Self-injury: a desperate strategy to reduce psychic tension

Why do some people self-injure, even without suicidal intent? Let's look at it.

Self-injury is repeated and deliberate behavior aimed at causing physical harm to oneself and without a (conscious) suicidal intent.

The most common forms of self-injury (but not the only ones) are skin cuts, cigarette burns or banging one's head against a wall.

In this article you will find the keys to understand self-injury, and the logic behind it..

Why would someone want to self-injure?

The image of someone inflicting cuts on their arms with a razor blade may be horrifying to many and incomprehensible to most, especially considering that there is no firm purpose to end one's own life. So what drives people to self-harm? what drives people to self-harm?

For a long time it was believed that self-injury was a symptom of psychosis, as to the popular belief that it is a wake-up call. Probably both ideas are wrong, the most recent explanations would indicate that self-injuries are rather an attempt on the part of the person to put an end to states of great psychic tension..

Traumatic experiences in childhood make the person more vulnerable to stress due to an altered process of brain maturation. Major risk factors include sexual abuse, maltreatment, emotional neglect and rejection by significant others. These are some common experiences in the personal history of individuals with borderline personality disorder (BPD).

Borderline personality disorder and self-injury

Self-injurious behaviors are very common in BPD.In fact, one of the criteria to be taken into account in determining the diagnosis of BPD is the presence of recurrent suicidal behavior, attitude or threats of suicide, or self-mutilation behavior. Almost all people with BPD show self-mutilation at least occasionally.

However, self-harm is not an exclusive symptom of BPD, can also be seen in depression, eating disorders and post-traumatic stress disorder.. In fact, causing physical harm to oneself is not exclusive to the human species either, for example, cases can be found among other primates, such as some monkeys that bite themselves.

Another criterion to be taken into account when diagnosing BPD is the occurrence of severe dissociative experiences.

Pain seeking to displace dissociation.

During the self-injury ritual there is at first a high psychic tension which is accompanied by a reduction of Pain perception. The person performs the self-injury to reduce this tension, after self-injury he/she is relaxed (wounds generate endorphins) and then begins to experience discomfort from the damage..

The strategy used is so effective in reducing emotional tension that, in the absence of another method to find relief, the person relapses into this behavior, generating a habit.

People with BPD, unlike other people, are not helped by distraction as an emotional self-regulation technique, and therefore resort to drastic strategies.

At first, the person who self-injures finds a momentary relief to his or her psychic overload, then guilt and shame appear, as well as the concern to hide the wounds.. The latter can provoke or worsen social isolation, generating additional discomfort and creating a vicious circle.

In addition, some of the consequences of self-injury can be a maintenance factor: attracting attention, provoking parents and/or engaging in relationships with others affected.

What is this psychic tension that leads them to self-injury?

Often people who seek relief from these self-destructive behaviors try to get rid of dissociative experiences. Dissociation is an alteration or splitting of psychic functions (e.g. memory) that affects mainly at the level of perception of the self or the environment. affects mainly at the level of the perception of the self or of the environment.

Depersonalization is a dissociative phenomenon and is typical of BPD as well as other forms of psychological trauma, such as post-traumatic stress disorder.

People suffering from depersonalization perceive themselves as remote, unreal, or strange. Often these feelings are accompanied by a reduction in pain perception..

Some research suggests that people with BPD have a higher pain tolerance threshold than the general population, and this higher pain tolerance would increase at times of pre-injury stress.

This form of altered pain sensitivity is an index that can be modified and may approach that of the normal population after psychotherapeutic treatment and after stopping self-injury.It can approach that of the normal population after psychotherapeutic treatment and after stopping self-injury.

This behavior is more common among girls and young women, possibly because they tend to direct negative feelings towards themselves. In fact, the prevalence of BPD is much higher among girls and young women, the prevalence of BPD is much higher among females than in men, just the opposite of antisocial personality disorder, which is based on inattention and violation of the rights of others.

How to detect self-injury?

These are the warning signs to be taken into account:

• Frequent unexplained scarring.
• Clothes to conceal, refusal to undress in the presence of someone or to go to the swimming pool.
• Storing razor blades, broken glass or healing materials.
• Drawings of self-injury.
• Nonspecific signs: isolation, mood swings, risk behaviors, low self-esteem and impulsivity.

Triggers that lead the person to self-injury may be frustrating interpersonal experiences. Sometimes it may also be a behavior emulated by peers as a sign of belonging.However, regular self-injury to overcome stress is usually an indication of strong emotional problems.

Alternatives to self-injury

In order to eliminate self-injurious behaviors as well as other indicators of emotional pain suffered by the person, it is necessary to acquire adequate strategies of emotional regulation, it is necessary to acquire adequate strategies of emotional regulation and to be able to work on the traumatic elements that are at the base of the discomfort.

Some meditation techniques aimed at mindfulness can help with emotional regulation, and in fact are one of the components of dialectical-behavioral therapy, which is the therapy of choice for BPD and has been shown to be effective also for self-injurious behavior, suicidal thoughts and/or behaviors, eating disorders and drug abuse.

For the traumas that often accompany self-injurious behaviors it may be useful to employ EMDR, a very useful technique for addressing post-traumatic stress disorder.

Bibliographic references:

• Schmal, C. (2014, May). Neural basis of self-injury. Mind and Brain, 66, 58- 63.