told me so....
The Bible compares
a self-absorbed person to a leech.
The leech has two
daughters: Give & Give!
- It's all give, give, give, all the time.
- I, me, my.
- Help me.
- Fix me.
- Love me.
- Need me.
- Look at me.
- Notice me.
"Oh pardon me! I realize that I've talked about myself long enough. Now why don't you tell
me what you think of me? Now, the Bible doesn't tell us to ignore ourselves. I want to be very clear about this, because some Christians get the idea that they're supposed to
hate their own egos. Not at all. Your're supposed to love yourself, take care of yourself, protect your body, soul & spirit & tend to your own needs.
Christians have a healthy focus on self. This only becomes a problem when your focus on yourself becomes all-encompassing. You enter the realm of self-absorption when meeting your own needs begins to crowd out your willingness or desire to meet other people's needs.
Self-blinding perceptions destroy spiritual growth
By Dr. Abraham Twerski, M.D.
http://www.jewishworldreview.com | People who feel good about themselves don't need to be constantly reminded how good they are.
It's only when one is tormented by feelings of worthlessness that one seeks to escape from them by constantly being
reassured that others do respect & value him.
It's ironic that psychology has applied the term "narcissistic" to these people, because although their behavior appears
to indicate that they're absorbed with self glorification, the fact is that in contrast to Narcissus,
who loved himself, these people actually despise themselves.
Their self deprecation is a result of a distortion of self perception. People wrongly see themselves as inadequate & the correction of such a concept of self would allow them to dispense with the desperate defense of self absorption & grandiosity.
One doesn't really have an option whether or not to have a self-image. The only option is whether to have one that is accurate or one that is distorted.
Thinking poorly of one self isn't a virtue. Virtue is truth & there is no virtue in denying the truth about oneself.
I know what you're thinking: "It IS true! I'm no good. I'm not lying! Just ask anyone; they'll tell you how worthless I am!"
To you I say the following: "You may be convinced & you may have convinced yourself, that you're without
worth & value. But that's subjective. You have ulterior motives that have led you to seeing yourself this way. These motives have distorted
your view of your self which is unwarranted by the objective facts."
A proper adjustment to reality can only be achieved when reality is correctly perceived. A person of average income,
who deludes himself that he is a millionaire is inevitably going to misapprehend his purchasing power.
A person who is in fact a millionaire & has the delusion that he's a pauper is similarly maladjusted.
Just as one must have a valid concept of one's external reality, so one must have a valid concept of one's inner reality.
We must know what our positive traits are in order to cultivate them & develop them to their fullest.
Similarly we must know what our weaknesses are in order correct them & improve upon them.
Just as a person isn't consciously aware of his throat until it becomes inflamed, so one isn't conscious of
the self unless it's ill.
Ideally a healthy person isn't self conscious. A true self awareness will result in neither vanity nor self-centeredness, but to the contrary, is necessary to avoid & overcome vanity & self-centeredness. It's also essential for the self-fulfillment which is a prerequisite for spiritual growth.
Spiritual growth means growth in character & this can & must be guided
by conscious effort. While various factors in a person's environment can have a significant impact on his character, especially
those occurring in early life, the human being is capable of developing or weakening his moral & ethical nature & therefore
bears the ultimate responsibility for being & becoming whatever he is.
of character is contingent on our being aware of our character flaws, which is dependent on self analysis & self reflection.
Step 4 of the Twelve Steps of Alcoholics Anonymous calls for a searching & fearless inventory of ourselves. This step applies to all of us. We must be courageous in confronting our misdeeds which are certain to be revealed
by a thorough soul searching.
this is only half the story. An accurate inventory requires looking at assets & liabilities. We must also be prepared
to discover unknown abilities within ourselves, much like finding hidden treasure under the floorboards of our home.
discovery of dormant & unrecognized assets may pose a threat to us. Some people have a pattern of beginning a venture, bringing it close to fruition & then doing something to precipitate
they certainly have a desire to succeed, the additional responsibilities & stresses that success is certain to bring can overwhelm the desire for success & make failure the easier course.
unpleasant as repetitious failure might be, it has the redeeming feature that one may say: "Don't expect anything of me. I'm incapable of doing things right."
is due to a negative, distorted self image where feelings of inadequacy & incompetence make success a formidable challenge.
Self-improvement requires that we have an accurate assessment of our potential. Such an awareness will not allow us to "cop out" & hibernate in a rut.
Potentials that aren't expressed demand to be actualized & indeed produce distress if they aren't actualized, much like a nursing mother may experience
pain if her infant doesn't take the milk that she has to give.
Some people may live a long life without ever having been aware of their potential & without having fulfilled themselves. They may even amass great wealth & may be considered by others to be eminently successful.
Yet, their failure to know themselves & to cultivate their potential is a dereliction of their responsibility to themselves.
Amassing wealth isn't a uniquely human
trait as squirrels are known to hoard more nuts than they can consume. The human uniqueness isn't acquiring form with but
in maximizing that which is within. This is an essential of spirituality.
in fixing your self?
