What are self-injuries? (Psychology)

The Self-harm (85%), burns (30%), blows (32%), punctures, scratches, pinching, pulling of the hair, etc. These are behaviors that involve self-inflicted physical damage. In many cases, several simultaneous forms of self-injury are used.

The self-injurious behavior appear especially in young and young adults, and its tendency decreases as the age advances. A study carried out by Romuald Brunner found that of 5,000 pupils between the ages of 14 and 15, 2% of boys and 6% of girls carried out self-injurious behavior.

People who hurt themselves often feel sad, empty, with many difficulties in identifying their own feelings and expressing them. Doubts invade his mind, and cause a desperate search to control that cascade of unidentifiable feelings.

For many people, self-harm can lead to being seen as a friend, since it ends up being a tool to escape these uncontrolled emotions, allowing this intense and heavy sensation to be tolerated.

We could say that the person who is injured has not learned adaptive behavior to control stress, and resorts to this action because it really is easier than trying to understand and express what they feel. In fact, they can hardly explain what happens inside them because they do not understand it themselves, nor why they feel what they feel so intensely.

How is the profile of people who self-harm?

The disturbance par excellence of self-harm is the Borderline personality disorder (TLP). This disorder is classified into group B of personality disorders, the so-called"dramatic-emotional"in the DSM-IV-TR.

This disorder is characterized mainly by a large Emotional instability , Behavioral and social. They tend to be serious self-injurious behaviors, and have a highly impulsive and aggressive behavioral pattern. This causes their interpersonal relationships to be difficult, unstable and unsafe. Moreover, it is the most common of personality disorders (it suffers between 0.2% and 1.8% of the population).

In addition to people with BPD, other psychopathological disorders are also sensitive to self-harm, such as mood disorders, anxiety, post-traumatic stress disorder, eating disorders, dissociative disorders, and obsessive-compulsive disorder .

Blitz

Although we discussed above the reasons why a person decides to self-harm, the truth is that they are accompanied by frustrating interpersonal experiences. Situations that the person experiences as difficult, with feelings of humiliation or overexertion can lead a person to self-harm.

These people learn very early on that the interpretation of their feelings and emotions is wrong or bad. When this happens, you do not know what you should feel or whether it is okay or not to feel it.

In fact, it is possible that many of these people learned that certain feelings were not allowed, receiving in some cases, even punishment for it.

It is important to note that self-injurious behavior is"contagious". This is because this phenomenon, when it is shared by someone else we know, creates a sense of belonging to a collective, which reinforces behavior.

However, only those people who are under strong emotional tensions due to personal problems will be those that self-harm to overcome the stress.

Warning signs of self-injurious behavior

• Frequent scars not explainable or for no apparent reason, cuts, burns and bruises; Especially in the arms thighs, belly and hips.
• Blood stains on clothing.
• Frequent accidents.
• Clothing to hide, such as long pants or jerseys in times when it is already hot.
• Negative to undress in the presence of someone, and avoidance of all those situations that require it: go to the doctor, go to the beach, the pool...
• Saving blades, crystals, and useful things to control what can happen before self-injury.
• Some not so specific signs that go unnoticed, such as sudden and very obvious mood swings, low self-esteem, impulsivity, isolation, irritability.
• Need to be alone for a long time.

Self-harm from the point of view of those affected

Then you can read some testimonials from people who have self-injurious behaviors that we have selected from the book Self-harm: the language of pain , Which we hope will help you to better understand those affected.

"I do not know why I'm self-injurious. Some professionals have told me it's to attract attention, but I do not think that's the reason. The only thing I have clear is that after making cuts I feel much better, calmer. Sometimes I think I do to myself what I would like to do to others, but I do not think that's the explanation either because I would not hurt anyone. I do not know, I can not answer your question." A patient of 19 years.

"Sometimes I feel like I'm in a kind of trance... I feel like I'm going crazy, I do not exist, I'm not real, it's like I'm dead... Sometimes I burn myself to see if I'm alive and still feel something." A patient of 34 years.

"I've had an internal struggle for many years. As time passed, as I did not find effective solutions, I began to self-injure and this was effective. I was feeling better; When he thought that he could no longer do it, that it was not worth fighting, and that life had no meaning, he resorted to the courts. It would seem strange, but I did not want to die, I wanted to stop suffering, I wanted to learn to tolerate the unforeseen, to live without so much pain... I wanted, but I could not, I did not know... Self-harm was getting stronger and I ended up hooked, I could not stop To hurt me, any situation or unforeseen was enough to hurt me. Nobody noticed until one day my hand went away and I needed an intervention. There was blood everywhere, I thought I was going to bleed into my room and I asked for help." A patient of 29 years.

Reasons for self-harm

After reading these words, you can surely understand these people a little better. In any case, so that you can know even better what is happening to them, we teach you the reasons that lead these people to inflict damage.

