Self-injury seems to be a growing problem, and in order to deal with it you must first understand it.

What is self-injury?

Self-injury is an attempt to alter a mood state by inflicting physical harm on the body. This may include cutting (with razors, knives, glass, etc.), or burning, hitting the body with an object or fists, or not allowing wounds to heal. People realize that hurting themselves brings relief from anguish and turn to it as a leading coping mechanism.

Why does self-injury make some people feel better?

Many factors or a combination of factors seem to be involved, including a biological predisposition, a need to reduce tension, and a lack of experience in dealing with intense emotions. Some studies suggest that when people who self-injure feel emotionally overwhelmed, performing self-injury brings their levels of psychological and physiological tension and arousal back to a bearable level almost immediately. Simply stated, when the feel a strong uncomfortable emotion and don't know how to handle it, hurting themselves reduces the emotional discomfort quickly and calms them down.

Who is most likely to self-injure?

The typical person in therapy for self-injury is a single, bright, well-educated female, and from a middle to upper middle class family. She usually started self-injuring in middle to late adolescence. Often (but not always) she has a background of physical, emotional, and/or sexual abuse or has experienced chaotic family conditions. Eating disorders often are co-reported. However, focusing only on those receiving therapeutic treatment for self-injury may vastly underreport the number of males and minorities who self-injure. One report estimates that males may account for as many as 40% of self-Injurers, but their injuries are overlooked as a product of macho outbursts such as fighting or sports injuries.

How common is this behavior?

It is difficult to accurately estimate the number of people who self-injure, because it is sometimes tricky to distinguish self injurious behavior from suicide attempts. In some studies, no attempt is made to distinguish between the two behaviors. And, as the injures are often purposely hidden, reports from hospitals, police, or social service agencies underreport the occurrence. In the general population of the United States, estimates of individuals engaging in self-injury range from 14 to 600 persons per 100,000 annually (.014 to .6%). The rates are higher in adolescents and young adults; estimates in the general college student population range from 1.8 to 12%.

Is treatment available?

Treatments currently being explored range from talk therapy, to teaching problem-solving skills, to medications that help relieve underlying depression and anxiety that may contribute to the self-injury. What all of the treatments have in common is the aim to end the feelings that prompt the behavior, not just stop the behavior itself.

Are there signs and symptoms?

Signs include scars of current cuts or abrasions and flimsy excuses for these wounds. A person may wear long sleeves and pants in warm weather to hide his or her wounds.

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