Monday, February 11, 2013

Self Injury......understanding it

One of the biggest questions people have about self-injury is WHY? Why would someone intentionally cause harm to ones self? They must be crazy to do that. Rest assured! They are not crazy and they are NOT alone. Self-injury is more common than people realize. It is especially prevalent in people with dissociative disorders.
People with DID may hurt themselves intentionally. It doesn't make sense and it may make you afraid or sad to see the damage that has been done. Why would anyone do this to herself? One of the reasons people with DID do this is because they were so abused as children that they feel they need to continue the abuse because they feel bad about themselves. Some people with DID do not realize they are hurting themselves because one of their alters is doing it. Some common self-injury behaviors are:
Burning the skin
Cutting the skin
Poking holes in the skin
Pulling hair out of the head
Hitting oneself
Biting the arms
Breaking bones in the body (not as common)
Not eating
Perhaps you have witnessed or saw the aftermath of self- injury. It can be frightening to say the least. You may want to know why she hurt herself, become angry with her or feel sad. Some of the reasons we have heard from other people as to why they self-injure are:
Feels emotionally numb
Feels hatred
Doesn't feel worthy of love
Trying to stay grounded
Pain makes them feel alive
Makes me feel better
Although some of these reasons may not make sense to you they feel very real to the person who is doing self-injury. When a person grows up in a home where there is abuse they get love and pain confused. They may have had a parent who would say "I love you" and 5 minutes later would beat them. It can be difficult to understand how a person who claims to love you would end hurting you. When abuse is done repeatedly the person being abused begins to think poorly of themselves and often times begins to no longer feel pain.
When an abused child grows up sometimes they do not know how to handle feelings of anger or sadness. The only thing that helps to feel better is to hurt themselves because that is all they know. As a child who was never allowed to express emotions grows up they learn that pain is the one emotion that was given to them. That is why a lot of people hurt themselves. They do not have good coping skills when dealing with emotions. That is one thing that the therapist can help them to learn.
If the person with DID can not stop the self-injury behavior she may have to go into the hospital for awhile to be safe. If one of the alters is doing the harm that alter needs to sign a safety contract with the therapist and the person with DID (host personality) to ensure that they will not harm the body anymore. One thing to mention is that although it is scary most people who are DID and self-injure are not trying to kill themselves. It is just another coping mechanism (an unhealthy one) that is used to deal with feelings. If the person with DID or one of her alter's threatens to kill themselves do not ignore them! Call 911 immediately! A person who threatens suicide is looking for help and should always be taken seriously no matter how many times they may have threatened it in the past!
Some more information:
Because I hurt.
In spite of the title, there is no shame here. If you cause physical harm to your body in order to deal with overwhelming feelings, know that you have nothing to be ashamed of. It's likely that you're keeping yourself alive and maintaining psychological integrity with the only tool you have right now. It's a crude and ultimately self-destructive tool, but it works; you get relief from the overwhelming pain/fear/anxiety in your life. The prospect of giving it up may be unthinkable, which makes sense; you may not realize that self-harm isn't the only or even best coping method around.
For many people who self-injure, though, there comes a breakthrough moment when they realize that change is possible, that they can escape, that things can be different. They begin to believe that other tools do exist and begin figuring out which of these non-self-destructive ways of coping work for them. This site exists to help you come closer to that moment.
How do you know if you self-injure? It may seem an odd question to some, but a few people aren't sure if what they do is "really" self-injury. Answer these questions:
Do you deliberately cause physical harm to yourself to the extent of causing tissue damage (breaking the skin, bruising, leaving marks that last for more than an hour)?
Do you cause this harm to yourself as a way of dealing with unpleasant or overwhelming emotions, thoughts, or situations (including dissociation)?
If your self-harm is not compulsive, do you often think about SI even when you're relatively calm and not doing it at the moment?
If you answer #1 and #2 yes, you are a self-injurer. If you answer #3 yes, you are most likely a repetitive self-injurer. The way you choose to hurt yourself could be cutting, hitting, burning, scratching, skin-picking, banging your head, breaking bones, not letting wounds heal, among others. You might do several of these. How you injure yourself isn't as important as recognizing that you do and what it means in your life.
Self-injurious behavior does not necessarily mean you were an abused child. It usually indicates that somewhere along the line, you didn't learn good ways of coping with overwhelming feelings. You're not a disgusting or sick; you just never learned positive ways to deal with your feelings.

I stopped a few weeks ago, but I keep obsessing about hurting myself. Help?
It's not uncommon for people to continue thinking obsessively about self-injury for a while after they've made the decision to stop. Hurting yourself has been a huge part of your life up until recently, and you're used to dwelling on it. You might think that you're supposed to be "cured" now and that all thoughts of SI should magically vanish from your head, so when you catch yourself thinking about that blade or lighter or whatever, you get angry and frustrated and shove the thought away.
Foa and Wilson (1991) deal with intrusive thoughts by a combination of giving yourself permission to think about it and exposure/habituation techniques combined with ritual prevention. Exposure refers to repeatedly presenting someone with the situation about which they obsess, and habituation happens when, after much exposure without resulting to usual actions, the person gets used to the situation and it no longer distresses them.
To adapt these techniques, first make yourself safe. If you're in a mind-set in which self-injury seems very very likely, it might be better to use distraction techniques to get past that place. Line up a support person whom you can call if you get overwhelmed by this technique. Try to tolerate it for as long as you can, even if you're uncomfortable.
First, designate two 10- or 15-minute time periods daily. Choose times when you will be alone and able to think without being interrupted. To begin, set a timer for the designated amount of time. Then obsess about hurting yourself. Think about what it would feel like, how you would feel afterwards, how much you want to do this -- all those thoughts you've been trying to suppress. Get as distressed as you can, and stay focused on the topic of injuring yourself. You may find, especially after the first few times, that you get really bored toward the end of your time period. That's a good sign -- you're becoming habituated.
When the time is up, stop thinking about SI. If thoughts of wanting to harm come into your mind at other times during the day, acknowledge them and remind yourself that you will think about them later, when it's time. Then let them go. If they come back, repeat the process. Don't shove them away or try to ignore them; just acknowledge, remind yourself they have their time soon, and let go.
After a week or so you will notice an improvement (maybe even after just a few days). One crucial thing: no matter what, do not act on the thoughts of SI. They are just thoughts, and you can use the skills that you used to stop harming to get through these times. In order for habituation to occur, you have to get through the exposure without resorting to the old behavior. Use distraction and substitution for SI (ritual) prevention.
 These pages copyright 1996-2002, Deb Martinson. All rights reserved. Noncommericial reproduction is encouraged; please credit author.


  1. Great information. Congratulations on stopping. :)

  2. Thanks friend. You helped me a lot, ya know?!

  3. Thank you for this clear and easy to understand write up. You are very brave.

  4. Thank you for sharing in such an easy way. I often share this with people who dont understand. It helps both them and myself. Namaste