Self mutilation is very difficult to understand from the prospective of people who have never experienced the behavior themselves. For family members or friends of someone who self mutilates, it is terrifying, confusing, and frustrating.
Definition of Self MutilationThere are various definitions of self mutilation, and even plenty of names for this type of behavior. The self mutilation referred to in this article involves the direct and deliberate destruction or alteration of the body. This type of self mutilation is sometimes referred to as self harm, or self injury. Examples of self harming behaviors include cutting, burning, needle sticking, and severe scratching.
It is important to draw a distinction between the type of self mutilation discussed in this article versus various other forms of self harm that exist. The type of self mutilation discussed here is generally not conducted with the intent to commit suicide.
Research has shown that individuals who engage in self harm are usually not trying to kill themselves when they engage in the behavior, although some may report that they have mixed feelings about the intent of the acts. This is not to say that people who engage in self mutilation are not suicidal; many people who self mutilate also have suicidal thoughts or even make suicide attempts. In addition, in cases of very severe self mutilation, people have died from their injuries. But, self mutilation usually serves a different purpose than attempt at killing one's self.
Why People Engage in Self MutilationMany believe that people engage in self mutilation to get attention. This is a myth. Most people who self harm do it in private and make sure that the location of the injury is one that cannot be seen. They are also often ashamed of the behavior and keep it a secret. This sort of secrecy and shame about the behavior suggests that it is certainly not meant to manipulate others or to garner attention. Of course, there are some people who report that they self mutilate for attention, but they are in a very small minority.
Research has shown that most people self mutilate in order to help regulate internal experiences such as emotions, thoughts, memories, and physical sensations. People who self mutilate report that they do this behavior to escape from emotional pain, release anger, slow racing thoughts, end episodes of dissociation, or have a sense of control. In fact, for many people who self harm, the behavior probably serves many different purposes depending on what experience they are having at the time.
Who Engages in Self Mutilation?Unfortunately, self mutilation is not an uncommon behavior. For example, one study found that about 40% of college students have engaged in self mutilation at least once, and about 10% have engaged in self mutilation 10 or more times. There is evidence that men and women engage in self mutilation at equal rates.
People who have experienced maltreatment during their childhood (sexual abuse or neglect, for example) or who were separated from a caregiver in childhood are at greater risk for self mutilation than the general population. Also, there is evidence the people who experience dissociation are at greater risk for self mutilation.
How Is Self Mutilation Treated?Because self mutilation is often an attempt to regulate internal experiences, such as strong emotions or negative thoughts, cognitive behavioral treatments for self mutilation have focused on helping the person find new, healthier ways of managing emotions and thoughts. For example, one cognitive behavioral treatment for borderline personality disorder, dialectical behavior therapy, addresses unhealthy attempts at coping by helping the patient learn and practice a new set of coping skills.
Because self mutilation is often triggered by strong emotions, dissociation, or intrusive thoughts, medications that help alleviate these symptoms may also be useful in treatment.
What To Do If A Friend or Loved One Self MutilatesIf you suspect that a friend or loved one is engaging in self mutilation, it is important to talk to them about it. Self mutilation is a very serious behavior that can lead to severe injury or death; it should not be ignored.
When approaching someone to talk about such a difficult topic, it is important to confront them in the most caring way possible. Although you may feel frustrated, angry and scared, your conversation is unlikely going to be a productive one if you confront your loved one with intense emotion. Think carefully about what you want to say ahead of time, and pick a time when you can discuss the situation in an appropriate setting.
Get Treatment for Self MutilationIf you are a loved one is struggling with self mutilation, there are a variety of treatment resources available. These articles cover more about how to find a therapist and the types of therapists available:
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Gratz KL. "Emotion Dysregulation in the Treatment of Self-Injury." Journal of Clinical Psychology: In Session, 63:1091-1103, 2007.
Gratz KL. "Risk Factors for and Functions of Deliberate Self-Harm: An Empirical and Conceptual Review." Clinical Psychology Science and Practice, 10:192-205, 2003.
Linehan MM. Skills Training Manual for Treating Borderline Personality Disorder. New York: Guilford Press, 1993.