Absorbed in self-help - Boost from baby boomers brings billions to business
Associated Press: Oct. 11, 2003 12:00 AM
NEW YORK - In
the past 3 decades, Pam Lontos has spent thousands of dollars on more than 200 self-help books. She says the books by authors
like Zig Ziglar help her stay motivated & enthusiastic about her life
"I'm interested in the books about self-achievement & setting goals," said the 57 year-old owner of a public relations agency in Orlando.
"If you start to apply the
principles they talk about, you change the way you do things & do more positive things," she added. "It becomes a habit."
Lontos is one of the millions of baby boomers born between 1946 & 1964 that have helped fuel
the growth of the self-help industry.
Although the genre has been around for years, boomers' desire to improve themselves as they get older & advance in their careers & families substantially has increased demand
in the category.
In recent years, the numbers
of books, tapes, videos & materials offering advice about everything from alcoholism & dysfunctional marriages to how to succeed in business has exploded into a multibillion-dollar industry.
Meanwhile, gurus including Ziglar & Anthony Robbins tour the country making millions offering
self-help seminars, publications & other services.
The self-help business also has gotten a boost from prominent boomer-age media figures Oprah Winfrey, 49 & Dr. Phil McGraw, 53, whose
talk shows & publications focus on the notion that self-help works & that people have power over their lives.
"Baby boomers have very busy lives, usually 2 career marriages
w/people running around taking their children to art, karate & all over the place," said Victor Goldman, a psychotherapist
& marriage counselor in Port Jefferson, N.Y.
He routinely recommends self-help titles to his patients.
"Having a book that offers you 1 or 2 tips a day, e.g., on dealing w/the stress or anxiety can be a big help," he said.
The concept appeals to many boomers because
the generation was one of the first broadly to embrace the idea of self-empowerment & spirituality. While doing so, they also shrugged off taboos that previously may have made discussing personal problems socially unacceptable.
"A lot of the 1960's was
about being your own person, having independence & pursuing your own dream. That means you can also help yourself," Lontos said.
"My parents' generation
was more about conformity. People are also much more open now. They embrace their problems."
That attitude has translated into lucrative business opportunities for
media heavyweights like Winfrey, whose net worth is estimated
at $1 billion & bookstores & publishers.
With most self-help titles ranging between $10 to $25, profits are to be made.
Peter Vegso, president of Health Communications Inc., estimates more than 80 million books
have been sold in his company's popular Chicken Soup for the Soul books.
Vegso describes his typical customer as a woman in her late 30's to mid-50's whos eager for
ways to improve the quality of her frequently hectic life.
"This is a growing area & we see lots of
opportunity," Vegso said. "I just think the woman of today is much more apt to seek out that kind of information & more apt to talk among themselves about what
they find helpful in this book or that book."
Does your boss have to take all the credit for your hard work? Your boss believes he/she must get everything accomplished.
While there's nothing wrong w/this, your boss believes he/she did it all by themselves.
Your boss' motto is "If I'm going to succeed, I want all the credit." Your boss is more generous when it comes to the blame - if your boss fails, the blame is placed someplace else. It's typically placed on others!
Your boss prides her/his personal accomplishments. Never once has your boss asked about your experiences. Nor could your boss care less. Your boss' accomplishments come at the expense of your own goals.
If this describes your boss, then your boss is self-absorbed!
Gentle Suggestions will send the manager a politely written letter informing them that they're perceived as "Self Absorbed" & that
this behavior is negative, destructive
The letter will
encourage your boss to correct this behavior. The letter will provide several
suggestions for changing the negative behavior & helping the boss become more effective.
The letter explains your concern w/out
disclosing who you are. You remain completely anonymous
because each letter is sent from Gentle Suggestions. (sorry but the website is no longer available:)
are you living your life absorbed in pain, hurt or extreme sadness? read
on about how some people cope with pain that is unbearable for them to cope with in a positive manner...
i'm thinking that those involved as parents forced to abandon children, put baby up for adoption, forced into abortion, or kids whose parents were divorced, or parent who
dies... may be absorbed in hurtful pain as below...
in our problems? not knowing
healthy coping mechanisms...
The Sad Times of Our Lives
There are specific situations that especially depress us. Understanding those times & knowing some of the available resources can be helpful. Of necessity, the coverage of these topics will be brief, but there are valuable references listed here.
It wasn't until I'd published this book online in 1997 & was active on Forums in Mentalearth: Self-Help and Recovery from Self-Harm (you have to register first & please abide by the rules) that I learned that self-injury occurs among distraught anxious & depressed but functioning, educated women.
They taught me that self-injury can serve other purposes, such as reduction of distress. Since then I've read in recent publications about similar motivations.
One of the most detailed & readable articles about self-injury is in Look Beyond the Scars: Understanding and Responding to Self-Injury and Self-Harm. This 2002 study interviewed in depth 24 self-injurers
from all over England. I've relied quite a bit on their impressive report.
Painful life circumstances can lead to self-produced pain
In the kinds of self-injury cases I'm concerned with here, there frequently is some very hurtful & disturbing condition in which the tendency to self-injure develops. You don't usually start with a method to hurt yourself; you start off with horrible circumstances & psychologically painful thoughts.
