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Deliberately hurting oneself is among those human behaviors that seem baffling and counter-intuitive from the outside. And a common fear of those engaged in this type of behavior is that peers just wouldn’t get it. While most students don’t deliberately harm or injure themselves, it’s certainly something that’s happening, studies show.
“Self-injury tends to go through jags,” says Dr. Janis Whitlock, director of the Cornell Research Program on Self-Injury and Recovery at Cornell University, New York. “It’s not uncommon for someone to not injure for a year and then start again in when they get triggered by a variety of stressors—everything from academic to romantic problems.” Understanding self-injury can help clue us in to the complexities of our own and others’ experience, and lead us to healthy ways to handle the stresses of being a non-traditional student, however they manifest.
What is self-injury?
When people intentionally cause harm, pain, or damage to their own body, without the intent to die, it’s called non-suicidal self-injury (or self-harm). We tend to think of self-injury as cutting. In reality, it can be any type of behavior that intentionally causes tissue damage to the body, so it could involve burning, pulling out hair, or some acts of externalized aggression, such as punching walls. Self-injury may happen under the influence of drugs or alcohol (though using alcohol or drugs isn’t itself considered self-injury). Self-injury is different from suicidal self-harm, which is motivated by the intent to die and includes suicidal thinking. That said, people who self-injure are more likely than others to consider suicide (see: What raises the risk for self-injury?).
- Self-injury isn’t necessarily used as a way to get attention from others. However, some people may self-injure because they haven’t yet learned how to ask for what they need in healthier ways. If someone needs attention, take it seriously.
- Self-injury may co-occur with other issues, such as depression or anxiety, but it is not itself a disorder, diagnosis, or disease. Self-injury is a symptom.
- Eating disorders, such as anorexia or bulimia nervosa, are different from self-injury, though people with eating disorders are at higher risk of self-injury compared to the general population, according to a 2015 meta-analysis by the Cornell Research Program on Self-Injury and Recovery.
- Tattoos and piercings aren’t considered self-injury, unless someone is seeking out pain as a substitute for healthier ways to handle distress.
- Heavy drinking or drug abuse isn’t technically a form of self-injury, though the behaviors are often related. A 2011 study in the Journal of American College Health found that almost one in five students who self-injured did so when under the influence of alcohol or other substances.
- Self-injury isn’t the same as BDSM, erotic practices that involve submission and dominance, which may include consensual behaviors that cause physical pain. Self-injury is about seeking emotional release, while consensual BDSM practices are about sexual pleasure.
- Self-injury may be a means by which some people feel more in control of how and when they experience pain.
Why do some people self-injure?
Self-injury can happen as a result of not being able to cope with certain stressors or emotions. “The behavior is seen a lot in [students] because the pressures during this timeframe—like grades, relationships, and jobs—increase,” says Dr. Retta Evans, associate professor of Community Health and Human Services at the University of Alabama at Birmingham.
Self-injury is more common in those who are also experiencing depression or anxiety, sexual abuse or trauma, eating disorders, or substance abuse. “Self-harm was an outlet for the internal turmoil—the physical pain was much more bearable than the anxiety I was going through alone,” says a first-year graduate student at the University of Delaware.
People self-injure for a variety of reasons. Sometimes those reasons evolve over time. In our survey, many students referred to self-injury as a temporary behavior that they had managed to move past. “As a child, I was sexually abused by an uncle. I started [self-injuring] the third year it [was] happening. But with time [and through] hearing other stories, I began to accept that it wasn’t my fault. The more I talk about it, the more I’m beginning to have self-confidence,” said a second-year student at Indiana Institute of Technology.
These are among the most common reasons for self-injuring:
1 To experience emotions differently
“Self-injury normally happens for me because emotional sadness is so strong and I want to have a way to physically see and feel the pain.”
—First-year graduate student, University of Memphis, Tennessee
2 To “take away” or escape from unwanted feelings or thoughts
“Self-injury to me meant an escape from emotional pain that I did not understand and did not want my family to see. It happened because I did not want to be seen as weak in my family’s eyes; I was supposed to be a role model.”
