SELF-HARM: CAUSES, SIGNS, AND TIPS - ARTE - 2025

Self- injuries are those behaviors that involve self-inflicted physical damage, usually cuts (85%), burns (30%), blows (32%), punctures, scratches, pinches, hair pulling, etc. In many cases, several simultaneous forms of self-harm are used.

Self-injurious behavior appears especially in youth and young adults, and its tendency diminishes as age advances. In a study carried out by Romuald Brunner, it was found that, out of 5,000 students between the ages of 14 and 15, 2% of the boys and 6% of the girls engaged in self-injurious behaviors.

People who hurt themselves often feel sad, empty, with many difficulties when it comes to identifying their own feelings and expressing them. Doubts invade your mind, causing a desperate search to control that cascade of unidentifiable feelings.

For many people, self-harm can lead to being seen as a friend, since it ends up being an outlet for these uncontrolled emotions, allowing this intense and heavy feeling to be tolerated.

We could say that the person who is injured has not learned adaptive behaviors to control stress, and they resort to this action because it really is easier for them than trying to understand and express what they feel.

In fact, it is difficult for them to explain what is happening inside them because they do not understand it themselves, nor why they feel what they feel so intensely.

What is the profile of people who self-harm like?

The disorder par excellence of self-injurious people is Borderline Personality Disorder (BPD). This disorder is classified within group B of personality disorders, the so-called "dramatic-emotional" in the DSM-IV-TR.

This disorder is characterized above all by great emotional, behavioral and social instability. They tend to serious self-injurious behaviors, and have a highly impulsive and aggressive behavior pattern.

This makes their interpersonal relationships difficult, unstable, and unsafe. As if that weren't enough, it is the most common among personality disorders (between 0.2% and 1.8% of the population suffer from it).

In addition to people with BPD, other psychopathological disorders are also sensitive to self-harm, such as mood disorders, anxiety, post-traumatic stress disorder, eating disorders, dissociative disorders, and obsessive-compulsive disorder.

Warning signs of self-injurious behavior

-Frequent unexplained scars or for no apparent reason, cuts, burns and bruises; especially on the arms, thighs, belly and hips.

-Blood stains on clothing.

-Frequent accidents.

-Clothes to hide, such as long pants or sweaters in times when it is already hot.

-Refusal to undress in the presence of someone, and avoidance of all those situations that require it: going to the doctor, going to the beach, the pool…

-Store blades, crystals, and useful things somewhere to control what may happen to self-harm.

-Some not so specific signs that go more unnoticed, such as sudden and very obvious mood swings, low self-esteem, impulsivity, isolation, irritability.

-Need to be alone for a long time.

Causes

Situations that the person experiences as difficult, with feelings of humiliation or overexertion can lead a person to self-harm.

These people learn very early that the interpretation of their feelings and emotions is wrong or bad. When this happens, you don't know what to feel or whether or not it's okay for you to feel it.

In fact, it is possible that many of these people learned that certain feelings were not allowed, receiving in some cases, even punishment for it.

It is important to note that self-injurious behavior is "contagious." This is so because this phenomenon, when shared by someone else we know, creates a feeling of belonging to a group, which reinforces behavior.

However, only those people who are under strong emotional stress due to personal problems will be the ones who self-harm to overcome stress.

The main causes of self-harm are:

Mode of control and relief of very intense and negative emotions

These emotions are perceived as uncontrollable, highly unbearable and above all impossible to identify. The person feels overwhelmed and cannot take it anymore. Self-harm is a tool that alleviates this discomfort.

Guilt

The feelings are more related to guilt, mistakes they may have made and self-loathing.

As a way of feeling something

In the last testimony we could see very well that she needed a proof that she was still alive, that she continued to exist despite not feeling anything.

As a way of expressing anger and anger, also uncontrollable

These people may become afraid of hurting others, so the way they find to avoid it is by being aggressive with themselves.

