Self-Inflicted Injury : Causes, Risk Factors, Signs, Treatment, and Ways to Avoid Self-Inflicted Injury

A self-inflicted injury is an act of intentionally harming self without meaning any harm. It is also known as self-harm, non-suicidal self-injury, and para-suicidal behavior.

People do so in the act to cope with distress, anger, and other painful emotions. Self-inflicted injury can be harmful emotionally and physically in long term. People mostly harm or injure legs, arms, or torso as these areas can easily be hidden under the clothing. Some also injure their head as they can be easily hidden under the hair or a hat.

According to the Mental Health Association, the common methods of non-suicidal self-injury include:⁽¹⁾

• Skin cutting
• Head banging and hitting
• Burning

Other types of self-inflicted harm include:

• Scratching or picking the skin
• Hair pulling
• Punching objects that injure hands
• Inserting objects into body openings
• Jumping off high walls
• Drinking harmful liquids
• Taking harmful substances
• Intentional exposure to infection or toxins
• Taking high doses of harmful substances

People engage in self-injury as a coping mechanism to manage difficult feelings such as fear, anger, or sadness. It provides them temporary relief from emotional pain that is hard to be understood by others.

People may self-injure to:

• Express their pain especially if they are unable to express it through words
• Communicate distress in an indirect way
• Distract from painful emotions or memories
• Feel like having control over some aspects of their life
• To feel disconnected, numb, or dissociated
• Punish self for emotions or failures

It can be helpful for these people to cope with the difficult feeling but may cause mental and physical harm.

Self-injury can also become a compulsion for some and would get difficult to stop.⁽²⁾ Such people feel compelled to keep doing the act of self-injury as a habit.

Anyone can indulge in the act of self-injury but there are some who are more at risk of it.

Self-harm is more common in teenagers and it is observed to occur in approximately 15% of teens, 17-35% of students, and 4% of adults.⁽¹⁾

A review found 12-14 years of age to be the most common age of onset of self-injury in young adults.⁽³⁾

It happens because people at a young age feel misunderstood, isolated, and rejected by peers and may experience bullying, academic pressure, and other events that they may find difficult to talk about with others.

People with sexual minorities are more likely to cause self-harm than heterosexuals. This may be related to the discrimination harassment, and violence experienced by young LGB people.⁽⁴⁾

These people may feel compelled to hide their identity. An inability to do this may lead to frustration which would be a factor leading to self-harm.

Self-harm is an expressive sign of mental health condition. It can be due to self-loathing or a way to cope with intense feelings caused by the condition.

Self-injury can also be due to past trauma. The traumatic events include domestic violence, chronic stress, or sexual abuse. These can cause a range of intense emotions.

It might be difficult for friends and family to see the warning signs of injury as the person may tend to hide the injuries.

The signs to look out for include:

• Unexplained scars
• Hiding legs and arms even if the weather is warm
• Eating less than normal
• Having a frequent unexplained injury
• Difficulty in managing feelings, or seeming extremely sad or angry
• Low self-esteem
• Becoming withdrawn and avoiding social interaction
• Developing another mental health condition

Admitting that self-harm is occurring and causing harm is the first step toward avoiding the self-inflicted injury. Realizing this the person can replace self-harm with other coping strategies.

Talking to a friend about feelings and experiences can be helpful. If a friend or a family member is not possible, try speaking with a doctor or a nurse or a counselor.

Speaking about such feelings to anyone can be difficult. In such a case, a person can write an email, or a letter instead.

Even if having a trusted friend or a family member, speaking to a professional can be more helpful.

Those having serious thoughts of suicide should contact the National Suicide Prevention helpline.

Those having self-harm feelings should keep the sharp, hazardous objects, and harmful liquids out of reach.

Distraction can be an effective way to avoid self-harm till the feeling of self-harm passes away. Distraction techniques include:⁽⁵⁾

• Calling a friend
• Playing with an animal
• Watching TV shows or movies
• Doing something creative
• Going for walk or run

A person can release the feelings in some alternative ways, which include:

• Crying
• Punching
• Scribbling or ripping
• Screaming or shouting
• Venting feelings by writing or talking to relatives

People should find a temporary substitute for self-inflicted injuries. These substitutes may include:

• Rubbing ice on the skin
• Gently snapping an elastic band
• Drawing on the skin where a person can cause injury

The treatment would be different for different people. Mostly it may include a combination of psychotherapy, medication, and treatment for the co-occurring condition.

The treatment may also depend on the severity of the condition. Sometimes a person may require staying in the hospital for a period of time.

The purpose of the therapies is to help a person:

• Learn new coping skills
• Identify the reason for self-harm
• Process difficult events and emotions
• Learn a healthy way to manage emotions

Self-inflicted injuries are the way to cope with difficult emotions and experiences. Support from loved ones and professionals can be helpful in coming over this self-harming behavior and gradually getting rid of it.