In the new DSM-5 non-suicidal self-injury (NSSI) is deemed a “condition for further study” as opposed to a full-blown clinical diagnosis. But that doesn’t make it any less concerning.
Non-suicidal self-injury is the newest and most appropriate term for a condition also known by some as parasuicide, deliberate self harm, self-abuse, self-mutilation, self-inflicted violence, and cutting—which in actuality are variations of NSSI with differing definitions. NSSI distinguishes suicidal self-injury from non- suicidal self-injury.
Some of the behaviors that are considered self-injury besides cutting are burning, scratching, hitting or biting oneself, ingesting or embedding toxic substances or foreign objects, hair pulling, and interfering with the healing of wounds.
As non-suicidal self-injury is often featured in the media as a young person’s problem and indeed often does have its start in youth, many people aren’t aware that NSSI also exists among adults of all ages. NSSI, of course, doesn’t just magically go away after adolescence—and sometimes it doesn’t even begin before adulthood.
Although it’s hard to gather accurate statistics on such a stigmatized behavior, the Cornell Research Program on Self-Injury and Recovery estimates that 12 to 20 percent of young adults self-injure (Chicago Tribune). And it’s not females only, contrary to popular belief.
Why might we think that men don’t self-injure? Popular media, for one. As far as I know, well-known contemporary movies, for example, have featured only women as self-injurers: there’s Shame (2011), in which Sissy (Carey Mulligan) is revealed to be a cutter, and Secretary (2002), in which Lee (Maggie Gyllenhaal) has been hospitalized related to both cutting and burning herself.
What are some of the possible reasons for NSSI? A selected list from Pine Grove, a treatment facility:
- Desire to release tension
- Desire to gain control
- Mental disorders
- Association with others who self-harm
Rachel Bender, MA, reporting in a University of Pennsylvania newsletter, explains how NSSI evolves into a deeper problem:
The sensation of relief tends to wear off very quickly. Soon after NSSI, people feel more guilty, ashamed, or angry with themselves. Ironically, these are some of the very emotions they were trying to escape in the first place! Additionally, people usually feel that they need to keep their NSSI behaviors a secret from friends and loved ones. Carrying this secret can make people feel more lonely and isolated. After repeated NSSI, individuals may also feel as though they are ‘addicted’ to deliberate self-harm. They want to stop hurting themselves, but they have difficulty breaking the cycle. This sense of lost control over one’s own behavior can be distressing. Finally, self-harming behaviors can lead to infections, permanent scars, or accidental death. In the end, NSSI does not truly help people deal with the issues that led them to self-harm in the first place.
Looking for solutions? Deborah Serani, PhD, Psychology Today, has “10 tips for reducing self-injury.”
Other resources include the following books:
- Treating Self-Injury, updated last year, by Barent W. Walsh, PhD
- The Tender Cut, by sociologists Patricia Adler and Peter Adler (2011)
- Cutting, by therapist Steven Levenkron (1998)
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