Self-injury is deliberate harm inflicted on a person's own body. It can be in the form of cutting or burning the skin, preventing wounds from healing, throwing fists or other parts of the body against hard objects or pulling out hair. Self-injury, also called self-harm or self-mutilation, is not likely to be a suicide attempt. Instead, it's an unhealthy way to cope with painful feelings like anger, anxiety, sadness, depression, emptiness, guilt and self-hatred.
People who harm themselves are mostly trying to relieve their emotional pain or give themselves something to focus on other than their negative feelings or difficult life circumstances. Some use self-injury to get a sense of control or to feel something other than emptiness. A person who self-injures may indeed feel better afterwards, but it usually doesn't last long. That's because self- injury can't get at the underlying reasons for the pain. When the negative feelings return, so does the urge to self-injure again. Some people feel trapped in an endless cycle of self-abuse, which can make them feel even worse about themselves.
Self-injury often begins in the teen years when emotions are acutely felt and the experiences of conflict, rejection, loneliness and peer pressure can be very intense. Some people who injure themselves were abused as children. Others are in conflict over their personal identity or sexuality. Some service members or military family members who self-injure are coping with the loss of someone close or other traumatic events related to military life. Choosing self-injury over other ways of coping may indicate that the person tends to be impulsive and highly self-critical.
Signs of self-injury
Unfortunately, it can be difficult to know when a person is involved in self-injury. It is usually not attention-seeking behavior. Instead, the person is more likely to keep self-injury hidden out of shame and guilt. These are some of the red flags that others may notice:
- Fresh wounds or scars that might have been caused by burns or cuts, especially on the wrists, arms, thighs or chest
- Blood stains on clothes, towels or bedding, as well as tissues found in the garbage
- Sharp objects such as razors, knives or glass shards in the person's belongings
- Long sleeves or long pants worn regularly, even in the summer
- Claims of frequent accidents or mishaps
- A significant amount of time spent alone, especially in the bathroom or bedroom
Consequences of self-injury
The most common consequence of self-injury is that it can become addictive. It may begin as a way to feel better or more in control in a given situation. But after a while, it begins to seem out of control and impossible to stop. And the deeper the involvement with self-injury, the more difficult it is for the person to stop and change to healthier ways to deal with emotional pain.
Other possible consequences of self-injury include:
- Worsening of the painful feelings that self-injury temporarily relieved
- Infection, either from wounds or from sharing cutting tools
- Life-threatening blood loss if major blood vessels are accidentally cut
- Permanent scars or disfigurement
- Untreated underlying problems such as depression or post-traumatic stress disorder
Although self-injury is not a suicide attempt, a person's familiarity with inflicting pain on the body can increase the risk of suicide if the underlying distress continues or becomes worse.
What you can do
If you've been harming yourself, and you're ready to get help, the first thing to do is confide in someone you can trust. This first step is probably the most difficult because it can be embarrassing and scary to talk about something so personal. If you're still in school, you might talk to a school nurse or a teacher if you're not ready to tell to your parents. If you're a service member or a military spouse, you could start with your primary care manager at the military treatment facility or your chaplain. You may find that it's a relief to open up about the thing you've been hiding and allow another person to help you take the next step toward recovery. If you're not sure you need help, the Self Injury Foundation has a series of questions and answers for self-injurers that may help you think through your situation.
If you're the parent of a teenager you suspect is self-injuring, you may feel shocked or disgusted, but it's important that you try not to be judgmental or critical. Threats and ultimatums may only increase the risk of further self-injury. If your son or daughter has not revealed the self-injury, you may want to consider bringing it up in a caring and non-confrontational way. You might say, "I'm concerned about the injuries on your arms, and I want to understand what you're going through." When your child knows that you can handle the self-harm and will be there with your support no matter what, it will be easier to establish communication. The Self Injury Foundation also has Questions and Answers for parents who want to better understand self-injury and what they can do to help their children.
As a member of the military community, you can get support and care for self-injury behavior and its underlying causes through your military treatment facility or TRICARE. Your primary care manager can provide a referral for medical counseling services near you. You can also speak with a Military OneSource consultant (800-342-9647) for a referral to appropriate support services in your community.