Samookaleczenie/cięcie się – Patofizjologia i mechanizm

Samookaleczenie/cięcie się
Patofizjologia i mechanizm

Samookaleczenie (NSSI) definiuje się jako celowe uszkadzanie tkanek ciała bez intencji samobójczych, najczęściej w formie cięcia (70-90% przypadków). Mechanizm ten służy regulacji afektu, przynosząc chwilową ulgę w postaci zmniejszenia negatywnych emocji i wzrostu spokoju, co jest potwierdzone badaniami wykazującymi zmiany w walencji i pobudzeniu afektywnym przed i po akcie samookaleczenia. Kluczową rolę odgrywa uwalnianie β-endorfin, które poprawiają samopoczucie na krótki czas, co może prowadzić do uzależnienia od tego zachowania. Dysregulacja układu nerwowego autonomicznego, zwłaszcza zwiększona reaktywność układu współczulnego, oraz zaburzenia osi HPA są istotnymi elementami neurobiologicznymi patogenezy NSSI. Samookaleczenie może również pełnić funkcję uziemiania, pomagając przerwać dysocjację i emocjonalne odłączenie, szczególnie u osób z historią traumy.

Samookaleczenie/cięcie się – patogeneza i mechanizm działania

Psychologiczne podłoże samookaleczania
Model regulacji afektu w samookaleczaniu

Neurobiologiczne podstawy samookaleczania

Rola beta-endorfin i układu opioidowego
Dysregulacja układu nerwowego autonomicznego
Samookaleczanie a dysocjacja

Samookaleczanie jako forma uzależnienia

Tolerancja i progresja samookaleczania

Relacja między samookaleczaniem a samobójstwem
Czynniki ryzyka i predyspozycje do samookaleczania

Współwystępujące zaburzenia psychiczne
Traumy i trudne doświadczenia życiowe
Czynniki osobowościowe i indywidualne

Wnioski

Kolejne rozdziały

Samookaleczenie/cięcie się – patogeneza i mechanizm działania

Samookaleczenie, znane również jako niesamobójcze samookaleczanie (NSSI – nonsuicidal self-injury), definiuje się jako celowe, samodzielne uszkadzanie tkanek ciała bez intencji samobójczych. Jest to szkodliwy sposób radzenia sobie z bólem emocjonalnym, smutkiem, złością i stresem. Najczęstszą formą samookaleczenia jest cięcie (około 70-90% przypadków), choć występują również inne formy, takie jak przypalanie, uderzanie, drapanie czy celowe zakłócanie procesu gojenia się ran.¹²³

Psychologiczne podłoże samookaleczania

Osoby, które się samookaleczają, często cierpią z powodu trudności w zarządzaniu lub wyrażaniu emocji. Złożona mieszanka uczuć, która wywołuje samookaleczenie, może obejmować poczucie bezwartościowości, samotności, paniki, złości, winy, odrzucenia i nienawiści do siebie. Badania pokazują, że przed aktem samookaleczenia osoby te często czują się przytłoczone, smutne i sfrustrowane, a po samookaleczeniu – uspokojone i odprężone.⁴⁵⁶

Samookaleczanie może być próbą:

Zarządzania lub zmniejszania silnego niepokoju i zapewnienia poczucia ulgi⁷
Odwrócenia uwagi od bolesnych emocji poprzez ból fizyczny⁸
Poczucia kontroli nad ciałem, uczuciami lub sytuacjami życiowymi⁹
Poczucia czegokolwiek, nawet jeśli jest to ból fizyczny, gdy emocjonalnie osoba czuje pustkę¹⁰
Wyrażania wewnętrznych uczuć w sposób zewnętrzny¹¹
Komunikowania uczuć stresu lub depresji światu zewnętrznemu¹²
Karania siebie¹³

Samookaleczanie rozwija się jako próba radzenia sobie z przytłaczającymi negatywnymi emocjami. Intensywne negatywne emocje poprzedzają akt samookaleczenia, a jego wykonanie skutkuje zmniejszeniem negatywnych emocji oraz uczuciem spokoju i ulgi. Samookaleczanie jest szczególnie powszechne u osób skłonnych do samokrytyki i negatywnych emocji skierowanych na siebie.¹⁴

Model regulacji afektu w samookaleczaniu

Najczęściej występującą funkcją samookaleczenia jest regulacja afektu – czasowe złagodzenie przytłaczających negatywnych emocji. Badania konsekwentnie wspierają model regulacji afektu w samookaleczeniu poprzez trzy rodzaje dowodów:

Większość uczestników, którzy się samookaleczają, zgłasza, że robią to, aby zmniejszyć negatywny afekt
Badania oparte na samoopisie oraz badania laboratoryjne sugerują, że negatywny afekt poprzedza samookaleczanie, a po nim afekt się poprawia
Odpowiedniki samookaleczania wykonywane w warunkach laboratoryjnych powodują zmniejszenie negatywnego afektu¹⁵

Badania wskazują na znaczące zmiany zarówno w walencji afektywnej, jak i pobudzeniu przed i po samookaleczeniu. Stany afektywne o wysokim pobudzeniu i negatywnej walencji zmniejszają się (np. uczucie przytłoczenia), podczas gdy stany afektywne o niskim pobudzeniu i pozytywnej walencji zwiększają się (np. spokój, odprężenie, ulga). Te zmiany afektywne działają jako wzmocnienie i zwiększają prawdopodobieństwo, że zachowanie będzie powtarzane.¹⁶

Neurobiologiczne podstawy samookaleczania

Rola beta-endorfin i układu opioidowego

Jednym z kluczowych mechanizmów biologicznych w samookaleczaniu jest uwalnianie beta-endorfin. Kiedy ciało napotyka coś, co może je uszkodzić, zakończenia nerwowe w dotkniętych obszarach wysyłają sygnały alarmowe do mózgu. W odpowiedzi na te sygnały, mózg uwalnia beta-endorfiny. Te substancje chemiczne wywołują efekt domina, który na krótki czas poprawia samopoczucie. Efekt ten nie trwa jednak długo, co może prowadzić do coraz częstszego samookaleczania, aby ponownie poczuć tę ulgę.¹⁷

Najnowsze badania potwierdzają tę teorię. W pierwszym badaniu oceniającym poziom śliny β-endorfiny w życiu codziennym w kontekście aktów samookaleczenia odkryto, że poziomy β-endorfiny bezpośrednio przed aktem samookaleczenia były znacznie niższe niż bezpośrednio po nim. Wyniki sugerują, że akty samookaleczenia mogą być związane z chwilowym wzrostem poziomu β-endorfiny, co może wzmacniać angażowanie się w samookaleczanie.¹⁸

Zaangażowanie endogennego układu opioidowego (EOS) było wielokrotnie omawiane w kontekście rozwoju i utrzymywania się samookaleczenia, głównie ze względu na jego rolę w percepcji i regulacji bólu społecznego, emocjonalnego i fizycznego. Model homeostazy zaproponowany przez Stanleya i współpracowników sugeruje, że akty samookaleczenia mogą być strategią inicjowania uwalniania β-endorfiny, co wzmacnia te zachowania poprzez mechanizm pozytywnego wzmocnienia.¹⁹

Dysregulacja układu nerwowego autonomicznego

Układ nerwowy autonomiczny składa się z dwóch komponentów: układ współczulny kontroluje pobudzenie i aktywację fizyczną (np. reakcja walki lub ucieczki), a układ przywspółczulny kontroluje procesy fizyczne, które są automatyczne (np. produkcja śliny). Układ współczulny unerwia wiele części ciała zaangażowanych w reakcje stresowe.

