Non-Suicidal Self-Injury: Who is Affected and Why Does It Occur?

Physical pain has almost always been defined as the sensation that produces aversion reactions; that is to say, an unpleasant experience that we try to avoid. It appears when our nervous system registers that certain cell tissues have been injured and allows us to react in time to get away from danger.

However, human beings do not always act consistently with this logic; in some cases pain is something that is intentionally sought, something that is achieved through self-harm. This idea is what is behind the concept of Non-Suicidal Self-Injury..

What is Non-Suicidal Self-Injury?

Self-harm is very easily associated with suicide attempts, but in reality, in many cases, the The objective you have in mind when it occurs is not death itself: self-harm is valued in itself, not as a half.

Thus, Non-Suicidal Self-Injury consists of the type of self-harm that occurs because of a learned dynamic to try to reduce the levels of anxiety through practices such as cutting, biting or striking against hard objects in which the body itself is damaged.

A mental disorder?

There is no broad consensus as to whether Non-Suicidal Self-Injury is itself a mental disorder or a symptom that may reveal the presence of one. In the DSM-IV diagnostic manual it appears as a symptom linked to Borderline personality disorder, although in version V it appears as its own diagnostic label.

The truth is that this behavior is in itself harmful, but at the same time it can be considered as a "lesser evil" that serves to alleviate a very high state of anguish in which lies the root of the true trouble.

Why does ANS occur?

What the ANS is trying to achieve is a feeling of momentary relief produced in part by the distraction that involves physical pain, which allows you to disengage your attention from abstract ideas and memories that are even more painful.

According to the logic behind Non-Suicidal Self-Injury, the simple possibility of experiencing something other than that kind of anxiety and that is a solution for the rumination (thinking in a loop about something that causes discomfort) is valued very positively.

In other words, to understand why Non-Suicidal Self-Injury appears as a pattern of learned actions it is necessary to take into account not the pain felt at the time of get injured, but the effect that pain has on a person who has suffered for a long time for other reasons. That is, you do not have to see the snapshot or the frozen image of the self-injury, but the process of sensations and experiences that have led to that outcome, since this is what allows us to take into account the usefulness that pain can have for the person. In that sense, it would resemble the trichotillomania.

There is also an alternative explanation about the causes of ANS that links it to a low self-esteem and a tendency to think negatively about oneself, thereby self-harm would be a way of reflecting that self-contempt through self-punishment. However, it is quite possible that low self-esteem is another symptom of the underlying problem, and not the cause of Non-Suicidal Self-Injury.

ANS as a predictor of suicides

Although the purpose of the ANS is not to end one's life, it is true that its presence is a predictor of possible suicide attempts in the future.

A person who self-injures will have a greater chance of coming to propose to die, among other things because the "ritual" that can lead to these kinds of events has already been assimilated and is being thought of with greater frequency. In addition, the same causes that lead to this learned behavior pattern can lead to the desire to die, either in a more or less rational way or in the middle of a nervous breakdown.

Symptoms of Non-Suicidal Self-Injury

The most obvious symptoms of ANS are scars from cuts and bites and bruises from bumps.

The cuts, which are very common, tend to appear on the arms and legs, and therefore can be visible with a wide variety of clothing types. Other forms of self-harm are more discreet. Usually begins with parts of the arms and legs that are close to the thorax, since they are the parts of the extremities most easy to hide and at the same time they are not as sensitive areas as the front parts of the trunk (as long as the inside of the arms).

The profile of people who harm themselves

Non-Suicidal Self-Injury is more frequent among young people: fundamentally, adolescents and post-adolescents. This may be due to the fact that the emotional instability produced by hormonal changes produces larger and more serious anxiety attacks, added to the social changes that appear at this stage of life: doubts about one's own identity, about what to study, problems in fleeting relationships, etc.

In addition, there are certain personality traits that are more common among people who practice this kind of self-harm. These are people with high impulsivity and emotionality (or sensitivity) who, in addition, have low self-esteem and value their abilities downwards and pessimistically.

Treatments and psychotherapy

The most effective psychotherapeutic options are those that are framed within the Cognitive Behavioral Therapies, that is, they address both actions and thoughts. Specific, Linehan's Dialectical Behavior Therapy (DBT), created especially to deal with cases of Borderline Personality Disorder, has been widely used.

The basis of these therapeutic approaches is to constantly postpone the moment of self-injury until it does not occur. It is a way of acting on behavior that is reminiscent of addiction treatment.

In any case, the role of psychologists focuses on both the decrease in frequency and the intensity of these behaviors as in learning ways of thinking and relating to others that allow get away from stress adaptively and without suffering. In the same way, a level of vigilance is maintained to detect moments in which suicidal ideation may appear.