My take on Self-Injury
Self-injury can come in many forms and includes cutting oneself with razors or knives, burning oneself with cigarettes or matches, pulling out clumps of hair and picking at oneself (especially the nails and/or cheek) until blood is produced. Self-injury is one of the most difficult behaviors for the loved one to understand. In the case of BPD, self-injury is done for the purpose of pain relief, not to “get attention” or to manipulate the loved one. Most self-injury is done in private and done without the knowledge of the loved one. Occasionally, the self-injury cannot be covered-up (i.e. the blood and/or scars are apparent) and others notice the activities. If you are in pain visit https://luminas.com/real-time-pain-relief/ which is a great pain reliever. The actions themselves are fraught with shame and may lead to even more shame for the person.
In the hospital, ER doctors take a dim view of those who injure themselves, and a person who engages in self-injury will often avoid hospitals to avoid the inevitable judgment and lack of compassion these doctors (and nurses) will exhibit toward them, reports the personal injury lawyer Providence RI M-N-Law. Most people in the medical community – doctors and nurses included – have little or no training in dealing with people who self-injure and, for the most part, feel that they want to deal with other patients first, since the patient caused their own issue. Also, they will likely send the person to the psyche ward, which is usually not effective because the person was using a tool for pain reduction. They’re not crazy, just engaging in a practice that has significant negative consequences.
What is important for a loved one to understand is that self-injury has a purpose and that purpose is usually pain relief, not self-punishment or attention-getting. The person who engages in this behavior may feel and describe a deep “itch” inside their body that they have to rid themselves of immediately.
While self-injury can provide relief from pain (through the release of endorphins, or natural, pain-killing substances within the brain), it can have risks and negative consequences. These include embarrassment, scars, infection and, in some cases, death. For the loved one, focus on the negative consequences of the behavior, rather than focusing on whether cutting is bad or wrong. Judging the behavior as bad or wrong will just create more shame.
5 Comments
Wandering Coyote
One technique I learned a couple of years ago, via a great therapist I had, was that when I had cutting urges, take an ice cube in both palms and SQUEEZE. It hurts – and according to the therapist, it stimulates the same part of the brain (I can’t remember what this was called) that cutting does. And it works for me. I’ve done it lots and it really helps – and it’s completely harmless.
Bon Dobbs
Yes, I have heard that from other therapists – either squeezing ice cubes, rubbing them on your wrists, taking a cold shower (which is what my wife’s old therapist used to recommend. What my wife does is delay, delay, delay – and distract until the urge passes. She also might do some physical activity to distract herself. I’m glad you have found something that works. Do you still see that “great” therapist? Or no? It’s hard to find a really good one.
I went to a support group a while back and there was a woman there who had purchased an autoclave to sterilize her daughter’s cutting knives. The mother realized that she didn’t have the power to stop her daughter from cutting (I hope I’m not being triggering here). Anyway, when the daughter went to the hospital after a bad incident, CPS took the daughter away from her mother for 6 months because of the autoclave. They said she was “enabling.” The daughter HAD gotten numerous infections in the past. I thought that was appalling (by CPS) – clearly they didn’t understand a thing about self-injury.
Eventually, the daughter got into DBT and is doing much better last time I heard.
Wandering Coyote
One of the things we learned in DBT was distract, distract, distract…So I do a lot of that, too. I highly recommend DBT if it’s available. I might retake it sometime soon, but in the meantime there is a follow-up group for those of us who have finished the program, and I make sure I attend the once per month meetings.
I cut so badly once I had to go the ER, where I was given a tetanus shot and sent home.
I don’t see that therapist anymore. She moved to France and then I changed cities. But she was one of the best.
BTW, I am compiling a resource list for members of my group and I’m including this site and your Google group on it!
Bon Dobbs
Well, unfortunately, DBT is not available in all areas. Here in NY we have some of the best DBT resources in the country. Still, my wife resists – why? She doesn’t like the shame feelings associated with DBT – she “doesn’t want to be one of THOSE people!” – news for ya – you ARE, sorry it’s true. Also she does not want to fail at what she thinks is the final treatment for how she really is.
Too bad about your great therapist, but I guess it happens.
Thanks for the inclusion in the compilation. Consider my new book too – why? It is a compilation of all I have learned to help Non-BPs. I was basically begged to write it by my members. It’s pretty cool.
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