A very wide variety of distressing circumstances & feelings precede intentional bodily injury; here are some examples:
Young people are sometimes emotionally abused & told they're:
They may be blamed for their parents' troubles or divorce, etc. It isn't surprising they may end up feeling guilty, shame, self-hatred & wanting to hurt or punish themselves.
Some have grown up in physically & sexually abusive families (beatings, threats & torture) & were called:
many were bullied by peers; some were raped.
Some responded with resentment, intense anger & repressed rage; others adopted the negative evaluations & felt worthlessness, felt no one could ever care for them & felt like a piece of trash.
click here to visit teenscene's page: "no one cares about me" - w/some good info concerning invalidation.
Some responded to being hated with a defiant attitude, e.g.
- "you can't make me change!"
- "I deserve to be abused but I can hurt myself more than you can."
Some wanted get back at the abusive person by hurting themselves via self-mutilation, i.e., showing visual signs of their feelings. Some physically responded to pain, punishment & self-punishment by actually feeling better, something like having an adrenalin rush or taking drugs; others found that burning or cutting themselves numbs them to pain.
Others were feeling depressed, helpless & hopeless or were without feelings, almost like being dead. Some responded to self-injury while feeling dead with, "The self-abuse showed me that I could feel & was alive."
Others felt alone, uncared for, scared, sad, not just neglected but utterly worthless, rejected by family & friends, placed in foster care, dumped by boy/girlfriend, etc. so, it felt better to hurt themselves & in that way, escape the hurt from others.
personal note: when i was a teen, i wanted to attempt suicide to try to get my parents to see how much i was hurting because i didn't
know whether or not they loved me or cared for me. although i was obsessing about suicide, listening to radio shows about
it, reading about, etc. i just couldn't do it. one day, i began to mess around with a razor and cut my wrists, just superficially...
it felt good. the only problem with that was, i had marked myself in a very "easy to see" place on my arms. the school nurse
talked with me, but that's as far as it went... i cut a few more times, but it wasn't a sufficient release for me... kathleen
Many were well aware they had seriously disabling psychological problems & felt weird, unable to cope, scared, helpless & inferior.
Still others felt out of control, couldn't do anything right, but were reassured by the courage they had when self-cutting, surprised at what injuries they could force themselves to inflict.
Also, some developed an eating disorder which countered the helplessness feeling; it meant, "I can control something (eating, not eating
& throwing up)."
Some had heard about self-injury from others & were impressed with their willpower.
This list of stresses isn't exhaustive but it illustrates the kind of psychological-emotional conditions that set the stage for the
development of self-injury reactions. Soon we'll see how that might happen.
Self-Injury varies in severity & serves very different purposes
It should be made clear, however, that not all people who Self-Injure start with a terrible traumatic crisis.
Some may have simply had friends or relatives who injured themselves & learned
the behavior that way.
Others who self-injure may have developed an unhealthy habit that helps them calm down:
- something like having a drink
- smoking cigarettes or dope
In these kinds of cases, the injuries weren't life threatening, maybe just a compulsion like:
- pulling out hair
- picking at sores
- sticking or hitting themselves
This self-abuse may be a distraction, a way to release tension, to regain some sense of control over a situation, or to show others that they really are hurting.
Note: People who injure themselves don't necessarily have a mental health problem, esp. if the physical
damage is mild to moderate.
i.e., in a sample of about 2000 ordinary military recruits (60% males) about 4% had a history of
self-harm. That 4% scored higher on:
but not high enough to keep them out of military service.
On the other
hand, it's fairly common for Self-Injury to be combined with various psychiatric diagnoses. Therefore, to understand this behavior in some people it's important to realize comorbid disorders may be involved, including:
Most of these additional diagnoses have a center core of:
In addition, a different kind of Self-Injury occurs in the repetitive head-banging of autism & retardation. The most horrific mutilation, such as cutting
off a limb, an ear, or self-castration, is usually in a very severe psychotic condition. So, self-injury may range from a mild habitual coping technique to death or an extreme response to overwhelming stress.
Major Depression & Borderline Personality Disorders
Certain diagnoses have been studied because they're associated with frequent self-injury & suicidal behavior, namely,
One study (Brown,
Comtois & Linehan, 2002) distinguished between
suicidal self-injury & nonsuicidal self-injury in 75 Borderline women (over
50% were also diagnosed as having depression or anxiety).
The patients were about 30 & had self-injured an average of 6 times in the last year, so they were quite injury prone. The women who inflicted nonsuicidal
injuries gave these reasons:
The main reason for self-injury given by the suicidal patients was, "was to make things better for others." That's interesting but you can be sure it's more complicated
than that. They all wanted to reduce internal stress.
Another study of suicidal self-injury in Borderline Personalities attempts to clarify certain differences between potentially lethal behavior
in people suffering Major Depression & those with Borderline Disorders (Gerson & Stanley, 2004).
Seriously depressed patients usually seem to be suicidal out of a deep sense of despair or self-disdain & seek the nothingness or peace of death. If their suicidal efforts fail, depressed patients may become even more depressed, hopeless, guilt-ridden, withdrawn & lethargic. Gradually, if treated with medication & psychotherapy, they usually become less suicidal in time.
