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Ask and Expert: What's the Big Deal with Self-injury? |
by Wendy Lader, Ph.D.
People who self-injure are often dismissed by those who don’t engage in these behaviors as “just wanting attention or being “EMO” or “drama queens”. Therefore their solution to the behavior is to “Ignore it and it will go away”.
Self-injurers themselves sometimes dismiss their own behavior with statements such as, “I’m not hurting anyone, why don’t you leave me alone!”
This begs the question: Are we putting too much emphasis on self-injury? ; In other words, are we making a mountain out of a molehill?
The answer for us at S.A.F.E. ALTERNATIVES® is an unconditional and resounding NO! Self-injury is a symptom that should not be ignored!
We strongly believe that there is a deeper meaning to the behavior and a more insidious danger than the creation of infection or scars (Conterio & Lader, 1998). Injuries can indeed place self-injurers in physical danger, however, it is the inability to identify, feel and articulate ones emotional states that puts them at true risk. Being able to recognize, express and accept the full range of emotions is paramount if the self-injurer is ever going to feel comfortable in his or her own skin. A necessary goal of any intervention is to help the self-injurer get past the “mask” that he or she often shows to the world, and allow others to see his or her genuine feelings. (S.A.F.E. TEAM, 2008)
S.A.F.E. has treated thousands of people who self-injure since we opened our doors in 1986, and dialogued with thousands more. We have always known self-injury to be a coping strategy, a survival technique, if you will, to help deal with intense emotional states which seem too overwhelming to bear, and not a meaningless bid for attention.
In recent years, research has overwhelmingly supported our experiential impressions, confirming that -the number one reason people turn to self-injurious behaviors is for the purpose of emotional regulation (Klonsky E.D, 2007; Nock and Prinstein, 2005; Bresin,et al, 2010 ) that is, to relieve internal suffering, and not to hurt or “manipulate” others . Self-injury, does serve to modulate intense emotional states both effectively and quickly. This suggests that rather than totally avoiding uncomfortably intense emotions, self-harm may be a dysfunctional attempt to deal those feeling states. In other words, self-harm may be “a desperate attempt to down-regulate the negative feelings that are exacerbated by ineffective emotional coping strategies, such as rumination, self-blame, and helplessness”. (Mikolajczak, M. et al 2009).
However, while it does temporarily calm, it never actually addresses the original problem, so it is bound to re-emerge, possibly even bigger than before. Each time an intense emotional state arises, the self-injury response becomes habituated, with the addictive like quality of needing an increase in the response, to match the intensity of the emotion.
The key to emotional health is not simply abstinence, but rather understanding that the impulse to injure is a “clue” that they need to pay attention to the source of their emotional storm. That is, to focus on identifying, labeling and expressing thoughts and feelings rather than just “self-injure them away”. The less one knows about one’s internal life and emotional cues, the more vulnerable one is likely to feel. Moreover, the less one is able to communicate thoughts and feelings to others, the more likely one is to experience a sense of alienation. (Lader, W. 2006).
In sum, self-injury is a copying strategy. Just asking one to give up their coping strategy rarely works and in fact can lead to more dangerous behaviors which will be explored in our next edition.
Bresin, K, Gordon,K, Bender, T, Gordon, L, Joiner, T. (25 May 2010) No pain, no change: Reductions in prior negative affect following physical pain. Motivation and Emotion . Volume 34, Number 3, 280-287.
Conterio, K. and Lader, W. with Kingson-Bloom, J. Bodily Harm: The Breakthrough Healing Program for Self-Injurers, New York: Hyperion, 1998.
Klonsky, E. D. (2007a). The functions of deliberate self-injury: A review of the evidence. Clinical Psychology Review, 27, 226-239.
Lader, W. (2006) A look at the increase in body focused behaviors. Paradigm Magazine. Vol 11(1) & Vol. 9 (4).
Mikolajczak, M., Petrides, K.V. and Hurry, J. , (2009), Adolescents choosing self-harm as an emotion
regulation strategy: The protective role of trait emotional intelligence. British Journal of Clinical Psychology 48, 181–193
Nock, M. K. & Prinstein, M. J. (2005). Contextual features and behavioral functions of self-mutilation among adolescents. Journal of Abnormal Psychology, 114, 140-146.
S.A.F.E Team . Self –Injury: A Manual For School Professionals. Chicago: Virgin Ink Press, 2008
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