Wholeness Healing Today

Self-Harming Behavior

I remember learning about my numbers and the alphabet in kindergarten. My teacher had a unique way of making this learning so much fun and I couldn’t wait to share all my knowledge when I returned home each day. I can still visualize the letter people who hung from the ceiling all around the room. They were inflatable and decorated with
pictures of words starting with the letter itself. Mr. F had very large spotted feet. Mr. H was adorned with green hair that fanned out like a peacock’s feathers, while Mr. T displayed his vertically long teeth. I’m very thankful for my educators and the foundation of vital learning provided to me. It was there I developed a lifelong yearning to learn and educate myself. Thankfully I was able to take my first college course by the time I reached high school. I couldn’t wait to begin my journey learning about psychology, which later provided a spring board for my passion in learning and working in the field of mental health.

In the field of mental health, self-harming behavior has often been a symptom of various clients who come in for therapy. It seems increasingly clear that, like the self-harm behavior itself, there are a lot of hidden facts. The nature  of secrecy surrounding this behavior may be a likely factor to this. It is important to distinguish this behavior from suicide as they are often discussed, assessed and treated as the same. In actuality, they are quite opposite in nature. The primary foundations of suicidal behavior and self-harming behavior are different. Suicidal behavior is exhibited with an intent to die while those who self-harm are seeking a means to cope and survive. It is important to reduce the stigma and bring more awareness to self-harm behaviors as this impacts 4% of the adult population who have harmed themselves at least once. Studies suggest that up to 20% of high school students and 40% of college students have harmed themselves at least once. (Gratz and Chapman, 2009).

The material and words become increasingly complex and difficult to pronounce when exploring the field of mental health. It is not enriched with art projects, creative visual aids, or conversation around the family dinner table each night. However, one may find the topic hidden in musical lyrics from revolutionary artists seeking to expose a message or issue they struggle to otherwise communicate. Johnny Cash’s song “Hurt” which was originally done
by Trent Reznor of Nine Inch Nails reads “I hurt myself today, to see if I still feel. I focus on the pain, the only thing that’s real.” The original song writer indicated he was in a ‘bleak and desperate place’. Another example of this is from Blue October‘s song “Razorblade.” “A brief bout with a razorblade cut me, I freaked out, thinking people didn’t love me,” reads the lyrics.

The difficulty that comes with describing intense emotions and mental health overall lends to the development
of various myths and assumptions, essentially a stigma around many of the topics. But here are some of the facts.
Self-harm is “when one intentionally damages one’s own bodily tissue without intending to die.” Self-harm is essentially a coping strategy. It is often the quickest relief for someone suffering from emotional pain. It has been described as providing fast relief and a powerful rush. Other characteristics of self-harm include that the damage is physical, intentional and immediate. It can include lacerations, burning, bruises, or picking, scratching or scraping.

Self-harm can develop from superficial to life-threatening by means of tolerance and a need to provide an emotional
relief effect. Someone who dissociates while self-harming may not be aware of the seriousness of the harm he/she
inflicts upon himself/herself. Self-harm may cause one to be more prone to suicide due to the tendency for negative
emotions and the need for self-hatred to intensify. Self-harm is not suicide but can increase the likelihood for suicidal behavior.

Self-harm is not a manipulative behavior. When an individual has a human need in which they don’t have the language or words to communicate, self-harm, like any other dysregulated behaviors, may be a way to elicit the attention to the problem. As previously described, the topic of self-harm is not likely to be a topic brought up at home. One may learn about it from peers and have inaccurate information about it. One may also not have the emotional language to share the pain. In fact, when the onset of emotional pain begins at an early age, language
development may lag and emotional reactivity may ensue.

While self-harm is the most common symptom of borderline personality disorder (75% of those with BPD) it does not mean those who self-harmed have and meet the criteria for BPD. Furthermore, self-harm is not limited only to females. The research indicates that it is just as common among males, but there may be more secrecy involved. Biological factors such as low activity in serotonin systems, overly active neurotransmitters in the brain such as
opioids, and personality characteristics of impulsivity or neuroticism, which is the tendency to experience strong negative emotions, make one more likely to self harm. Painful childhood experiences and unresolved trauma also make one more susceptible to self-harming behavior.

“I’ve got shame, I’ve got scars, that I will never show, I’m a survivor in more ways than you know”, are words sung by Demi Levato from her song ‘Warrior.’ There are many options in treating self-harming behavior. Treatment that teaches emotional regulation such as dialectical behavior therapy or cognitive behavior therapy can assist in learning about thoughts and feelings and alternative ways to cope as well as doing deeper trauma work by identifying and healing the trauma. Medication options are also available. As with many behaviors, strengthening one’s motivation for change, developing skills to manage urges and emotions, as well as developing a supportive, safe environment can provide the keys to lasting change.

I appreciate my early learning experiences that integrated rhythm, dance, and play. I make it a point to incorporate these very same modalities when seeking to teach others about mental health. I also think it is essential to provide a foundation of emotion filled language at an early age. Learning self-regulation strategies and coping strategies is essential to managing the self-harming behavior that often stems from early childhood traumas. When a child doesn’t have the tools to make sense of his/her world, there is a deep suffering that can result. If we can equip individuals at an early age with critical social-emotional skills and provide nurturing, supportive learning rnvironments, we can make a difference. If we can also educate adults with the difference of self-harm versus suicide, we can, perhaps, address and treat the issue more effectively.

Works Cited
Brady, B. and Maron J. (2015, January 8) Why Johnny Cash felt so hurt. On the record. Retrieved from https://rapidcityjournal.com/blackhillstogo/arts-music/on-the-record-why-johnny-cashfelt-so-hurt/article_aed3b15c-f6df-56ae-bf39-1bb0d058f1bf.html

Furstenfeld, Blue Miller, Delahoussaye, R. and Noveskey, M. (2003). Razorbladed. History for sale [album]. Santa Monica, CA: Brando/Universal Records.

Gratz, K. L. PhD and Chapman, A. PhD. (2009). Freedom from self harm, overcoming self -injury with skills from DBT and other treatments. Oakland, CA:New Harbinger Publications.

Lovato, D. (2013 ) Warrior. DEMI [album]. Hollywood, CA: Hollywood Records Reznor, T. (1994). Hurt. The downward spiral [album]. Hollywood, CA: Nothing, TVT, Interscope.

Whitlock, J. PhD and Lloyd -Richardson, E. PhD. (2019) Healing self -injury. New York, NY: Oxford University Press.

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  • Licensed Independent Clinical Social Worker
    Licensed Independent Mental Health Practitioner

  • Jody Johnson, LICSW, LIMHP, began working at Wholeness Healing Center as a therapist in 2007. Jody graduated from the University of Nebraska at Omaha with her Masters in Social Work.  She received her bachelor degree in Social Work from the University of Nebraska at Kearney.


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