Cheryl, a mother of three, got in her car from a long day of work. As she fought the five-o’clock traffic, she fantasized about resting on the couch, watching the six o’clock news and treating her kids and herself to a delivered pizza. However, what Cheryl saw when she walked through the door of her home was anything but what she had imagined. Startled from the opening door, Lisa, her fifteen-year-old daughter, dropped the razorblade she was holding as blood ran down her arm into the kitchen sink. The sink water ran and blood-stained towels sat on the counter as Cheryl stood frozen in the doorway unable to get a grip on what she was witnessing.
This scene may sound familiar or it may not, but chances are within your lifetime you will encounter someone who engages in self-inflicted violence. This article is intended to promote awareness about self harm and its implications. Self harm, also known as self injury, cutting, self mutilation, parasuicide or self-inflicted violence, exists whether or not you want to talk about it. The definition, prevalence, and misconceptions of self-inflicted violence will be discussed.
We all do things to hurt our body in some way or another. Whether we smoke a cigarette, pierce our body with jewelry posts, drink too much alcohol, overeat, eat too much fat or sunbathe too long, we have all been guilty of harming ourselves in one way or another. However, where is the line drawn between a bad habit and a psychological disorder?
“The American Journal of Psychiatry” defines self injury as “the commission of deliberate harm to one’s own body. The injury is done to one’s self without the aid of another person, and the injury is severe enough for tissue damage to result, such as scarring.” Acts with conscious suicidal intent and those associated with sexual arousal are excluded from self-injurious behaviors. Self mutilation may be aimed at relieving unbearable emotions, sensations of unreality, or feelings of numbness. This disorder may be associated with mental illnesses, such as Borderline Personality Disorder, a characterological disorder with a history of trauma, abuse, and insecurities surrounding abandonment.
Roughly two-thirds of self-injurers choose to “cut” by means of a razorblade, scissors, fingernails, glass, etc. Other methods of self-injury include burning, self-hitting, hair pulling, bone breaking, and interference with wound healing. The prevalence among individuals that self mutilate varies, but a recent study suggests approximately one out of every 100 Americans, at one time or another, will use self harm as a means of coping with an overwhelming situation or feeling. A more shocking statistic reported by the “Journal of Youth and Adolescence” found that out of 440 high school students (from urban and suburban high schools) 13.9% of those interviewed said they had engaged in some form of self injury. Among adults, the most common professions of those who self mutilate are teachers, nurses, and managers.
In a 1986 survey among self-injurers, researchers found 85 to 97 percent of respondents were female. The typical self-injurer is in her mid 20s to early 30s and has been harming herself since her teens. She tends to be middle- to upper-middle class, intelligent and well-educated, as well as experiences a background of abuse and/or has an alcoholic caregiver. However, this is just the typical picture. There are no cultural or social boundaries among individuals engaging in self mutilation.
From the “average Joe” to celebrities alike, all types of individuals suffer from this behavior. In a 1999 “Access Hollywood” interview, Angelina Jolie admitted a history of self harm and spoke about her feelings surrounding the disorder. Jolie stated, "I was trying to feel something....I was looking at different things thinking romantically about...about blood. I really hurt myself." Jolie continued to report, "I was just....a kid. I was like 13, and, I was saying that it is not something that is cool. It’s not cool. And I understand that it is a cry for help..."
In a 1995 television interview on the BBC, Princess Diana admitted to intentionally cutting her arms and legs. She stated, “You have so much pain inside yourself that you try and hurt yourself on the outside because you want help.” Johnny Depp has a series of seven or eight scars on his left forearm where he has cut himself with a knife on different occasions to commemorate various moments or rites of passage in his life. In a 1993 interview with “Details” magazine, Johnny explained his self-injury by stating, “My body is a journal in a way. It's like what sailors used to do, where every tattoo meant something, a specific time in your life when you make a mark on yourself, whether you do it yourself with a knife or with a professional tattoo artist.”
In a WKSU news report, adolescent therapist, Ingrid Monteith reported a dramatic increase in the number of cutting teens she treats on a regular basis. Monteith reports media exposure, such as teen music and television shows covering the issues, are responsible for the increase. Opponents argue with increased exposure about the issue more individuals have courage to come forward and tell their story.
Self harm is a social taboo. When people hear of someone who self harms, onlookers may respond with disgust and judgment by what they see or hear. Also, many people feel self injury is an attention-getting ploy. However, that theory could not be further from the truth. Those who self mutilate are ashamed of what they do and often refuse to talk about their behavior with medical or psychological professionals. Because of the stigma surrounding self-inflicted violence, self-injurers wear baggy and long-sleeve clothing to cover wounds. Additionally, these individuals are often armed with a cover-up story to tell to anyone who discovers their wounds.
Many people think those who self harm are psychotic. Self mutilation is similar to other addictions, like alcoholism or gambling. When someone cuts or harms one’s self, endorphins are released in brain providing an immediate “high.” Individuals committing self-inflicted violence use this defense as a coping mechanism. Self injury is a way to deal with life’s struggles. It is a way for self-injurers to feel something – even if it is only for a moment.
Suicide vs. Self Harm
According to “Nursing Standard,” self-inflicted violence can have many misconceptions. Self harm can be mistaken by professionals as a suicide attempt, although most people who self harm have no intention of committing suicide. However, there is a correlation between the two acts. In a recent study published in the “American Journal of Psychiatry,” those who self injure possess a 30 percent increased risk of successfully committing suicide. Because of the misconception between self mutilation and suicide in the medical field, a bill of rights was established for those who participate in self harm. The bill of rights protects self-injurers from automatically being considered a dangerous person or a danger to one’s self. The bill states “no one should be involuntarily committed because of participation in self injury.”
Overall, with an increase in self-inflicted violence, a problem does exist. However, is the problem the self harm? Or, is it the misconceptions of the uneducated? Or, both? Either way, dissemination of information is increasing and research surrounding this disorder is increasing to aid professionals in the treatment of individuals who self harm by providing tools for more healthful coping skills.
Remember, there is a good chance you will encounter someone in your life that engages in self mutilation. So, I ask you - if Lisa were your daughter, friend, neighbor, wife, sister or student, would you be informed enough about self harm to know what to do?