Why do People Self-Harm? When Feeling Bad Means Feeling Better

Let's Talk About Self-Harm. Why Feeling Bad Means Feeling Better

We all have battles that feel bigger than us sometimes and we all have characteristic ways of dealing with emotional pain, physical pain, shame, regret or guilt. There is a full bank of very normal human experiences and emotions that can threaten to break any one of us. Sometimes, they last for too long. When it feels as though there is no relief, it can drive even the strongest of us to try anything to get the pain to stop. 

What is self-harm?

Self-harm is any deliberate injury made to the self, by the self. It doesn’t include anything that is socially sanctioned, such as piercings or tattoos. People who self-harm don’t want to die. What they want is for the pain to stop. Most self-harm happens without any thoughts of suicide, but it can predict suicidal behaviour in the future. The problem is that while self-harm provides a temporary escape from emotional pain, it may feed a need for the escape to be more permanent.

Who self-harms? 

The group of people who self-harm is a diverse one. They are men and women of all backgrounds, races and ages. They are people like any one of us – the people we live with, work with and love. Some people who self-harm have anxiety, depression, an eating disorder or borderline personality disorder, but sometimes self-harm exists on its own. 

Self-harm appears to be more common among those who are homosexual, bisexual or questioning their sexuality.

There are a number of ways that people self-harm, including cutting, burning, scratching and banging or hitting. Women were more likely to use cutting, while men were more likely to hit themselves or burn themselves. 

Research of adolescents and young people who self-harm found that on average, they have about five non-suicidal thought of harming themselves each week. The thoughts tend to last between 1–30 minutes. On average, people who self-harm seem to hurt themselves on average between one and two times a week. 

Thoughts of self-harm rarely come with suicidal thoughts, but they do happen with thoughts of drug or alcohol use about 15-20% of the time, and thoughts of and bingeing or purging about 15-20% of the time. Despite these stats, most people who self-harm are not under the influence of drugs or alcohol when they hurt themselves. 

Let’s clear up a couple of myths.

The idea that self-harm is done for attention or to exploit the ones who care isn’t supported by the research. Although a very small number of people might hurt themselves for attention, this is rarely the case. Most people don’t disclose their self-harm. It is often done very much in private as a way to quickly relieve overwhelming negative feelings. 

Another common myth is that self-harm is often driven by (or caused by) childhood sexual abuse. Again, this has not been supported by the research. In an analysis of a number of studies, only a very small relationship was found between child sexual abuse and self-harm.

Why do people self-harm?

Everything we do is driven by a need. The needs we have are always valid, but the behaviours we choose aren’t always going to be the best or most effective way to meet that need. Needs can be voracious, relentless and compelling. When a need is powerful enough, as needs will tend to be for all of us from time to time, it is understandable that somebody might call on whatever means available to them to end the pain of that unmet need. 

Research has found that self-harm can be an attempt to fulfil a number of valid, powerful needs:

  1. To provide relief from persistent negative thoughts.

    When negative thoughts are persistent and powerful, the pain can feel overwhelming. There is a growing body of research that claims self-harm is a strategy people use to distract themselves from negative, painful thoughts about themselves, things that have happened or about self-injury itself.

  2. To provide relief from overwhelming negative feelings.

    People who self-harm tend to experience intense negative feelings immediately before they hurt themselves. In particular, feelings of anger, self-hatred or rejection have been associated with a significantly greater likelihood of self-harm. After an episode of self-harm, those negative feelings are decreased and there are increased feelings of calm and relief. The relief from the negative feelings, however temporary, can be powerful enough to drive future episodes of self-harm.

  3. As an expression of anger towards the self, or a form of self-punishment.

    Self-criticism seems to play a pivotal role in self-harm. In a review of a number of studies, it was found that found that slightly more than half the people who self-harm do it as an expression of anger towards themselves or as a way to punish themselves. 

Why self-harm brings relief.

The experience of physical pain seems to soothe emotional pain. Images of the brains of people who self-harm have found that physical pain leads to less activity in the part of the brain that is associated with negative emotions (anterior cingulate gyrus and the amygdala). 

