Did you know that March 1 was Self-Injury Awareness Day? Self-injury, most commonly represented by cutting, goes through phases where it is prominent in the media. Sometimes it is portrayed accurately, but more often it’s sensationalized and misperceived. Unfortunately, it’s also often misunderstood by the family and friends of people who self-injure, which can result in reactions that don’t help and may even exacerbate the situation. So, let’s try to really understand what leads some people to cut, scratch or burn their skin, bang or hit their heads, or do other things designed to harm their own bodies.At its core, self-injury is a way to deal with unbearable bad feelings. It may be sadness, anger, trauma, frustration, fear or any other deeply distressing emotion lying underneath. Typically, the person feels overwhelmed by the emotional pain and doesn’t know what to do about it. For example, she (or he) may act on an urge to cut one time, and feel a temporary release of the pain and tension. This experience paves the way for self-injury to become a habit.QUIZ: Assess Your Self-EsteemLucy’s StoryLucy grew up with parents who love her very much and would do anything for her, but they have no idea how to express or acknowledge emotional issues. So Lucy never saw anyone modeling how to deal with difficult feelings. Unfortunately, Lucy had some childhood and teenage experiences with mistreatment by some “friends.” She kept them a secret for many years, and struggled with shame, low self-esteem and sadness. When she was in middle school, Lucy discovered cutting. She doesn’t know why she first started, just that it seemed like the right thing to do. For years, she cut almost every day, hiding the multiplying scars under bracelets and long sleeves. It became so instinctual that she felt extremely stressed when she couldn’t cut and continued to deeply believe that it was just what she was supposed to do. Now halfway through high school, Lucy has learned to talk about what’s going on inside her in therapy and with a trusted friend. Though she tries, and often succeeds, to go longer periods of time without cutting, the impulse is still strong at times. Nancy’s StoryNancy married her high school sweetheart and heard from all her friends that she was the luckiest girl in the world. He made a good living, they had two great children and life appeared to be a fairytale. Then, she learned about all the prostitutes—many prostitutes for many years. She blamed herself for her husband’s transgressions—partly because he told her that everything was her fault, and partly because she was inclined to assume she wasn’t good enough in any way. For many years, Nancy’s emotional and spiritual framework didn’t permit her to consider ending the marriage. During these years, she found ways to numb the pain, primarily cutting and starving herself. When her husband ultimately sought a divorce, Nancy found the strength to rebuild herself and her life. As part of this long process, she dealt with the pain and anger that she had suppressed for years and found that she could handle her emotions without self-injury.MORE: Therapy Options: What’s Out There?It is difficult to know what to do if you learn someone you care about is self-injuring. Here are the two most vital things to remember:1. Do not overreact. People who self-injure are not trying to kill themselves. They may also be depressed or suicidal, but that is a separate issue. They are trying to deal with bad feelings and help themselves go on with life. Cutting isn’t a suicidal gesture. So, even though it’s upsetting to learn that someone you care about it intentionally hurting themselves, don’t freak out. It’s not going to help if your reaction is overwhelming.2. Do not underreact. On the other hand, take it seriously, even if the wounds don’t look serious. Self-injury is a sign of significant underlying distress, and needs attention and help, possibly from a professional with experience in this area. People who self-injure are not just looking for attention. In fact, they often feel ashamed and go to great lengths to hide the behavior. So, when you discover it, don’t take it lightly.The bottom line is that self-injury is all about difficult feelings. Stopping self-injury requires figuring out how to deal with those feelings in a healthy and productive way, instead of being drawn in by the destructive impulses. It’s important for everyone to understand not just what self-injury is—but also what it isn’t.MORE: How to Be There for Someone with Cancer
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