How is self-injury emotionally unhealthy?

Originally Published: October 11, 2013
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Dear Alice,

The general consensus is that self injury is emotionally unhealthy, but I don't understand how. Are there reasons besides religious ones and that it is socially unacceptable?

Dear Reader,

Self-injury is a coping mechanism used to deal with emotional distress and pain, anger, shame, frustration, low self-esteem, and sadness. It comes in many forms, such as cutting or burning the skin, head banging, biting, hitting or punching, skin picking, breaking bones, and hair pulling. The practice is usually done without suicidal intentions, and is instead a mechanism to achieve a temporary release of tension. In general, self-injury is perceived as emotionally unhealthy in the medical and psychological communities because it provides very short-term relief at the cost of involving high-risk behaviors that can quickly escalate or cause permanent damage.

Individuals who self-injure may engage in the behavior for a variety of reasons: to feel control over their bodies, convey inner feelings externally, punish themselves for their perceived shortcomings, express emotional distress to others, or, perhaps, to escape emotional pain through physical pain. The primary reason why self-injury is perceived as “unhealthy” is because it is dangerous. Cutting, for example, can result in excessive blood loss, infections, disease spreading through shared cutting instruments, and in the worst cases, fatality. Punching, hitting, and head banging can result in loss of consciousness, severe bruising, concussion, and breaking bones.

In some cases, an individual will experience one or two isolated incidences of self-injury and move on to alternative methods of releasing negative feelings. For others, self-injury becomes a long-term pattern that some describe as “addictive.” Usually, self-injury is associated with underlying psychological stresses and disorders, such as borderline personality disorder, depression, eating disorders, and post-traumatic stress disorder (PTSD). In general, treatment for self-injury is based on the underlying cause of the behavior, such as depression, personality disorders, or anger management concerns. However, some self-injurers appear to be well-functioning and have no active psychological diagnoses — therefore, treatment in these cases may be more complex.

Recovery from self-injury may be a lengthy and difficult process. Learning to engage in healthy coping mechanisms requires time and dedication — and the first step is the desire to get support. Sometimes, dramatic lifestyle changes, such as moving away or changing schools or jobs, are necessary to avoid triggers. However, steering clear of triggers, making use of less risky coping patterns, and ultimately achieving recovery are well worth the effort. If you or someone you know engages in self-injury, it’s a good idea to reach out to a compassionate and experienced counselor who is able to properly diagnose and treat the behavior. Columbia students can contact Counseling and Psychological Services (Morningside campus) or the Mental Health Service (CUMC campus) for support.

Take care,

Alice

February 26, 2014

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All good points, however I feel that you've missed an important reason why self-injury is emotionally dysfunctional. Self-injury is a means of dealing with intense or overwhelming feelings - it is...
All good points, however I feel that you've missed an important reason why self-injury is emotionally dysfunctional. Self-injury is a means of dealing with intense or overwhelming feelings - it is essentially avoidant. It provides temporary relief without actually addressing the issue at hand, which is that there is something dramatically wrong enough to elict this kind of extreme avoidance. Emotions have an evolutionary purpose: they exist to motivate us to do things. Fear motivates us to flee, shame to hide, etc. They come from a simple formula: event + beliefs. So if someone is experiencing extreme emotions, and self-injures to make the emotions stop or lessen, it works, temporarily, but the underlying issue is still there: the beliefs and/or events that created the emotion in the first place. And because the emotions are there for a very strong evolutionary reason, the body is going to keep sending the self-injurer the same messages again and again until the problem is dealt with - often, as studies have found, more strongly each time. After all, if you're not listening the first, third, or tenth time, it only makes sense that your body and brain would try harder to get you to listen. So yes, cutting can be physically dangerous. So can a lot of other things, though. The real problem is that it doesn't actually solve the underlying distress, and can, in fact make it much worse. As any therapist worth their salt will tell you, avoidance only ever makes the emotional distress worse in the long run. Besides, people often experience distress about the cutting itself - shame, fear, anxiety - and that's obviously unproductive too. The real solution to the overwhelming distress that leads to self-harm is to identify the emotions and where they're coming with, so you can find more productive situations and beliefs. Many self-injurers find a lot of relief through mindfulness-based therapies, such as Dialectical Behavioral Therapy, or Mindfulness-Based CBT. These therapies emphasize learning to identify emotions and where they're coming from, and distress-tolerance techniques, among other things.