Research has also found something interesting that seems to happen when physical pain stops – emotional pain also starts to ease. For any of us, having a bad experience, and then having that bad experience taken away will bring overwhelming relief which feels better than before the bad experience. Let’s say that someone trustworthy tells you that you have one week to live. Then, the next day they tell you that they got it wrong and that you’re absolutely fine. The relief and joy you feel when the bad experience (thinking you’re going to die) is taken away, lifts you higher than you were before it.

The research has been done in people who have no history of self-harm, but it may explain why some people intentionally seek to hurt themselves. Emotional pain and physical pain activate the same areas of the brain. Relief from physical pain (when the self-harm episode ends) brings simultaneous relief from emotional pain. The greater the emotional pain, the greater the relief.  

This does not mean that people who self-harm are wired differently to the rest of us. They aren’t. When emotional pain feels overwhelming and unmanageable, it’s understandable that people who self-harm might tap into their own internal resources to find relief from that pain, even if it means first having to inflict intense physical pain. Intense emotional pain can feel as though it has a life of its own. It can feel out of control. Self-inflicted physical pain, on the other hand, is manageable and controllable.

When physical pain is inflicted deliberately, the beginning and ending of that pain is something that can be managed and used to bring relief to emotional pain. This is not something done to manipulate or control other people. For people who self-harm, physical pain which is under their control is more manageable and more tolerable than emotional pain which feels out of their control. It is a way to bring the self back into balance, which is something we are all driven to seek. When the need for balance is strong enough (brought on by an important unmet need), it will make the unthinkable – the deliberate infliction of pain – feel like an option.

If you are someone who self-harms …

Healing won’t happen by telling yourself that you need to heal. You’ve been doing that. It also doesn’t happen by telling yourself that you need to be brave, strong, resilient. You are already that. It happens when you start to trust. Trust that the people around you have what it takes to fight for you and with you against whatever it is that’s hurting you. 

We all need a hand from time to time, and if this is your turn to ask for help, be kind to yourself and let that happen. Whether it’s a parent, a friend, a partner, a counsellor, a doctor – there are people who want to understand and help you. There is a human connection between all of us, whether you can see it or not, feel it or not, or believe it or not. It’s there. You are not alone. There are people who have such a deep, unwavering, fierce commitment to helping things to better for you. Part of the struggle convinces you that there isn’t, but there is. Don’t let your struggle make you blind to them. Trust that they will cope with your story.

Asking for help is an almighty, incredible strength. You have proven that you are a fighter – brave, strong, beautiful and incredible. You wouldn’t have got through what you’ve been through if you weren’t. Open hearts will bring open hearts. Know that there are people who will always be ready to fight for you. 

If you or someone you love is struggling with self-harm: For Extra Support – When Being Human Gets Tough.

[irp posts=”2373″ name=”To the Ones Who Are Self-Harming, Here’s What You Need to Know …”]

[irp posts=”2376″ name=”When Someone You Love is Self-Harming”]

19 Comments

Kate

I think there is too much stigma surrounding this phenomenon and when people hear about it they automatically assume its a suicidal tendency – when that is not always the case.

I was one such person before I lost a very close friend of mine (suddenly). the emotional pain of grief was more torturous than any physical pain I’d ever endured and I couldn’t bare the thought of ‘cutting’ myself but it came about as a last resort and this article is spot on about the psychological effect – in the worst of the emotional turmoil I would cut and this feeling of absolute relief would wash over me….

Thankfully, it only lasted about a year and then I stopped (because I knew deep down it wasn’t the healthiest way of dealing with my problems), but since then, I would never think of judging another person for doing it – only that I cringe because I’ve been there and know its ultimately unhealthy and we need to learn to be kinder to ourselves!

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Karen Young

Kate thank you so much for sharing your story! I hear you – there is way too much stigma about so many mental health issues. What you are describing makes so much sense. Your voice is strong and important – we need to understand more about this from the people who know – and that is people like you who have been there. I’m so pleased you were able to find your way through – that mustn’t have been easy but you did it. You are strong, brave, and your wisdom is important – thank you.