Badania nastolatków wykazały, że adolescenci, którzy się samookaleczają, mają większą reaktywność fizjologiczną (np. przewodnictwo skóry) na stres niż adolescenci, którzy się nie samookaleczają. To sugeruje, że osoby samookaleczające się mogą mieć problemy z regulacją odpowiedzi fizjologicznej na stres.²⁰

Związek między samookaleczaniem a układem nerwowym autonomicznym można również wyjaśnić poprzez model opioidowy homeostazy NSSI, dysregulację osi podwzgórze-przysadka-nadnercza (HPA) oraz aktywność układu nerwowego autonomicznego. Substancje opioidowe endogenne w organizmie człowieka, w tym β-endorfiny, enkefalina, dynorfina i endomorfina, mogą pomóc ludziom zmniejszyć negatywne emocje, zwiększyć pozytywne emocje i regulować odpowiedź organizmu na ból.²¹

Zachowania samookaleczające mogą regulować systemy neurobiologiczne (tj. endogenne układy leków opioidowych) i psychologiczne (tj. wzmocnione negatywne efekty), które są dotknięte przez traumę z dzieciństwa. Wyniki te mogą wyjaśniać, dlaczego pacjenci z NSSI angażują się w samookaleczenie, aby regulować emocje.²²

Samookaleczanie a dysocjacja

Samookaleczanie może być stosowane jako strategia uziemiania – sposób na przerwanie lub zatrzymanie procesu dysocjacji. Dla osób, które zmagają się z uporczywą dysocjacją i emocjonalnym odłączeniem, samookaleczanie i inne ryzykowne lub destrukcyjne zachowania mogą być jedynym sposobem, w jaki doświadczają siebie jako „żywych” lub „rzeczywistych”.²³

Niektórzy używają samookaleczania do radzenia sobie z natrętnych myśli, obrazów, doznań lub wspomnień związanych z traumą. Ponownie, uwalnianie endorfin przez organizm może zapewnić uspokajający efekt, antidotum na aktywację przez ciało układu współczulnego.²⁴

Niektórzy nastolatkowie doświadczyli traumy, która może powodować fale emocjonalnego odrętwienia zwane dysocjacją. Dla nich cięcie się i inne typy samookaleczenia mogą być sposobem na sprawdzenie, czy nadal mogą „czuć” ból. Inni opisują to jako sposób na „przebudzenie się” z tego emocjonalnego odrętwienia.²⁵

Samookaleczanie jako forma uzależnienia

Samookaleczanie może mieć cechy uzależniające. Akt samookaleczenia powoduje uwolnienie endorfin i innych neurochemikaliów w mózgu, co zasadniczo daje osobie rodzaj „haju”. Substancje chemiczne ostatecznie rozpraszają się, a następnie rozwija się głód, aby ponownie doświadczyć tego uczucia. To tworzy cykl uzależnienia, który sprawia, że jeszcze trudniej jest zatrzymać zachowanie.²⁶

Podobnie jak w przypadku innych zachowań kompulsywnych, mózg zaczyna łączyć uraz z chwilowym poczuciem ulgi od złych uczuć. Za każdym razem, gdy rośnie napięcie, mózg pragnie tej ulgi i skłania nastolatka do ponownego poszukiwania ulgi poprzez samookaleczanie. W ten sposób może stać się nawykiem, nad którym ktoś czuje się bezsilny. Pragnienie cięcia, aby uzyskać ulgę, może wydawać się zbyt trudne do odparcia, gdy napięcie emocjonalne jest wysokie.²⁷

Według niektórych ekspertów, osoby, które samookaleczają się, mają trudności z regulacją swoich emocji. Poprzez cięcie, przypalanie lub inne formy samookaleczenia, stymulują endogenny układ opioidowy w swoim mózgu, tworząc doznania podobne do reakcji na narkotyki czy alkohol. Ta ulga może powodować, że wielu nastolatków używa samookaleczenia jako dysfunkcyjnego mechanizmu radzenia sobie i uzależnia się od krzywdzenia samych siebie.²⁸

Jednym z powodów, dla których młodzi ludzie mogą uzależnić się od samookaleczania, jest niska kontrola emocjonalna. Mózg nie przestaje się rozwijać aż do około 25 roku życia, więc nastolatki i osoby we wczesnych latach 20. mogą mieć trudności z zarządzaniem swoimi emocjami. Jest to szczególnie prawdziwe w przypadku osób z traumą. Aby zrekompensować niską kontrolę emocjonalną, nastolatki i młodzi dorośli mogą uzależnić się od samookaleczania, ponieważ daje im to poczucie kontroli nad emocjami.²⁹

Tolerancja i progresja samookaleczania

Podobnie jak w przypadku innych zachowań uzależniających, nastolatki lub młodzi dorośli, którzy próbują przestać się samookaleczać, mogą cierpieć z powodu objawów odstawienia samookaleczania. Może to prowadzić do nawrotu. Osoby takie będą doświadczać przymusu samookaleczania, ponieważ jest to ich sposób radzenia sobie ze stresem. Jeśli nie mają innego mechanizmu radzenia sobie, a nawet gdy uczą się nowych mechanizmów radzenia sobie, ich mózgi będą automatycznie wracać do „potrzebuję się samookaleczać. Potrzebuję tej ulgi. Potrzebuję poczuć się lepiej”.³⁰

Doznania fizjologiczne, których doświadczają, gdy przestają się samookaleczać, takie jak zwiększona drażliwość, płacz, uczucie mrowienia w preferowanym obszarze samookaleczenia i napięcie mięśniowe, sprawiają, że niezwykle trudno jest powstrzymać się od tego zachowania.³¹

Z czasem osoby, które się samookaleczają, stają się bardziej przyzwyczajone do bólu, który sobie zadają, i dlatego ranią się bardziej dotkliwie, aby uzyskać ten sam poziom ulgi. Ta spirala może prowadzić do trwałych urazów i poważnych infekcji.³²

Relacja między samookaleczaniem a samobójstwem

Chociaż samookaleczanie zasadniczo różni się od zachowań samobójczych, nadal istnieje związek między tymi zjawiskami. Samookaleczenie nie jest zwykle próbą samobójczą, ale może zwiększyć ryzyko samobójstwa ze względu na problemy emocjonalne, które wywołują samookaleczenie. Wzorzec uszkadzania ciała w chwilach rozpaczy może zwiększyć prawdopodobieństwo samobójstwa.³³³⁴

Ludzie, którzy się samookaleczają, są bardziej narażeni na śmierć samobójczą, a samookaleczenie występuje w 40-60% samobójstw. Niemniej jednak tylko mniejszość osób, które się samookaleczają, ma myśli samobójcze.³⁵

Intencją samookaleczenia jest prawie zawsze poczucie się lepiej, podczas gdy w przypadku samobójstwa jest to zakończenie odczuwania (a zatem życia) w ogóle. Samookaleczenie jest często wykonywane przy użyciu metod zaprojektowanych do uszkodzenia ciała, ale nie na tyle poważnie, aby wymagało leczenia lub zakończyło życie. Próby samobójcze są zazwyczaj bardziej śmiertelne niż standardowe metody NSSI.³⁶

