The Sunday News
Pastor Barbara Meck Silumbu
Deliberate self-harm, self-injury, cutting self or self-mutilation is direct injury of body tissue done without the intent of committing suicide. Deliberate self-harm (DHS) is a behaviour and not an illness. Other common definitions of deliberate self-harm are “An act with non-fatal outcome in which an individual deliberately initiates a non-habitual behaviour, that without intervention from others will cause self-harm, or deliberately ingest a substance in excess of the prescribed or generally recognised therapeutic dosage.” (Platt et al., 1992 WHO).
“A deliberate and voluntary physical self-injury that is not life threatening and is without any conscious suicidal intent.” Sutton 2005 describes it as “Self injury is a compulsion or impulse to inflict physical wounds on one’s own body, motivated by unbearable psychological distress or regain a sense of emotional balance. The act is usually carried out without suicidal, sexual or decorative intent.”
Deliberate self-harm has become very common and usually rushed to the emergency unity as para suicide. On assessment the reasons for self-injury vary and can be any of the following: “I was bored and lonely, punishing self, was drunk and high, I hate myself, I don’t know what was happening, I wanted to shock people, I was angry at someone, it stopped me from thinking negatively, I felt depressed and unhappy, I wanted to get back to someone, it helped me release tension and relax, I felt I was a failure, I wanted to feel pain, it stopped me from thinking bad thoughts or killing myself”. The list goes on and on.
Self-injury is usually an attempt to relieve psychological tension and deal with overwhelming negative emotions. Self-injury behaviours are, carving, scratching, branding, marking, picking and pulling skin and hair, burning and abrasions, ingestion of sharps — toxins, cutting, biting, head banging, bruising, and excessive body piercing. Warning signs are injuries that cannot be explained including cuts, bruises or burns. Wearing of long pants, dress sleeves in warm weather. Very sad, low self-esteem, overwhelmed by negative feelings, inability to function at school, work home, and problems in relationships.
Professor Amany Haroun wrote about a patient “I want to cut. I want to see pain, for it is the most physical thing to show. You cannot show pain inside. I want to cut, cut, cut, show. Get it out. What out? Just pain.”
The feelings that are associated with cutting are, before, the patient/ client feels emotional pain, tension, stress, low self-esteem, worthless, hopeless, lonely, vulnerable, confused, very sad and detached. During the self-mutilation, or self-harming behaviour they feel satisfaction, pleasure, numbness, in control, relief and exhilaration. After they feel ashamed, guilty, out of control, confused, crushed and disturbed.
Causes may be genetic, stress, drug intoxication, mental illness, cultural and or socio-economic problems.
Treatment can be medication treating the underlying mental illness for example depression, anxiety, substance induced mental challenges, talk therapy, counselling or psychotherapy to teach client coping skills to deal with negative emotions, to reduce anxiety, release tension and anger.
Other conditions that are associated with self-injury are border line personality disorders, bipolar disorders, psychosis, autism, depression, anxiety, substance abuse, post traumatic stress disorder, conduct disorder and suicide.
Self-harm is not attention seeking therefore people practising this behaviour should be assisted to seek help. They need to be screened for suicide and other mental health conditions.
Feedback: Pastor Barbara Meck Silumbu (Clinical Psychologist 263 78354 6817/ 263 774666795)