Self-injurious behavior is defined as an act that intentionally inflicts harm on the body without the intent to commit suicide. The most common forms of self-injury are cutting or scratching with needles, knives, glass, razor blades, any sharpened object…even fingernails; branding or burning with hot objects (e.g., cigarettes, curling irons, stove burners) or using friction (e.g., rubbing on the skin with a pencil eraser of extended periods of time); picking at the skin or reopening old wounds that are beginning to heal; swallowing toxic substances or sharp objects; biting; or punching or hitting (e.g., repeatedly punching a wall or banging one’s head against a wall). This is not an exhaustive list, however. Self-injurers find unique ways to hurt themselves.

What all of these behaviors have in common for the self-injurer is that instead of feeling pain at the completion of these acts, self-injurers instead feel a temporary sense of relief. Self-injury is a coping mechanism for those who do it. It enables the self-injurer to deal with intense emotional distress. The motivation behind self-injury can be difficult to grasp. Reasons for the behavior include, but are not limited to: a way to regulate strong emotions; a way to distract from emotional pain; a way of expressing emotions that cannot be verbalized; a way to exact control over one’s body; a way to self-punish or a form of self-hate by those who have had a history of physical, sexual or emotional abuse; and/or a way to self-soothe for those who cannot calm their own intense emotions.

Self-injury is indiscriminant; it affects people from all strata of society. In the United States it is estimated that about 2 million people, approximately 1% of the population, are self-injurers. These people possess some common traits: the expression of anger and emotions was discouraged during their childhood and adolescence and/or co-existing conditions such as obsessive-compulsive disorder, substance abuse, or eating disorders are present and/or the lack of appropriate coping mechanisms for dealing with strong emotions and/or the lack of a social support network.

Often self-injury is a secretive behavior. Outward indications that the behavior is taking place may include: obvious cuts, scratches, or burns that do not appear to be accidental and for which no logical explanation is given; in increase in ‘accidents’ that cause injuries of the type described above; frequently bandaged arms and/or wrists (bandages may not be typical, such as bandanas or sleeved gloves); reluctance to take part in activities that require exposed legs, arms or torsos; and wearing long sleeves and long pants even in hot weather.

Treatment for self-injurious behavior varies. One effective treatment is family therapy. Improving communication within the family unit along with teaching conflict-resolution skills often help strengthen relationships between parents and adolescents. Cognitive therapy which helps self-injurers develop more socially appropriate coping mechanisms with which they can diffuse strong emotions may help to de-habituate self-injurious behaviors.