Poziom cierpienia psychicznego doświadczanego podczas samookaleczenia jest często znacznie niższy niż ten, który prowadzi do myśli i zachowań samobójczych. Jednakże, choć samookaleczenie nie powoduje samobójstwa, sam akt angażowania się w samookaleczenie zmniejsza zahamowania wobec zachowań samobójczych, jeśli ktoś staje się samobójczy. Innymi słowy, wielokrotne „ćwiczenie” ranienia ciała sprawia, że łatwiejsze staje się rzeczywiste zranienie ciała z zamiarem samobójczym.³⁷

Związek między samookaleczeniem a samobójstwem jest skomplikowany. Chociaż osoby z niesamobójczym samookaleczeniem nie zamierzają popełnić samobójstwa, mogą spowodować większe szkody niż zamierzali, co może skutkować powikłaniami medycznymi lub śmiercią. W ciężkich lub długotrwałych przypadkach samookaleczenia, osoba może stać się zdesperowana z powodu braku kontroli nad zachowaniem i jego uzależniającego charakteru, co może doprowadzić do celowej próby samobójczej.³⁸

Czynniki ryzyka i predyspozycje do samookaleczania

Nie ma jednej konkretnej przyczyny samookaleczania, jest to zjawisko wieloczynnikowe. Jednak pewne warunki i czynniki ryzyka są powiązane z większym prawdopodobieństwem wystąpienia zachowań samookaleczających:

Współwystępujące zaburzenia psychiczne

Samookaleczanie często współwystępuje z różnymi zaburzeniami psychicznymi, takimi jak:

Zaburzenia lękowe
Autyzm
Zaburzenie dwubiegunowe
Zaburzenie osobowości z pogranicza (borderline)
Depresja
Zaburzenia disocjacyjne
Zaburzenia odżywiania, szczególnie anoreksja
Zaburzenie obsesyjno-kompulsyjne
Zespół stresu pourazowego (PTSD)
Zaburzenia snu
Zaburzenia związane z używaniem substancji³⁹

Osoby cierpiące na aleksytymię (trudność w identyfikowaniu i opisywaniu własnych emocji) mogą być bardziej narażone na samookaleczanie. Badania wykazały, że aleksytymia była znaczącym predyktorem samookaleczania, przy czym obecni samookaleczający się wykazywali najwyższy poziom aleksytymii, następnie byli samookaleczający się, a na końcu osoby, które nigdy się nie samookaleczały.⁴⁰

Traumy i trudne doświadczenia życiowe

Stresory, które mogą zwiększyć ryzyko samookaleczania, obejmują:

Rozpad rodziny lub konflikt
Trudności w relacjach
Znajomość innych osób, które się samookaleczają
Występowanie samookaleczania w rodzinie
Bycie ofiarą bullingu
Problemy w szkole lub pracy
Nadużywanie alkoholu i narkotyków
Przeszła trauma, zaniedbanie lub nadużycie⁴¹

Patogeneza NSSI była wielokrotnie wiązana z długotrwałymi doświadczeniami stresu psychospołecznego, obiektyfikacją ciała lub odrzuceniem czy wiktymizacją przez rówieśników, potencjalnie moderowanymi przez predyspozycje genetyczne.⁴²

Badania pokazują, że samookaleczanie często zaczyna się w okresie dojrzewania i jest szczególnie rozpowszechnione w domach, w których panuje represyjne środowisko, gdzie negatywne emocje są zamiatane pod dywan lub gdzie nie omawia się uczuć.⁴³

Czynniki osobowościowe i indywidualne

Czynniki osobiste, które mogą zwiększyć ryzyko samookaleczania, obejmują:

Wcześniejsza historia samookaleczania
Doświadczanie agresji lub przemocy
Zaburzenia psychiczne
Niska samoocena
Zły obraz ciała i nienawiść do siebie
Choroba fizyczna lub niepełnosprawność
Impulsywność – działanie bez myślenia
Słabe umiejętności radzenia sobie
Trudności z rozwiązywaniem problemów⁴⁴

Samookaleczanie jest powszechne wśród osób, które zmagają się z dysregulacją emocjonalną, lękiem, depresją, negatywną emocjonalnością i samokrytyką.⁴⁵

Różnice sensoryczne u osób z autyzmem są związane z rytualistycznymi i powtarzającymi się zachowaniami, w tym z samookaleczaniem, i są nawet najsilniejszymi predyktorami samookaleczania.⁴⁶

Wnioski

Samookaleczenie/cięcie się to złożone zjawisko o wieloaspektowej patogenezie. Mechanizm samookaleczania opiera się na interakcji czynników psychologicznych (regulacja afektu, radzenie sobie z dysocjacją, potrzeba kontroli), neurobiologicznych (uwalnianie beta-endorfin, dysregulacja autonomicznego układu nerwowego) oraz społecznych (trauma, trudne doświadczenia życiowe).

Samookaleczanie najczęściej służy jako mechanizm radzenia sobie z przytłaczającymi negatywnymi emocjami, dając chwilową ulgę i poczucie kontroli. Jednakże, ze względu na swoją uzależniającą naturę i potencjał do eskalacji, może prowadzić do poważnych konsekwencji zdrowotnych i zwiększonego ryzyka zachowań samobójczych, mimo braku pierwotnej intencji odebrania sobie życia.

Zrozumienie patogenezy i mechanizmu samookaleczania jest kluczowe dla opracowania skutecznych strategii terapeutycznych, które będą adresować zarówno behawioralne aspekty samookaleczania, jak i leżące u ich podstaw problemy psychologiczne i neurobiologiczne.

Kolejne rozdziały

Zapraszamy do dalszego czytania naszego leksykonu.

Wybierz kolejny rozdział z menu poniżej, aby otworzyć nową podstronę kompedium wiedzy i uzyskać szczegółowe informację o leku, substancji lub chorobie.

