Self mutilation: What is it?

Self-mutilation is the act of deliberately injuring one’s own body. Self-mutilation, also referred to as self-harming, self-injury, self-inflicted violence or cutting, is a recognized psychiatric disorder and does not represent an attempt to take one’s life.

Although the intent is not to kill oneself, some forms of self-mutilation can lead to serious medical consequences, up to and including death.

Similar to women with eating disorders, especially bulimia nervosa, women who practice self-injury often go to great lengths to keep their symptoms secret. Therefore it may be difficult to spot signs of a serious problem. Self-harming symptoms include:

o Scars, such as from burns or cuts

o Fresh cuts, scratches or other wounds

o Bruises

o Hair loss or bald spots

o Broken bones

o Keeping sharp objects on hand

o Spending a great deal of time alone

o Wearing long sleeves or long pants even in hot weather

o Claiming to have frequent accidents or mishaps

o Forms of self-injury

Self-mutilation also differs from socially acceptable cultural or artistic expression, such as tattooing or body piercing. Rather, self-harming is an unhealthy effort to cope with overwhelming emotions, such as intense anger, rage, terror, fear, sadness or shame.

What Are the Effects of Self-Injury?

Self mutilation can be an impulsive act. A young woman may become upset, or triggered, and develop an urge to hurt herself. Most commonly, self-harming is a planned, almost ritualistic event, inflicted in a controlled and methodical manner.

Self-harming is repetitive behaviour and does not usually occur just once. The arms, legs and front of the torso, are the most frequent targets of self-harming, because these areas can be easily reached and easily hidden under clothing. But any area of the body may be subjected to self-harming.

One of the most common forms of self-mutilation is cutting, which involves making cuts or scratches on the body with a sharp object. Other forms of self-harm, include:

o Cutting

o Burning

o Poisoning

o Overdosing

o Carving words or symbols on the skin

o Breaking bones

o Hitting or punching

o Piercing the skin with sharp objects

o Head banging

o Pinching

o Biting

o Pulling out hair

o Interfering with wound healing

What Are the Causes of Self-Mutilation?

While self-harming may bring a momentary sense of calm and a release of tension, it’s usually followed by guilt and shame and the return of painful emotions. Self-mutilation may accompany a variety of co-occurring mental illnesses, such as depression, anorexia nervosa, bulimia or other eating disorders, post-traumatic stress disorder, and borderline personality disorder. Self-harming is also known as self-injury, self-injurious behaviour, self-inflicted violence and self-mutilation.

The mix of emotions that triggers self-injury is complex. In general, self-harming is usually the result of an inability to cope, in healthy ways, with deep psychological pain. For instance, a woman may have a hard time regulating, expressing or understanding her emotions. Physical injury distracts her from these painful emotions or helps her feel a sense of control. Alternatively, a woman may feel constantly numb or disconnected from herself and the world, and may use self-injury to be able to feel or “wake up.”

Self-mutilation can affect anyone, from pre-adolescents to older adults. But certain factors may increase the risk of self-harming, including:

o Age. Most women who engage in self-injury are adolescents. Self-harming often starts in the early teen years, when emotions are more volatile and young women face increasing peer pressure, loneliness and conflicts with parents or other authority figures.

o Family history. Some evidence suggests that self-harming is more common in people who have a family history of suicide, self-injury or self-destructive acts.

o Life issues. Some women who harm themselves were sexually, physically or emotionally abused. They may also have experienced neglect in childhood. Social isolation and living alone may also increase the risk. Unstable living conditions, such as unemployment and divorce, also may be factors.

o Mental health problems. Self-harming is commonly associated with certain mental illnesses, including borderline personality disorder, depression, anxiety disorders, substance abuse disorders, post-traumatic stress disorder and eating disorders (anorexia, bulimia, binge eating).

o Alcohol or substance misuse. Women who engage in self-mutilation often do so while under the influence of alcohol or illicit drugs, or during period of withdrawal from these substances.

If you are aware of anyone who may be hurting themselves in a manner described in this article, please alert someone so that the person can access help as soon as possible. Parents be very aware of your children, pay attention to their arms and thighs as these areas are usually the areas damaged.

Dr Miller is Health Psychologist at the Milton Cato Memorial Hospital