—Fourth-year student, Dominican University, California
3 To bring recognition to their problems
“Sometimes emotions are just too much to handle, and you feel as though no one can understand what you’re trying to convey. And so this frustration becomes too much, and you lash out.”
—Third-year graduate student, Emory University School of Law, Georgia
4 To avoid taking anger out on someone else
“I got so angry that I hurt myself because I couldn’t hurt the other person. I’m a nice person, but when people do mean things toward me, I hurt myself instead. It’s the only way I can vent.”
—Fourth-year graduate student, Berea College, Kentucky
5 To punish yourself or help you deal with a failure
“To me, it meant an outlet for what I was feeling—or not feeling. I self-injured as a form of self-criticism or punishment. When I messed up, I thought I deserved it.”
—Second-year graduate student, Texas Christian University
6 To continue the habit
“Self-injury was a form of punishing myself for perceived ‘stupidity’ when it began. But it’s currently a compulsion when I experience severe frustration or stress.”
—Second-year graduate student, University of Rhode Island
How to help yourself or a friend who self-injures
Usually, when people learn how to cope with their emotions and talk about how they feel, they experience less of an urge to hurt themselves. Simple techniques and skills can decrease the intensity of emotions and make them more manageable. “Finding a different outlet [for distress] was the key to my recovery,” says a second-year student at SAIT Polytechnic, Alberta. These three approaches can help you or a friend:
1 Reach out and talk
If you’re self-injuring, reach out. Talk to a friend, your partner, mentor, professor, member of your religious community, or member of your support group (in person or online). Ask for their support, and spend time with people who make you feel good.
If you’re concerned that someone else may be self-injuring, check in with them. “Let [them] know you care,” says Dr. Lance Swenson, associate professor in psychology at Suffolk University, Massachusetts. “Remind your friend you’re there to listen. Tell them you can help them get help. Most people who self-injure aren’t consciously aware of why they’re [doing it], at least not in the moment.” Seek out support for yourself too, so that you’re in a strong position to be there for your friend.
“Let [them] know you care,” says Dr. Lance Swenson, an associate professor in the psychology department at Suffolk University, Massachusetts. “Remind your friend you are there to listen. Tell them you can help them get help. Most people who self-injure are not consciously aware of why they’re [doing it], at least not in the moment. They shouldn’t feel like they have to face it alone.”
That said, it’s not on you to solve this. “The roots of self-injurious behavior are likely very complicated. No matter how much you care about a [person], and how hard you try to help, they may continue this behavior despite your best efforts to help them,” says Dr. Davis Smith, a physician at the University of Connecticut.
How to talk to someone you are concerned about:
- Ask straightforward, direct questions in a calm manner, such as, “Are you thinking about hurting yourself?”
- Actively listen—focus on what they’re saying—then offer support.
- Take your loved ones seriously. If your friend mentions any thoughts about suicide, especially a plan or method, call 911 or enlist the support of others to help you find the right avenue to accessing professional support.
- Encourage your friend to talk to a trusted mentor, professor, or member of their religious community; be there for them, but do not take on the full burden yourself.
- Encourage them to consider seeking help from a licensed mental health professional (for example, a psychologist, social worker, or counselor—ask your health care provider or at a counseling center in your community).
2 Test coping strategies and figure out what works
If you’re concerned about a friend, you may be able to help them explore these techniques. If you’re self-injuring, test these strategies and take note of what helps. “Distress tolerance skills” can be used in place of self-injury. See Get help or find out more (below) for more info.
1 Do the opposite of what you feel:
For example, listen to your favorite upbeat song, or watch a funny YouTube video. Look in the mirror and smile—watch as your expression changes.
2 Exercise hard and fast:
Do 25 jumping jacks, go for a jog, or dance around the room. Research shows that cardio exercise can reduce your stress and improve your mood. Regular physical activity can be protective.
