What is self-mutilation?
Self-mutilation, self-injury or non-suicidal self-harm is the act of deliberate, repetitive, impulsive, non-lethal harming of one’s body.
Many people who self-harm do not even know they are doing it. For example, some people pinch themselves until they create a scar or pick at their fingernails until they bleed. The adoption of self-injury practices usually indicates an unhealthy coping response.
In the DSM-IV there was no clear diagnostic category for the disorder, with some debate still as to what would delineate symptoms of the disorder from the disorder itself, as well as where it should best be accommodated. However, in the DSM-V self-mutilation has its own diagnostic category, non-suicidal self-harm. Self-harm is most easily viewed as a form of pain (adrenaline) addiction / impulse-control disorder.
Different acts of non-suicidal self-harm
The actual act of self- harm may include the following:
bruising or breaking bones
picking scabs or interfering with wound healing
punching self or objects
some forms of hair pulling
excessive body piercing
inserting objects into body openings
Co-morbidity of other psychological disorders with non-suicidal self-harm
People with self-mutilation problems are more likely than normal to struggle with co-morbid (co-occurring) psychological disorders. As with most diagnoses, compulsive self-harm would not be diagnosed where the condition is better explained within another psychiatric diagnosis. Self-mutilators tend to struggle with one or more of the following:
borderline personality disorder
schizotypal personality disorder
dependent personality disorder
post-traumatic stress disorder
attention deficit hyperactive disorder
dissociative identity disorder
Early environmental causes of compulsive self-harm
A self-harmer doesn’t usually start with a method to hurt themselves; they start off with horrible circumstances and psychologically painful thoughts. Some self-harmers suffer harsh early environments that might include the following:
Childhood physical and/or sexual abuse (beatings, threats or torture): These kids are often also blamed for the abuse, and often the families cover it up. This kind of environment can lead to resentment, intense anger, and repressed rage, with defiance, for example, ‘You can’t make me change’, or alternatively with feelings of worthlessness.
Childhood emotionally abuse: Children are sometimes told they are bad, sinful, selfish, hurtful, hateful, uncaring, crazy or weird. This often converts to feelings of guilt, shame, self-hatred and wanting to hurt or punish themselves.
Other causes of self-harm
Not all people who self-harm start with a terrible traumatic crisis. The problem with self-harm is that whatever the cause, it can often progress from humble beginnings. Other reasons for self-mutlation or self-harm include the following:
Development of an unhealthy habit or coping skill that helps them calm down
Learning self-harm behaviours from copying friends or relatives who self-harm.
Addictive cycle of self-harm: Some people become addicted to self-harm and adopt the normal pattern of powerlessness. As part of this normal addictive pattern it takes less and less provocation to self-harm, and the person has less and less ability to control the behaviour once it has begun.
This developing powerlessness may well have a neurochemical derivative, and is accompanied by typical addiction problems of unmanageability (greater amounts of damage being caused, harder to cover it up, more risk of fatality etc etc), as well as denial (reasons given that permit the behaviour such as ‘it is okay to cut myself today as the pain is unbearable, but I will never do it again’)
Reasons people practice non-suicidal self-harm
Research shows that people self-mutilate for many and varied reasons. Often these reasons are over-determined. Nevertheless, some of the reasons for self-harm or self-mutilation might include the following:
becoming numb to pain through self-harm
using self-harm as a way of escaping emotional feelings of harm from others
getting back at an abusive person through self-mutilation and to show external signs of the internal hurt
receiving a high like an ‘adrenaline rush’ from the self-harm
using the self-harm as a way of feeling alive, while struggling with depression, helplessness and hopelessness
being panicked and out of control and needing to do anything to cope with the moment
attempts to get attention through guilt and fear, or even awe (in some teenage social circles)
culturally and sub-culturally sanctioned self-harm (not always entirely within the control of the individual), which can cover a spectrum from earrings and tattoos, through male circumcision to other ritual maiming ceremonies in order to pass through manhood, and even to extremely barbaric activities such as female circumcision