Generality
Self-injury is a disorder of the psychological sphere, which causes those affected to intentionally procure physical harm, as a form of punishment.
In general, self-injuring people hurt themselves by resorting to cuts or burns, taking large quantities of drugs (overdoses), puncturing themselves with awls or similar tools, not eating or ingesting large quantities of alcohol.
Unlike the common opinion, those who suffer from self-harm want to commit suicide or have suicidal tendencies rarely.
The treatment of self-injury requires the intervention of specialists in the field of psychiatry and psychology.
Among the most effective therapies, cognitive-behavioral psychotherapy and family psychotherapy deserve special mention.
What is self-injury?
We speak of self - harm when an individual intentionally brings harm to his body.
In general, self-harming people act with the intent to punish themselves. Rarely, they intend to kill themselves.
Self-injury is a particular disorder, because it involves the psychological sphere, but manifests itself with physical signs.
mode
People suffering from self harm injure themselves in various ways.
Among the most common gestures with which self-injured persons produce injuries are:
- Skin cuts and burns.
- Perforations using awls or similar pointed tools.
- Strokes to the head or the rest of the body.
- Intake of toxic chemicals or ingestion of large quantities (overdoses) of drugs.
- Ingestion of large amounts of alcohol.
- Failure to swallow food. In this regard, readers are reminded that there is a certain link between self-harm and eating disorders, such as anorexia nervosa and bulimia.
To learn more about anorexia nervosa and bulimia, the reader can click here (anorexia nervosa) and here (bulimia).
- The incessant practice of physical exercise.
Causes
According to doctors and experts in human behavior, self-injury is an expression of overwhelming emotional stress, intolerable anxiety, unbearable life circumstances or serious feelings of guilt .
Usually, these difficult situations are the result of:
- Social problems, such as: being submissive to someone; having difficulties in the workplace or at school, having difficulties relating to friends, parents or partners; feeling excluded for their sexual preferences; etc.
- Physical trauma, such as acts of violence and acts of sexual abuse.
- Emotional traumas, linked for example to the death of a loved one or to the loss of a child, during the phase of pregnancy (spontaneous abortion).
- Psychological problems, such as: depression, lack of self-confidence, unstable personality, etc.
Experts in human behavior have long studied the reasons behind self-injury, trying to respond in some way to the question "why do self-injurers hurt themselves?"
It is their opinion that, for the self-harming subject, obtaining physical damage represents a way to feel better, to reduce the emotional stress or the anguish that grips him, to alleviate any sense of guilt.
MORE AFFECTED PEOPLE
According to some statistical surveys, the people who suffer most from self-harm are:
- Young people . The problem of self-injury can affect individuals of any age, but it has a particular incidence in the youth population.
- Homosexual or bisexual people . It seems that in these individuals, self-injury is the result of acts of discrimination and prejudice against them.
- Those who have self-defeating friends . Experts believe that some people produce voluntary damage by emulation or because the sight of a self-defeating friend (while hurting) impressed them.
- Those who have been victims, in a more or less recent past, of violence or sexual abuse .
- Prisoners, asylum seekers and war veterans .
Epidemiology
Experts believe that self-injury is an under-diagnosed disorder, as self-harming people tend to hide their problems.
According to some estimates, referring to the juvenile population and taking into account only hospitalized individuals, self-injury would affect a subject every 10 .
The most common way self-injuring people get damage is through cuts in the skin.
An interested US medical study considered 4, 000 self-injuring persons hospitalized and analyzed the reason for their hospitalization. The analysis reported that about 80% of the subjects had taken an exaggerated dose of drugs and about 15% had obtained cuts.
This observation does not conflict with what was said above, regarding the most common way in which self-harm is harmed: cuts in the skin are the most common modality in general, while exaggerated assumptions of drugs represent the most frequent way on admission.
Symptoms
The manifestations of self-injury include physical signs and abnormal behavior, related to physical signs.
