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Self-harm: injuries, cuts, damage

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They cut their skin apprehensively. Take a penknife and cut out various signs on the hand. They extinguish cigarettes on themselves. Ballpoint pen scratch themselves to the blood. They pull out their hair. Open wounds, preventing them from healing. Bones are broken. They pierce nails into their bodies. Clasp hands with plaits. They deliberately inflict hellish physical pain so that they no longer experience mental suffering.
They like to hush up this phenomenon. It is not customary to say that a loved one is prone to self-harm. They try to hide the fact of mutilation to themselves by all means. By most ordinary people, conscious self-harm is perceived as recklessness, obsession, a flaw in education, a cheap way to attract attention. However, the problem of intentionally inflicting injury on a person exists. And this issue is much more complex and wider than the efforts now spent by society to resolve it.

What is meant by the term "self-harm", which is often referred to as the English equivalent of "self-harm"? This is a deliberate and deliberate infliction by the subject of a variety of bodily harm to himself. Such damage, as a rule, is always noticeable to others. The individual inflicts self-harm, guided by some internal reasons, trying to achieve some state or goal. Moreover, a person has no obvious suicidal intentions. That is why he never crosses the line, which can lead to death. However, in some situations, due to non-observance of safety boundaries due to ignorance or negligence, self-harm causes premature death.
Cases of self-mutilation are recorded in people of different ages, with different social status, level of education, financial situation. According to sociologists, the propensity for self-mutilation is determined by more than 1% of the human population. Most often, single or repeated episodes of self-harm are determined in adolescents. Most of these teenagers are orphans, brought up in boarding schools or stay in children's penal colonies.

In the teenage category, the frequency of execution of malicious acts is striking. More than 10% of adolescents who periodically practice such actions harm their body more than once a week. For 20% of teenagers who have a problem with self-mutilation, this process occurs with a frequency of once a month. Moreover, from the entire problematic teenage group, a few units of children surveyed indicate that some significant event served as the reason for performing self-harm. The vast majority of adolescents cannot explain what motives push them to torture their own bodies.
Young women are also prone to bodily harm. Self-mutilation is no less common among prisoners serving sentences in correctional facilities. Attempts to inflict physical harm on themselves are often made by prisoners of war, participants in hostilities, and war veterans.

Selfharm: severity and self-harm
All options and methods of self-harm can be conditionally divided into three categories according to the severity of the injuries and the mental status of the person at the time such actions are performed.

Group 1. Severe injuries
Serious and dangerous consequences of self-damage are recorded relatively rarely. Such extremely painful acts include: exentration - removal of the eyeball along with all its contents, cutting off part or all of the penis, castration - removal of the testicles, amputation of the fingers or the entire limb.
Such manipulations almost always indicate the presence of severe mental disorders in a person, for example: an acute psychotic episode, schizophrenia, delirious mania. Very often self-mutilation in schizophrenia is performed under the influence of imperative hallucinations, when the patient hears "voices" ordering him to damage the body. Severe injuries may be caused by acute alcohol intoxication or drug intoxication.

Another reason for serious episodes of self-harm is transsexualism. The desire to live and be accepted as a person of the opposite sex can push a man to cut off his penis.
Explanations of such actions may be fanatical religious in nature. For example, a man full of fanaticism, being blindly following the biblical laws, cuts off his own hand, punishing himself as a sinner. Or he, as a great Christian, is screening himself for the glory of the Lord. Acts of self-harm can be a process of rituals. For example, the ritual action of Moroccan folk healers is to enter into a trance state and inflict deep cuts on the head.

Group 2. Stereotypic actions
Some people during some time interval perform monotonous template actions. A common form of stereotypic acts is a methodical and rhythmic banging of a head against a wall. Another form is applying yourself a series of bites. However, it is not possible to establish and explain the purpose of stereotypic actions.
According to scientists, the performance of repetitive motor acts indicates autism. In patients, a lot of different variants of repetitive behavior are determined. One of the leading manifestations of the disorder is stereotyping - various meaningless movements, such as: chaotic waved hands, swaying and tilting the head, rocking the torso back and forth. 30% of patients with autism are characterized by auto-aggression - an activity that can cause injuries to the person himself. For example, he can regularly make a series of bites of his own body.

Also, stereotypic behavior may be associated with moderate or severe severity of oligophrenia. Some patients with a deep degree of mental retardation (idiocy) periodically show aggression and autoaggression. They can suddenly hit and bite both others and themselves. They occasionally scratch their skin.
Stereotypic movements may be symptoms of Tourette’s syndrome. The need to shrug and scratch the itchy skin are prodromal signs suggesting the onset of an episode of a series of nerve tics.

