Many young people describe self-harm as a way of coping with feeling numb, or intense pain, distress or unbearable negative feelings, thoughts or memories. They are trying to change how they feel by replacing their emotional pain or pressure with physical pain. Some people harm themselves because they feel alone, and hurting themselves is the only way they feel real or connected. Others self-harm to punish themselves due to feelings of guilt or shame or to ‘feel again’.
For most young people self-harm is a coping mechanism, not a suicide attempt. However, people who repeatedly self-harm may also begin to feel as though they cannot stop, and this may lead to feeling trapped, hopeless and suicidal. People who self-harm are also more likely than the general population to feel suicidal and to attempt suicide.
Self-harm can be something that someone tries once, or it can become a habit as they search for relief from distress. The problem is that this relief is only temporary, and the circumstances usually remain.
From Youth BeyondBlue
Every young person who self-injures has their own reasons for doing so. Many young people who self-injure have been exposed to:
- Abuse (physical, sexual, emotional) and neglect
- Violence (domestic and other)
- Excessive family conflict and/or breakdown
- Significant loss
An accumulation of these adverse experiences (developmentally and/or in a short timeframe) can be the source of significant trauma and distress resulting in:
- Insecurity and a compromised sense of safety
- A sense of powerlessness, hopelessness and fear
- Complicated grief reactions
- Damaged self-concept including a tendency for self-criticism and self-loathing
- Feelings of shame, guilt and rage
- Difficulties coping with overwhelming emotions leading emotional dysregulation and dissociation
The consequences of adverse experiences not only contribute to self-injurious behavior but also a range of other health and behavioral issues like substance use problems, mental illness and a range of other mental health concerns (including persistent suicidality). Further, these complications can lead to disrupted and conflicted relationships with significant others and constrain participation in constructive and developmentally significant activities such as school. This can have the effect of making young people feel socially excluded and reinforce negative self-beliefs which in turn increases the likelihood of self-injury.
Self-injury can also be a learned behavior modeled and reinforced by others. There is evidence that some young people self-injure as a way of bonding with peers or fitting in (Cameron et al, 2012).
Self-injury can also be a way of coping with high levels of stress. Some young people feel pressure from their own high expectations or the weight of expectation from significant others to perform at a very high standard at school, work or in a chosen pursuit. They may seek release through some form of self-injury.
Sexual abuse & self-injury in the youth AOD client population
In a recent study of clients attending a Melbourne based youth AOD service, Daley (2009) found that at least 77% of young women accessing youth AOD services had a history of self-injury, and of these, 80% had a history of childhood sexual abuse. Little research has been undertaken with young men, but anecdotal evidence suggests that there are also high levels of childhood sexual abuse among young men who self-injure.
Sexual abuse does not cause self-injury, and likewise, not all people who self-injure have a past history of childhood sexual abuse. It is however important to acknowledge that young people presenting to AOD services, who do have a history of abuse, have an increased likelihood using of self -injury as a coping mechanism. It is common for a young person to have been unable to disclose their abuse, or to have not been believed when they have made discloses. The long term effects of both the abuse, and the absence of a safe physical and emotional place in which to process this, can manifest in the young person developing a deep sense of self-loathing, particularly in regards to their bodies. Further, many young people who have suffered abuse continue to experience extreme and distressing emotions and/or states of dissociation.
There are two dominant explanations for dissociation. The first holds that dissociation shuts down the emotional pain associated with their past (or current) abuse. This helps an individual to cope with extremely painful thoughts, feelings and memories. Extended periods (for some, this can be years) of dissociation or ‘not feeling’ emotions is often the explanation people provide for wanting to self-injure. It is very common for people to explain their self-injury as ‘the only thing that made them feel alive’. It is believed that damage to the body – often resulting in the release of blood – is a visual and physical reminder that while feeling emotionally ‘dead’, the physical body still lives, as demonstrated by the blood. At the same time, damaging the body can be a demonstration of the individual’s disdain for themselves.
Alternatively, some young people self-injure to elicit a sense of dissociation in response to the distress caused by overwhelming emotions. This explanation is in total contrast to the one offered above, but is equally prevalent among people who self-injure. For these people, self-injury is an intense physical distraction that disassociates them from overwhelming emotions. It also offers a physical demonstration of their extreme inner turmoil.