Self-injurious behavior has significantly increased over the past decade. Most professionals who do research and clinical work with this disorder, define it as an addiction. Self-injury shows various addictive qualities and may serve as a form of self-medication, depending on the individual and the circumstances. It can serve as a coping mechanism for the stress of everyday living. Some people report that they harm themselves to deal with painful feelings. They report that this makes them feel better.  Individuals who practice self-injury report having a difficult time controlling their urge to self-injure. Many self-injurers describe both the immediate effect and overall practice as something with addictive properties. For example, some talk about moments of feeling the strong need to injure even when there is no obvious trigger. They also report rituals surrounding the behavior, including “self-injury free” hours or days. It is frequently talked about similarly to other drugs and talk about needing increasingly more or deeper injuries to feel the same effect.  The addiction theory suggest that self-injurious acts may solicit involvement of the endogenous opioid system (EOS) which regulates both pain perception and levels of endogenous endorphins which occur as a result of injury (Winchel & Stanley, 1991). Overestimation of the EOS can then lead to actual withdrawal symptoms which in turn lead to more self-injurious behavior. It is used by some to change mood and feelings.   Besides the previous study, there is additional research in the medical and psychiatric field indicating  a physiological component to self-harm, such as the release of endorphins, adrenalin, and dopamine into the brain, thereby causing a feeling of calm and well being. 

Self-harm is also used by some, although thought to be a minority, to punish themselves.  Others report that this behavior protects them from suicidal impulses. A smaller group uses self-harm for the thrill of it; that is, a way to distract oneself from negative thoughts or boredom. Lastly, there is a still smaller group of self- mutilators who are suicidal. 

No specific drug therapy has yet been found to be helpful to reduce the compulsion to mutilate oneself. However, ant-i depressant drug therapy or anxiety management may help treat underlying symptoms that contribute to the desire to hurt oneself. Treatment needs to be tailored to the particular reason for self-harm. Unfortunately, a person who engages in self-injurious behavior may not know why they do it, so part of the process is identifying the source of the behavior or the function it serves for the individual, as well as his or her significant other.There are a number of self-help books, blogs, and groups online to support those with this disorder.  Still, a complete assessment from a professional therapist is very important, because it is difficult to identify the sources of self-harming behavior without such help.  Many self-harmers are not even aware that there are reasons for inflicting pain on themselves, especially when the behavior  has become habitual.

As a psychotherapist, my role is to help the patient identify the source(s) of the injurious behavior, offer healthy alternative coping mechanisms, and then integrate these coping mechanisms into the patient’s life outside of therapy. I often work with the family when the self-mutilator is an adolescent.

Seeking Help

If you, a partner, or a family member participates in self-harming behavior and think psychotherapy may help you find a healthier alternative, please feel free to contact me with your questions and concerns.

To see books I recommend on self harm please go here.