Group 3. Domestic self-mutilation
The most common variant of auto-aggressive actions can be arbitrarily called "household self-harm." In this case, a person inflicts superficial damage to himself of mild or moderate severity. However, he does not pursue the goal of committing suicide and controls the process of inflicting wounds on himself. Domestic self-mutilation can occur once, sporadically or be of the nature of regularly repeated actions.
Some types of domestic self-harm are considered in the framework of compulsions - obsessive uncontrolled actions. Compulsive processes include tearing off hair on the head, nibbling nails and picking nail plates, and intensively combing the skin. Periodically performed, repeatedly performed cutting of the skin, cutting out various symbolic signs, cauterizing the body with various hot or burning objects, injuring the skin with needles, and preventing wound healing may indicate borderline mental disorders.
Occasional cases of self-harm are observed in post-traumatic syndrome. A single episode of self-harm can be produced when a person is in an extreme situation or is in a state of intense stress. Self-harm can be caused by a severe depressive state.

Why people cripple themselves: reasons for self-harm
The causes and provocateurs of acts of self-harm described a great many. Along with plausible versions, there are many false hypotheses, myths and misconceptions.

Reason 1. Crippling oneself is “dosed" harm, not an attempt to commit suicide
One of such implausible explanations is the conviction of some inhabitants that the case of self-mutilation is an attempt of a person to commit suicide. However, this view is not at all true.
Numerous studies have shown that a person who has decided to commit a true act of suicide is 100% convinced of the senselessness of his existence on earth. She is led by a conviction about the need to end her mortal life. The future suicide often carries out preparatory activities, so he chooses such suicide methods that will guarantee him a fatal outcome.

At the same time, a person who inflicts domestic self-harm to himself, as it were, “doses out” the degree of injuries. His goal is to injure himself and feel physical pain for the sake of gaining some condition or other benefits. However, his plans do not include deliberate interruption of his own life.

Reason 2. Self-ugliness as a way to attract attention
Another belief that does not quite correspond to the truth is the opinion that by mutilating oneself a person tries to attract the attention of others. Indeed, some persons cut their skin, guided by the desire that this fact be noticed by some other person.
For example, a girl carves hearts on her hand, hoping that her feelings will be noticed by a young man of interest to her. In such a situation, she will surely try to get the cut out sign into this guy’s field of vision. Thus, the young lady shows that she lacks his attention. She needs his presence. She longs for love. That is, she tries to satisfy a certain need, and she cannot report for some reason about the need to fulfill her desire. Or the guy, because of his thoughts, refuses to satisfy the girl's need. Moreover, such options for self-harm can be easily detected by their simplicity and demonstrativeness.

However, in most cases, self-harm does not at all aim to draw attention to your person. To be noticed and appreciated, people most often resort to other actions. For example, a girl, in order to interest a guy, will try to look attractive and extraordinary. She will wear bright clothes and will make catchy makeup. She can start talking loudly, accompanying her statements with lively facial expressions and expressive gestures. She can become polite, delicate, helpful. But it is unlikely that she will extinguish cigarettes on her skin when her object of interest is not nearby.
Psychologists claim that most people strive with all their might to mask the traces of their actions. Most often they injure in places that are not accessible to others. If they hurt their hands, they will wear clothes with long sleeves. If it is not possible to hide deep scratches under the clothes, then they will assure that they were scratched by a cat. If you can’t hide the bite marks, they will say that they were attacked by a dog. That is, since deliberate self-mutilation causes a sensible person a sense of shame, he will seek to hide such a sin.
Reason 3. Torturing your body - a method of manipulation or a cry for help

Some people really inflict physical pain on themselves, trying to achieve something from others. Crippling themselves, they try to change their minds and influence the behavior of their close circle. However, self-harm cannot be called pure manipulation. Since this will be a completely strange phenomenon when a teenager cuts his hands, trying to get from his parents, for example, a new mobile phone.
In most cases, the act of self-mutilation is focused on receiving moral support and spiritual help from loved ones. By committing such an action, a person wants to say that he has some serious problem that he himself is not able to solve.

Reason 4. Self-mutilation is an attempt to extinguish one’s heartache and cope with one’s emotions.
As a rule, a person committing an act of self-mutilation is overwhelmed by intense emotions. Destructive feelings incinerate his soul: resentment, anger, fear, anxiety. He can be swallowed up by the painful ideas of his own guilt. He may suffer from the fact that he does not have the opportunity to throw out a flurry of emotions outside. Because he has no one to share his grief with. He does not see a like-minded person nearby who is able to understand and support him.
Inflicting physical suffering on oneself is an attempt to calm one’s overwhelming feelings. After experiencing physical pain, a person feels relief and reassurance. Severe pain and blood pouring in a stream washes away suffering, frees the soul from negative emotions. For them, self-harm is a method of eliminating painful memories, disturbing thoughts, frightening anticipations.

