What to know about Self Harm

kelliemontgomery's picture

Self mutilation or cutting is often seen as a very paradoxical way to control, cope with or relieve emotional pain. The nerves of the skin are very sensitive and when our skin is cut these nerves send signals to the brain warning us of impending injury. Having the urge to cut or self mutilate, a person must be motivated by something stronger and more intense than the physical sensation of pain in order to bypass his/her own body's defenses. Such intense feelings can come from an event in the past, current incidents that create intense feelings or a build up of anger, hurt or despair.

While there are many healthier ways of coping with these feelings, those who cut often feel unable to turn to others, to share what they are experiencing inside or to express it in other ways. This is NOT their fault. Many individuals who cut never felt they could go to their caregivers for comfort or soothing growing up. "A child who has to cope with inexplicable and difficult feelings on his or her own turns inward" (Levenkron).

Others feel a tremendous sense of shame in regards to how they feel and often believe they would be judged by others if they 'took off the mask' revealing their pain. Over time, this pain can build up and if it is not talked about, released or soothed in other ways it becomes overwhelming. In Steven Levenkron's book, "Cutting" he states that often the first incident of self mutilation begins with strong feelings of anger, anxiety or panic. If the feeling is not too intense then other remedies such as throwing something or knocking something down may help. Its only when the person becomes so overwhelmed that none of these "remedies" help that they take the initial step to harm themselves. These feelings go far beyond frustration and often some who cuts feels very guarded, alone or scared.
Its importnat to note that people will generally seek repetition of what is familiar, rather than to seek out what is new or constructive in different ways. When a person is in so much pain they will bypass thinking about long term solutions for a quick, short term fix to a problem. Which is why self mutilation is like many disorders (eating disorders, OCD, alcohol or drug dependence) where an individual feels compelled to use the only tools they know that will provide momentary relief.


A good predictor or recovery is the presence of resources and a good support system. Even one individual that that person can talk to and whom they feel they can trust and depend on is great predictor for recovery. People who are good helpers are those who have the ability to empathetic; understanding and able to convey so; nurturing and knowledgeable about cutting, depression or low self esteem and optimistic about the person's ability to recover.
In addition, its important to note when "privacy" becomes isolation; if you are concerned you are isolating try to find at least one person who can be supportive.
The road to recovery is often about being able to translate your feelings into words, rather than acting out these feelings to harm. Using these words to communicate with someone caring and supportive is key because you are increasing your ability to be assertive and supporting your own voice.
Increasing the amount of coping tools in your tool box is an excellent idea. There are things you can do that:
Express how you feel
Things that Distract you
Things that Soothe you
THings that help relieve Physical Tension or Stress
(think about ideas that would fit into some or all of these categories)
Examples can include art, exercise, music, comedy, caring for an animal, having a stress ball, working with clay, even cleaning....and of course, talking with someone you trust.
Make a plan for what you will do next time you may get triggered or want to cut

Kellie Montgomery, LMFT

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