Materiały źródłowe

#1 Self-injury/cutting – Symptoms and causes – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/self-injury/symptoms-causes/syc-20350950
Nonsuicidal self-injury, often simply called self-injury, is the act of harming your own body on purpose, such as by cutting or burning yourself. It’s usually not meant as a suicide attempt. This type of self-injury is a harmful way to cope with emotional pain, sadness, anger and stress. […] Self-injury may result from: Poor coping skills. Nonsuicidal self-injury is usually the result of an inability to cope in healthy ways with stress and emotional pain. […] Difficulty managing emotions. Having a hard time controlling, expressing or understanding emotions may lead to self-injury. The mix of emotions that triggers self-injury is complex. For example, there may be feelings of worthlessness, loneliness, panic, anger, guilt, rejection and self-hatred. […] Self-injury may be an attempt to: Manage or reduce severe distress or anxiety and provide a sense of relief.
#2 Self-Harm: What It Is, Causes, Types & Treatment
https://my.clevelandclinic.org/health/diseases/12201-self-harm
Self-harm is when you injure yourself on purpose. Also known as nonsuicidal self-injury disorder, people who self-harm do things to hurt themselves but don’t want to cause death. […] Self-harm can take many forms. Some are more common than others, but all come with risks. Some of the most common self-harm behaviors include: Cutting with sharp objects to break through or injure skin. […] It’s hard to say exactly what causes a person to self-harm. But certain mental health conditions are linked to self-injury, including: Anxiety, Autism, Bipolar disorder, Borderline personality disorder, Depression, Disruptive, impulse-control and conduct disorders, like conduct disorder and intermittent explosive disorder, Dissociative disorders, especially dissociative identity disorder and dissociative amnesia, Eating disorders, especially anorexia nervosa, Obsessive-compulsive disorder, Post-traumatic stress disorder (PTSD), Sleep disorders, Substance use conditions and disorders, including alcohol intoxication, alcohol use disorder and cannabis use disorder.
#3 What Is Cutting and What Are the Warning Signs? | Self-Harm
https://www.hhills.com/rehab-blog/what-is-cutting-and-what-are-the-warning-signs/
Non-suicidal self-injuryâoften referred to as self-harmâinvolves any act of intentionally injuring or causing harm to oneself. While self-harm can take on various forms, Mental Health America reports that 70â90% of people who self-harm choose cutting as their preferred method. Self-harm is not a mental health disorder but rather a symptom of an underlying issue(s). […] The leading causes of cutting and self-injury are poor coping skills and an inability to manage emotions in healthy ways. Reasons individuals self-harm can include: unresolved or ongoing trauma, untreated mental health conditions, to cope with overwhelming feelings of anger, sadness, or guilt, self-punishment for perceived faults, to express emotions that are too hard to verbalize, to feel a sense of control over oneâs life or circumstances, to reduce emotional numbness, releasing emotional pain through physical pain. […] Understanding the causes of cutting and self-injury can help make it less scary, reduce angry feelings, foster compassion, and encourage the need to seek treatment.
#4 Self-injury/cutting – Symptoms and causes – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/self-injury/symptoms-causes/syc-20350950
Nonsuicidal self-injury, often simply called self-injury, is the act of harming your own body on purpose, such as by cutting or burning yourself. It’s usually not meant as a suicide attempt. This type of self-injury is a harmful way to cope with emotional pain, sadness, anger and stress. […] Self-injury may result from: Poor coping skills. Nonsuicidal self-injury is usually the result of an inability to cope in healthy ways with stress and emotional pain. […] Difficulty managing emotions. Having a hard time controlling, expressing or understanding emotions may lead to self-injury. The mix of emotions that triggers self-injury is complex. For example, there may be feelings of worthlessness, loneliness, panic, anger, guilt, rejection and self-hatred. […] Self-injury may be an attempt to: Manage or reduce severe distress or anxiety and provide a sense of relief.
#5 Self-injury/cutting – Symptoms and causes – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/self-injury/symptoms-causes/syc-20350950
Provide a distraction from painful emotions through physical pain. […] Feel a sense of control over the body, feelings or life situations. […] Feel something anything even if it’s physical pain, when feeling emotionally empty. […] Express internal feelings in an external way. […] Communicate feelings of stress or depression to the outside world. […] Punish oneself. […] Self-injury is not usually a suicide attempt, but it can increase the risk of suicide because of the emotional problems that trigger self-injury. And the pattern of damaging the body in times of distress can make suicide more likely.
#6 The functions of self-injury in young adults who cut themselves: clarifying the evidence for affect regulation
https://pmc.ncbi.nlm.nih.gov/articles/PMC2723954/
The functions of non-suicidal self-injury were examined in 39 young adults with a history of skin-cutting and other self-injurious behaviors including banging, burning, and severe scratching. […] Results indicate that self-injury is associated with improvements in affective valence and decreases in affective arousal. […] Specifically, participants tended to feel overwhelmed, sad, and frustrated before self-injury, and relieved and calm after self-injury. […] Further, these affective changes predict lifetime frequency of self-injury, suggesting that they reinforce the behavior. […] Finally, although reasons for self-injury related to both affect-regulation (e.g., to release emotional pressure that builds up inside of me) and self-punishment (e.g., to express anger at myself) were endorsed by a majority of participants, affect-regulation reasons were overwhelmingly rated as primary and self-punishment reasons as secondary.
#7 Self-injury/cutting – Symptoms and causes – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/self-injury/symptoms-causes/syc-20350950
Nonsuicidal self-injury, often simply called self-injury, is the act of harming your own body on purpose, such as by cutting or burning yourself. It’s usually not meant as a suicide attempt. This type of self-injury is a harmful way to cope with emotional pain, sadness, anger and stress. […] Self-injury may result from: Poor coping skills. Nonsuicidal self-injury is usually the result of an inability to cope in healthy ways with stress and emotional pain. […] Difficulty managing emotions. Having a hard time controlling, expressing or understanding emotions may lead to self-injury. The mix of emotions that triggers self-injury is complex. For example, there may be feelings of worthlessness, loneliness, panic, anger, guilt, rejection and self-hatred. […] Self-injury may be an attempt to: Manage or reduce severe distress or anxiety and provide a sense of relief.
#8 Self-injury/cutting – Symptoms and causes – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/self-injury/symptoms-causes/syc-20350950
Provide a distraction from painful emotions through physical pain. […] Feel a sense of control over the body, feelings or life situations. […] Feel something anything even if it’s physical pain, when feeling emotionally empty. […] Express internal feelings in an external way. […] Communicate feelings of stress or depression to the outside world. […] Punish oneself. […] Self-injury is not usually a suicide attempt, but it can increase the risk of suicide because of the emotional problems that trigger self-injury. And the pattern of damaging the body in times of distress can make suicide more likely.
#9 Self-injury/cutting – Symptoms and causes – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/self-injury/symptoms-causes/syc-20350950
Provide a distraction from painful emotions through physical pain. […] Feel a sense of control over the body, feelings or life situations. […] Feel something anything even if it’s physical pain, when feeling emotionally empty. […] Express internal feelings in an external way. […] Communicate feelings of stress or depression to the outside world. […] Punish oneself. […] Self-injury is not usually a suicide attempt, but it can increase the risk of suicide because of the emotional problems that trigger self-injury. And the pattern of damaging the body in times of distress can make suicide more likely.
#10 Self-injury/cutting – Symptoms and causes – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/self-injury/symptoms-causes/syc-20350950
Provide a distraction from painful emotions through physical pain. […] Feel a sense of control over the body, feelings or life situations. […] Feel something anything even if it’s physical pain, when feeling emotionally empty. […] Express internal feelings in an external way. […] Communicate feelings of stress or depression to the outside world. […] Punish oneself. […] Self-injury is not usually a suicide attempt, but it can increase the risk of suicide because of the emotional problems that trigger self-injury. And the pattern of damaging the body in times of distress can make suicide more likely.