The most typical manifestations of self-injury include:
- The presence of cuts or burns (usually cigarette burns), at the level of the wrists, arms, legs or chest.
- The tendency, on the part of the self-injuring party, to cover damaged parts of the body with clothing, even when the ambient temperature is high.
- Signs of depression, such as low mood, ease of crying, lack of motivation and lack of interest in something.
- The demonstration of a certain disgust with oneself.
- Suicidal tendency.
- The tendency to isolate and talk little with other people.
- Changes in eating habits, with an unusual drop (or an unusual increase) in body weight.
- Signs of low self-esteem, from continuous self-criticism to never feeling fit to perform any task.
- The tendency to tear your hair or compulsively eat your nails
- Signs of alcohol or drug abuse.
IS THE INTENTION TO MAKE AN EVIL CONTINUE?
In general, self-injured persons damage themselves after a moment of crisis, during which the thoughts that trigger the disorder "are felt" in a more insistent manner.
At the end of the crisis, the situation returns to normal and the intention to hurt itself gradually disappears.
Therefore, self-injuring people alternate moments of serenity more or less long to critical moments, in which they feel the desire to get injuries.
THE FEAR OF BEING DISCOVERED
People suffering from self-harm fear that other people may discover their problems.
This is the reason why they tend to isolate themselves, to take on a particularly reserved attitude, to cover wounds on their bodies in a sometimes suspicious manner and not to ask for help from those responsible.
COMPLICATIONS
Those suffering from self-harm can be fatally injured .
In fact, some intoxications from drugs or harmful products, very deep cuts or some blows to the head can also lead to death, especially if the relief is not immediate.
Furthermore, it is important to remember the danger linked to the possible complications of conditions, such as anorexia nervosa, bulimia or alcohol abuse.
Self-harm and voluntary suicide
As stated at the beginning of the article, it is very rare for self-harming people to do damage with the intent to commit suicide.
Voluntary suicide, therefore, is not usually in the intentions of those suffering from self-harm and the procurement of physical damage is always contained within certain limits.
WHO IS MORE AT RISK OF COMPLICATIONS?
Medical data in hand, those who are most at risk of complications from self-harm:
- They damage themselves in an extremely violent or dangerous manner.
- Injuries are produced regularly.
- They tend to isolate themselves completely from the world, closing every social relationship with other people.
- They suffer from some mental illness.
WHEN TO REFER TO THE DOCTOR?
A person suffering from self-harm could need immediate relief if, for example, he is overdosed on drugs; has exaggeratedly abused alcoholic substances; has lost consciousness; complains of severe pain following a certain stroke or injury; manifest serious respiratory problems; has lost large amounts of blood following one or more cuts; he is in a state of shock as a result of a cut or a burn; etc.
Diagnosis
In general, medical investigations aimed at diagnosing self-injury include an accurate physical examination and an analysis of the behavioral and psychological profile.
It is important to accurately outline the characteristics of a condition of self-harm, as an accurate diagnosis allows the treating physicians to plan the most appropriate supportive therapy.
Fundamental point!
Much of the physicians' ability to accurately diagnose self-injury depends on the sincerity of the individual under examination.
Self-injuring people tend to lie about their problems and, often, the diagnosis pathways are affected by this anomalous behavior.
The awareness, on the part of self-harming subjects, of needing medical assistance is the starting point for the precise description of the disorder in progress and for achieving recovery.
EXAMINATION OBJECTIVE
The objective examination consists in the evaluation of the patient's general state of health, in the measurement of some of his body parameters (weight, blood pressure etc.) and in the observation, on his body, of the signs suspected of self-harm.
Wounds, cuts and burns are fairly obvious signs.
However, the behavior and appearance of those who have abused alcohol or drugs may also be an expert eye.
ANALYSIS OF THE BEHAVIORAL AND PSYCHOLOGICAL PROFILE
The behavioral and psychological profile analysis is generally up to an expert in mental health and psychological diseases.
