Non-suicidal self-injury (NSSI) may not result in death if the person indulging in such behavior is not suicidal in nature. However, some other risks and dangers may fester if the self-harm continues.NSSI is more common in adolescent and young adult populations than previously thought.
One big problem that clinicians face with self-harming patients is not only because of the obvious danger of the patient harming themself but also to ascertain whether the patient has suicidal intent.
Most commonly, however, NSSI includes cutting, burning, or stabbing oneself without suicidal intent. Other types of NSSI include hitting, pinching, banging, or punching walls and other objects to induce pain, breaking bones, ingesting toxic substances, and interfering with the healing of wounds.
So why do these people indulge in self-harming behavior? Some of the reasons may include:
A way to reduce tension or negative feelings
A way to resolve interpersonal difficulties
Self-punishment for perceived faults
A plea for help
To resolve a feeling of numbness
Most of the patients who engage in self-harming behavior claim that it helps them to temporarily feel better and not feel overwhelming emotions.
In a recent study, a team led by Kathryn R. Fox (Harvard University) tested three hypotheses as to why NSSI might improve mood.
1. Pain-offset relief hypothesis
the removal of physical pain can lead to a sense of emotional relief.
2. Self-punishment
Highly self-critical individuals may regard pain as something they deserve and pain caused by self-injury is interpreted positively
3. Distraction
Another line of research suggests that pain might improve mood by acting as a potent distractor.
Distractions, such as taking a walk or listening to music, can improve mood in healthy people as well as people suffering from depression. However, some researchers suggest that these light distractions may not be sufficient to help regulate negative moods in some people. Instead, a much stronger distraction, such as physical pain, may be necessary to improve mood.
The dangers
The instant relief that NSSI provides is the reason why all those engaging in such behavior develop an addictive pattern of self-harming which can prove to be quite difficult to discontinue.
‘Although distinct from suicidal behavior, NSSI frequently occurs in adolescents who, at other times, have contemplated or attempted suicide. One recent study found that 70 percent of teenagers engaging in NSSI had made at least one suicide attempt and 55 percent had multiple attempts. Some adolescent inpatients report hurting themselves specifically to stop suicidal ideation or to stop themselves from actually attempting suicide. Consequently, Favazza conceptualizes self-injurious behaviors without suicidal intent as a morbid form of self-help.’ - (“Non-Suicidal Self Injury in Adolescents” Journal from US National Library of Medicine National Institute of Health)
In a lot of cases, NSSI is preceded by a psychological disorder that may go undiagnosed if immediate treatment is not provided to the patient. “A sizeable percentage of adolescent and young adults who engage in NSSI—almost half—may not meet criteria for depression, anxiety, eating disorder, substance use disorder, or other major psychiatric disorders” -(Psychiatric journal NCBI)
Low self-esteem and high-grade self-critical behavior are two other characteristics that precede NSSI as well as succeed it. A loop of repeated self-harm feeds these characteristics making it harder and harder to make the loop and realize one’s self-worth.
Lastly, it is important to realize that at the end of the day NSSI is nothing but a bad coping mechanism, a faulty way to regulate and process emotions and turmoils that one encounters in day-to-day life. It is important that this coping mechanism is fixed and more healthy and better coping mechanisms are introduced in its place. More importantly, it may also be a plea to help or a signal to an underlying disorder that needs to be diagnosed.
- Chaitanya Nair
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