Self-Injury

Effects

Self-injury was considered for many years a suicidal gesture, although it is now recognized as a morbid, but effective coping strategy. These behaviors provide immediate release from anxiety, depersonal-ization, racing thoughts, and rapidly fluctuating emotions. Self-injury tends to lead to the lessening of tension, cessation of depersonalization (grounding), euphoria, improved sexual feelings, diminution of anger, satisfaction of self-punishment urges, security, uniqueness, manipulation of others, and relief from feelings of depression, loneliness, loss, and alienation. It provides a sense of control, reconfirms the presence of one's body, dulls feelings, and converts unbearable emotional pain into manageable physical pain. As such, it represents an emotion regulation strategy and a grounding technique to end dissociative episodes.

Psycho-Medical View of Causes

Psychiatrists and clinicians view self-injury as a symptom of several impulse-control disorders. Lodged primarily within the dramatic-emotional cluster, it is associated as an occasional side-effect of borderline personality disorder (inappropriate anger and impulsive self-harming behavior), antisocial personality disorder (the tendency to be aggressive, to have reckless disregard for personal safety), histrionic personality disorder (a pervasive pattern of excessive emotionality and attention-seeking behavior often enacted through physical appearance), posttraumatic stress disorder (sometimes due to rape or war), various dissociative disorders (including multiple personality disorder), eating disorders, and a range of other conditions such as kleptomania, Addison's disease, depersonalization, substance abuse, alcohol dependence, and various depressive disorders.

Psycho-Medical Demographics

The traditional literature on self-injury has posited the typical demographics of self-injury as starting in early adolescence, with most practitioners desisting after adolescence. Girls are generally considered more frequent practitioners than boys, with some three quarters or more of the population consisting of women. At the same time, others assert that male practitioners are more plentiful or equal in numbers to women. Traditionally, like eating disorders, self-injury is seen as located primarily among an intelligent, middle- or upper-class population that is disproportionately Caucasian. Finally, psychologists view it as a short-term, adolescent phenomenon.

Historical Evolution

Three significant historical periods exist that affect the population, prevalence, meaning, and practice of self-injury. Self-injury has existed for a long time, although throughout most of history there has been little public awareness of the phenomenon. Practitioners acted alone, in a social vacuum. Somewhere in the vicinity of 1996, public knowledge of self-injury began to arise, with depictions of it appearing in books, films, television shows, magazines, newspapers, and other media. Several celebrities came out in public and admitted their self-injury, and discussions of it flourished in high schools. This burgeoning awareness, although limited in scope, spread fairly rapidly through segments of the population that were most likely to come into contact with self-injurers: adolescents, young adults, educators, doctors, and psychologists. It affected the way self-injurers thought about themselves and were regarded by others, but they still mainly kept to themselves. A third period dawned around 2001-2002, when Web sites began to appear on the Internet focused on self-injury (self-mutilation, self-harm) complete with public chat rooms where people could interact with fellow and former self-injurers.

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