Reason 5. Self-harm - a sign signaling spiritual emptiness
In some situations, self-harm is caused by a feeling of inner emptiness, a feeling of loss, oppressive loneliness. Such a person does not live fully. He does not feel joy from everyday life. His existence is gray, monotonous, faceless.
For such a person, deliberately inflicting physical pain on himself is an action intended to feel that she is still alive. Such a subject cuts and cripples himself in order to obtain evidence that he exists. Self-harm is a way of returning to reality. The passage of physical pain returns such a subject to reality. He begins to feel himself and notice the world around him.

Reason 6. Self-harm - a way to avoid tragedy.
Such a person is controlled by conviction: if he hurts himself physically, he will avoid what he fears. Such an individual is certain that a threat has hung over his head. He senses an approaching misfortune. He believes that some kind of tragedy should happen to him in the future. Thinking of such a subject is swallowed by fears and anxiety. And more often than not, he cannot explain what exactly he fears. His fears are pointless and global.
However, he is convinced that evil rock will circumvent him if he is physically suffering. Self-mutilation is a ritual action designed to shield oneself from a potential drama. Engaged in systematic and regular self-harm, he seems to postpone the moment of the catastrophe.

Reason 7. Auto-aggression - a way to punish yourself
Often the act of self-harm acts as a method of punishing oneself. Such an individual suffers greatly from having committed a real or imaginary negative act. He is tormented by remorse that he offended someone and caused pain. The subject blames himself for being a poor parent, an unruly spouse, an ungrateful child. He bears the stigma of a loser. He considers himself an insignificant creature.
To reduce the intensity of suffering, he decides to punish himself. And he does it in a very strange way. In his understanding, punishment must necessarily be associated with physical pain. Therefore, he strikes himself, arranges all kinds of torture, hoping to pay off his conscience for the mistakes made. He feels that the act of self-mutilation brings some relief and reduces the feeling of guilt.

How do scientists explain the need for self-mutilation? From a physiological point of view, the mechanism for obtaining relief from self-harm can be explained by a feature of the functioning of the body.
At the time of pain in the body, the work of the antinociceptive system is activated. Excessive synthesis of endorphins is observed in response to stress, which is pain. The production of internal opiates is a protective reaction of the body, the purpose of which is to provide a physiologically natural way out of stress, that is, without compromising adaptive capabilities.

Through increased production in the hypothalamus and pituitary gland of endogenous opiates - endorphin and enkephalin - the intensity of the pain syndrome is reduced. These substances have a strong analgesic and anti-shock effect. A huge amount of endorphins is released during any physical injury, for example: during electric shocks, during cold stress. It is established that the synthesis of endorphins in the human body is activated when he participates in hostilities or sports competitions. Due to the accelerated and increased production of these substances, the subject can to some extent ignore pain and is able to mobilize the body's resources.
In addition, endogenous opiates give a person a biochemical “reward” - they cause a state of euphoria. The subject captures such an elevated mood bordering on bliss. Поэтому со временем у него формируется связь: причинение себе боли и последующая эйфория.

Что делать, когда хочется себя истязать: методы сопротивления
Конечно, человек, у которого существует проблема самоповреждения, волен сам решать. Продолжать и дальше устраивать себе пытки: вырывать волосы, царапать, резать, кусать. Or put an end to their physical suffering and learn how to resolve difficulties that have arisen wisely and harmlessly. It is his choice to continue to suffer or begin to learn to build harmonious relations with society. Any person has the right to choose: to be a victim and live in agony or to show courage and engage in the development of his own personality to achieve complete harmony in the inner world.
However, the person who is engaged in the regular destruction of his body most often cannot make the right choice. Since he has such a problem that has led him to a standstill. His soul is torn by contradictions and conflicts. He does not understand his place on earth. He is confused in his life and does not know in which direction he needs to move. He does not know how to express his feelings in a constructive way and does not know any other ways of neutralizing emotions, except for mutilating himself. He is weakened, exhausted and very unhappy.

That is why close people should not ignore and remain indifferent to such a delicate problem that exists in their relative. They can support a person in distress and help him avoid the subsequent hellish suffering. However, it must be borne in mind: if the person whom you are sincerely trying to help with all your strength resists your services, then it is unlikely that you will be able to do anything. A person who does not have a motivation for change has no chance of changing his existence. Therefore, if a person refuses your services, it is better to leave him alone and seek professional medical help.
What to do when a relative is prone to self-harm? No need to create the appearance that everything is normal, and nothing catastrophic happens. It is necessary to talk with the affected person, tactfully indicating that you are aware of the difficulties. You need to tell the person that his situation is very worrying about you. What is important to you is his well-being and mood. That you are ready to come to his aid and provide the required assistance.