#11 Self-injury/cutting – Symptoms and causes – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/self-injury/symptoms-causes/syc-20350950
Provide a distraction from painful emotions through physical pain. […] Feel a sense of control over the body, feelings or life situations. […] Feel something anything even if it’s physical pain, when feeling emotionally empty. […] Express internal feelings in an external way. […] Communicate feelings of stress or depression to the outside world. […] Punish oneself. […] Self-injury is not usually a suicide attempt, but it can increase the risk of suicide because of the emotional problems that trigger self-injury. And the pattern of damaging the body in times of distress can make suicide more likely.
#12 Self-injury/cutting – Symptoms and causes – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/self-injury/symptoms-causes/syc-20350950
Provide a distraction from painful emotions through physical pain. […] Feel a sense of control over the body, feelings or life situations. […] Feel something anything even if it’s physical pain, when feeling emotionally empty. […] Express internal feelings in an external way. […] Communicate feelings of stress or depression to the outside world. […] Punish oneself. […] Self-injury is not usually a suicide attempt, but it can increase the risk of suicide because of the emotional problems that trigger self-injury. And the pattern of damaging the body in times of distress can make suicide more likely.
#13 Self-injury/cutting – Symptoms and causes – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/self-injury/symptoms-causes/syc-20350950
Provide a distraction from painful emotions through physical pain. […] Feel a sense of control over the body, feelings or life situations. […] Feel something anything even if it’s physical pain, when feeling emotionally empty. […] Express internal feelings in an external way. […] Communicate feelings of stress or depression to the outside world. […] Punish oneself. […] Self-injury is not usually a suicide attempt, but it can increase the risk of suicide because of the emotional problems that trigger self-injury. And the pattern of damaging the body in times of distress can make suicide more likely.
#14 Nonsuicidal Self-Injury: What We Know, and What We Need to Know
https://pmc.ncbi.nlm.nih.gov/articles/PMC4244874/
For decades, knowledge about nonsuicidal self-injury (NSSI) was limited to only a small handful of empirical studies. […] It is crucial to establish accurate conceptual and clinical models of this behaviour. […] NSSI most commonly functions to (temporarily) alleviate overwhelming negative emotion. […] Intense negative emotions precede NSSI, and the performance of NSSI results in reduced negative emotions as well as feelings of calm and relief. […] NSSI is especially common in people prone to self-directed negative emotions and self-criticism. […] NSSI and suicidal behaviours differ in several important ways. […] More importantly, people who engage in NSSI do not intend to end their own life. […] NSSI may represent a unique risk factor for suicide as it is strongly associated with emotional and interpersonal distress, which increases risk for suicidal ideation and (or) desire, and desensitizes people to the pain associated with SIBs, which increases capability to act on suicidal desire.
#15 The functions of self-injury in young adults who cut themselves: clarifying the evidence for affect regulation
https://pmc.ncbi.nlm.nih.gov/articles/PMC2723954/
A recent review of this literature suggests that evidence most consistently supports an affect-regulation model of self-injury. […] Specifically, three types of evidence support an affect-regulation function: (a) most participants who self-injure report that they do so to reduce negative affect (b) self-report and laboratory studies suggest that negative affect precedes DSH and that affect improves following DSH and (c) proxies for DSH performed in laboratory settings cause reductions in negative affect. […] The present study found substantial changes in both affective valence and arousal from before to after self-injury. […] High-arousal negative affect states decreased (e.g., overwhelmed), and low-arousal positive affect-states increased (e.g., calm, relaxed, relieved). […] These data indicate that the affective changes associated with self-injury may provide reinforcement and increase the chances that the behavior will be repeated. […] For most self-injurers, it appears that self-injury is performed to cope with acute negative affect and arousal. […] For these patients treatment should seek to reduce negative affect and foster the development of alternative strategies for affect regulation.
#16 The functions of self-injury in young adults who cut themselves: clarifying the evidence for affect regulation
https://pmc.ncbi.nlm.nih.gov/articles/PMC2723954/
A recent review of this literature suggests that evidence most consistently supports an affect-regulation model of self-injury. […] Specifically, three types of evidence support an affect-regulation function: (a) most participants who self-injure report that they do so to reduce negative affect (b) self-report and laboratory studies suggest that negative affect precedes DSH and that affect improves following DSH and (c) proxies for DSH performed in laboratory settings cause reductions in negative affect. […] The present study found substantial changes in both affective valence and arousal from before to after self-injury. […] High-arousal negative affect states decreased (e.g., overwhelmed), and low-arousal positive affect-states increased (e.g., calm, relaxed, relieved). […] These data indicate that the affective changes associated with self-injury may provide reinforcement and increase the chances that the behavior will be repeated. […] For most self-injurers, it appears that self-injury is performed to cope with acute negative affect and arousal. […] For these patients treatment should seek to reduce negative affect and foster the development of alternative strategies for affect regulation.
#17 Self-Harm: What It Is, Causes, Types & Treatment
https://my.clevelandclinic.org/health/diseases/12201-self-harm
Self-harm behaviors can lead to infections, nerve damage and permanent and/or severe scarring. Sometimes, it can lead to severe injuries or death. […] When your body encounters something that can damage it, nerve endings in the affected areas send emergency signals to your brain. One of the things your brain does in response to those signals is to release beta-endorphins. These chemicals trigger a domino effect that makes you feel better for a short time. But the effect doesn’t last very long. So, people who self-harm may use it more often to try to feel better. […] Self-harm still has risks. Because it isn’t a sustainable way to feel better, it also negatively affects your physical and mental health and well-being.
#18 Salivary beta-endorphin in nonsuicidal self-injury: an ambulatory assessment study | Neuropsychopharmacology
https://www.nature.com/articles/s41386-020-00914-2
Nonsuicidal self-injury (NSSI) is a prevalent and impairing behavior, affecting individuals with and without additional psychopathology. […] This is the first study assessing salivary -endorphin in daily life in the context of NSSI acts. […] We found that -endorphin levels immediately before an NSSI act were significantly lower than directly after NSSI. […] The results of the present study indicate that it is possible to assess salivary -endorphin in daily life in the context of NSSI. […] Furthermore, our results provide a first indication that NSSI acts could be associated with a momentary increase of -endorphin, and this might reinforce NSSI engagement. […] The pathogenesis of NSSI was repeatedly linked to prolonged experiences of psychosocial stress, body objectification, or rejection or victimization by peers, potentially moderated by genetic predispositions.
#19 Salivary beta-endorphin in nonsuicidal self-injury: an ambulatory assessment study | Neuropsychopharmacology
https://www.nature.com/articles/s41386-020-00914-2
The involvement of the endogenous opioid system (EOS) has repeatedly been discussed with regard to the development and maintenance of NSSI, mainly due to its role in the perception and regulation of social, emotional, and physical pain. […] Taken together, it seems that peripheral as well as central systems are involved in the perception and regulation of pain. […] Taken together, -endorphin appears to be involved in the regulation of different forms of pain, and reduced -endorphin levels were found in individuals with NSSI. […] Therefore, homeostasis model proposed by Stanley et al. proposes that NSSI acts may be a strategy to initiate the release of -endorphin. […] We found a positive association between severity of the self-inflicted injury and -endorphin levels, but no significant association between -endorphin levels and subjectively experienced pain. […] More research is needed to replicate and extend our findings on peripheral -endorphin in daily life.
#20 Self-harm – Wikipedia
https://en.wikipedia.org/wiki/Self-harm