In contrast, the Borderline patient (70% have self-injured) becomes suicidal more quickly in response to changing circumstances or relationships & they report feeling better soon after the self-injury.
This is more in keeping with their impatient, impulsive personalities. Starting in late adolescence, they often cling to others but have problems with dependency & anger control, so their relationships may become highly emotional & unstable.
A major problem here is that Borderline personalities, who often self-injure in order to regulate their strong, rapidly changing emotions, run a serious risk of unintentionally dying because they underestimate the risk of death in self-injury.
Their therapists may also underestimate the risk, believing (correctly) their Borderline patients don't intend to kill themselves. Research has documented that single acts of self-injury are rarely lethal but when repeated over & over self-injuries can become a serious risk.
Be aware. About 10% of Borderline patients eventually die by suicide (Paris, et al, 1987). A cognitive-behavioral therapy, Dialectical Behavior Therapy, has
been developed specifically for Borderline Personality Disorders (Linehan, 1993).
of paradoxical behavior
Most of us hate pain & do all we can to avoid hurting ourselves; our bodies have powerful reflexes & natural mechanisms to avoid injury & pain - the sight of our own blood flowing out of a cut is alarming to most of us.
Some of the consequences of self-injury to some people aren't what you'd expect, namely, it can be an escape or venting mechanism, it may release built up emotions of anger, self-hatred, badness (blood
letting can be seen as,"letting the badness flow out of me.").
Also, a dramatic self-injury can stop the downward spiral of depressive thoughts. Other people discover that the process of inflicting self-injury & pain takes their attention away from the most disturbing thoughts.
So, some people simply learn they can produce pain or a shocking injury that distracts them from depression, guilt, anger & worrisome obsessions. As a result, some might start to self-injure repeatedly, ironically, to feel better (to come out of a terrible emotional
This may seem odd, but it'll not be surprising to people familiar with the concept of negative reinforcement (see chapter 4) in which the payoff or powerful reinforcement following some behavior is escape from an unpleasant situation. Reinforced self-injury can become a compelling habit.
Here's how one girl described her self-cutting from 13 to 16:
"I was bullied & teased about my weight for 2 years & I couldn't stand it any more. I became so angry with my body that I tried to commit suicide just to punish myself. I wanted to cut my wrists but couldn't do that, so I cut my arms instead.
I was calm as I did it. It felt I was finally in control of my life. It was a relief. The pain was intense but I focused all my attention
on it. It proved I was still human & had feelings. From that first time, cutting became my preferred way to release feelings.
When I got upset or angry, I'd just go to my room & cut with a razor or a sharp knife, then clean up the blood & wear long
sleeves. I got to the point that I was cutting every day, it felt like I was an addict. I got a high cutting, a real buzz. But I also hated myself for doing it & I got scared as it became dangerous.
Eventually, my Dad saw
the scars & took away my knives & razors. It was terrible when people at school found out. They watched me & asked
me why I did it. I really wanted to die then & took a big overdose. I've been in treatment at Mental Health ever since.
I'll be graduating in 6
months; I'm doing OK in school. I'd really like to be a journalist."
a personal story...
I can't remember whether I was in the 8th grade or the 9th grade. It's a fuzzy memory period of pain, heartache
& unresolved feelings, that is - until recently.
I wanted to die. I wanted to hurt myself.
that you're saying?" Is that what you're thinking? "Why would an 8th or 9th grader want to die? Why would that child want to hurt herself?"
Can you picture me? The year - let's say it's 1971 and I'm in the 8th grade, because I really feel as though
that's the year I was feeling like this.
Five foot, 2 inches tall, about 110 pounds, light brown hair with many blonde highlights, shoulder length hair,
olive skin, brown eyes, always smiling, friends with everyone, wearing a peace sign necklace, bass weejun shoes, a jumper
and a turtleneck. I'm saying hi to everyone as I pass by them in the halls on the way to class. I mean everyone. I had no
enemies, only friends.
I went to school in my 7th & 8th grade years with the high school. It was a regional high school with four
small New Hampshire towns attending. We had no black students. We had one or two hispanic students. We had a courtyard that
we could go outside and sun ourselves in. It was a nice school, fairly new.
The oldest child of three children, parents married, both professionals, college educated, high school sweethearts,
actually. I was in the band, playing the clarinet first, the alto saxaphone in the end, in the choir, played the piano as
well & was in the ski club. I liked all music, was a babysitter, and stayed out of trouble most of the time.
I was miserable though, because most of all, I just wanted to know that my parents loved me, that they cared about me & that they would do something to show it to me that was comforting, soothing & reassuring.
I wanted them to notice my newly acquired negative coping behaviors, but they never did. I wanted them to notice that I was drinking alcohol, but they noticed & if they did - they never said anything about their alcohol being missing.
In fact, they threw it back in my face by restocking their bar after my party on the weekend while
they weren't home emptied it. They never said anything. The neighbors complained about the cars parked up & down the street
& the beer cans thrown on the ground up & down the street, but they never said anything to me about it.
One day I had decided that I just wanted to kill myself. It would be better to be dead than to go on living in doubt of my own parents' love for me. I was tired of being miserable.