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Artemis Manias

I found to article very useful, I work with people who self-harm . I do find all articles written by Karen extremely useful in a way that people who are not therapists can understand so I forward them to clients and post them on FB.
Thank you

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SharonH

I wasn’t going to write this reply but then decided that I have nothing to be ashamed of and that it is a coping mechanism while dealing with almost insurmountable problems.

As one who self-harms, this article helped in a tremendous way. I already understood most of its points, but it is very reassuring and an absolute aid in helping me explain to the (very few) people who know what I do.

In my case it’s only done when the internal pressure of the many things that face me in life come to a head. It helps me in the way that letting off excess steam in a boiler that is about to explode helps to avoid a catastrophe. I cannot explain the relief it provides. It takes knowledge to know just how to do it without creating a harmful physical condition. We do become experts at it, unfortunately.

Most of us “cutters” take great care to hide our wounds/scars from others. To me it is a safety valve. My psychologist understands and tries to help me avoid and cope with the problems that bring it about. But these attacks come mostly in the middle of the night, when negative thoughts tend to come upon me.

I pondered over whether to hit that “reply” tab. It is the first time I’ve ever written about it in public. But to see this article addressing a very much misunderstood behavior is gratifying. Thank you so much for providing light on a subject that is so taboo. Most writings revolve around teenagers, but I am here to validate that we older folks are also subject to this type of behavior.

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Teri

Sharon,
As a one who also self-harms, I have to say I agree with everything you said. I too am an older folk and it is difficult now days to find any information, let alone another our age who can relate to the issues that are taboo. Thank you so much for sharing. I wish for you to find that inner peace and happiness that I know I’m striving to find in my life. Thank you Karen for writing this article as well.

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SharonH

Teri, though not happy that you too self-mutilate, it is comforting to know that this practice stretches across so many age groups. I felt so alone and thought I must be some sort of freak. Not true!

This article AND the responses have been therapeutic in themselves. Good to know that the commonly held belief that mostly teens self-mutilate is incorrect.

So nice to be able to be open and honest about this. This article is a real “keeper” and many thanks to Karen-Hey Sigmund for having the courage to put it on the web where others can hopefully read it and understand a very taboo subject.

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Karen - Hey Sigmund

Sharon I’m so pleased you hit the ‘reply’ button. What you describe makes so much sense. We ALL have our ‘stuff’ and the more we can talk about it, the more we are able to heal ourselves and each other. Your voice is your power. You will have made a difference to people by sharing your experience – it’s powerful, brave and important. Thank you!

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Linda

Thank you very much for sharing. Your reply, insight, and courage has helped many of us to understand and better support others! My very best wishes to you.

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aamlewis16

Wow, this is the best writing I have ever seen on this subject. It compassionately explains why people self-harm and what it accomplishes. Spot on. I had a therapist tell me that my behavior was undoubtedly a very effective solution to the problem at hand, but I really needed a better way to cope. She was right, it was effective, and it helped to have her and this article acknowledge that fact without being horrified. Getting my mood disorder under control makes it now seem almost inconceivable to me that I ever cut. But I still know why I did.

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Karen - Hey Sigmund

I’m so pleased that you were able to find somebody who understood. It takes courage and strength to look behind the reasons we do some things. Thank you for sharing your story. I know it will give hope to plenty of people who read it.

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Stephanie

I agree. I recently saw someone whom burn themselves. I wasn’t aware of their pain.. I was selfish only thinking of my situation.
I feel my problem is not worth exploring. I hope they are able heel.
They cannot heal if I’m in their families way.

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Karen - Hey Sigmund

The idea that people would hurt themselves can be confronting to anyone who doesn’t understand what drives it. I love that you have been so open to taking a different view. Sometimes standing with respect and quiet acceptance of another person’s situation, their needs and their pain, even if we don’t quite understand, can be one of the most powerful ways to support somebody’s healing.

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How we are with them, when they are their everyday selves and when they aren’t so adorable, will build their view of three things: the world, its people, and themselves. This will then inform how they respond to the world and how they build their very important space in it. 

