Why do self-harming people harm themselves?

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Non-suicidal self-injury– this is when a person deliberately inflicts shallow yet painful injury on his / her skin with no aim to kill him/herself.

It might get you wondering why would anyone want to cause themselves pain?; pain is bad; one of the reasons I hated school? The painful strokes you get when you are in trouble, a slight headache, toothache, or stomach ache can make one rushes to get pain killers.

So why would anyone deliberately cause themselves pain?

Two theories of psychopathology explain function behavioral analysis.
Non-suicidal self-injury may be due to negative reinforcement and positive reinforcement.

The negative reinforcement include;
  • The purpose of this self-inflicting injuries is to cause relief or reduce negative emotions such as tension, anxiety and self-reproach or as a result os solving interpersonal conflict.
  • Reduction of unpleasant thoughts including suicide, self-injury works as a distraction.
The positive reinforcement include;
  • Another reason could be a result of self-punishment. An act someone might have done in the past that makes them disgust or hates themselves and can’t seem to forgive nor forget it. Victims confess there a sense of relief they feel during this process.
  • Gaining attention or help from a significant other, maybe spouse or lover.
  • An expression of anger.

Differential diagnosis

Borderline personality disorder-Individuals with a borderline personality disorder often manifest disturbed or aggressive and hostile behaviours. Nonsuicidal self-injury disorder can be a symptom of borderline personality disorder historically.

Although they have been associated together these disorders differ because while other borderline disorders show aggressive and hostile behaviour non-suicidal self-injury shows closeness, collaborative snd positive relationships both are involved in different neurotransmitter systems though they are not apparent on clinical examination.

Suicidal behaviour disorder- the major difference between suicidal and non-suicidal is suicidal the individual has the intention of dying. However, reports show that many victims of suicide have a history of no suicidal self-injury. The same is suicide intent can be associated with the use of various methods of self-harm. The caretaker or guardian should be careful with suicide may happen.
  • The injury is normally caused by a very sharp object like a knife, needle, thorns, razorblade (just to mention a few.

Who is likely to be a victim of non-suicidal injury?

According to admissions of hospital reports, self-injury normally starts in the early teen years and may continue to the late twenties.

However, these statistics may not be with absolute accuracy because most of the victims on non-suicidal self-injury do not seek clinical attention and tend to stigmatize themselves from everyone.

It is not known if this affects the frequency of their self inflicting incidents. Young children may try this but end up not feeling a sense of relief but pain and distress so stop immediately.

Some report shows that when a self-injury individual is being hospitalized in the inpatient unit, another individual may begin the same behaviour.
Is self-harm addictive?

Yes, most of these self-inflicting injuries actors repeatedly,  mostly with a sense of urgency or craving like an alcohol  or drug addict 

Other kinds of non-suicidal injury include;

Stereotype self-injury.

This is a type of self-injury that includes headbanging( I've seen some toddlers do this); self-biting or self hitting and is usually associated with intense concentration or under conditions of low external stimuli or developmental delay.

Excoriation (skin-picking disorder)

It occurs mainly in females, which involves picking an area of the skin that an individual feels blemish (with ananflw0 and is usually on the face or scalp (top of the head). The picking is done due to the urge and the experience of pleasure even the individual know that they are causing harm to themselves. There is no use of any tool.

Hair-pulling disorder (trichotillomania)

This is self-harm behaviour involving pulling out one’s hair from the scalp, eyebrows, or eyelashes. The behaviour occurs in certain periods and can sometimes last for hours and many who do this are sometimes in a relaxed mood or distraction. (I had a friend who used to pull out her hair while studying).

  • The act of cutting performed by tools (implements ) may raise the possibility of blood-borne disease.
  • Things might go wrong, and one may end up dying even if it wasn’t the initial plan.

Have you ever done self-harm? What was the reason?  What did you feel after?
Concise textbook of clinical psychiatry.

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