Briefly, it consists of a series of questions aimed at establishing the methods of self-injury and the reasons for which the patient produces damage to himself (so if it is for a form of depression, if it is for a physical trauma suffered, if it is for a trauma emotional, if it is for a serious psychological illness etc).
At the end of this evaluation and with the data collected during the physical examination, the team of doctors and specialists who carried out the various investigations is able to draw up an evaluation of the case under observation.
- Interpersonal relationships and possible problems of social interaction.
- The ways the patient gets damage.
- How often the patient takes damage.
- Particular feelings or circumstances that precede the intention to hurt oneself.
- What (if it is ever aware of it) reduces the temptation to go to harm
- If the intention to procure damage is occasional or persistent.
- What are the thoughts when patients are injured.
- If self-injury is linked to some suicidal tendency.
Treatment
In most cases, the treatment of self-injury requires the collaboration of several specialists - including doctors, psychiatrists and psychologists - and is psychological ( psychotherapy ).
Among the psychological treatments, the most commonly used (and perhaps most effective) are: cognitive-behavioral psychotherapy and family psychotherapy .
According to some experts in the field of self-harm, it would be important, for therapeutic purposes, also group therapy .
The healing process could take several months of therapeutic sessions, as self-injury is a very delicate and difficult problem to treat.
COGNITIVE-BEHAVIORAL PSYCHOTHERAPY
Cognitive-behavioral psychotherapy consists in preparing the patient to recognize and dominate the "distorted" feelings and thoughts that lead to damage to his body.
It includes a part "in the studio", with the psychotherapist, and a part "at home", reserved for the exercise and improvement of the domain techniques.
FAMILY PSYCHOTHERAPY
Family psychotherapy is a type of psychological treatment that affects the whole family of the self-injuring patient
Briefly, it is based on the concept that parents, siblings and other close relatives play a decisive role in supporting their loved one, during the therapeutic path provided for him.
To obtain good results from family psychotherapy, it is good that the family learns the characteristics of the disorder in action and how to best help those who are suffering.
When is family psychotherapy inadequate?
Family psychotherapy is not appropriate if self-injury is linked to family difficulties, such as sexual abuse or violence carried out by one of the two parents.
GROUP THERAPY
Group therapy consists of groups of people with similar problems, who share their ailments and support each other.
Relating to subjects in similar situations makes sharing their problems easier, makes them feel less alone and can be extremely useful for therapeutic purposes (for example, one patient might recommend another a new strategy of domination of "distorted" thoughts and so on). Street).
ARE THERE DRUGS?
There is no specific drug against self-injury.
However, it is good to point out that, in the presence of depression or other mood disorders, the team of specialists could agree on the administration of some antidepressant drugs .
WHY DO PHYSICIANS SUGGEST YOU TO CARE?
Doctors recommend self-harming people to be cured and to continue therapy, for the following reasons:
- One out of 3 self-injured person, who suffered serious damage once, repeats the same gestures at least one more time during the same year.
Please note that a serious injury could also lead to death.
- 3 long-term self-defeating people (at least 15 years) every 100 come to commit suicide, since they are no longer able to support the cause that drives them to hurt themselves.
- Cuts and burns can leave permanent scars. Furthermore, injuries to nerves and tendons could definitively compromise the sensory capacity of a certain area of the body or its adequate functionality.
SOME ADVICES
According to experts in human behavior, self-defeating people could find relief and overcome moments of crisis in various ways:
- Talking to someone. If the self-harming subject is alone, he can use the phone and call a trusted friend or relative.
- Leaving home. This advice is particularly suitable for all those cases of self-harm in which the cause is linked, in some way, to a family member.
- Listening to music and starting a new activity in order to find a distraction.
- Going to a relaxing / comforting place.
- Finding alternative ways to express anxious thoughts, stress, etc.
- Getting "harmless" pains, such as eating extremely hot food or taking a cold shower.
- Focusing your mind on something positive.
- Enjoying moments of leisure.
- Collecting in a personal diary or in a series of personal letters all the feelings induced by self-injury.