Those who engage in self-harm face the contradictory reality of harming themselves while at the same time obtaining relief from this act. It may even be hard for some to actually initiate cutting, but they often do because they know the relief that will follow. For some self-harmers this relief is primarily psychological while for others this feeling of relief comes from the beta endorphins released in the brain. […] The autonomic nervous system is composed of two components: the sympathetic nervous system controls arousal and physical activation (e.g., the fight-or-flight response) and the parasympathetic nervous system controls physical processes that are automatic (e.g., saliva production). The sympathetic nervous system innervates (e.g., is physically connected to and regulates) many parts of the body involved in stress responses. Studies of adolescents have shown that adolescents who self-injure have greater physiological reactivity (e.g., skin conductance) to stress than adolescents who do not self-injure.
#21
https://journals.lww.com/inr/fulltext/2023/11000/mechanisms_and_intervention_strategies_of.8.aspx
The association of ED with NSSI has also been confirmed through a series of imaging research results. […] The neurobiological mechanism underlying ED in NSSI can be explained by the NSSI Opioid Homeostasis Model, hypothalamic-pituitary-adrenal (HPA) axis dysregulation, and autonomic nervous system activity. […] The endogenous opioid substances in the human body include -endorphins, enkephalin, dynorphin, and endomorphin, which can help people reduce negative emotions, increase positive emotions, and regulate the human body’s response to pain. […] NSSI behaviors can regulate the neurobiological (ie, endogenous opioid drug systems) and psychological (ie, enhanced negative effects) systems, which are affected by childhood trauma. […] The results might be able to explain why NSSI patients engaged in self-harm to regulate emotions.
#22
https://journals.lww.com/inr/fulltext/2023/11000/mechanisms_and_intervention_strategies_of.8.aspx
The association of ED with NSSI has also been confirmed through a series of imaging research results. […] The neurobiological mechanism underlying ED in NSSI can be explained by the NSSI Opioid Homeostasis Model, hypothalamic-pituitary-adrenal (HPA) axis dysregulation, and autonomic nervous system activity. […] The endogenous opioid substances in the human body include -endorphins, enkephalin, dynorphin, and endomorphin, which can help people reduce negative emotions, increase positive emotions, and regulate the human body’s response to pain. […] NSSI behaviors can regulate the neurobiological (ie, endogenous opioid drug systems) and psychological (ie, enhanced negative effects) systems, which are affected by childhood trauma. […] The results might be able to explain why NSSI patients engaged in self-harm to regulate emotions.
#23 Understanding Self-Injury | Mental Health Treatment | Lifeskills
https://lifeskillssouthflorida.com/mental-health-blog/understanding-self-injury-in-the-context-of-trauma-and-dissociation/
With regard to dissociation, self-injury can be used as a grounding strategy- a way to interrupt or stop the dissociative process. For those that struggle with pervasive dissociation and emotional disconnection, self-harm and other risky or destructive behaviors may be the only way that person experiences themselves as âaliveâ or âreal.â […] Some use self-harm to cope with or stop intrusive thoughts, images, sensations or memories related to the trauma. Again, the bodyâs endorphin release can provide the calming effect, the antidote to the bodyâs activation of the sympathetic nervous system. […] It is hypothesized that trauma memories are actually stored in the limbic system, the part of the brain that controls emotions and drives. Importantly, this part of the brain does not involve speech or language, leaving a person with implicit memories of terror, anger, sadness resulting from the trauma with little or no explicit memories to describe or put words to their experiences. […] Overall, it is important to remember that self-harm has a function and it is imperative to identify the function to help the individual identify a safe, alternative behavior.
#24 Understanding Self-Injury | Mental Health Treatment | Lifeskills
https://lifeskillssouthflorida.com/mental-health-blog/understanding-self-injury-in-the-context-of-trauma-and-dissociation/
With regard to dissociation, self-injury can be used as a grounding strategy- a way to interrupt or stop the dissociative process. For those that struggle with pervasive dissociation and emotional disconnection, self-harm and other risky or destructive behaviors may be the only way that person experiences themselves as âaliveâ or âreal.â […] Some use self-harm to cope with or stop intrusive thoughts, images, sensations or memories related to the trauma. Again, the bodyâs endorphin release can provide the calming effect, the antidote to the bodyâs activation of the sympathetic nervous system. […] It is hypothesized that trauma memories are actually stored in the limbic system, the part of the brain that controls emotions and drives. Importantly, this part of the brain does not involve speech or language, leaving a person with implicit memories of terror, anger, sadness resulting from the trauma with little or no explicit memories to describe or put words to their experiences. […] Overall, it is important to remember that self-harm has a function and it is imperative to identify the function to help the individual identify a safe, alternative behavior.
#25 Cutting and Self-Harm (for Parents) | Nemours KidsHealth
https://kidshealth.org/en/parents/cutting.html
Most of the time, self-harm is not a suicide attempt. But it can be easy to underestimate the potential to get seriously sick or hurt through bleeding, infections, or other problems. […] Cutting often begins as an impulse. But many teens discover that once they start, they do it more and more, and can have trouble stopping. Many teens who self-injure report that it provides a sense of relief from deep painful emotions. Because of this, it’s a behavior that tends to reinforce itself. […] Cutting, especially, can be habit forming. Though it only provides temporary relief from emotional distress, the more a person cuts, the more they feel the need to do it. As with other compulsive behaviors, the brain starts to connect the injury to the momentary sense of relief from bad feelings. […] Whenever the tension builds, the brain craves that relief and drives the teen to seek relief again by self-injuring. So it can become a habit someone feels powerless to stop. The urge to cut to get relief can seem too hard to resist when emotional pressure is high. […] Some teens have experienced trauma, which can cause waves of emotional numbness called dissociation. For them, cutting and other types of self-harm can be a way to test whether they can still „feel” pain. Others describe it as a way of „waking up” from that emotional numbness.
#26 Self-injury: An overview for counselors – Counseling Today Archive
https://ctarchive.counseling.org/2020/09/self-injury-an-overview-for-counselors/
Many experts in this area indicate that self-injury has the qualities of an addiction. The act of self-injury causes endorphins and other neurochemicals to be released in the brain, which essentially gives the person a type of high. The chemicals eventually dissipate, and then a craving develops to experience that feeling again. This creates a cycle of addiction that makes it even harder to stop the behavior. […] Although I have students who experiment with cutting and do it out of curiosity, there is a subgroup of students who chronically self-injure. They can’t seem to kick the habit, no matter how hard they try. Typically, this means that their underlying issues have yet to be resolved and that an adequate replacement coping mechanism needs to be put in place.
#27 Cutting and Self-Harm (for Parents) | Nemours KidsHealth
https://kidshealth.org/en/parents/cutting.html
Most of the time, self-harm is not a suicide attempt. But it can be easy to underestimate the potential to get seriously sick or hurt through bleeding, infections, or other problems. […] Cutting often begins as an impulse. But many teens discover that once they start, they do it more and more, and can have trouble stopping. Many teens who self-injure report that it provides a sense of relief from deep painful emotions. Because of this, it’s a behavior that tends to reinforce itself. […] Cutting, especially, can be habit forming. Though it only provides temporary relief from emotional distress, the more a person cuts, the more they feel the need to do it. As with other compulsive behaviors, the brain starts to connect the injury to the momentary sense of relief from bad feelings. […] Whenever the tension builds, the brain craves that relief and drives the teen to seek relief again by self-injuring. So it can become a habit someone feels powerless to stop. The urge to cut to get relief can seem too hard to resist when emotional pressure is high. […] Some teens have experienced trauma, which can cause waves of emotional numbness called dissociation. For them, cutting and other types of self-harm can be a way to test whether they can still „feel” pain. Others describe it as a way of „waking up” from that emotional numbness.
#28 Ask a Therapist: Is Self-Harm an Addiction?
https://www.embarkbh.com/blog/self-harm/self-harm-addiction/
