The image of someone inflicting cuts on their arms with a razor blade can be horrifying to many and incomprehensible to most, especially considering that there is no firm intention to end one’s life. So, What leads people to self-harm?
For a long time it was believed that self-harm was a symptom of psychosis, as compared to the popular belief that it is a wake-up call. Probably both ideas are wrong, the most recent explanations would indicate that self-harm is more an attempt by the person to end states of great psychological tension.
Traumatic experiences in childhood make the person more vulnerable to stress due to an altered process of brain maturation. Among the greatest risk factors are sexual abuse, mistreatment, emotional neglect and rejection by people of reference. These are some common experiences in the personal history of individuals who suffer from borderline personality disorder (BPD).
Borderline personality disorder and self-harm
Self-harming behaviors are very common in BPD; In fact, one of the criteria to take into account when determining the diagnosis of BPD is the presence of behavior, attitude or recurrent threats of suicide, or self-mutilating behavior. Almost all people with BPD display self-mutilation at least occasionally.
However, self-harm is not an exclusive symptom of BPD, They can also be seen in depression, eating disorders, and post-traumatic stress disorder.. In fact, causing physical harm to oneself is not exclusive to the human species either; for example, cases can be found among other primates, such as some monkeys that bite themselves.
Another criterion to take into account when diagnosing BPD is the occurrence of severe dissociative experiences.
Search for pain to displace dissociation
During the self-harm ritual, there is at first a high psychological tension accompanied by a reduction in the perception of pain. The person carries out self-harm to reduce this tension, After being injured, she feels relaxed (wounds generate endorphins) and then begins to experience discomfort from the damage..
The strategy used is so effective in reducing emotional tension that, in the absence of another method to find relief, the person relapses into this behavior, creating a habit.
For people with BPD, unlike other people, distraction does not help them as an emotional self-regulation technique, and that is why they resort to drastic strategies.
At first, the person who self-injures finds momentary relief from their psychological overload, then guilt and shame appear, as well as the concern to hide the wounds. The latter can cause or worsen social isolation, generating additional discomfort and creating a vicious circle.
Furthermore, some of the consequences of self-harm can be a maintenance factor: attracting attention, provoking parents and/or establishing relationships with other affected people.
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What is this psychological tension that leads them to self-harm?
People seeking relief from these self-destructive behaviors often try to free themselves from dissociative experiences. Dissociation is an alteration or splitting of psychic functions (such as memory) that It affects above all at the level of perception of oneself or the environment.
Depersonalization is a dissociative phenomenon and is typical of BPD, as well as other forms of psychological trauma, such as post-traumatic stress disorder.
People who suffer from depersonalization perceive themselves as distant, unreal or strange. These sensations are often accompanied by a reduction in the perception of pain..
Some research suggests that people with BPD have a higher pain tolerance threshold than the general population, and this greater pain tolerance would increase during times of stress prior to self-harm.
This form of altered pain sensitivity is an index that can be modifiedbeing able to approach that of the normal population after psychotherapeutic treatment and after stopping self-harm.
This behavior occurs more among girls and young women, possibly because they tend to direct negative feelings toward themselves. In fact, The prevalence of BPD is much higher among women than in men, just the opposite of antisocial personality disorder, which is based on inattention and violation of the rights of other people.
How to detect self-harm?
These are the warning signs to take into account:
The triggers that lead a person to self-harm can be frustrating interpersonal experiences. Sometimes it can also be a behavior emulated by peers as a sign of belonging.although regularly self-harming to overcome stress is generally indicative of strong emotional problems.
Alternatives to self-harm
To eliminate self-harm behaviors as well as other indices that account for the emotional pain that the person suffers, it is necessary to acquire appropriate emotional regulation strategies and to be able to work on the traumatic elements that are at the base of the discomfort.
Some meditation techniques aimed at mindfulness can help with emotional regulation, and in fact are one of the components of dialectical-behavioral therapy, which is the therapy of choice for BPD and has also been shown to be effective for self-injurious behavior. , suicidal thoughts and/or behaviors, eating disorders and drug abuse.
Regarding the traumas that usually accompany self-harming behaviors, it may be useful to use EMDR, a very useful technique for addressing post-traumatic stress disorder.
