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What Is Self-Harm or Self-Injury?

Self-injury, also sometimes called self-harm, is when people intentionally hurt themselves. It is usually considered a behavior, a sign of emotional distress, and a coping mechanism, not an addiction (though it can be a consequence of substance abuse behaviors such as binge drinking alcohol) or a mental health issue (extreme, cumulative grief) in itself. March 1 was International Self-Injury Awareness Day (SIAD), as it has been every year since 2002, but the topic is important enough to discuss all year long. Self-harm is usually regarded as different from a suicide attempt (although it could lead to accidental death). The goal is not to die but rather to cope with some internal tension or dissociation. Incredibly, it seems to help with this, though it is unhealthy. The Centers for Disease Control and Prevention doesn’t seem to see a distinction, lumping suicide and other types of self-injury together under the term self-directed violence. According to the Mayo Clinic, most self-injuries are performed in secret and target the torso, arms, or legs—areas that can be concealed. People practice various types of self-harm, including:
  • Using a sharp object (knife, razor blade, a piece of broken glass) to pierce the skin or make cuts or scars in the skin, sometimes in the form of words or symbols.
  • Banging the head against a wall, door, desk, or other hard objects.
  • Biting, scratching, or hitting themselves.
  • Causing burns with matches, cigarettes, curling irons, or other hot objects.
  • Embedding objects under the skin or into muscles.
That’s not to say that an individual can’t use more than one method, or that there aren’t other methods. The Mighty, a site that bills itself as a digital health community, asked its readers and contributors for other behaviors that sometimes could be self-harm. One example was numbing themselves with excessive use of drugs and alcohol. (They could have added tobacco products, which author Kurt Vonnegut referred to as “a fairly sure, fairly honorable form of suicide.”) Not that the purpose of alcohol or drug (or tobacco) is always self-injury, but it can be. So can these other behaviors:
  • Overspending.
  • Isolating themselves.
  • Having more casual sex than usual.
  • Putting everyone else’s needs before their own.
  • Eating too much or too little.
  • Allowing toxic people into their lives.
  • Putting themselves in risky situations.
  • Exposing themselves to sad or depressing media to feel worse.
  • Avoiding going to the doctor.
  • Sabotaging important relationships.
  • Exposing themselves to allergens.
  • Dressing inappropriately for the weather to punish themselves.
  • Exercising compulsively to cause pain or injury.
People who self-harm need help. They may have mental health issues, substance use disorders, be suicidal, or become suicidal. If you see signs of self-harm, encourage them or their loved ones to get them help. The not-for-profit organization Crisis Text Line has free, confidential crisis intervention counselors available 24 hours a day, seven days a week. You can contact the organization by texting HOME to 741741. Sources mentalhealth.gov – Self-Harm cdc.gov – Self-Directed Violence and Other Forms of Self-Injury mayoclinic.org – Self-injury/cutting reuters.com – “Embedding” a severe form of self-harm among teens: study themighty.com – 15 Behaviors We Don’t Always Recognize Are Self-Harm geist.com – The Honourable Suicide of Kurt Vonnegut crisistextline.org – Crisis Text Line

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