Call for attention

Sometimes, by the general public, these people are considered attention seekers. The truth is that they do not seek to attract attention in themselves, but to express what they do not know how to express in the "easiest" way they have found.

Neural substrate

It is a fact that people who self-injure are more insensitive to pain than other people who do not injure themselves. In a study by Martin Bohus at the University of Freiburg, he investigated the perception of pain of people who hurt themselves.

Self-harm is related to an excessive control of the prefrontal cortex, which reduces sensitivity to pain, in addition to the amygdala, which is responsible for processing emotions.

Furthermore, in these patients, painful stimuli seem to inhibit emotional tension better than weak stimuli. In other words, everything indicates that self-harm has an emotional regulation role in these patients.

Are self-harm suicide attempts?

It is important that you bear in mind that self-injurious behaviors are not a suicide attempt, but quite the opposite: they seek to avoid reaching that point by calming down what they feel so intense.

While it is true that there are some cases that end in suicide, it is a reality that either they did not seek it (and the planned self-harm went wrong), or they sought suicide by seeking other methods other than the usual one used for self-harm.

Possible addictive behavior

At times, self-injurious behavior can turn into a true addiction, leading to an endless vicious cycle.

The bodily response is the one that plays the central role of reinforcement: The inner emotional tension diminishes, the dissociative feelings disappear and the person finds the relief they needed.

Later on, other feelings more related to shame and guilt appear, which together with the concern to hide the bandages and scars, can lead to social avoidance and isolation.

If we see it from this point of view, it is logical that they try to avoid uncomfortable questions that they know will hardly be understood. However, sometimes attracting attention, provoking parents or establishing relationships with others affected can also reinforce self-injurious behavior.

This does not mean that they seek attention with their behavior. We have already commented that they try to hide their behavior. It means that by receiving attention (and with it, affection), self-injurious behavior may be reinforced.

Tips for family and friends

-Don't react with fright, anger or reproaches. These people need understanding and acceptance, not the other way around.

-Converse with the affected person about self-harm without anger and with great respect. It will help you to verbalize your emotions within your means.

-When you talk to the affected person about self-harm, do so openly, but without imposing the conversation. They are the ones who have to “give their consent” and not feel obligated to anything.

-Do not ignore the behavior or minimize it, it is important that those affected know that they deserve attention.

-Let him know that you want to help and that you will be there when he or she needs it. It offers physical closeness without forcing it.

-Do not express prohibitions, punishments or ultimatums. You will only make the situation worse.

-Be interested in the concerns and needs that lead the affected person to put self-injurious behaviors into practice.

-Provide material to heal the wounds and bandage them. If necessary, help him to cure and disinfect them, and take the affected person to the doctor in serious cases.

-Help her know how to give affection and love to herself. Oddly enough, this person has not learned to love and pamper himself.

-Don't ask him what you can do. These people don't really know what they need. Better ask them if you can do "this", and they will say yes or no.

-The confiscation of sharp objects is useless and you will only fuel their creativity to continue doing it.

-It is important to go to therapy. As far as possible, without forcing anything and always with love and respect, it is very important that your family member or friend understands that they should receive psychological therapy, which will help them better understand themselves and that they will feel little by little better. If he is reluctant, you should not continue insisting, but you should try again the occasions that are necessary later.

References

1. Hawton, K., Hall, S., Simkin, S., Bale, L., Bond, A., Codd, S., Stewart, A. (2003). Deliberate self-harm in adolescents: a study of characteristics and trends in Oxford, 1990–2000. Journal of Child Psychology and Psychiatry, 44 (8), 1191-1198.
2. Mosquera, D. (2008). Self-harm: the language of pain. Madrid: Pleiades.
3. Pattison, EM, Kahan, K. (1983). The deliberate self-harm syndrome. American Journal of Psychiatry, 140 (7), 867-872.
4. Schmahl, C. (2014). Neural bases of self-injury. Mind and Brain, 66, 58-63.