Generality
Self-harm is a psychological disorder that induces those affected to intentionally obtain physical harm as a form of punishment.
Generally, self-injurious people harm themselves by resorting to cuts or burns, taking large amounts of drugs (overdoses), puncturing themselves with awls or similar tools, not eating or ingesting large amounts of alcohol.
Contrary to popular opinion, self-harm sufferers rarely want to commit suicide or are suicidal.
Treatment of self-harm requires the intervention of specialists in the field of psychiatry and psychology.
Among the most effective therapies, cognitive-behavioral psychotherapy and family psychotherapy deserve a special mention.
What is self-harm?
We speak of self-harm when an individual intentionally harms his or her body.
Typically, self-harming people act with the intent of punishing themselves. Rarely, they have the intention of killing themselves.
Self-harm is a particular disorder, because it involves the psychological sphere, but manifests itself with physical signs.
Mode
People who suffer from self-harm harm themselves in various ways.
Among the most common gestures with which self-harming injuries produce themselves are:
- The cuts and burns of the skin.
- Perforations with awls or similar pointed instruments.
- Blows to the head or the rest of the body.
- The intake of toxic chemicals or the ingestion of large quantities (overdoses) of drugs.
- Ingestion of large quantities of alcohol.
- Failure to ingest 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 know the details on anorexia nervosa and bulimia, the reader can click here (anorexia nervosa) and here (bulimia). - The relentless practice of physical exercise.
Causes
According to doctors and human behavior experts, self-harm is the expression of overwhelming emotional stress, intolerable anguish, unbearable life circumstances or severe guilt.
Usually, these difficult situations are the result of:
- Social problems, such as: being submissive to someone; have difficulties in the workplace or school, have difficulties in relating with friends, parents or partner; feeling excluded for their sexual preferences; etc.
- Physical trauma, such as acts of violence and acts of sexual abuse.
- Emotional trauma, for example related to the death of a loved one or the loss of a child, during pregnancy (spontaneous abortion).
- Problems of a psychological nature, such as: depression, lack of self-confidence, unstable personality, etc.
Human behavior experts have long studied the reasons behind "self-harm, trying to somehow answer the question" why do self-harm themselves? ".
It is their opinion that, for the self-injurious subject, getting physical harm represents a way to feel better, to reduce the emotional stress or anguish that grips him, to alleviate any feelings of guilt.
PEOPLE MOST AFFECTED
According to some statistical surveys, the people who suffer most from self-harm are:
- Young people. The problem of self-harm can affect people of any age, but it has a particular incidence in the young population.
- Homosexual or bisexual people. It seems that, in these individuals, self-harm is the result of acts of discrimination and prejudice against them.
- Those who have self-harming friends. Experts believe that some people will harm themselves by emulation or because the sight of a self-harming friend (while hurting themselves) has impressed them.
- Those who have been victims, in a more or less recent past, of sexual violence or abuse.
- Prisoners, asylum seekers and war veterans.
EPIDEMILOGY
Experts believe that self-harm is an underdiagnosed disorder, as self-harming people tend to hide their problems.
According to some estimates, referring to the youth population and which take into account only hospitalized individuals, self-harm would affect one in every 10 subjects.
The most common way that self-harming people harm themselves is through skin cuts.
An interested US medical study took into consideration 4,000 self-injured people admitted to hospital and analyzed the reason for their hospitalization. The analysis reported that about 80% of the subjects had taken an exaggerated dose of the drugs and about 15% had made cuts.
This observation does not conflict with what has just been said "on the contrary, with regard to the most common way in which self-injuries cause themselves damage: skin cuts are the most common modality in general, while the exaggerated intakes of drugs represent the modality that most frequently leads to hospitalization.
Symptoms
Manifestations of self-harm include physical signs and abnormal behavior related to physical signs.
The most typical manifestations of self-harm include:
- The presence of cuts or burns (usually cigarette burns) in the wrists, arms, legs or chest.
- The tendency on the part of the self-injured subject to cover the injured parts of the body with clothing, even when the ambient temperature is high.
- Signs of depression, such as low mood, easy crying, lack of motivation and lack of interest in something.
- The demonstration of a certain disgust towards oneself.
- Suicidal tendency.
- The tendency to isolate themselves and to speak little with other people.
- Changes in eating habits, with an unusual decrease (or an unusual increase) in body weight.
- Signs of low self-esteem, from constant self-criticism to never feeling fit to perform some task.
- A tendency to pull your hair or compulsively bite your nails
- Signs of alcohol or drug abuse.
IS THE INTENTION TO HURT HIMSELF CONTINUOUS?
Generally, self-injuries cause harm to themselves following a moment of crisis, during which the thoughts triggering the disorder "make themselves felt" more insistently.
At the end of the crisis, the situation returns to normal and the intention to harm oneself gradually disappears.
Therefore, self-injured people alternate moments of serenity of varying lengths with critical moments, in which they feel the desire to get injured.
THE FEAR OF BEING DISCOVERED
People who suffer from self-harm fear that other people may discover their problems.
This is why they tend to isolate themselves, to take a particularly reserved attitude, to cover the wounds on their body in a sometimes suspicious way and not to ask for help from those in duty.
