Self-Injury: Myths and Misconceptions (Part 1)

"The great enemy of the truth is very often not the lie - deliberate, contrived and dishonest - but the myth - persistent, persuasive and unrealistic."

-- John Fitzgerald Kennedy

If you don't totally understand the concept of self-injury, you are definitely not alone. Many people, professionals included, have ideas about self-injury that aren't entirely accurate and often based on false beliefs.

Self-injury can best be defined as an act of violence (cutting, burning, etc.) that is done to oneself, by oneself, without the intent of suicide. Sometimes self-injury is called self-inflicted violence, self-harm, self-mutilation or cutting.

One of the most common misconceptions is that self-injury is the same thing as suicide. Suicide is the intentional act of killing one's self. Suicide is a purposeful end to one's life, while self-injury is most typically performed as an act of self-preservation, an act to sustain life. In basic terms, self-injury is a method of coping. I'll talk more about this idea in future blogs.

Self-injury generally provides temporary relief to intense emotional pain. Suicide is obviously a permanent solution to emotional and/or physical suffering. The damage done from self-injurious behaviors typically does not require medical intervention and is rarely lethal. Most of the people who intentionally hurt themselves never seek medical treatment and keep their injuries hidden. Those who attempt suicide often need medical intervention and the results of the suicide attempt are intended to be lethal.

One other difference between self-injury and suicide is that suicide is often attempted/contemplated while the individual is under the influence of alcohol or drugs. Most of the time, when people self-injure they are not using any substances.

In an emergency room, two people might be brought in with very similar injuries, such as lacerations to the wrists. While it would be easy to assume that both injuries might have resulted from a failed suicide attempt, the only sure way to know is to ask. If after hearing the reason for the injuries you're still not sure what happened, asking the person in a very direct manner, "Were you trying to kill yourself?" and "Were you hurting yourself to feel better?" might help clarify the issue.

I'll address more myths and misconceptions in my next post.

Tracy Alderman, Ph.D.