Non-Suicidal Self-Injury: Who Is Affected And Why Does It Occur?
Physical pain has almost always been defined as the sensation that produces aversive reactions; that is, 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 the pain is something intentionally sought, something that is achieved through self-harm. This idea is what is behind the concept of Non-Suicidal Self-Injury.
Self-harm is very easily associated with suicide attempts, but in reality, in many cases, the goal in mind when it occurs is not death itself: self-harm is valued in itself, not as a means.
Thus, Non-Suicidal Self-Injury consists of the type of self-injury that occurs due to a learned dynamic to try to reduce anxiety levels through practices such as cutting, biting or hitting hard objects in which the own body.
A mental disorder?
There is no broad consensus about whether Non-Suicidal Self-Injury is itself a mental disorder or a symptom that can 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 harmful in itself, but at the same time it can be considered a “lesser evil” that serves to alleviate a very high state of anxiety in which the root of the real problem lies.
What we try to achieve through ANS is a feeling of momentary relief produced in part by the distraction of physical pain, which allows us to disengage our 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 that is not that kind of anxiety and that is a solution for rumination (looping thinking 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 injury, but the effect that this pain produces on a person who has been suffering for a long time for other reasons. That is, we do not have to see the snapshot or the frozen image of the self-harm, but rather the process of sensations and experiences that have led to that outcome, since that is what allows us to take into account the usefulness that pain can have for the person. In that sense, it would be similar to trichotillomania.
There is also an alternative explanation for the causes of ANS that links it to low self-esteem and a tendency to think negatively about oneself, thus self-harm would be a way to reflect that contempt towards oneself through self-punishment. However, it is very possible that low self-esteem is another symptom of the underlying problem, and not the cause of Non-Suicidal Self-Injury.
The ANS as a predictor of suicide
Although the purpose of the ANS is not to end one’s own life, it is true that its presence is a predictor of possible future suicide attempts.
A person who self-harms will be more likely to intend to die, among other things because they have already assimilated the “ritual” that can lead to this type of events and think about it more frequently. Furthermore, the same causes that lead to this learned pattern of behavior can lead to the desire to die, whether in a more or less rational way or in the midst of a nervous breakdown.
Symptoms of Non-Suicidal Self-Injury
The most obvious symptoms of ANS are the scars caused by cuts and bites and the bruises left by blows.
Cuts, which are very common, usually appear on the arms and legs. and therefore can be visible with a wide variety of types of clothing. Other forms of self-harm are more discreet. Normally you start with parts of the arms and legs that are close to the thorax, since they are the parts of the extremities that are easiest to hide and at the same time they are not as sensitive areas as the front parts of the trunk (as long as the neck is not injured). inner part of the arms).
The profile of people who self-harm
Non-Suicidal Self-Injury is more common among young people: fundamentally, adolescents and post-adolescents. This may be because the emotional instability produced by hormonal changes produces greater 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 one is going to study, problems in fleeting relationships, etc.
In addition, there are certain personality traits that are more common among people who practice this type of self-harm. These are people with high impulsiveness and emotionality. (or sensitivity) who, in addition, have low self-esteem and value their abilities in a low and pessimistic way.
The most effective psychotherapeutic options are those that are part of Cognitive Behavioral Therapies, that is, they address both actions and thoughts. Specifically, Linehan’s Dialectical Behavior Therapy (DBT) created especially to address cases of Borderline Personality Disorder, has been widely used.
The basis of these therapeutic approaches is to constantly postpone the moment of self-harm until it does not occur. This is a way of acting on behavior that is reminiscent of addiction treatment.
In any case, the role of psychologists focuses both on reducing the frequency and intensity of these behaviors and on learning ways of thinking and relating to others that allow get away from stress adaptively and without suffering. Likewise, a level of surveillance is maintained to detect moments in which suicidal ideation may appear.
