The Enigma of Self-Injury
Self-Injury (which occurs when someone cuts or burns or otherwise harms themselves) is one of the harder behaviors associated with mental illness for people to fathom.
People mostly understand (I think) when someone becomes psychotic, gets stuck in a deep depression or has mood swings. These are exaggerations of normal states of mind—everyone has felt blue at sometime or another—everyone has felt euphoric or energized at least once.
Though loose, psychotic-style thinking is not something that everyone has experienced directly, at least the idea that people can experience hallucinations and delusions is familiar to most.
This basic understanding is not often there when people are confronted with someone who is cutting or burning or otherwise traumatizing themselves. People don't have good reference points to use so as to understand what motivates self-injury or what people who self-injure are trying to accomplish.
Trying to Understand Someone Who Self-Injures
That acts of self-injury are so often bloody and horrifying that it makes it harder for people to be thoughtful about what these acts mean. There is a tendency to panic when you see someone you care about bleeding from self-inflicted wounds, or covered with scars. Such panic interferes with thinking, and makes it harder for people to understand the motives behind self-injury.
Further complicating the matter is the way that self-injury looks like it must be a suicide attempt even though it usually isn't. An act of self-injury which might make sense if understood as a suicide attempt become all the more difficult to comprehend when the self-injurious person denies that they are trying to kill themselves and is telling the truth.
So why do people self-injure? What are they trying to accomplish when they harm themselves? The following list of 6 motivations seems to cover most of the common scenarios that people who self-injure describe.
The 6 Reasons
- Distract themselves, alter the focus of their attention, or regain control over their minds when experiencing pressing, unavoidable and overwhelming feelings or thoughts.
- Release tension associated with strong emotions or overwhelming thoughts.
- Feel something physical when they are otherwise dissociated and numb.
- Express themselves or communicate and/or document strong emotions they are feeling and cannot otherwise articulate.
- Punish themselves.
- Experience a temporary but intense feeling of euphoria that occurs in the immediate aftermath of self-harm.
6 Reasons Explained
Let's unpack these 6 reasons why people self-injure.
1. To Regain Control; To Shift Attention
People sometimes harm themselves because by doing so, they are able to gain a subjective sense of control over chaotic internal emotions and thoughts. Seizing this control involves shifting the focus of their attention away from something more troubling towards something less troubling. Cutting or burning one's self causes physical pain which is a very compelling and strong sensation.
Self-injurers sometimes use this pain sensation to override painful background chatter that fills their minds. For example, they may have been traumatized by a rape experience such that they have PTSD symptoms and constantly be replaying that rape in their minds.
By cutting themselves, they are able to refocus their attention on the pain of the cut and for a short while, experience relief from the rape trauma.
2. To Release Tension
A variation on the theme of regaining control, is the idea that people self-injure as a means of releasing tension. Sometimes an aspect of a person's chaotic internal experience is that feelings and thoughts build up a subjective state of tension or arousal that motivates people to do something to take action to reduce that tension or arousal. Cutting or burning one's self can, apparently, serve such a tension-reducing function.
An example will serve to illustrate. I read an account of a young woman who was consumed with suicidal thoughts which pushed her towards a compulsive feeling that she should end her life.
She coped with this compulsion by cutting herself, which refocused her attention, however temporarily, away from her suicidal ideation. This wasn't perhaps the most ideal coping solution in the world, but it was what she had come up with, and it was functioning to keep her alive.
3. To Return From Numbness
Traumatized people sometimes cope with their trauma by dissociating. Dissociation is a mental and emotional state where the normal unitary experience of consciousness gets chopped up into disconnected parts.
So, a person who dissociates may not remember something that happened to them that was very painful because through the process of dissociation they were able to store that painful memory in a section of their mind that the rest of themselves doesn't know how to find.
Feelings can also be dissociated or detached from the events that provoked them such as occurs in Depersonalization Disorder. So, a painful feeling associated with a traumatic memory might be detached from that memory such that the traumatized person remembers the event as though it happened in a movie; as though it happened to someone else and they were just watching it unfold, numb to the experience.
We're all familiar with the idea that it is painful to experience pain sensations. What people may not realize is that it is also painful to not feel anything.
Dissociated people who feel largely emotionally numb are often in great pain of a sort. Some of them will self-injure so as to generate a strong sensation that is capable of bringing them back to feeling something again. There are variations on this theme. Not all numb dissociated people will use physical pain to "return"; some will use other strong sensations such as are afforded by drugs or sex, etc. But some use physical pain.
4. To Express/Communicate/Document Pain
Sometimes, people who self-harm are not skilled at using language to describe their inner experiences. This can be because they are not particularly good with words.
It can be because they never learned (for whatever reason) what words to use to describe emotion. It can be because what they experience inside their minds is overwhelming to them (due to trauma or abuse) that words can't do justice. Particularly with regard to severe trauma and abuse, words fail to capture the magnitude of internal reactions.
In such cases where words are not available or are inadequate to contain emotional experience, what is left to a person trying to cope with that experience is to express it physically. This process of physical expression of inner experience is sometimes called "acting out."
One rather impulsive and aggressive form of acting out involves inflicting wounds on one's self with the intention of using these physical wounds as a communications device.
The idea is that there is some rough correspondence between easy-to-see self-inflicted physical wounds and internal and thus invisible emotional wounds.
People who self-injure as a means of communication may be doing it to draw attention to themselves (e.g., as a means of calling for help, not unlike a suicide attempt), or they may simply be trying to document to themselves that their internal experience of pain is valid and worthy. Some people who have been abused or neglected may not take their own emotional pain seriously until it has been rendered as physical damage.
5. To Self-Punish
Some people who self-injure do so because they seek to punish themselves. Often when this occurs people who harm themselves with intent to self-punish are also people who have survived substantial abuse.
One of the lasting long-term effects of abuse is, for some people, that the voice or perspective of the abuser gets implanted into the minds of the victims in such a way that the victim starts to judge him or herself in the same way that the original abuser did and then starts to be motivated to punish him or herself.
There's nothing magical about how this abuse implantation process works. In any relationship, each partner builds a mental model of the other partner into their own minds, and uses this model to predict what the other will do.
In the case of the abuser-victim relationship, the victim builds a model of the abuser. The abuser's words such as "because you're dumb, you're worthless, you're a failure" become a rational for the abuse. It's not long before those words resonate in the victim's head without them being said by the abuser. Then they start attacking themselves in the absence of the abuser.
The psychodynamic term for this process where alien values get injected into a person is "introjection," and the alien values are known as an "introject." For more detail on this general process, please see Foreclosed Identities.
People who self injure do not walk around all the time judging themselves from the hostile value system that has been introjected into them. Most of the time, they are able to view the world from their own, more organic perspective.
However, there are times when they get overwhelmed and that introjected perspective takes over and then the need to self-punish as compensation for being such a bad person gets expressed. Sometimes this need is expressed physically, through actual self-injury.
6. To Experience Euphoria
The final reason I'm aware of that people who self-injure describe has to do with feelings of euphoria or at least pleasant feelings that some self-injurers report occur right after they have finished cutting or burning or otherwise damaging themselves.
I think it's like what happens after you exercise vigorously—you get a "runner's high"; a temporary feeling of bliss that occurs right after you've worked out. Only in this case, the feeling of bliss happens in the aftermath of damaging yourself.
Some self-injurers have described this feeling as having addictive qualities. They remember how good that feeling felt and become motivated to self-injure to recreate that feeling.
