Non-suicidal self-injury: who is affected and why does it occur?

A pattern of behavior based on Pain and injury that is difficult to understand.

Physical pain has almost always been defined as the sensation that produces aversive reactions; that is, an unpleasant experience that we try to avoid. It arises when our nervous system registers that certain cell tissues have been injured and allows us to react in time to move away from danger.

However, human beings do not always act in a way that is consistent with this logic; in some cases pain is something intentionally sought after, something that is achieved through self-injury. This idea is behind the concept of Non-Suicidal Self-Injury..

What is Non-Suicidal Self-Injury?

Self-injury is very easily associated with suicide attempts, but in reality, in many cases, the goal in mind when it occurs is not death itself: self-injury is valued in itself, not as a means.

Thus, Non-Suicidal Self-Injury is the type of self-injury that occurs as a result of a learned dynamic to try to reduce anxiety levels through practices such as cutting, biting or hitting hard objects in which one's own body is damaged.

A mental disorder?

There is no broad consensus on whether Non-Suicidal Self-Injury is itself a mental disorder or a symptom that may reveal the presence of one. In the DSM-IV diagnostic manual, it is listed as a symptom linked to Borderline Personality Disorder, although in version V it appears as a diagnostic label of its own.

The truth is that this behavior is in itself harmful, but at the same time it can be considered as a "lesser evil" that serves to alleviate a very high state of distress in which the root of the real problem lies.

Why does SLA occur?

What ANS is intended to achieve is a feeling of momentary relief produced in part by the distraction of physical pain, which allows disengagement of attention from abstract ideas and memories that are even more painful.

According to the logic behind Non-Suicidal Self-Injury, the mere possibility of experiencing something other than that kind of anxiety and a solution to rumination (looped thinking about something that causes discomfort) is valued very positively.

In other words, to understand why Non-Suicidal Self-Injury appears as a pattern of learned actions it is necessary to take into account not the pain felt at the moment of injury, but the effect that this pain produces in a person who has been suffering for other reasons for a long time.. That is to say, it is not necessary to see the snapshot or the frozen image of the self-injury, but the process of sensations and experiences that have led to that outcome, since that is what allows us to take into account the usefulness that the pain can have for the person. In that sense, it would resemble trichotillomania.

There is also an alternative explanation about the causes of SSA that links it to low self-esteem and a tendency to think negatively about oneself, whereby self-injury would be a way of reflecting this self-deprecation through self-punishment.. However, it is quite possible that low self-esteem is another symptom of the underlying problem, and not the cause of Non-Suicidal Self-Injury.

SSA as a predictor of suicide

Although the purpose of NSA is not to end one's own life, it is true that its presence is a predictor of possible suicide attempts. a predictor of possible future suicide attempts..

A person who self-injures will be more likely to propose to die, among other things because he or she has already assimilated the "ritual" that can lead to this kind of event and thinks about it more frequently. In addition, the same causes that lead to this learned pattern of behavior can lead to the desire to die, either in a more or less rational way or in the midst of a nervous breakdown.

Symptoms of Non-Suicidal Self-Injury

The most obvious symptoms of NSA are the scars produced by cuts and bites and the bruises left by blows.

The cuts, which are very common, usually appear on the arms and legs, and can therefore be visible with a wide variety of clothing types.and can therefore be visible in a wide variety of clothing. Other forms of self-injury are more discreet. They usually start with parts of the arms and legs that are close to the thorax, since these are the parts of the extremities that are easiest to hide and at the same time are not as sensitive as the front parts of the trunk (as long as the inside of the arms are not injured).

The profile of self-injurers

Non-suicidal self-injury is more frequent among young people: mainly adolescents and post-adolescents. This may be due to the fact that the emotional instability produced by hormonal changes produces greater and more serious anxiety crises, added to the social changes that appear in this stage of life.The following are some of the most common symptoms: doubts about one's own identity, about what one is going to study, problems in fleeting relationships, etc.

In addition, there are certain personality traits that are more frequent among people who practice this kind of self-injury. These are people with a high impulsivity and emotionalism (or sensitivity) who, in addition (or sensitivity) who, in addition, have low self-esteem and value their capabilities low and pessimistically.

Treatments and psychotherapy

The most effective psychotherapeutic options are those that are framed within the Cognitive Behavioral Therapies, that is to say, that address both actions and thoughts. Specifically, Linehan's Dialectical Behavioral Therapy (DBT)created especially to address cases of Borderline Personality Disorder, has been widely used.

The basis of these therapeutic approaches is to constantly postpone the moment of self-injury until it does not occur. It is a way of acting on the behavior that is reminiscent of addiction treatment.

In any case, the role of psychologists is focused both on reducing the frequency and intensity of these behaviors and on learning ways of thinking and relating to others that allow them to to get away from stress in an adaptive way and without suffering from stress.. In the same way, a level of vigilance is maintained to detect moments in which suicidal ideation may appear.