I was identifying with prostitutes, searching for love in their sex trade. Listening to some radio talk show on Sunday nights till after midnight, my mind was racing about those
prostitutes on the show that they interviewed. I wondered what it would be like to be having sex, or making love everyday. I wondered why they thought it was so bad. I kept thinking to myself, don't they feel wanted? Don't they feel loved?
I was beginning to think of suicide everyday - all day & all night. Then this one day, I went into my red and white striped bathroom in the nice little
ranch house my parents had bought & I took the razor blade & simply "cut" into my skin. It bled, but not alot. It
didn't hurt though.
I lightly slid the razor across my skin. I felt some relief. I think back now to assign my relief to the fact that now I would have to cover the cut. If I covered the cut, obviously there would be a bandage, and maybe someone
would ask me about it.
Maybe someone would tell my parents that I was trying to commit suicide. Maybe they would run
to me, get down on their knees in concern and hug me. Maybe they would tell me how sorry they were for not showing their love
to me. I pictured it in my mind like that.
It never happened that way though. The school nurse asked me about my arm. I told her that I hurt myself. She said, "Okay." No one said anything else about it. It was over. No one else noticed. I was a good girl. I would
never have any reason to do anything stupid like commit suicide. I had never heard about "cutting" or self injury back then.
I do know that I felt the relief. I felt the inner pain subside for a few hours. It wasn't long but it worked for the moment. Cutting is an obvious
venture in reaching out. I need someone, or something, help me. I don't know how to ask for help. I don't know how to solve
my problems. Those are the thoughts I was having.
how I understand cutters... I can get it. I wanted someone to notice my unhappiness, my pain, my hurt, my need... but they
didn't, ever... even when I cut my wrists and bandaged them.
I guess I should have remembered the time my father dropped the meat, soaked in steaming hot gravy,
onto my forearm and told me that I didn't have anything to cry about. I guess I should have remembered
him telling my mother to tell me to "shut up." I guess I should have forgotten how he seemed to reach past my plate with that
meat when it landed on my forearm....
I guess I needed
to remember that he obviously burned me on purpose. I had 2nd and 3rd degree burns on my forearm. I still at 49 years old
have the scars. He wouldn't let my mom take me to the doctors. He told me that if I wanted to cry, he'd give me something
to cry about.
Self injury is a personal story. If you suspect your child, teen or young adult of cutting or self injury, get close & personal
with that special someone. Let them know you care and love them. Do it fast, so that the
self injury doesn't become habit.
of a method - self-injury or suicide?
Just as there are many causes of psychological pain, there are many ways to self-injure. Perhaps the most common method is self-cutting, most often on the arm.
Another method is taking an overdose, i.e., taking
drugs until you get sick or even lose consciousness, such as drinking until you pass out.
Note: the kind of harm done in self-injury attempts is usually different from suicide attempts.
Firing a large
bullet into your brain or jumping from the 10th floor is
definitely suicidal. Cutting your arm or foot isn't a common method for suicide but it's a common method to relieve the emotional hurt one's experiencing or to let others know they're very unhappy.
Some methods may serve either purpose, e.g., taking an overdose of drugs is a common method for both self-injury & suicide. Besides cutting & overdosing, self-injury includes:
- burning yourself
- hitting a wall
- jumping from somewhat high places
- hitting yourself
- getting others to hurt you
Most self-injury victims clearly differentiate in their minds between self-injury & making a suicide attempt (most self-harmers have had thoughts of suicide in the past but at any one time the intent is usually clear).
People wanting to self-injure may, of course, miscalculate the risks (& they're well aware of possible errors) but they often think of self-injury as a way of relieving their extreme emotional distress & thus, reduce the chance of dying right now.
I don’t want to imply that the distraught self-harmer always has a clear intent in mind - to die or not to die. There are people who injure themselves seriously & are willing to leave the outcome up to chance or fate or to whatever powers they believe in.
To those of us
who've never experienced the absorbed obsession
associated with intentionally injuring our bodies & have never gotten emotional relief in that way, the whole idea may seem incomprehensible & frankly, rather grotesque.
One’s first thought may be that this is a thinly veiled suicide attempt; i.e., they're really trying to kill themselves but won’t admit it. But
as we understand the situation better, we realize that for many self-abusers the act is self-protective, not self-destructive. They don’t want to die.
They want to
deal with their troubles & unhappiness; they'd like to find more constructive & effective ways of escaping psychological pain instead of self-injury. But until they discover better ways of coping, when they feel painfully distraught, the urge to self-injure returns.
My Self-Help Forum friends helped me understand that situation. I appreciated that.
Like so much human behavior, self-harm is, at first, hard to understand. Each victim of self-harm is unique, has a different history, a different set of personal problems & a different means of hurting him/herself. There's sometimes a well remembered & understandable original experience with self-injury followed by a long history of using similar self-injury techniques over & over.
A therapist may believe (I think wisely) that the therapeutic task is more to develop some effective
methods for dealing with the currently overwhelming emotional troubles rather than to analyze at length the childhood dynamics & reasons for starting to self-injure. But both routes might work.
How rare is self-injury?
