The Scarred Soul

Understanding and ending self harm.

Self-Injury: Does It Matter What It's Called?

Self-injury, self-harm, cutting, parasuicide: What should it be called?

What's in a Name? In Romeo and Juliet, William Shakespeare wrote the now infamous lines, "What's in a name? That which we call a rose By any other name would smell as sweet." Although Shakespeare might argue that a name holds little meaning, those studying topics such as self-injury might think a bit differently. As controversial as the behavior of self-injury is, the terminology used within this area is also filled with controversy.

Dating back to some of the earliest research within this field Kreitman et al. (1977) defined "parasuicide" as "a non-fatal act in which and individual deliberately causes self-injury." From this definition, "deliberate self-harm" (DSH for short) quickly sprouted and became an alternate way of referring to these behaviors. Both terms are often confused with suicide and attempted suicide, seemingly more so than some of the other names for self-injurious acts.

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The "deliberate" qualifier of DSH was eventually forsaken and "self-harm" evolved. Perhaps "deliberate" was discarded because of its redundancy or perhaps because some types of self-harm are not thought of as deliberate, but instead, beyond an individual's control (such as in the case of severe dissociation).

Several other terms have been used to describe the behavior I most often refer to as "self-injury." "Self-mutilation" came to the forefront in the late 1980's with the release of Rosen and Walsh's seminal book of the same name. "Self-inflicted violence," my personal term of choice (except that it's way too long to write and/or say), stemmed from The Cutting Edge, a newsletter written by and for women who engage in self-inflicted violence, edited by Ruta Mazelis. "Cutting," a description of a particular form of self-injury has, at times, been used to designate all forms of self-injury. "Self-abuse," "self-injurious behavior," and "self-destructive behavior" have all been employed in reporting self-injury.

While each of these terms is very similar, each is also unique. A "self-destructive behavior" could be interpreted to include substance use or even poor work habits. A young man who states that he self-injures by punching himself might not endorse an item stating that he self-mutilates, as his bruises eventually disappear and there is no permanent damage. And while it might not make much of a difference whether a twenty year old woman is referring to her own injurious behaviors as "cutting" or "self-injury," there a huge distinction when performing research in this area. One person's self-inflicted violence is not another person's self-destructive behavior, thus placing a task such as determining prevalence of this behavior in jeopardy simply due to lack of a standardized term.

So while Shakespeare's rose may go by any name, self-injury is a bit more particular.

 

Tracy Alderman, Ph.D., is the author of The Scarred Soul: Understanding and Ending Self-Inflicted Violence.

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