COMPLICATIONS
Sufferers of self-harm can cause lethal physical harm.
In fact, some intoxications from drugs or harmful products, very deep cuts or some blows to the head can even lead to death, especially if relief is not immediate.
In addition, it is important to remember the danger associated with 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 harm themselves with the intent of committing suicide.
Voluntary suicide, therefore, is not usually the intention of those who suffer from self-harm and the procurement of physical harm is always contained within certain limits.
WHO IS MOST AT RISK OF COMPLICATIONS?
Medical data in hand, those who:
- They harm themselves in an extremely violent or dangerous way.
- Injuries occur regularly.
- They tend to isolate themselves completely from the world, closing all social relationships with other people.
- They suffer from some mental illness.
WHEN TO SEE THE DOCTOR?
A person suffering from self-harm may need immediate help, if for example he is overdosed on drugs; has overused alcoholic substances; has lost consciousness; complains of severe pain following a certain blow or injury; have severe breathing problems; you have lost large amounts of blood following one or more cuts; is in shock from a cut or burn; etc.
Diagnosis
In general, medical investigations aimed at diagnosing self-harm involve a thorough physical examination and an "analysis of the behavioral and psychological profile.
It is important to accurately delineate the characteristics of a self-harm condition, as an accurate diagnosis allows treating physicians to plan the most appropriate supportive care.
Fundamental point!
Much of the ability of doctors to accurately diagnose self-harm depends on the sincerity of the individual under examination.
Self-harming people tend to lie about their disorders and, often, diagnosis paths are affected by this abnormal behavior.
The awareness, on the part of self-injured subjects, of needing medical assistance is the starting point for the precise description of the disorder in progress and for achieving recovery.
OBJECTIVE EXAMINATION
The physical 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 suspicious signs of self-harm.
Wounds, cuts and burns are fairly obvious signs.
However, to an expert eye, the behaviors and appearance of those who have abused alcohol or drugs can also be.
BEHAVIORAL AND PSYCHOLOGICAL PROFILE ANALYSIS
The analysis of the behavioral and psychological profile is usually done by an expert in mental health and psychological diseases.
Briefly, it consists of a series of questions aimed at establishing the modalities of self-harm and the reasons for which the patient harms 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 any problems of social interaction.
- The ways in which the patient does harm.
- How often the patient harms.
- Special feelings or circumstances that precede the intention to harm yourself.
- What (if you ever know about it) reduces the temptation to do harm
- Whether the intention to cause harm is occasional or persistent.
- What are the thoughts in the moment in which patients produce injuries.
- If self-harm is related to some suicidal tendency.
Treatment
In most cases, the treatment of self-harm 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 the most effective) are: cognitive-behavioral psychotherapy and family psychotherapy.
According to some experts in the field of self-harm, group therapy is also important for therapeutic purposes.
The recovery process could take several months of therapeutic sessions, as self-harm is a rather delicate and difficult problem to treat.
COGNITIVE-BEHAVIORAL PSYCHOTHERAPY
Cognitive-behavioral psychotherapy consists of preparing the patient to recognize and master the "distorted" feelings and thoughts that lead to harm to his own body.
It includes a part "in the studio", with the psychotherapist, and a part "at home", reserved for the exercise and improvement of mastery techniques.
FAMILY PSYCHOTHERAPY
Family psychotherapy is a type of psychological treatment that affects the entire 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 foreseen for him.
To obtain good results from family psychotherapy, it is good for the family to learn the characteristics of the disorder in progress and how to best help those who suffer from it.
When is family psychotherapy inadequate?
Family psychotherapy is not appropriate when self-harm is linked to family difficulties, such as sexual abuse or violence practiced 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.
Dealing with subjects in similar situations makes it easier to share their problems, makes them feel less alone and can be extremely useful for therapeutic purposes (for example, one patient could recommend another strategy to dominate "distorted" thoughts, and so on. Street).
ARE THERE DRUGS?
There is no specific drug for self-harm.
However, it should be noted 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 DOCTORS RECOMMEND CARE?
Doctors recommend self-injured people to treat themselves and give continuity to therapy, for the following reasons:
- One in 3 self-injurious people who have been seriously injured once repeats the same gestures at least one more time during the same year.
Remember that a serious injury could even lead to death. - 3 long-term self-harming people (at least 15 years) in every 100 commit suicide, as they can no longer support the cause that drives them to harm themselves.
- Cuts and burns can leave permanent scars. In addition, nerve and tendon injuries could permanently compromise the sensory capacity of a certain area of the body or its adequate functionality.
SOME ADVICES
According to human behavior experts, self-harming people could find relief and overcome moments of crisis in various ways:
- Talking to someone. If the self-abuser is alone, they can use the telephone and call a trusted friend or relative.
- Leaving the house. This advice is particularly suitable for all those cases of self-harm in which the triggering cause is related, 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 distressing thoughts, stress etc.
- Getting "harmless" pain, such as eating extremely spicy food or taking a cold shower.
- By focusing your mind on something positive.
- Indulging in moments of leisure.
- Collecting in a personal diary or in a series of personal letters all the sensations induced by self-harm.
