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 when a person intentionally inflicts harm upon themselves as a coping mechanism to deal with emotional distress and pain, anger, shame, frustration, low self-esteem, and sadness. This practice is also referred to as self-harm and self-mutilation. It comes in many forms, such as cutting or burning the skin, skin picking, and hair pulling. Some other forms can include head banging, biting, hitting or punching, and breaking bones. The practice is often done without suicidal intentions and can instead be a mechanism used to achieve a temporary feeling of relief. In general, self-injury is perceived as emotionally unhealthy because it may provide very short-term relief from emotional pain, but involves high-risk behaviors that can quickly escalate or cause permanent damage. Although people who engage in self-injury may find immediate relief, getting to the root cause of the distress may provide more lasting relief and be more supportive of emotional health. Further, self-injury can also physically harm the body, potentially leading to blood loss, infections, injury, and in extreme cases, death.

When someone is in emotional pain, feeling physical pain may seem like a relief as it may lead to the release of endorphins or painkilling hormones for some. Sometimes, for those who feel as though they aren't feeling anything, the pain is used as a way to combat numbness with a physical sensation. Most people have a negative response to pain in the moment, but if the pain associated with self-injury is followed by a feelings of relief, a person may become conditioned to make a positive association with the pain. Often, self-injury leads to low self-esteem and intense feelings of shame and guilt. Some people may self-harm a few times and then stop, while others may find establish a cycle of self-injury. 

Self-injury may also be emotionally unhealthy because it’s often used as a coping method among those with a negative self-image. This behavior essentially acts as an avoidant, temporary form of relief that doesn’t actually address the issue at hand. Emotions have an evolutionary purpose: they motivate people to act. While a person may find temporary relief through self-injury, the underlying issue that caused them to self-injure is still there. Because of this, the body may continue to send the same messages again and again — and as studies have found, can be reinforced over time —which may lead to more serious forms of self-injury. This cycle may continue until the root cause is addressed.

For people who are struggling with unhealthy coping mechanisms such as self-injury, it can be helpful to identify the emotions and their sources. Doing so will inform more effective methods to work through them. A mental health professional can help with this process. Many people who self-injure find relief through mindfulness-based therapies, such as dialectical behavioral therapy (a form of cognitive behavioral therapy) or mindfulness-based cognitive behavioral therapy. These strategies emphasize learning to identify emotions, where they're coming from, and distress-tolerance techniques, among others. It's great that you're asking these kinds of questions as getting more information on this concern can help inform any decisions about getting care or supporting others who may be using this behavior as a coping mechanism. 

Alice!

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