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Self Injury Awareness Month

23rd March 2022

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Self Injury Awareness Month

Self-harm is when someone deliberately hurts themselves.

Often associated with cutting, burning, or scratching, it can also include other behaviours such as binge drinking, drug abuse and/or restrictive eating. Self-harm can affect anyone, whatever their age, social / economic status, or gender. However as evidenced by research, it is most likely to occur in teenagers and young adults. This is reflected in a recent national study which revealed that 7.3% of girls and 3.6% of boys, aged 11 to 16 have self-harmed at some point. The figures for 17 to 19-year-olds were 21.5% and 9.7% for girls and boys respectively.

So why do so many young people self-harm and what can they do to help and support themselves?

Why do people self-harm?

Whilst there are no fixed rules about why young people self-harm, the primary motivation appears to be emotional regulation i.e., self-harm has become a way of expressing extreme feelings of fear, anger, sadness, hopelessness, and shame. Over time and in the absence of not knowing what else to do, hurting oneself becomes the only way of managing emotions. For some, the pain inflicted is preferable to the numbness it replaces – allowing the young person to feel something. For others, the physical pain replaces emotional pain that they can neither understand nor control.

In addition to managing distress, self-harm can also serve the function of helping to:

In day-to-day life, pain (such as accidentally stubbing your toe) intensifies negative emotions such as anger or frustration. This is true for most young people and adults. Neuropsychologists have revealed that for self-harming teenagers, their brains work a bit differently. Instead of becoming distressed when they see a fresh cut on their thigh or a burn on their arm, they are flooded with relief. In fact, the pain calms them and improves mood.

However, this only half the story. Research has shown that self-harming teenagers may be low in the stress hormone, cortisol. Although counterintuitive, cortisol is responsible for building drive and excitement. When cortisol levels are low, we feel lethargic and detached. Cutting, burning, or starving yourself raises levels of cortisol. So, it may be that self-harm is necessary to obtain “normal” levels of alertness in young people who consistently self-harm.

How can I help myself now?

Self-harm is a highly effective coping strategy. This makes it extremely difficult to give up. Young people who self-harm have already tried many of the recommended self-harm substitutes such as snapping rubber bands, punching pillows, and drawing on the skin with a red marker, with little if any success. So, what can help?

The first step to reducing or preventing self-harm is to develop awareness through:

Getting to know your triggers

Keep a diary and note down any triggers, thoughts, or feelings that you are having before an urge to self-harm. Even if you are unable to resist the urge, reflect on what was going on in the lead up to the episode:

Recognising and becoming familiar with your self-harm triggers is an important first step. It helps you become more aware of your urges before moving on to the next step:

Distract yourself

The main purpose of a distraction is to create a long-enough pause between the overwhelming emotions and the impulse to self-harm. In other words, it provides an opportunity to think through what other choices and options you have other than hurting yourself.

There are lots of distractions to choose from including going for a walk, listening to music, exercising, tidying your room, contacting a friend, stroking a pet, painting, gaming etc. Whatever alternative you choose, make sure it is a safe distraction to help move you from immediate crisis mode into a place where emotions can be expressed in a healthy way without taking them out on your body.

It can be helpful to make a list of 10 -15 specific distractions, in preparation for the times when the impulse to self-harm arises. Make sure that you have easy access to this list. If at first, it is still too challenging to prevent the self-harm in spite of the distraction, there is always the option of:

Delaying the self-harm

It may be difficult at first but try to wait five minutes before self-harming. Don’t worry if after the five minutes you are unable to resist the urge. Keep practising, and gradually increase how long you wait until you’re able to delay long enough for the urge to pass. Use one of your distractions or something that physically removes you from the situation in which you plan to self-harm.

How can I support someone who self-harms?

You may feel anxious, hurt, angry, helpless, and confused when you find out that a loved one self-harms. It can be hard to know what to say and how best to approach the situation. The following sites offer excellent advice and support:

Watch the following 5 minute animation for India’s story, a young woman who began self-harming as a response to anxiety caused by being bullied and low self-esteem:
Watch Video

#SelfInjuryAwarenessMonth




Article date 23rd March 2022

Article written by Imogen Clifford, Assistant Psychologist, Bristol CBT Clinic