There are few studies of the frequency & nature of self-injury. One study (BMJ, Nov., 2002,
Volume 325, pp 1207-1211) of 6000 British 15 & 16-year-olds
reported that 7% had deliberately hurt themselves sometime in the past (only 1 in 8 of that 7% had hurt themselves seriously enough to go to a hospital).
Another large study of teenagers reported that more than 10% had cut themselves sometime in the past. Hurting yourself may start at any period of life (as early as 6 or 8) but most commonly it starts in
the turmoil years of 11 to 14.
Wendy Lader, author of Bodily Harm, estimates that 1% of Americans use self-injury to deal with emotional distress but she says the rate is much higher among teens, especially females. Why more females?
Supposedly, according to Lader, partly because females tend to react inward when upset rather than outward - they'd
rather hurt themselves than someone else & besides, openly going into a rage isn’t a very feminine thing to do.
Among people who have this tendency, how often do they self-injure?
A few people may hurt themselves every day, e.g., pull out hair or pick at a sore, but more typically, say with cutting, it may be
every few days. Quite often there are several injuries close together & then a break for perhaps weeks or months. Such
an irregular schedule makes it hard to know if you've finally stopped hurting yourself or not.
Other causal factors involved in self-injury
Personal characteristics & environmental circumstances sometimes set the stage for self-injury; i.e., people who observe or hear about self-injury very often think of the self-abuser as mentally disordered.
This social perception could well contribute to the self-injurer having low self-esteem. And low self-esteem increases the risk of self-injury.
The 2002 BMJ study mentioned above found that young females hurt themselves 4 times as often as males.
For young women, the risk is increased if they've had family members or friends who self-harmed, been very depressed or anxious themselves, had low self-esteem, had abused drugs, or were impulsive.
For young males, high risk situations included having suicidal friends & relatives, using drugs & having low self-esteem.
We have seen that self-injury usually starts while a person is extremely upset; then in a fit of anger or self-hatred or depression or a feeling that everything's going wrong, the person hits the wall or cuts him/herself or puts a cigarette out on her/his
arm… & finds the intense emotional stress is relieved.
This experience - actually the emotional benefits of self-injury - is remembered & may be used again whenever the stress becomes intense again.
Often, just the open, intense expression of feelings cleared the air & resulted in lessening of the stress.
In some cases, the person clearly felt guilty - felt they'd been bad - & the self-injury took the form of self-punishment. For others, it wasn’t self-punishment at all, but it just felt good to escape the hurtful feelings or to discharge their intense feelings.
After emoting, some felt they were finally communicating & being heard; however, it would
be a mistake to dismiss the expressions of genuine feelings during self-injury as being merely attention getting behavior.
Indeed, most self-injury is done in secret & kept secret. Yet, it can be a cry for help. And why not? Most self-abusers feel that no one understands them & no one cares.
The reactions of others to self-injury
Some people become concerned that a person who is so angry that they self-injure is dangerous to others. It's true that some self-injurers are angry with others, but they seem to usually cope with aggression by turning it on themselves.
Professionals don't ordinarily consider self-injurers to be a risk to others. Of course, if the self-injury behavior begins to include aggressive acts, such as bullying or physical threats, then one would rightly have concerns about the welfare of others too.
Naturally, friends or relatives are often upset by this behavior & bluntly urge the self-abuser to stop. Some people who self-injure feel some resentment of this & think “if my hurting myself doesn’t bother me, why should other people be concerned? What’s it to them?”
The answer is that watching or even hearing about self-abusive behavior is troubling to most people, especially if it could be permanent or lethal, if the aggression might extend to others & if the observers don't realize that self-injury can be a method to allay the overwhelming stress.
Most self-abusers, however, in the course of time, feel that they'd like to avoid using self-injury as a coping mechanism. If they can find other ways of soothing their emotional turmoil, the self-injury response will extinguish.
Other people - friends, partners & relatives - often at least have negative feelings about self-injury; it doesn’t immediately arouse sympathy. Instead, it often causes a conflict situation where the self-abuser is criticized & called weird or crazy.
Even experienced therapists may not have dealt with much self-injury before, so like others, they may be baffled by it. Besides, young people often don't take kindly to the comment
that “you need to see a shrink” which is said more like an order or a demand, rather than
gentle concerned encouragement.
How should one respond to a person who self-injurers?
The simple answer is: with concern & respect, with a desire to understand & help, with no criticism, blame or negative comment. Some self-abusers appreciate getting to talk about their troubles, their feelings & even their self-injuries. Others feel they've been misunderstood, mishandled & neglected before, so “let’s not talk about it.”
Sometimes they get tired of telling the same history over & over without getting help; sometimes they've been told
that therapy will not be provided if they continue to self-injure (doesn’t seem empathic,
does it?); sometimes their helpers just seem uninterested,
treat them like a child, or appear to have little time.
If these are the kinds of experiences self-harmers have had in the past, naturally if you're a newly assigned helper, they aren't going to warm up to you right
away. It takes a little time & a lot of genuine concern. They do want help.
In most cases, however, self-injurers feel they were or would be helped by support groups made up of other self-harmers. They don’t believe that more statistical or diagnostic information about self-harm (in the form of the typical
brochure in the doctor’s office) would help them very
much but they're interested in ways of coping.
