why self injury happens

Editor's Note: the content of this Web article may be triggering for those who self-injure.

Why people self-injure

Deliberately injuring oneself runs so counter to most people's concept of sanity that they find it difficult to imagine that it serves some useful purpose. However, as one study put it:

“The assumption is that the alternative to self injury is “acting normally,” but, on the contrary…the alternative to self-injury is total loss of control and possibly suicide. It becomes a forced choice from among limited options.

--Solomon and Farrand (1996)[16]

The literature notes three psychological purposes that SI can achieve:

· Affect regulation—Controlling through physical pain a far more intense psychic pain (the backfire analogy suggested above), or to ward off or end a dissociative state (detachment from a normal sense of the self). Emotional control is not only the most common reason given by those who self-injure, but appears to be an element in the other two psychological purposes cited.

· Communication—A smaller proportion of self-injurers may use it as a means of communicating a psychological need or emotion the person is unable to put into words. Once the need is understood and met or the emotion has found another means of expression, the indirect effort to communicate through self-injury decreases. This aspect is elaborated upon in the next section.

· Control/Punishment—Like anorexia and bulimia, cutting provides a sense of control over some aspect of what seems to the subject to be an otherwise chaotic life. There may also be reenactment of an earlier, possibly suppressed trauma, (a high proportion of self-injurers have been victims of childhood physical and sexual abuse.) There may also be elements of bargaining and magical thinking at work, i.e. “If I hurt myself, I can prevent something I fear from happening.[17]

A consistent finding of those who have studied self-injurers is that they are relatively aggressive people who turn their anger and hostility back upon themselves.[18] Anger and anxiety appear to be the most common mood states at the time of self-injuring incidents.[19] It is significant, however, that self-injurers frequently cannot describe their emotional states at the times they harm themselves. This emotional inarticulateness (alexithymia is the recently coined psychological term) may lead to self-injury as a means of communicating to others (and to the self?) the way the sufferer feels when words literally fail her (or him). The cut becomes, as one writer has described it, “the voice on the skin”[20]

Another characteristic of those who self-injure is a sense of invalidation—of lacking a firm concept of who they are and where they stand in the world emotionally. This incoherence often arises from an upbringing in which adults denigrated, ignored or denied the validity of the child's strong emotions. While abuse is clearly invalidating, so is a non-abusive home in which there is a consistent pattern of adult arrogance toward or impatience with a child's efforts to express emotions.[21]

Statements like “You're being too sensitive,” or “You're angry, but you just won't admit it,” or “I'll give you something to cry about,” are part of standard parental response. Used occasionally, at moments of exasperation or distraction, they do no harm. But an unending pattern of such responses from a cold and distant parent can leave the child emotionally adrift as an adult, with impaired ability to tolerate strong emotional states, and to maintain a sense of self-worth and connection to others.[22]

As a result, the invalidated adult has a strong tendency to feel that she[23] is not in control of her life. But she does control the self-injuring behavior, and that theme appears constantly in writings by self-injurers:

• “I like the thought that it is ME causing the pain for once, not someone else.”
• “Cutting presents a way to make the pain show (and be felt) on the outside where I can deal with it…like I am accomplishing something while I am in a situation that I (usually) have very little control over…”
• “Sometimes I do it just to see my blood and know that I am still alive.”[24]

It is worth repeating here that only rarely is SI practiced as a means of manipulating others—or even communicating the sufferer's pain to others. If it is a form of dialogue at all, it is generally an internal one. It is usually practiced in secret, and discovery by others is likely to be accidental.