ilyssa, or any other therapist on the Obsidian Counseling team, about helping you or a loved one with symptoms like this please do not hesitate to reach out to us. We offer online therapy to individuals in the Chicago area and throughout Illinois.
Take the steps below to begin therapy:
OTHER SERVICES AT OBSIDIAN COUNSELING AND WELLNESS
When you work with a therapist at our counseling practice in the Chicago, IL area, you will be met with compassion and authenticity. We won’t judge you, and we assume there are reasons for all of your actions…even self harm. We’re here to help you find healing and make meaningful change in your life. Our therapists are honored to help guide folks, including teenagers, along their healing process. Specifically, we help people in addressing anxiety, trauma, and work stress. One of our more unique services is yoga therapy, which can also be done using online sessions. Additionally, we specialize in supporting LGBTQIA+ folks for a variety of issues. We hope that you take the leap to begin counseling with us. You deserve it.
About the Author/Therapist
Kari Holman is an LCPC in Illinois who believes you are the expert on your own mental health. She is able to help clients with a wide range of mental health concerns and specializes in providing counseling and psychotherapy services to the Latinx and LGBTQIA communities. If you’re interested in working directly with Kari, or have any questions about this blog post, please call (847) 450-0460 or email her at kariholmancounseling@gmail.com.
Other Resources Related to Self Harm
For more resources on how to help someone who self-harms, including what to say or not say, please see the follow:
Self.com – 5 Helpful Things to Say to a Friend Who Self-Harms (and 3 to Avoid)