Emotional Mooring: The Truth About Self-Injury And The Road To Recovery

A young woman sits in her bedroom with a razor at her arm, pressing thin lines into her flesh that begin to weep red. She says nothing and you never see her face, but for 3 minutes and 47 seconds she invites an anonymous audience to witness her most intimate pain. Hers is among the thousands of self-injury videos to be found on Youtube. Most are made by young adults, often barely adolescents, usually girls. Scattered amongst the demonstrations and confessionals are tutorials for how to disguise cutting scars with make-up, video montages of celebrities who are suspected or known self-injurers, inspirational monologues from people who have stopped cutting, and interviews with Demi Lovato regarding her own history of cutting. The endless clips serve as a testament to the new visibility of self-injury and the need for effective intervention as more and more young people seek relief through somatic trauma.

The heightened awareness and media coverage of self-injury may lead some to believe it is a recent phenomenon. Others make the mistaken assumption that it affects only teenagers or people with Borderline Personality Disorder, for which self-harm is a hallmark. But self-injury is not new, nor is it confined to any one group or diagnosis. Well before YouTube was a glimmer in anyone’s eye, Ancient Greek historian Herodotus recounted the story of a Spartan leader who used a knife to mutilate himself. In the late 1800s, European women stuck sewing needles into their skin, a practice so prevalent that doctors took to calling its practitioners “needle girls.” Van Gogh famously cut off part of his ear with a razor in 1888 while reeling over a fight with Gauguin and a few years later Alfred Kinsey began compulsively cutting his own genitals. In The Second Sex, published in 1949, Simone de Beauvoir saw self-mutilation by adolescent girls as way of exercising a false autonomy in the face of gendered oppression: “The girl gashes her thigh with a razor, burns herself with cigarettes, cuts and scratches herself. [W]hen she wounds herself, the girl is defying her future lover; you will never inflict on me anything more horrible than I inflict on myself.” By the 1970s, self-injury became public performance as Sid Vicious slashed himself on stage to the roar of approving crowds, but his cutting wasn’t confined to public spectacle — his private self-harm was just as prevalent.

To those who have never experienced self-injury, the drive toward it can seem baffling and even absurd. After all, one of our most innate instincts as humans is the avoidance of pain and the preservation of the body; the deliberate breaking, burning, or bruising of the flesh exists in contradiction to the most basic of survival instincts. But to those who do it, self-injury is often, at its core, not about annihilation, but coping. You cut not to hurt, but to stop hurting. You burn not to die, but to make life tolerable. Dr. Armando Favazza, author of Bodies Under Siege: Self-Mutilation in Psychiatry and Culture, says that, “[Self-injury is] the opposite of suicide. Those who do it want to live. They do it to feel better. It’s an impulsive act done to regulate mood.” Far from an irrational act of self-erasure, self-injury is often an attempt to heal, however temporarily, the wounds of psychological pain. It is a kind of emotional mooring when your emotional landscape is flooding. And it works. That’s what so many people don’t understand—people don’t cut or hit or burn themselves because it feels terrible, they do it because it provides effective, immediate, and accessible relief.

Rebecca Raye, a 19-year-old woman with a long history of cutting, explained her self-injury to NPR: “Part of me almost feels like […] all the things that are really hurting me at the moment are just kind of leaving me, along with the blood. I’ll just be really calm and my thoughts will finally kind of be making sense, instead of them like racing through my head and nothing quite clicking. Just kind of centralizes my thought on one thing.” These feelings are not just vague sentiments, but the product of a very real physiological response. Self-injury triggers the release of endorphins, a neurotransmitter with similarities to morphine, flooding your brain with chemical relief. While some people self-injure because they have no other way of managing overwhelming distress, others choose self-injury over healthier alternatives due to the pleasure it can provide. For some, the endorphin rush itself is an elating experience when emotional highs are in short supply.

While self-injury is not the domain of a single diagnosis and affects people with a wide range of mental health disorders, one group may be particularly vulnerable: people who have experienced abuse, particularly sexual abuse. In part, this is due to the general increase of psychiatric risk. But self-injury also provides a concrete way of disrupting the process of dissociation and depersonalization that many abuse and assault survivors experience as the result of trauma. Dr. Favazza says:

[O]ne of the sure ways to end these episodes of depersonalization is to cut yourself. They see the blood and they say, `OK, that’s where my body is because the blood is coming out from my skin, and I know where the boundaries of my body are,’ and then the depersonalization or the dissociative process ends.

In the absence of more effective methods of halting dissociation, self-injury offers rapid re-integration of mind and body, allowing you to return to your physical form by opening up your flesh. In some ways, it is a variation of de Beauvoir’s imagining of self-mutilation as a pre-emptive performance to guard against future trauma; instead, self-injury becomes a very real way of disrupting the psychic/somatic chasm of trauma, resisting ongoing traumatization, and restoring wholeness.

Although self-injury is one of the most visible expressions of pain, it is only a symptom, and although it seems effective, it offers only a temporary solution to enduring psychological distress. The injuries produced by cutting, burning, and hitting often become a new source of emotional suffering, and shame of the marks left on your body can lead you to self-isolate, further damaging your ability to heal. Worse still, even non-suicidal self-injury can cause significant physical damage and, in some cases, lead to death.

In order to stop self-injuring, it is critical to examine the underlying causes of your pain and develop a full diagnostic picture of your mental health. Only by identifying the roots of your distress will you be able to gain the insight to effectively process emotional disturbances in healthy and productive ways. But simply knowing what is wrong is not enough—often people who self-injure are acutely aware of the sources of their pain but are missing a roadmap for how to address it. You may have grown up in a home where emotional suppression was encouraged and you did not have the benefit of witnessing and practicing how to handle emotional turmoil. Or perhaps the type of distress you are experiencing is far beyond the reach of your normal coping skills. In addition to enhanced self-understanding, meaningful behavioral interventions must be made to give you the much-needed skills to express yourself and cope with triggering situations without relying on self-injury. Specialized therapies designed around your personal needs can greatly improve your distress tolerance while supplying you with the tools to respond to overwhelming feelings in ways that strengthen you and enhance your resiliency. Meanwhile, holistic therapies can help you re-establish a healthier, more caring relationship with your physical self that honors your body.

Princess Diana once told the BBC that she was driven to self-harm because, “[Y]ou have so much pain inside yourself that you try and hurt yourself on the outside because you want help. I was crying out because I wanted to get better in order to go forward.” Now is the time to get that help so you can move forward and begin healing mind, body, and spirit.

Bridges to Recovery provides comprehensive, residential treatment for people living with mental health disorders. Contact us to learn more about how we can help you or your loved on start the journey to recovery.