Even if a person refuses your help, a conversation in a friendly tone will significantly improve his well-being. He will understand that he is not alone with his misfortune. He will feel that there are people to whom he is not indifferent. He will know that his life is interesting to someone, and the problems are important. Such confidence will give him strength to search for other methods of resolving a difficult situation. And, it is quite possible that soon he himself will personally contact you for assistance and advice.
It is very important during a conversation with the affected subject to avoid reproaches, condemnations and criticisms of his actions. Almost always, a person who has injured herself, repents of her sin, regrets that she has caused loved ones to suffer. Reproaches and reproaches will even more oppress them and increase their guilt. The vast majority of people involved in self-mutilation are suspicious, impressionable and vulnerable. They are very sensitive and immediately understand where the truth is and where the falsity is. Therefore, it is necessary to behave very naturally, delicately and tactfully. Try to encourage them, rather than intensify their pain.

Another aspect that must be considered in cases of self-mutilation. A person almost always injures himself when he is alone. Therefore, in order to prevent a recurrence of an episode of self-harm, you should try to be with this person all his free time. Moreover, a joint pastime does not at all involve constant discussions about what happened. It is necessary to try to open the whole life to the suffering subject. Interested in some exciting things. To entrust him with the implementation of important, but pleasant for him affairs. Offer to try yourself in some unknown areas.
It should be borne in mind that a person who is prone to self-harm cannot be set clear orders and prohibitions. It is impossible to persistently and unceremoniously hinder when an individual decides to injure himself. Of course, this does not apply to cases where the subject has obvious mental problems. But in other situations, any person should have the right to choose. A person needs to feel his independence and autonomy. When he has the right to make a choice: to cripple himself or not, the likelihood that he will not harm himself is much higher. When you set the prohibitions and order not to harm yourself: you take away razors and knives, the more chances are that he will cripple himself more badly in spite of you and in spite of all the prohibitions. In a situation with self-mutilation it is impossible to forbid, but it is necessary to offer an alternative.

It is necessary for a person to offer to gradually replace malicious actions with other acts, less painful and dangerous. For example, if a person likes to stick needles into his body, advise him to take an acupuncture course - and there is pain, and there is benefit. If a person experiences euphoria by carving some kind of symbols on his skin as a sign of his punishment, offer to make him a tattoo in the salon, for example: on the inside of the wrist. Performing a tattoo on this sensitive spot will provide him with painful sensations, and in the end he will have an obvious visual sign of the punishment incurred. If the subject tortures himself by squeezing his hands with plaits, advise him to place a tight elastic band on his wrist. When he pulls it and let it go, he will feel pain, but there will be no noticeable marks on his skin.
You can jointly develop other options for substitution therapy: when the subject is overcome by a desire to harm his own body, he must occupy himself with other things. For example: tearing sheets of paper, striking a punching bag, hitting old dishes. A good way to counter self-harm is to seriously engage in sports, especially fighting. After a battle in the ring with a serious opponent, a natural adrenaline rush is observed. Together with this substance, endorphins are produced during intense physical exertion, designed to reduce the pain that occurs during enhanced training.

It is important for people around to understand that a person’s hands are not just scratches received through stupidity, but witnesses to the existence of a psychological problem. A complete elimination of the tendency to self-harm is possible only if the true cause is discovered and eliminated, causing a flurry of emotions or leading to internal devastation. The true culprit is often impossible to establish on their own, since memories of a traumatic event often lie beyond conscious perception.


In such a situation, only an experienced psychotherapist or a certified hypnologist can establish the root of evil and develop a strategy for resolving the problem. Therefore, if a person’s need for self-harm does not subside over time, there is one way out - seek medical help. However, even medical work cannot guarantee the rapid achievement of the desired result. The issue of self-harm is a complex task that does not accept haste and a standard approach. Each patient with this problem should have their own treatment plan developed, the step-by-step following of which will ultimately lead to victory over the propensity for self-harm.

Help, support and treatment for self-mutilation

Self harm can be the way you deal with problems. It helps you express feelings that you cannot put into words, help distract yourself from what is happening in life or throw out emotional pain. Ultimately, you are likely to feel better — at least for a short period of time. But then the painful feelings return, and you will feel the urge to hurt yourself again. If you want to stop, but don’t know how, remember this: you deserve a better life, and you can achieve it without harming yourself.

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