Self-injurers often find that the agency service personnel & staff
need more information about self-injury.
If you're a parent or a spouse of a self-abuser who also seems to be over-emotional, impulsive, unreasonable, provocative &/or uncontrollable & is driving you crazy, she or he may have a Borderline personality.
If so, get the book, “Stop Walking on Eggshells” by Mason, Kreger, & Siever (1998). It may
help you understand your loved one & be less upset by his/her roller coaster behavior. You need to take care of yourself & not get sucked into the loved one’s turmoil.
How do people stop hurting themselves?
I must emphasize again that self-injury is both psychologically difficult to understand & dangerous to one’s health. Therefore, an important & wise first move is to get professional help. I'll mention self-help techniques but please seek therapy with an experienced, well trained practitioner.
WARNING: the following self-help methods, while intended to be helpful, may be described
in some details that could trigger a self-injuring response. If you're in a mood to self-harm or if you're responsive to triggers, please don't read this section. If you're unsure of your self-control, please discuss how to reduce self-injury with your therapist soon.
The 2002 British study says the general answer about how people stop self-harming behavior is they start feeling better about themselves. How do they achieve that?
They get their life in order…somewhat. If they're completely “down,” they find a place to live,
a way to get food, a place to take care of their kids - real basic stuff (the threat of losing their children is a major stress…& motivator).
They work thru some of their intense feelings from the past & become more able to communicate with others, both to express things they don’t like & to relate
more positively. Generally, among the very poor & disadvantaged in Britain, finding a supportive environment (living conditions & helpful friends) was a crucial step towards achieving an acceptable adjustment.
In their personal lives, some of the subjects
in the British study who had reduced or quit self-harming had made use of self-help methods, e.g., a few had switched from hurting themselves to a somewhat controlled smashing of things, like breaking glassware or hitting objects with a bat.
Others had substituted using alcohol or drugs to relax or distract themselves instead of self-injury.
Another approach is to cause pain in some less objectionable way, such as flipping your wrist with a strong rubber
band or holding your hand in ice water or maybe just holding an ice cube.
A few people can substitute an imagined injury for an actual injury, e.g., by just thinking about cutting yourself or maybe marking with a red marker the place on your arm where you might cut & where the blood would flow, if you did
Instead of bodily hurting themselves, some people can vent their anger with physical exercise, e.g., do some real hard work, mow the lawn, lift heavy furniture, squeeze a pillow hard, workout at a gym & in some
of these ways feel less need to feel pain.
Breaking the chain of events early is possible (see chapter 11). Some had learned to detect early
a troublesome downward train of thought leading to self-injury & then they learned to consciously focus on distracting thoughts, such as watching TV, listening to music, taking a nap, or reading a magazine or book.
Still others found the chain of thought leading to more serious depression or self-hatred could be broken early by talking to supportive people, calling their therapist (or
just thinking about topics for the next session), or posting to an online
self-injury group (or imagining the conversation
at the next support group meeting).
Also, a few found interesting activities to do, like relaxing & meditating (see chapter
12), going shopping or for a walk or a workout, writing
their life story (see chapter 15), or doing drawings or art work to express their feelings.
Make a serious, effort (it'll take therapy
or weeks on your own) to understand these awful feelings that start & generate this whole process.
During some good times, prepare a list of things in your life that you appreciate, really enjoy, value & feel grateful for. Use this list (keep it
updated) as a handy reminder when depressed that there are good things in your life as well as bad things.
Be sure to include your good traits, talents, good deeds, assets, beautiful parts, etc., showing you aren’t
as bad as you sometimes think you are.
Procrastinate doing self-injury. Tell yourself to put self-criticism or self-injury off until later - “maybe tomorrow.” Most impulses lose their urgency when you put them off…especially if coupled with keeping your mind on other things.
The need to feel pain will diminish also because the deep depression, self-hatred, guilt or whatever has declined.
The environment is a powerful determinant of our behavior (see chapters
4 & 11). Hide away stuff you use to self-injure. Stay out of the room, chair, sink, or situation you usually hurt yourself in. Don’t go there mentally or physically. If you are “triggered” somewhere (a room, a TV show, a book, a discussion, an idea), quickly get out of that situation & think about other things.
Develop a routine to easily use when feeling especially bad - nurture, even “baby” yourself. Perhaps go for ice cream with a friend, take a long, warm bath,
look at especially selected pictures of good times & people you love, play with a pet, develop special activities with your family, enjoy a nice romantic/erotic story, etc.
Sometimes people find it helpful to sign an agreement with someone to not self-harm without calling them first. For very distraught times, however, the contract may not be a strong deterrent.
The above methods have worked for at least a few people. No one method works for all people who
self-injure. The methods that work are usually tailored for a specific person. I hope this long list helps you believe that you too can devise several techniques that might guide you away from deep depression &/or self-injury. Then try them out.
Changes needed in psychological services: Look beyond the scars
The British study group that I have cited several times found major deficiencies in professional care for the people
who self-injure. I believe the situation in the US is similar.
First, our institutions provide the same services for suicide & for self-injury, namely, medication & hospitalization or out-patient treatment. But people who self-harm see traditional psychiatric hospital treatment as poorly understanding their needs (often negative & dismissive) & thus, unlikely to give good service.