• As Mode of control and relief of very intense and negative emotions . These emotions are perceived as uncontrollable, highly unbearable and above all impossible to identify. The person feels overwhelmed and can not do more. Self-harm is a tool that relieves this discomfort.
• As At other times, feelings are more related to guilt, mistakes that you may have made, and self-contempt.
• As Way of feeling something . In the last testimony we could see very well that he needed a sample that he was still alive, that he still existed despite not feeling anything.
• As a way of Express anger and anger , Also uncontrollable. These people may become afraid of hurting others, so the way they can avoid it is by being aggressive with themselves.
• Sometimes, by the general public, these people are considered searchers to attract attention. The truth is that they do not seek to call attention to themselves, but Express what they do not know how to express in the most"easy"way they have found .

The real reason Why these hurtful behaviors are carried out is very simple: it works.

It is important that you keep in mind that Self-harm behaviors are not a suicide attempt , But on the contrary: they try to avoid getting to that point through calming that intense thing that they feel.

Although it is true that there are some cases that end in suicide, it is a reality that either they did not seek it (and it went wrong the planned self-harm), or they looked for the suicide looking for methods other than the habitual one used for the self-injury.

Sometimes self-injurious behavior can become a true addiction, leading to an endless vicious circle. This is something like:

The corporal response is that which plays the central role of reinforcement: The inner emotional tension diminishes, the dissociative feelings disappear and the person finds the relief he needed.

Later, there are other feelings more related to shame and the blame , Which together with the concern to hide bandages and scars, can lead to social avoidance and isolation.

If we see it from this point of view, it is logical that they try to dodge uncomfortable questions that they know will hardly be understood. Sometimes, however, drawing attention, provoking parents, or engaging in relationships with others may also reinforce self-injurious behavior.

This Does not mean that they seek with their behavior to attract attention . We have already said that they try to hide their behavior. It means that by receiving attention (and with it, affection), self-injurious behavior may be reinforced.

Neural substrate

In addition to these reasons, there is a neural substrate that explains them.

It is a fact that people who self-injure are more insensitive to pain than other people who do not hurt themselves. In a study by Martin Bohus at the University of Freiburg, he investigated the pain perception of self-injuring people.

The laboratory situation was as follows: The subjects had to put their hand in a bowl of ice water as long as they were able and assess the degree of pain that this supposed. Those subjects who had the diagnosis of BPD assessed their pain with a significantly lower score than the control subjects (ie,"healthy"subjects).

In addition, none of the people who participated in the study and had BPD withdrew their hand from the water before finalizing the experiment. However, all control subjects had to resign early because the pain was unbearable.

To make matters worse, people with BPD who participated in the study were asked to come back when they felt so bad as to inflict damage in normal situations, to repeat the same test. What was verified was that they still showed less sensitivity to pain.

Self-injuries are related to excessive control of the prefrontal cortex, which reduces sensitivity to pain, in addition to the amygdala, which is responsible for the processing of emotions.

In addition, in these patients, painful stimuli seem to inhibit emotional stress better than weak stimuli. In other words, it seems that self-harm has a role of emotional regulation in these patients.

Tips for family and friends

1. Do not react with fright, anger, or reproach . These people need understanding and acceptance, not the opposite.
2. Conversation with the affected person about self-harm without anger And with great respect. It will help you to verbalize your emotions within your possibilities.
3. When you talk to the affected person about self-harm, do it openly , But without imposing the conversation. They are the ones who have to"give their consent"and not feel compelled to anything.
4. Do not ignore the behavior or minimize it , It is important that those affected know that they deserve attention.
5. Let her know that you want to help And that you will be in the moment that he or she needs it. It offers physical proximity without forcing it.
6. Do not express prohibitions , Neither punishments nor ultimatums. You'll only make the situation worse.
7. Be interested in the concerns and needs That lead the affected to put into practice the self-injurious behaviors.
8. Provide material to heal wounds and bandage . If necessary, help to cure and disinfect them, and take the doctor to the affected person in a serious case.
9. Help her to know how to give herself love and self-love . Strange as it may seem, this person has not learned to love and pamper themselves.
10. Do not ask him what you can do . These people are not sure what they need. Better ask them if you can do"this", and they will say yes or no.
11. The confiscation of sharp objects is useless And you will only feed your creativity to continue doing so.
12. It is important to go to therapy . As much as possible, without forcing anything and always through the affection and respect, it is very important that your family member or friend understands that you should receive psychological therapy, which will help you to better understand yourself and to feel Little by little better. If you are reticent, you should not insist, but try again the necessary occasions later.

References

1. Hawton, K., Hall, S., Simkin, S., Bale, L., Bond, A., Codd, S., Stewart, A. (2003). Deliberate self-harm in adolescents: a study of characteristics and trends in Oxford, 1990-2000. Journal of Child Psychology and Psychiatry, 44 (8), 1191-1198.
2. Mosquera, D. (2008). Self-harm: the language of pain. Cambridge: Cambridge University Press.
3. Pattison, E.M., Kahan, K. (1983). The deliberate self-harm syndrome. American Journal of Psychiatry, 140 (7), 867-872.
4. Schmahl, C. (2014). Neural bases of self-injury. Mind and Brain, 66, 58-63.