Thursday, September 17, 2009

An Examination of the Practice of Self-Injury

(The following was written as a paper for school. The tone is definitely affected by the fact that I would be presenting this to a teacher. It has been edited to some degree to be appropriate for publishing on this blog)

Self-injury, also known by labels such as self-harm, self-inflicted violence, or self-mutilation, is the deliberate act of injury a person may inflict upon his or her body. The informal term “cutter” is used to refer to people who self-injure using a cutting instrument of some sort, typically razor blades, although other instruments may be used. Similarly, the act of self-injuring using a blade may be referred to under the general term “cutting”. People who self-injure are often assumed to be attempting suicide; however, the two acts are separate and should not be confused with each other. Despite the stereotypical image of a young White female teenager cutting her wrists to cope with depression, self-injury is performed by all demographics in several possible ways and for a number of reasons.

Why would someone self-injure? One reason is dissociation, a psychological condition during which an individual will feel cut off from their emotions and feel it hard to interact with or feel a part of the world. Dissociation is a self-defense mechanism triggered by traumatic experiences as a way of avoiding sensations that cause anxiety (“dissociation”). When an individual suffering from dissociation self-injures, the sensation of pain and sight of the blood may allow him or her to feel connected to the world once more. Another example of a reason someone may self-injure is as a method of dealing with intense emotional distress that he or she feels he or she is unable to express to his or her social group. The pain and injury can then be a physical manifestation of that psychological distress. When the wound subsequently heals, it can symbolize the mental anguish of the person who has self-injured fading away. A female who self-injures wrote the following to describe why she self-injures:

“‘This’ pain I can see it but I can’t feel it
It haunts me
When I cut myself I can see where the pain
is coming from and watch it heal
And I can easily care for it
‘This’ pain doesn’t have a specific place
It moves around and creeps into strange places.” (from A Bright Red Scream by Marilee Strong, page 5)

Who self-injures? Really anyone; however, people who self-injure are statistically most common to be female. Books on the subject of self-injury will frequently use female pronouns to describe people who self-injure even when males who self-injure are described in the same book. In Marilee Strong’s A Bright Red Scream, the author says she uses female pronouns specifically because “the vast majority of cutters are female, and because females are far more often victims of sexual abuse, a common contributing factor to self-mutilation”. There are males who self-injure, but their numbers are considerably fewer than those of females who self-injure. In addition to theories created to explain this discrepancy by speaking about innate gender differences, there is the suggestion that the trend of males who self-injure may be more widespread than is indicated by reported cases and that males may be reluctant to share because of cultural memes that discourage males from showing any signs of vulnerability. The association of self-injury with females lends strength to this theory because of the cultural misogyny linked with such memes.

Cultural awareness of self-injury is limited and often misunderstood. As a common form of self-injury is for the individual to make cuts on the wrist, self-injury may be mistaken for a suicide attempt. Self-injury, however, is a method for dealing with psychological distress as a means for the individual to better enjoy his or her life, and is entirely independent from suicidal desire for death. Self-injury has its place in popular culture. For example, the song Iris by the Goo Goo Dolls has a verse referencing self-injury as a result of dissociation “And you can’t fight the tears that ain’t coming / Or the moment of truth in your lies / When everything seems like the movies / Yeah, you bleed just to know you’re alive”.

Although often negatively associated with recent teenage subcultures such as Goth or the trendier Emo, the practice of self-injury is ancient and did occur in Biblical times. A Bible verse (Mark 5:5) describes a man who has been possessed by demons and cuts himself: “Night and day among the tombs and in the hills he would cry out and cut himself with stones.” Additionally, psychotherapist Steven Levenkron draws comparison to Christian flagellants flogging themselves. Psychiatrist Armando Favazza also sees a link between self-injury and mystical Islamic healers in Morocco who slice open their hands and have their patients consume small quantities of their blood as a means of passing along spiritual healing power, as well as various religious acts to gain favor from divinity that include the Catholic mortification of the flesh. Self-injury can be related to practices in several cultures and in different contexts. It is stigmatized in our present-day American culture because of societal attitudes about blood and self-injury’s erroneous association with suicide.

It is important to understand that self-injury is not performed as an attempt of suicide. The intent is not to die. Nor is the performance of self-injury a mental illness in and of itself, though it may be a sign of one. Self-injury is a coping technique for dealing with psychological distress and is performed repeatedly simply because it works, albeit temporarily. Self-injury is effective because when damage is made to an individual’s body, an endorphin release is triggered to act as a natural painkiller, making self-injury similar to the runner’s high with an endorphin rush to make the individual feel good. This endorphin rush becomes addictive, and people who self-injure find themselves caught in a cycle where they feel they need the self-injury in order to survive, but become acclimated to the endorphin release and need greater and greater injuries to feel the same level of relief. As self-injury is an effective coping technique, the people who want to help people who self-injure cannot simply address the issue of self-injuring, but rather the source of the psychological distress that leads them to seek out the self-injury at all.

In conclusion, it can be said that self-injury is a very prevalent activity that exists as a dangerous coping mechanism. The behavior does not appear to be limited by race, ethnicity, education, sexual orientation, socioeconomic status, or religion. The behavior is also often misunderstood and relegated into the taboo. I for one believe that self-injury should be discussed more within the subject of mental health in order to make it less of a shameful activity or an attempt to fit in with a trendy crowd in the eyes of the general public and allow these people who need help greater access to it.

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