When it comes to the question Is self-harm an addiction?, the answer is it can be for some. As Spindel explained, those who self-injure have a difficult time regulating their emotions. By cutting, burning, or otherwise self-harming, they stimulate the endogenous opioid system in their brains, creating sensations like drug or alcohol reactions. […] When the endogenous opioid system is activated, the body produces naturally occurring chemicals that can make people feel better and relieve stress and pain, Spindel said. This relief can cause many teenagers to use self-harm as a dysfunctional coping mechanism and become addicted to hurting themselves. […] According to Spindel, one reason why young people can become addicted to self-harm is low emotional control. The brain does not stop developing until around age 25, so teens and those in their early 20s can have a hard time managing their emotions. Spindel said this is especially true for those with trauma. To compensate for their low emotional control, teenagers and young adults can become addicted to self-harm because it makes them feel theyre in control of their emotions.
#29 Ask a Therapist: Is Self-Harm an Addiction?
https://www.embarkbh.com/blog/self-harm/self-harm-addiction/
When it comes to the question Is self-harm an addiction?, the answer is it can be for some. As Spindel explained, those who self-injure have a difficult time regulating their emotions. By cutting, burning, or otherwise self-harming, they stimulate the endogenous opioid system in their brains, creating sensations like drug or alcohol reactions. […] When the endogenous opioid system is activated, the body produces naturally occurring chemicals that can make people feel better and relieve stress and pain, Spindel said. This relief can cause many teenagers to use self-harm as a dysfunctional coping mechanism and become addicted to hurting themselves. […] According to Spindel, one reason why young people can become addicted to self-harm is low emotional control. The brain does not stop developing until around age 25, so teens and those in their early 20s can have a hard time managing their emotions. Spindel said this is especially true for those with trauma. To compensate for their low emotional control, teenagers and young adults can become addicted to self-harm because it makes them feel theyre in control of their emotions.
#30 Ask a Therapist: Is Self-Harm an Addiction?
https://www.embarkbh.com/blog/self-harm/self-harm-addiction/
Spindel, whos worked with many teens addicted to cutting, said young people who lack the ability to self-regulate their emotions can turn to this type of self-harm because of the sensations it produces. She noted its believed to stimulate dopamine production in the brain, and the feelings of relief this hormone helps produce can lead young people to become addicted to cutting. […] As with any addictive behavior, teenagers or young adults who attempt to stop self-injuring can suffer from self-harm addiction withdrawal. This can cause them to relapse. […] Teens are going to get these urges to self-harm because thats their way of coping with stress, Spindel said. And if they dont have another coping mechanism to use, and even when theyre learning new coping mechanisms, their brains are going to go straight back to I need to self-harm. I need to have this relief. I need to feel better. The physiological sensations they get when they stop self-harming, such as increased irritability, crying, tingling sensations in the preferred self-harm area, and muscle tension, just make it extremely difficult to abstain from the behavior.
#31 Ask a Therapist: Is Self-Harm an Addiction?
https://www.embarkbh.com/blog/self-harm/self-harm-addiction/
Spindel, whos worked with many teens addicted to cutting, said young people who lack the ability to self-regulate their emotions can turn to this type of self-harm because of the sensations it produces. She noted its believed to stimulate dopamine production in the brain, and the feelings of relief this hormone helps produce can lead young people to become addicted to cutting. […] As with any addictive behavior, teenagers or young adults who attempt to stop self-injuring can suffer from self-harm addiction withdrawal. This can cause them to relapse. […] Teens are going to get these urges to self-harm because thats their way of coping with stress, Spindel said. And if they dont have another coping mechanism to use, and even when theyre learning new coping mechanisms, their brains are going to go straight back to I need to self-harm. I need to have this relief. I need to feel better. The physiological sensations they get when they stop self-harming, such as increased irritability, crying, tingling sensations in the preferred self-harm area, and muscle tension, just make it extremely difficult to abstain from the behavior.
#32 What Is Self-Injury, Self-Harm, Self-Mutilation? | HealthyPlace
https://www.healthyplace.com/abuse/self-injury/what-is-self-injury-self-harm-self-mutilation
Self-injury, also known as self-harm or self-mutilation, is defined as an act wherein someone deliberately hurts or injures themselves. Self-injury is most often used as a coping mechanism and is not an attempt at suicide. […] The severity of self-harm doesn’t necessarily relate to the severity of a person’s underlying problems. Usually, as time passes, one of the effects of self-harm is that the person who is self-injuring becomes more accustomed to the pain they inflict on themselves and so they harm themselves more severely to get the same level of relief. […] This spiral can lead to permanent injury and serious infections. […] It’s important to make a distinction between self-harm and attempted suicide, though people who self-mutilate often go on to attempt suicide. […] By contrast, in self-harm, the degree of harm is clear, predictable and often highly visible; such as in the case of cutting or burning.
#33 Self-injury/cutting – Symptoms and causes – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/self-injury/symptoms-causes/syc-20350950
Provide a distraction from painful emotions through physical pain. […] Feel a sense of control over the body, feelings or life situations. […] Feel something anything even if it’s physical pain, when feeling emotionally empty. […] Express internal feelings in an external way. […] Communicate feelings of stress or depression to the outside world. […] Punish oneself. […] Self-injury is not usually a suicide attempt, but it can increase the risk of suicide because of the emotional problems that trigger self-injury. And the pattern of damaging the body in times of distress can make suicide more likely.
#34 Self-Injury in Franklin, Morgan City, New Iberia, Prairieville, LA & Ocean Springs, MS | Gulf Coast Integrative Health
https://gulfcoastih.com/self-injury/
Self-injury is often an impulsive behavior and can result in feelings of guilt and shame after the initial feelings of relief. […] Although self-injury is usually not an attempt of suicide, the risk of suicide may increase as the emotional problems caused by self-injury intensify. […] The pattern of damaging the body in times of mental distress can sometimes make suicide more likely to occur.
#35 Self-harm – Wikipedia
https://en.wikipedia.org/wiki/Self-harm
Self-harm refers to intentional behaviors that cause harm to oneself. This is most commonly regarded as direct injury of one’s own skin tissues, usually without suicidal intention. Other terms such as cutting, self-abuse, self-injury, and self-mutilation have been used for any self-harming behavior regardless of suicidal intent. […] Although self-harm is by definition non-suicidal, it may still be life-threatening. People who do self-harm are more likely to die by suicide, and self-harm is found in 40â60% of suicides. Still, only a minority of those who self-harm are suicidal. […] The desire to self-harm is a common symptom of some personality disorders. People with other mental disorders may also self-harm, including those with depression, anxiety disorders, substance abuse, mood disorders, eating disorders, post-traumatic stress disorder, schizophrenia, dissociative disorders, psychotic disorders, as well as gender dysphoria or dysmorphia.
#36 How Are Self-Injury and Suicide Related? – Child Mind Institute
https://childmind.org/article/how-are-self-injury-and-suicide-related/
The intent of self-injury is almost always to feel better, whereas for suicide it is to end feeling (and, hence, life) altogether. […] Self-injury is often carried out using methods designed to damage the body but not to injure the body badly enough to require treatment or to end life. Suicide attempts are typically more lethal than standard NSSI methods. […] The level of psychological distress experienced in self-injury is often significantly lower than that which gives rise to suicidal thoughts and behaviors. […] Although self-injury does not cause suicide, the very act of engaging in self-injury reduces inhibition to suicidal behavior if someone becomes suicidal. In other words, having âpracticedâ injuring the body repeatedly makes it easier to actually injure the body with suicidal intent.
#37 How Are Self-Injury and Suicide Related? – Child Mind Institute
https://childmind.org/article/how-are-self-injury-and-suicide-related/
The intent of self-injury is almost always to feel better, whereas for suicide it is to end feeling (and, hence, life) altogether. […] Self-injury is often carried out using methods designed to damage the body but not to injure the body badly enough to require treatment or to end life. Suicide attempts are typically more lethal than standard NSSI methods. […] The level of psychological distress experienced in self-injury is often significantly lower than that which gives rise to suicidal thoughts and behaviors. […] Although self-injury does not cause suicide, the very act of engaging in self-injury reduces inhibition to suicidal behavior if someone becomes suicidal. In other words, having âpracticedâ injuring the body repeatedly makes it easier to actually injure the body with suicidal intent.