3 Use your five senses:
This helps you connect with what is going on around you and anchor yourself in the present moment. For example, sink your heels into the floor or ground and focus on how it feels beneath your body. Hold something soft or fuzzy. Squeeze a stress ball. Place a cool, wet washcloth on your face. Light a scented candle and breathe in deeply. Cook and/or eat your favorite food and really allow yourself to enjoy the flavor. Go for a walk or drive and take in the sights and smells. Take ice from the freezer and hold it tightly in your hand. Get into warm water (take a shower or bath).
4 Take slow, deep breaths:
Imagine you’re blowing up a balloon. When you inhale deeply, your lower belly should expand. Count to three on each inhale and each exhale.
5 Think about your emotions:
Face them instead of pushing them away. Labeling an emotion (e.g., “My heart is racing and I’m feeling anxious”) can often help you figure out why you’re feeling that way (e.g., “I have a big presentation coming up next week and I’m anxious about preparing for it”). Write down how you’re feeling in a notebook or journal.
6 Focus on your heart:
Put your hand on your heart so you can feel your heartbeat and count the beats per minute. Try to slow down your heart rate by taking slow, deep breaths.
7 Actively cherish what you have:
Look at pictures on your phone or computer that make you smile. Make a list of all of the things you’re grateful for or happy about in your life.
8 Actively cherish who you are:
Make a list of your accomplishments—e.g., “I’m an amazing researcher,” “I’m a caring daughter,” “I take excellent care of my dog.”
9 Sink into something else:
Read a book, story, or article. Listen to your favorite music, play an instrument, or sing (even if you have no musical talent!). Engage in your favorite hobby or master a skill, such as gardening, cooking, baking, playing a video game, knitting, painting, or drawing.
10 Prioritize sleep:
Get up as close to the same time every day as possible; this will help you go to bed at a more regular time too. Your bed is for sleeping only (no electronics or social networking). Relish it.
3 Consider seeking professional support
Checking in with a counselor can relieve some of the pressure and help you find strategies and resources you wouldn’t otherwise know about—whether it’s you who’s self-injuring or your friend. Your healthcare provider or a counselor in your community may be able to help directly or refer you to an expert. Certain therapeutic techniques—such as cognitive behavioral therapy (CBT) or dialectical behavioral therapy (DBT)—are designed to build healthy coping skills directly. If you ever feel suicidal, call 911, go to the nearest emergency room, or call the National Suicide Prevention Lifeline at 1-800-273-TALK(8255).
“I used to self-harm back when I was dealing with a lot. I eventually sought out counseling—and it was the best decision I’ve made,” says a first-year graduate student at the University of New Hampshire. “I’m so much happier and healthier, and can better manage my stressors and issues now that I’ve talked through the things that cause them to happen.”
Find out here Second-year undergraduate, Elgin Community College, Illinois “Calm Harm is a self-help tool, based on dialectical behavioral therapy, that helps users prevent self-harm the moment when urges arise. The app is based on the idea of “riding the wave” of emotional stress past its peak, until things get a little bit easier.” USEFUL? FUN? EFFECTIVE?
Calm Harm provides ways you can blow off some steam—anytime, anywhere. Whether I need comfort, a distraction, to express my feelings, or a way to release, the app lists dozens of strategies.
You’re able to review some of the recommended activities, which was fun. That way, you can test out a few to try before the time comes when you use it for real, because scanning through impractical solutions will lead to frustration and discouragement.
Remembering to take advantage of the app takes some practice. It’s almost like I needed an app to remind me to use Calm Harm.
Second-year undergraduate, Elgin Community College, Illinois
“Calm Harm is a self-help tool, based on dialectical behavioral therapy, that helps users prevent self-harm the moment when urges arise. The app is based on the idea of “riding the wave” of emotional stress past its peak, until things get a little bit easier.”
Retta R. Evans, PhD, MCHES, associate professor, program coordinator, Community Health & Human Services, University of Alabama at Birmingham.
Michelle M. Seliner, MSW, LCSW, chief operating officer, S.A.F.E. Alternatives.
Lance P. Swenson, PhD, associate professor, Suffolk University, Boston, Massachusetts.
Janis Whitlock, PhD., director, Cornell Research Center on Self-Injury and Recovery, Cornell University, New York.
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