Self-harm: a desperate strategy to reduce psychic tension

Self-harm is repeated and deliberate behaviors intended to cause physical harm to oneself and without a (conscious) purpose of suicide.

The most common (but not the only) forms of self-harm are cuts to the skin, cigarette burns, or hitting the head against the wall.

In this article you will find the keys to understanding self-harm, and the logic to which they respond.

• Related article: "Non-Suicidal Self-Injury: Who Is Affected and Why Does It Occur?"

Why would anyone want to self-harm?

The image of someone cutting their arms with a razor blade can be scary to many and incomprehensible to most, especially considering that there is no firm purpose to end one's life. Then, What leads people to self-harm?

Self-harm was long believed to be a symptom of psychosis, in terms of the popular belief that it is a wake-up call. Both ideas are probably wrong, more recent explanations would indicate that self-harm is rather an attempt by the person to end states of great psychic tension.

Traumatic experiences in childhood make the person more vulnerable to stress due to an altered process of brain maturation. Among the greatest risk factors are sexual abuse, maltreatment, emotional neglect and rejection by reference persons. These are some common experiences in the personal history of individuals with borderline personality disorder (BPD).

• You may be interested in: "Borderline Personality Disorder: causes, symptoms and treatment"

Borderline personality disorder and self-harm

Self-injurious behaviors are very common in BPD; in fact, one of the criteria to take into account when determining the diagnosis of BPD is the presence of a behavior, attitude or recurrent threats of suicide, or behavior of self-mutilation. Almost all people with BPD show self-mutilation at least occasionally.

However, self-harm is not an exclusive symptom of BPD, can also be seen in depression, eating disorders, and post-traumatic stress disorder. In fact, causing physical harm to oneself is not exclusive to the human species, for example cases can be found among other primates, such as some monkeys that bite themselves.

Another of the criteria to take into account when diagnosing BPD is the occurrence of severe dissociative experiences.

Seek pain to displace dissociation

During the self-injury ritual there is initially a high psychic tension accompanied by a reduction in the perception of pain. The person carries out self-harm to reduce this stress, after being injured, she is relaxed (wounds generate endorphins) and then begins to experience discomfort from the damage.

The strategy used is so effective in reducing emotional tension that, in the absence of another method to find relief, the person relapses into this behavior, creating a habit.

For people with BPD, unlike other people, distraction does not help them as a technique for emotional self-regulation, and therefore they resort to drastic strategies.

At first, the person who self-injures finds a momentary relief from her psychic overload, then guilt and shame appear, as well as the concern to hide the wounds. The latter can cause or worsen social isolation, generating additional discomfort and creating a vicious cycle.

In addition, some of the consequences of self-harm can be a maintenance factor: attracting attention, provoking parents and / or establishing relationships with others affected.

What is this psychic tension that leads them to self-harm?

Often people seeking relief from these self-destructive behaviors try to rid themselves of dissociative experiences. Dissociation is an alteration or doubling of psychic functions (such as memory) that it affects above all at the level of the perception of oneself or the environment.

The depersonalization it is a dissociative phenomenon and is typical of BPD, as well as other forms of psychological trauma, such as post-traumatic stress disorder.

People with depersonalization feel remote, unreal, or strange. Often these sensations are accompanied by a reduction in the perception of pain.

Some research suggests that people with BPD have a higher pain tolerance threshold than the population general, and this greater tolerance to pain would increase in the moments in which the tension is suffered prior to self harm.

This form of altered pain sensitivity is an index that can be modified, being able to approach that of the normal population after a psychotherapeutic treatment and after stopping self-harm.

This behavior occurs more among girls and young women, possibly because they tend to direct negative feelings towards themselves. In fact, the prevalence of BPD is much higher among women than in men, just the opposite of antisocial personality disorder, which is based on inattention and violation of the rights of other people.

How to detect self-harm?

These are the red flags to watch out for:

• Frequent unexplained scars.
• Disguise clothing, refusal to undress in the presence of someone or to go to the pool.
• Save razor blades, broken glass, or material to heal.
• Drawings of self-harm.
• Nonspecific signs: isolation, mood swings, risky behaviors, low self-esteem and impulsivity.

The triggers that lead to self-harm can be frustrating interpersonal experiences. Sometimes it can also be a behavior emulated by peers as a sign of belongingWhile regularly self-injuring to overcome stress is generally indicative of strong emotional problems.

Alternatives to self-harm

To eliminate self-harm behaviors as well as other indices that account for the emotional pain suffered by the person, it is necessary to acquire adequate emotional regulation strategies and to be able to work on the traumatic elements that are at the base of the discomfort.

Some mindfulness meditation techniques can help with emotional regulation, and are actually one of the components of mindfulness. dialectical-behavioral therapy, which is the therapy of choice for BPD and has also been shown to be effective for self-injurious behavior, suicidal thoughts and / or behaviors, eating disorders and drug or drug abuse.

Regarding the traumas that usually accompany self-injurious behaviors, it can be useful to use EMDR, a very useful technique for the approach of post-traumatic stress disorder.

Bibliographic references:

• Schmal, C. (2014, May). Neural bases of self-injury. Mind and Brain, 66, 58-63.