September 23, 2004

In the face of emotional stress many people, mostly females between the ages of 13 and 30, inflict cuts on themselves. This behaviour becomes an addiction requiring immediate professional help, writes Tazeen Mohsin

Self-injury is not something people like to talk about. But it has been estimated that one in ten adolescents deliberately hurt themselves. Though most cases go unreported, at least two to three million people are victims of self-injury. The majority being females between the ages of 13 and 30. However, there are people from other age groups, gender, religion and across the economic divide as well.

Hurting oneself is usually linked to depression. Some victims may become suicidal. They intentionally inflict pain on themselves in response to any difficult and stressful situation. This infliction could vary from minor cuts, deep wounds, burning themselves with cigarettes, punching themselves with objects that are harmful, pulling their hair out, and sometimes even taking drug overdoses to deal with difficult emotional situations.

Such people usually use razors, utility knives, scissors, needles, broken glass, or whatever they find to make repetitive cuts on their arms, legs or other body parts. People who inflict self-injury are not sick or insane. In the formative years of their lives they were deprived of learning a positive way to deal with their emotions. They are perfectly normal people who are unable to handle stressful situations.

The most frequent reasons for self-infliction amongst teenagers is "to find relief from a terrible state of mind" and "because I want to die". Inflicting pain makes them feel more alive or calm, and more in control of their lives. It gives them an odd sense of well- being and strength; the same feelings that were taken away from them at some point in their life.

At other times, it reflects anger towards oneself. When these youngsters were abused, they felt ashamed, guilty and blamed themselves for it, which in turn caused them to feel the need to punish themselves by inflicting pain on their bodies.

Some people will go to the extent of carving names on their bodies as a way to remind themselves of how terrible they are. For them this is not senseless or irrational behaviour.

Self-destruction reflects deeper, more complicated personal and mental problems. It is most common amongst people who have been sexually abused, molested, bullied, emotionally harassed, experienced difficult relations or are survivors of incest.

It has been said that children who get inadequate attention, are violated, neglected, or abused, lose their sense of security. They do not know how to protect themselves. They re-enact their abuse and lack of protection through a variety of self-harming behaviours. They feel worthless and meek. They experience an inability to tolerate intense feelings and often have trouble expressing emotional needs, which is where the injury steps in to help "end" or lessen the stress.

Another theory is that some victims are constantly reminded that they are beautiful and that they will attract attention of the opposite sex, and as they become afraid of being raped (possibly again) or victimized, they create scars to hopefully scare away anyone who tries to come in contact with them.

Self-injury then becomes an addiction, which is extremely hard to stop. The pain is blocked out because the victims are so focused on hurting themselves that they ignore everything else. It does hurt afterwards. But preventing patients from hurting themselves can cause them to experience symptoms such as agitation, paranoia and irritability.

Most victims find it very hard to talk about what they are doing to themselves as it involves a lot of shame and guilt. They have this gnawing feeling that they are insane or crazy. This conduct is actually a cry for help because they cannot express their feelings in words. It is usually done to get attention from others as they haven't learnt to express themselves in a normal way. They want others to care for them.

Sometimes such people manipulate the situation by trying to make others feel guilty of their past mistakes and callous behaviour with them. Unfortunately, when people hear about this form of self-harm, they label these people as being psychotic or crazy, that is why few people come forward and ask for help.

Even though self-injury lessens as one grows older, immediate help should be sought. There are some victims who may hurt themselves more severely or frequently, finally, resulting in a suicidal attempt. More harm can be done than intended from infections. Some people use rusty razor blades or anything sharp to hurt themselves.

Replacing pain with another form of pain is neither recovery nor does it help. It leaves the person feeling more isolated and alienated. People who self-injure can learn to use, with help from outside, new and healthier stress-coping mechanisms. This process may take years.

New coping mechanisms may include exercising, painting, writing, yoga or dancing. A process that involves self-expression is often helpful. Whatever works as an alternative method of coping with the feelings of anxiety or stress or ‘numbness’ is often a good start towards recovery.

 

Tehmina, aged 25, appears a normal, average mother of a three-year-old daughter. “I have one dreadful secret though,” she confesses with a shy smile. “When I was 10 my father died. Soon after, my mother married a man I did not get along with. We had frequent fights, which always culminated in my physical and emotional abuse by him. My mother was completely powerless before him. He justified himself by saying I needed to be “disciplined”. I didn’t know what to do. I hated my stepfather, I hated my mother, but most of all, I hated being alive, and being me.

All the anger was piling up. I kept on storing it. My friends had perfect families, which made me feel more worthless. I felt very lonely and couldn’t trust anyone. One day, after a serious fight with my stepfather, I picked up a pair of scissors and started hitting my arm repetitively. It felt good when the blood came out. I didn’t feel numb anymore. I felt the pain I was holding inside was running out as my blood. It was the perfect outlet.

From that day onwards, I would cut myself with a knife on the slightest provocation. I, however, did feel scared that someone would find out, so, I made sure I wore full sleeves. There were a lot of times I felt guilty of what I was doing, but couldn’t stop myself. Even after when my mother got divorced, I continued with the practice.

When I was around 20, I made a deep cut on my arm. At university, while sitting in my class I unconsciously scratched my wound which caused it to bleed. One of my classmates (now husband) noticed the blood before I could run to wash it.

Later, he confronted me. I couldn’t hold it inside me anymore and just broke down in tears. Eventually all my life history came pouring out. He helped me to come out of it by giving emotional support. All my friends, as well as my mother, got involved. I, then, finally, sought professional help. The support and love helped me conquer my addiction.