Self-injury is defined as any deliberate behavior that causes
physical harm but is not done with conscious suicidal intent that a
person engages in to manage or decrease emotional distress. Self-injury
is something that is often misunderstood, even by helping
professionals.
Deb Martinson has created a site, Secret
Shame, full of a wealth of information about self-injury. She
provides a comprehensive list of what
self-injurers say this behavior does for them. In general, these
reasons can be grouped into three categories:
Affect
regulation — Trying to bring the body back to equilibrium
in the face of turbulent or unsettling feelings. This includes
reconnection with the body after a dissociative episode, calming of
the body in times of high emotional and physiological arousal,
validating the inner pain with an outer expression, and avoiding
suicide because of unbearable feelings. In many ways, as Sutton
says, self-harm is a “gift of survival.” It can be the most
integrative and self-preserving choice from a very limited field
of options.
Communication
— Some people use self-harm as a way to express things they
cannot speak. When the communication is directed at others, the SIB is
often seen as manipulative. However, manipulation is usually an
indirect attempt to get a need met; if a person learns that direct
requests will be listened to and addressed the need for indirect
attempts to influence behavior decreases. Thus, understanding what
an act of self-harm is trying to communicate can be crucial to
dealing with it in an effective and constructive way.
Control/punishment
— This category includes trauma reenactment, bargaining and
magical thinking (if I hurt myself, then the bad thing I am fearing
will be prevented), protecting other people, and self-control.
Self-control overlaps somewhat with affect regulation; in fact,
most of the reasons for self-harm listed above have an element of
affect control in them.
Self-injury is certainly an issue for many trauma survivors. I
understand self-injury as serving a function, as a coping strategy.
People who self-injure may not have developed healthy ways
to feel and express emotion or to tolerate distress. Another reason
that it is so important that trauma therapy focus on the development of basic skills like identifying and
managing emotions. I work with clients in my practice to develop a list
of alternatives to self-injury, all the while acknowledging the
substitutes may not (especially at first) work as effectively as
self-injury did.
If this is an issue for you, please seek help from someone who
understands the issue and who can work with you to develop alternatives.
It is possible.
For more information read:
Common Myths about Self-Injury
Self-Injury Fact Sheet
Alternatives To Self-Injury
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