Will it be a loving, warm, open-hearted space with lots of doors for them to throw open to the people and experiences that are right for them? Or will it be a space with solid, too high walls that close out too many of the people and experiences that would nourish them.

They will learn from what we do with them and to them, for better or worse. We don’t teach them that the world is safe for them to reach into - we show them. We don’t teach them to be kind, respectful, and compassionate. We show them. We don’t teach them that they matter, and that other people matter, and that their voices and their opinions matter. We show them. We don’t teach them that they are little joy mongers who light up the world. We show them. 

But we have to be radically kind with ourselves too. None of this is about perfection. Parenting is hard, and days will be hard, and on too many of those days we’ll be hard too. That’s okay. We’ll say things we shouldn’t say and do things we shouldn’t do. We’re human too. Let’s not put pressure on our kiddos to be perfect by pretending that we are. As long as we repair the ruptures as soon as we can, and bathe them in love and the warmth of us as much as we can, they will be okay.

This also isn’t about not having boundaries. We need to be the guardians of their world and show them where the edges are. But in the guarding of those boundaries we can be strong and loving, strong and gentle. We can love them, and redirect their behaviour.

It’s when we own our stuff(ups) and when we let them see us fall and rise with strength, integrity, and compassion, and when we hold them gently through the mess of it all, that they learn about humility, and vulnerability, and the importance of holding bruised hearts with tender hands. It’s not about perfection, it’s about consistency, and honesty, and the way we respond to them the most.♥️

#parenting #mindfulparenting
Anxiety and courage always exist together. It can be no other way. Anxiety is a call to courage. It means you're about to do something brave, so when there is one the other will be there too. Their courage might feel so small and be whisper quiet, but it will always be there and always ready to show up when they need it to.
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But courage doesn’t always feel like courage, and it won't always show itself as a readiness. Instead, it might show as a rising - from fear, from uncertainty, from anger. None of these mean an absence of courage. They are the making of space, and the opportunity for courage to rise.
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When the noise from anxiety is loud and obtuse, we’ll have to gently add our voices to usher their courage into the light. We can do this speaking of it and to it, and by shifting the focus from their anxiety to their brave. The one we focus on is ultimately what will become powerful. It will be the one we energise. Anxiety will already have their focus, so we’ll need to make sure their courage has ours.
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But we have to speak to their fear as well, in a way that makes space for it to be held and soothed, with strength. Their fear has an important job to do - to recruit the support of someone who can help them feel safe. Only when their fear has been heard will it rest and make way for their brave.
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What does this look like? Tell them their stories of brave, but acknowledge the fear that made it tough. Stories help them process their emotional experiences in a safe way. It brings word to the feelings and helps those big feelings make sense and find containment. ‘You were really worried about that exam weren’t you. You couldn’t get to sleep the night before. It was tough going to school but you got up, you got dressed, you ... and you did it. Then you ...’
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In the moment, speak to their brave by first acknowledging their need to flee (or fight), then tell them what you know to be true - ‘This feels scary for you doesn’t it. I know you want to run. It makes so much sense that you would want to do that. I also know you can do hard things. My darling, I know it with everything in me.’
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#positiveparenting #parenting #childanxiety #anxietyinchildren #mindfulpare
Separation anxiety has an important job to do - it’s designed to keep children safe by driving them to stay close to their important adults. Gosh it can feel brutal sometimes though.

Whenever there is separation from an attachment person there will be anxiety unless there are two things: attachment with another trusted, loving adult; and a felt sense of you holding on, even when you aren't beside them. Putting these in place will help soften anxiety.

As long as children are are in the loving care of a trusted adult, there's no need to avoid separation. We'll need to remind ourselves of this so we can hold on to ourselves when our own anxiety is rising in response to theirs. 

If separation is the problem, connection has to be the solution. The connection can be with any loving adult, but it's more than an adult being present. It needs an adult who, through their strong, warm, loving presence, shows the child their abundant intention to care for that child, and their joy in doing so. This can be helped along by showing that you trust the adult to love that child big in our absence. 'I know [important adult] loves you and is going to take such good care of you.'