Needed are specific facilities & trained staff that would
provide understanding, respectful, caring “safe houses” for a day or a few days; counselors specializing in self-injury; education & counseling for children, spouses, parents or friends involved; self-help instruction &
self-help support groups; special attention to child care while families are broken up; & so on.
Some available literature
The major search engines will fetch many Web sites providing information & concrete suggestions for coping with
self-injury. Note particularly PsychCentral & Healthyplace.com.
Other Web sites provide support groups, understanding articles & suggestions for dealing with self-injury: Self-Injury: You are NOT the Only One & Self-help methods with self-injury are described in Stopping Self-Injury & in this article Self-Inflicted Violence: Helping those who Hurt Themselves by Tracy Alderman.
Two large Web sites cite many articles & review over 75 in print books in this area: Home-Health-Conditions-Self-Injury & Self-Injury Books.
There are a surprising number of books in print about this general topic, a couple by Clinical Psychologists & therapists:
- Alderman (1997) & Levenkron (1999)
- one by therapists who recommend extensive
inpatient treatment (Conterio, Lader &
- another by a psychiatrist (Favazza, 1996)
- two by journalists who interviewed people
with this compulsion (Hyman, 1999) & (Strong, 1999).
Any of the books can help you become aware & empathize with a self-harmer but I’d suggest one of the books written by a professional.
too absorbed in work or career?
men have a role to play, too
March 2, 2004
Men will not commit to relationships, let alone to having children, by Sushi
Some aspects of our lives we can control - i.e., which career we want. But other things we can't control - like when we'll meet the person with whom
we'll have children.
Last Friday on this page, my colleague Pamela Bone wrote that because of the declining birthrate, men & women need to consider having children earlier than their 30's.
Bone raises some valid points. But I fear her solution doesn't account for the full range of human experience.
To urge people to have children earlier is unrealistic in today's environment where many men & women are struggling simply to meet the
right person. People don't have enough control over their lives to plan exactly when they have children.
Sure, some people are lucky & meet their partners early. But not all childless women in their 30's have chosen to forgo
having children so they can have a career. For many, childlessness is a result of not meeting the right person - of not finding
"a suitable boy", as my father would put it.
Bone concedes that young men are often less anxious than women to commit to parenthood. This is a key issue:
how do we get
men to accept having children earlier?
Many won't commit even to a long-term relationship, let alone one that involves children.
Some young men are too self-absorbed, too career-oriented, or stuck in a sort of ill-groomed,
selfish immaturity, for a woman to feel they would be able to provide
a stable &
loving environment in which to bring up children.
Put bluntly, some men just don't measure up. These men are unwilling to shoulder the collective responsibility of a declining birthrate.
In the culture of the 1950's, many men understood themselves to be providers, taking on a mortgage that could be serviced on one income &
accepting children as the natural consequence of marriage. But it's a different world now.
These days there is a greater value put on individual
fulfilment. Men often want to achieve things in life, travel & build assets before they think they can make a serious commitment to having children.
Bone goes on to warn that people who don't have more children, or any children, may regret it for the rest of their lives.
Many do. But it's also fair to say that many women believe that by having children early, they sacrificed their own desires to do more with their lives.
My mother was 20 when she gave birth to me. Many times she has told me that while she loves all 3 of her children, devoting her life to them robbed her of her youth & the chance to see the world & enrich her life with more
experiences. She tells me she'll take her unfulfilled dreams to
Bone also says women should be able to have a career & children, & that "climbing the career ladder has no biological time limit on it".
There's indeed ample evidence that a woman may be able to drop out of the workforce for a while to have children - but
there's no guarantee she can catch up with the experience gained by her colleagues who remain in work. And often coming back
full-time is simply not viable.
Of course, some women do have children & return to work to climb the corporate hierarchy, but it's not easy.
Essentially, to reverse the declining birthrate we must have a debate that engages men as well as women. Even
if workplaces & universities were to become more flexible to allow women to study / work & have children, the job is only partially complete.
There also needs to be a corresponding shift in the mindset of men, to acknowledge the rapid cultural changes that are taking place.
In the past 30 or so years women's lives have changed considerably. I am 39. Women in my age group grew up in a world where we didn't have to fight to be equal. We
always believed we were.
I grew up understanding that I can't expect a man to provide for me. It's my responsibility to earn a living to pay for a roof
over my head & food on the table.
The opportunity to have a career wasn't just a dream to fulfil my personal desires, it was a means to earn a living.
And it's natural for women like me to believe that having children is as much a man's responsibility as it is a woman's.
Being equal doesn't just mean women are free to pursue careers. Being equal also means we expect men to shoulder some of the responsibility for having children at a time that is safe & sensible for women.
Young men should make their voices heard in this debate. How do some of them account for their lack of commitment to relationships that involve children?
And what level of responsibility do they accept in sharing the burden of a declining birthrate?
We can't always have babies on cue. It's one of those aspects of our lives over which we don't have complete control.
I was brought up to believe that having a child is a privilege - a privilege that is granted by the opposite sex. I think it's important not to forget that.