#38 Self-injury (Cutting, Self-Harm or Self-Mutilation) | Mental Health America
https://mhanational.org/conditions/self-injury-cutting-self-harm-or-self-mutilation/
Self-injury, also known as self-harm, self-mutilation, or self-abuseâoccurs when someone repeatedly harms themselves on purpose in a way that is impulsive and not intended to be lethal. While self-harm is not intended to be lethal, people who harm themselves are at a higher risk of attempting suicide if they do not receive help. […] Self-injury is their way to cope with or relieve painful or hard-to-express feelings and is generally not a suicide attempt. The relief that self-injury brings is temporary, and destructive cycle often develops without proper treatment. Self-injury can also be a way for people to have control over their bodies when they have little or no control over other parts of their lives. […] The relationship between suicide and self-injury is complicated. While people with non-suicidal self injury do not intend to complete suicide, they may cause more harm than intended, which could result in medical complications or death. In severe or long-term cases of self-injury, a person may become desperate about their lack of control over the behavior and its addictive nature, which may lead them to purposefully attempt suicide.
#39 Self-Harm: What It Is, Causes, Types & Treatment
https://my.clevelandclinic.org/health/diseases/12201-self-harm
Self-harm is when you injure yourself on purpose. Also known as nonsuicidal self-injury disorder, people who self-harm do things to hurt themselves but don’t want to cause death. […] Self-harm can take many forms. Some are more common than others, but all come with risks. Some of the most common self-harm behaviors include: Cutting with sharp objects to break through or injure skin. […] It’s hard to say exactly what causes a person to self-harm. But certain mental health conditions are linked to self-injury, including: Anxiety, Autism, Bipolar disorder, Borderline personality disorder, Depression, Disruptive, impulse-control and conduct disorders, like conduct disorder and intermittent explosive disorder, Dissociative disorders, especially dissociative identity disorder and dissociative amnesia, Eating disorders, especially anorexia nervosa, Obsessive-compulsive disorder, Post-traumatic stress disorder (PTSD), Sleep disorders, Substance use conditions and disorders, including alcohol intoxication, alcohol use disorder and cannabis use disorder.
#40 A âchoiceâ, an âaddictionâ, a way âout of the lostâ: exploring self-injury in autistic people without intellectual disability | Molecular Autism | Full Text
https://molecularautism.biomedcentral.com/articles/10.1186/s13229-019-0267-3
Alexithymia was a significant predictor of self-injury, with current self-harmers exhibiting the highest levels of alexithymia followed by historic and then non-self-harmers. […] The use of NSSI to control overwhelming feelings, and the traumatic and frustrating difficulty of communicating how they feel, also corroborated our quantitative data around alexithymia. […] Sensory differences in autism are associated with ritualistic and repetitive behaviours including self-injury, and are even the strongest predictors of self-injury.
#41 Self-harm and self-injury | Better Health Channel
https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/self-harm
No one has to cope alone; self-harming behaviour is treatable. […] For anyone who self-harms, just realising it is a not a long-term solution to problems is a step in the right direction. […] It can be difficult to break away from self-harm. Treatment will include learning to find other ways to manage intense feelings. […] Stressors that may increase the risk of self-harm include: family breakdown or conflict, relationship difficulties, knowing others who self-harm, having a family history of self-harm, being bullied, school or work problems, alcohol and drug abuse, past trauma, neglect or abuse. […] Personal factors that may increase someones risk of self-harm include: a previous history of self-harm, experiencing aggression or violence, mental health conditions, low self-esteem, poor body image and self-hatred, physical illness or disability, impulsivity acting without thinking, poor coping skills, difficulties with problem solving.
#42 Salivary beta-endorphin in nonsuicidal self-injury: an ambulatory assessment study | Neuropsychopharmacology
https://www.nature.com/articles/s41386-020-00914-2
Nonsuicidal self-injury (NSSI) is a prevalent and impairing behavior, affecting individuals with and without additional psychopathology. […] This is the first study assessing salivary -endorphin in daily life in the context of NSSI acts. […] We found that -endorphin levels immediately before an NSSI act were significantly lower than directly after NSSI. […] The results of the present study indicate that it is possible to assess salivary -endorphin in daily life in the context of NSSI. […] Furthermore, our results provide a first indication that NSSI acts could be associated with a momentary increase of -endorphin, and this might reinforce NSSI engagement. […] The pathogenesis of NSSI was repeatedly linked to prolonged experiences of psychosocial stress, body objectification, or rejection or victimization by peers, potentially moderated by genetic predispositions.
#43 Psychology Behind Cutting Self Harm: Looking at the Underlying Causes
https://discoverymood.com/blog/psychology-behind-self-harm-looking-at-the-underlying-causes/
Self-harm is the act of hurting oneself, whether it is physical or emotional, intentional, or non-intentional. […] The psychology behind self-harm is multifactorial meaning that there is no one single trigger or cause. […] Research shows that self-harm frequently starts in adolescence and is particularly prevalent in homes where there is a repressive environment, where negative emotions are swept under the carpet or where feelings arenât discussed. […] Cutting is the most common form of physical self-harm, formally known as non-suicidal self-injury. […] Like other forms of self-injury behavior, cutting is not a form of suicide but rather an unhealthy coping mechanism individuals use to relieve stress. […] Cutting is part of a vicious cycle associated with anger, sadness neglect followed by a quick mental relief from cutting.
#44 Self-harm and self-injury | Better Health Channel
https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/self-harm
No one has to cope alone; self-harming behaviour is treatable. […] For anyone who self-harms, just realising it is a not a long-term solution to problems is a step in the right direction. […] It can be difficult to break away from self-harm. Treatment will include learning to find other ways to manage intense feelings. […] Stressors that may increase the risk of self-harm include: family breakdown or conflict, relationship difficulties, knowing others who self-harm, having a family history of self-harm, being bullied, school or work problems, alcohol and drug abuse, past trauma, neglect or abuse. […] Personal factors that may increase someones risk of self-harm include: a previous history of self-harm, experiencing aggression or violence, mental health conditions, low self-esteem, poor body image and self-hatred, physical illness or disability, impulsivity acting without thinking, poor coping skills, difficulties with problem solving.
#45 6 Reasons Why People Self-Injure
https://www.mentalhealth.com/library/reasons-people-self-injure
People may harm themselves to cope with or temporarily alleviate distressing feelings or situations. Self-injury for these individuals may cause relief or feelings of calm. Additionally, people report that they engage in self-harm as a form of self-punishment. Overall, self-harm is common among people who struggle with emotional dysregulation, anxiety, depression, negative emotionality, and self-criticism. […] Self-injury, on its own, is different from suicidality because people who self-harm do so as a coping mechanism, typically without the desire to kill themselves. On the other hand, suicidal intent specifically refers to the desire to end their life. […] Self-injury occurs when someone cuts, burns, or otherwise harms themselves. They typically donât intend to kill themselves, but they do have an increased risk of dying by suicide.
#46 A âchoiceâ, an âaddictionâ, a way âout of the lostâ: exploring self-injury in autistic people without intellectual disability | Molecular Autism | Full Text
https://molecularautism.biomedcentral.com/articles/10.1186/s13229-019-0267-3
Alexithymia was a significant predictor of self-injury, with current self-harmers exhibiting the highest levels of alexithymia followed by historic and then non-self-harmers. […] The use of NSSI to control overwhelming feelings, and the traumatic and frustrating difficulty of communicating how they feel, also corroborated our quantitative data around alexithymia. […] Sensory differences in autism are associated with ritualistic and repetitive behaviours including self-injury, and are even the strongest predictors of self-injury.