The Questions We Never Ask: ‘Why Did They Cut Themselves?’

Self-harm, like the word suggests, is an act to harm oneself physically and/or emotionally. In its most general form, self-harm may constitute acts of making cuts on wrists, arms, legs and perhaps even stomach. Such acts may also include burning oneself with boiling hot water or cigarettes, holding one’s breath or suffocating oneself with a pillow and so on. The less-obvious forms of self-harm include the excessive consumption of any intoxicant like alcohol, cigarettes or drugs, the sudden and extreme display of promiscuous behavior, and deliberately putting oneself in dangerous situations.

Teens and young adults are more prone to self-harm. Now, you may ask why. Adolescence, the teen years and young adulthood is a phase of transition, which entails a lot of changes, decisions and choices to be made. These may or may not always be the way the individual prefers the situation. On the other hand, they may not even know what they prefer. This stage of ambiguity causes feelings of unrest and emotional turmoil which most young adults fail to comprehend. Feelings of sadness, loneliness, anger and a sense of loss of control may all seem overwhelming – therefore, leading to the urge for avoidance or to search for meaning and understanding.

At such a stage, the act of self-harm provides a clarity as to the source of pain for these individuals. They are aware that the pain is being caused by cutting, which they are inflicting on themselves. Furthermore, that also gives them a false sense of control over their feelings and emotions. For some individuals, the process of watching their blood flow also provides them a sense of instant relief from pain, which can be temporarily gratifying in its own way. Additionally, it is important to understand that self-harm is more a form of reducing tension rather than of ending life. However, self-harm is usually taken seriously as it may be a precursor to suicidal ideations or attempts.

Alcohol, drugs and sex give a false sense of control to cause pain to oneself on demand. They also provide an affirmation of where the pain is stemming from.

Furthermore, it is important to understand the cause(s) of self-harm or the symptoms accompanying it. This would help us determine the underlying problem and how the therapy/treatment needs to be undertaken. The possible causes could be depression, anxiety, a personality disorder, or neuroticism (a relatively mild mental illness that is not caused by organic diseases – involving symptoms of depression, anxiety, obsessive behavior, hypochondria but not a radical loss of touch with reality). Some individuals also cause self-harm out of anger and frustration, without realising the degree to which they are hurting themselves.

As a mental health professional, the importance of understanding the reasons to why someone would inflict pain on themselves is immense. Therefore, I also feel the importance of educating others about the same. This insight can not only help the loved ones understand the proplr suffering, but also replace maladaptive coping mechanisms (like self-harm) with more adaptive strategies.

In order to identify the urge to self-harm, it is important to be insightful about one’s feelings and emotions. Most teen transitioning from 19-20 start developing good insights; however, this can happen sooner as well. The feelings of being impulsive, immense anger, restlessness, or the inability to stay calm are either due to a particular triggering event or loneliness.

Once the urge has been identified, the act can be nipped in the bud. Of course, it takes effort and patience, but it is very much possible. For me, the first step is the acceptance that something may be wrong with me – and therefore, I am looking for an outlet. Even recognising that self-injury is an attempt to soothe oneself – and that you need to develop other, better ways to calm and soothe yourself – is a very helpful technique. More often than not, it is extremely helpful talking to someone you trust about your urges to self-harm.

A technique that helped me was reminding myself that “this is just a momentary urge and it will pass if I wait it out.” Counting backward or listening to soothing music at that moment can help you take your mind off the urge, and even take the feeling away.

Some professionals suggest that if this initial step isn’t possible, then perhaps taking a red felt pen and drawing marks (where one usually makes the cuts) can also prove to provide similar relief. Sometimes, in order to reduce the intensity of self-harm, professionals initially suggest reducing the impact of the harm and probably hurting oneself in ‘harmless ways’ – like holding a cube of ice or dipping one’s hands into a bowl of ice or stomping your feet on the ground. During one of my group therapy sessions in Mumbai, few adolescents revealed that punching a boxing bag helped them deal with their urges to good effect. Their depressive and anxiety symptoms also seemed to have reduced.

For those who struggle with substance abuse or promiscuity as a form of self-harm, studies and experiences show that having a ‘buddy’ to warn you each time you may be going overboard may be helpful. Setting small limits for yourself on a night may also do the trick. Additionally, one could also use a vape instead of smoking cigarettes or illicit drugs. As mentioned above, realising the urge and being wary of the same is the key to adopting these adaptive strategies.

Finally, if you feel the need to self-injure, try asking yourself these questions first:

1. Why do I harm myself? Why do I feel I must injure myself? What has driven me to cut (or burn) myself?

2. Have I done this before? How did I cope then? Did I feel the same way?

3. What other paths have I pursued to ease my pain prior to this? Is there something else I can do – an alternative to self-harming that won’t hurt?

4. How am I feeling now?

5. How will I feel later, when I am injuring myself?

6. How will I feel afterwards? How will I feel the next morning?

7. Can I avoid the problem that has driven me to this point? Is there a better way I can handle it the next time?

8. Must I injure myself?

Write them down so you can refer to them later and analyse your reasoning. Answering these can really help you understand the underlying issue and help develop more adaptive coping mechanisms. These responses may further help one’s therapist in providing more specific coping aids.

 The author is the co-founder of Invisible Illness.

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Featured image used for representative purposes only.

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