Understanding nonsuicidal self-injury

Self-injury, self-mutilation, self-harm, it doesn’t matter what it’s called. It’s the act of intentionally inflicting pain on the body in order to relieve negative feelings or a negative cognitive state, not including social norms such as tattoos, piercings or any self-harm related to religious practices.

In professional terms, self-harm is referred to as nonsuicidal self-injury. There’s a common misconception among people that those engaging in self-injury are trying to kill themselves. This isn’t true. Often the person engaging in the activity is just trying to find relief from emotional pain, but not trying to die.

While self-harm may not have suicidal intent, it’s important to note that self-injury is one of the biggest predictors of suicide. This’s because the person is building up a tolerance to pain which can eventually lead to building up enough tolerance to kill themselves. Studies have shown that individuals who self-harm are more likely to attempt suicide compared to those who don’t self-harm. But again, just because it’s a predictor for suicide, doesn’t mean that an individual is trying to kill themselves when they engage in self-harm.

“Letting it out doesn’t have to leave a scar.” Photo From: mamamia.com

It’s also important to talk about some of the warning signs of self-harm and suicide that a person might exhibit. The individual may have a lot of scars, cuts, burns, etc, on the dorsal side of their forearm, upper thighs, stomach or other parts of their body. They will also often make excuses as to why these markings are on their bodies. An individual who self-harms will often wear long sleeves or baggy clothing even during inappropriate times of the year, such as summer (when it’s more acceptable to be wearing short sleeves and shorts). Finding sharp objects such as razor blades, knives or other objects such as lighters in unusual places like under the bed, in the bathroom medicine cabinet or in a nightstand drawer is also another warning sign. Another warning sign is if the individual is avoiding social engagements and isolating themselves (especially if they consistently avoid social activities that require the individual to show skin such as a pool party).

Oftentimes the behavior of self-harm will begin in adolescence and can continue for many years. There are two theories for the psychopathology of the disorder. The first is that the behavior is learned through positive or negative reinforcement. Positive reinforcement might initiate that the individual is punishing themselves and the behavior is inducing a pleasant state. Negative reinforcement might seek the reduction of negative emotions or avoiding distressing thoughts. The second theory is that it comes from punishing oneself. By using self-injury as a means of self-punishment, it makes up for acts the individual did that caused harm or distress to others.

Self-injury can be hard to understand and hard to talk about, but it doesn’t have to be. Communication with someone who self-harms based on love, empathy and understanding can make having a conversation much easier. Being open to having a conversation, can help someone; all it takes is an active listener. To learn more about nonsuicidal self-injury, check out Psychology Today here.

To learn more about the correlation between nonsuicidal self-injury and suicide, read this article by Raychelle Cassada Lohmann, MS, LPC.