To help your young one feel held on to by you, even in absence, let them know you'll be thinking of them and can't wait to see them. Bolster this by giving them something of yours to hold while you're gone - a scarf, a note - anything that will be felt as 'you'.

They know you are the one who makes sure their world is safe, so they’ll be looking to you for signs of safety: 'Do you think we'll be okay if we aren't together?' First, validate: 'You really want to stay with me, don't you. I wish I could stay with you too! It's hard being away from your special people isn't it.' Then, be their brave. Let it be big enough to wrap around them so they can rest in the safety and strength of it: 'I know you can do this, love. We can do hard things can't we.'

Part of growing up brave is learning that the presence of anxiety doesn't always mean something is wrong. Sometimes it means they are on the edge of brave - and being away from you for a while counts as brave.
Even the most loving, emotionally available adult might feel frustration, anger, helplessness or distress in response to a child’s big feelings. This is how it’s meant to work. 

Their distress (fight/flight) will raise distress in us. The purpose is to move us to protect or support or them, but of course it doesn’t always work this way. When their big feelings recruit ours it can drive us more to fight (anger, blame), or to flee (avoid, ignore, separate them from us) which can steal our capacity to support them. It will happen to all of us from time to time. 

Kids and teens can’t learn to manage big feelings on their own until they’ve done it plenty of times with a calm, loving adult. This is where co-regulation comes in. It helps build the vital neural pathways between big feelings and calm. They can’t build those pathways on their own. 

It’s like driving a car. We can tell them how to drive as much as we like, but ‘talking about’ won’t mean they’re ready to hit the road by themselves. Instead we sit with them in the front seat for hours, driving ‘with’ until they can do it on their own. Feelings are the same. We feel ‘with’, over and over, until they can do it on their own. 

What can help is pausing for a moment to see the behaviour for what it is - a call for support. It’s NOT bad behaviour or bad parenting. It’s not that.

Our own feelings can give us a clue to what our children are feeling. It’s a normal, healthy, adaptive way for them to share an emotional load they weren’t meant to carry on their own. Self-regulation makes space for us to hold those feelings with them until those big feelings ease. 

Self-regulation can happen in micro moments. First, see the feelings or behaviour for what it is - a call for support. Then breathe. This will calm your nervous system, so you can calm theirs. In the same way we will catch their distress, they will also catch ours - but they can also catch our calm. Breathe, validate, and be ‘with’. And you don’t need to do more than that.
When things feel hard or the world feels big, children will be looking to their important adults for signs of safety. They will be asking, ‘Do you think I'm safe?' 'Do you think I can do this?' With everything in us, we have to send the message, ‘Yes! Yes love, this is hard and you are safe. You can do hard things.'

Even if we believe they are up to the challenge, it can be difficult to communicate this with absolute confidence. We love them, and when they're distressed, we're going to feel it. Inadvertently, we can align with their fear and send signals of danger, especially through nonverbals. 

What they need is for us to align with their 'brave' - that part of them that wants to do hard things and has the courage to do them. It might be small but it will be there. Like a muscle, courage strengthens with use - little by little, but the potential is always there.

First, let them feel you inside their world, not outside of it. This lets their anxious brain know that support is here - that you see what they see and you get it. This happens through validation. It doesn't mean you agree. It means that you see what they see, and feel what they feel. Meet the intensity of their emotion, so they can feel you with them. It can come off as insincere if your nonverbals are overly calm in the face of their distress. (Think a zen-like low, monotone voice and neutral face - both can be read as threat by an anxious brain). Try:

'This is big for you isn't it!' 
'It's awful having to do things you haven't done before. What you are feeling makes so much sense. I'd feel the same!

Once they really feel you there with them, then they can trust what comes next, which is your felt belief that they will be safe, and that they can do hard things. 

Even if things don't go to plan, you know they will cope. This can be hard, especially because it is so easy to 'catch' their anxiety. When it feels like anxiety is drawing you both in, take a moment, breathe, and ask, 'Do I believe in them, or their anxiety?' Let your answer guide you, because you know your young one was built for big, beautiful things. It's in them. Anxiety is part of their move towards brave, not the end of it.

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