- Each of the six subconscious aims for NSSI suggests a last-ditch effort to regulate dysregulated emotions.
- To understand NSSI, people must grasp how physical and emotional survival can get paradoxically conflated.
- With NSSI, numbness—an unfeeling, ego-protecting mechanism—gets replaced by bodily pain, its feeling antidote.
- NSSI, ironically intended to reduce shameful feelings, can unintentionally add to them.
The “Unnatural” Paradoxes of Non-Suicidal Self-Injury (NSSI)
The negatively broad category of NSSI reflects complicated, unresolved personal issues. Take the most frequently used outlet, self-cutting, but also consider self-burning, self-hitting (including head-banging), harsh skin scratching, scraping, and rubbing, and short-of-fatal drug overdosing.
Although individual reasons for deliberately committing this masochistic act may differ, most of them are best understood ironically. Yet despite the abundant (and ballooning) literature on this universal phenomenon, curiously, very little has been written about its predominantly paradoxical aspects.
While distinct from one another, each of the six paradoxical explanations for NSSI proposed below signifies last-ditch attempts to regulate dysregulated emotions—including pressure-intense anxiety, depression, anger, and extremely frustrating upsets generally. And these desperate efforts make up behaviors that mental health professionals would define, paradoxically, as themselves dysregulated.
It might be added that none of these explanations are mutually exclusive. They can, in a sense, “join forces” with others to account for why an individual might engage in this difficult-to-grasp defense mechanism.
Nonetheless, though these behaviors end up self-defeating, when viewed in the immediate or short-term, such bodily injury to self warrants being seen as adaptive, despite its being blatantly maladaptive in the longer term.
I should add that in the descriptions that follow, I’ve made liberal use of quotation marks (e.g., “soft suicide”) to emphasize that the word or phrase enclosed in quotes is being employed in an ironic, non-traditional, factually-false sense.
Ultimately, the crucial thing to consider is how self-harmers’ survival instincts got so fiercely twisted. And this is where the conflation between physical and emotional survival needs to be better understood.
It’s actually far less common for people suffering from physical pain to attempt NSSI than for their counterparts struggling with its emotional equivalent. And that’s because the latter group’s affliction is a lot more likely to lead to chronic feelings of despondency, despair, and the diagnosis of major depression.
As demoralizing and overwhelming as bad bodily pain can be, it’s still not usually experienced as “limitless,” as is the possibly unbearable severity of emotional pain. Nor, typically, is it as ruminative, obsessive, or endowed with self-hatred. That’s why self-injurers can become addicted to a defense that peculiarly transfers what’s emotional to what’s “merely” physical. And why, too, it can be extraordinarily challenging to overcome.
Six Paradoxes That “Normalize” the Dynamics of NSSI
1. To Control What’s Experienced as Uncontrollable
One frequently mentioned paradoxical reason for NSSI behavior is the desire to shed overwhelmingly intense, dysphoric emotions through, well, bloodshedding. Self-harmers aren’t able to figure out how to ameliorate their heavy emotional burden in any way that (ironically) feels safe to them.
But this immediate remedy—and all the inverted “self-help” techniques presented here—constitute only a temporary respite for them. They can’t possibly provide an enduring sense of control over their dysregulated emotions. Inevitably, the momentary, non-resolving closure they get from NSSI is destined to open right back up later on.
2. To Choose Pain Over Emotional Numbness
Consider that one primal defense mechanism for dissociating from psychological pain is by numbing oneself to it. Yet here, the self-injurer actually defends against such numbness by consciously opting to insert physical pain into the equation. Thus, one defense gives way to its polar opposite since, in this case, non-voluntary numbness is more psychically painful than the brute physical pain the individual can voluntarily substitute for it.
Literally, this exchange wouldn’t appear to make a whole lot of sense. Still, by focusing on their self-induced physical pain, self-injurers can escape the scary feelings intimately linked to a numbness or emptiness that’s left them feeling frighteningly unreal and dead inside. Or incapable of feeling anything at all.
Their “relief,” through intentionally provoking pain, may not do much to elevate their spirits, but it does provide convincing evidence that they’re still alive.
E. D. Klonsky (2007a), one of the most prolific writers in the NSSI field, puts it like this:
The physical injury or sight of blood may jolt the system and help self-injurers regain a sense of self. For this reason, feeling generation is another term that can be used to refer to the antidissociation function of self-injury.
3. To Intentionally Reduce Shame by Unintentionally Adding to It
One of the rudimentary causes of self-harm involves deep feelings of humiliation and shame. Considered as a form of angry self-punishment for being bad, such a self-degrading act can distract from unbearably self-critical emotions. But regrettably, secondary shame and guilt will then be added onto what self-injurers have chosen specifically to ameliorate primary shame.
This boomerang effect usually compels them to repeat the self-inflicted pain which, albeit temporarily, worked for them earlier.
And “comfortably” habituating themselves to such in-the-moment pain reduction contributes to its ever-increasing threat, for they can “fail” in their non-intended, quasi-suicidal action by accidentally killing themselves (as in dying from a carelessly monitored drug overdose).
4. To Avoid Suicide by Strategically Committing a Kind of “Soft-Suicide”
Life-compromising behavior that’s scrupulously measured may gratify the impulse to mortally punish oneself while yet expressing ambivalence about doing oneself in.
Comprehended normatively, it’s partly cowardly and partly courageous. The act self-protectively removes the person from the “real” thing, even as—full-scale-ahead—it boldly moves them toward a more prudent blood-letting alternative.
5. To Communicate Physically What Can’t Be Communicated Verbally
Another paradoxical reason for NSSI is the desire to convey one’s extreme inner turmoil to others when the individual can’t adequately communicate their emotional distress verbally. In such instances, they may feel obliged to externalize their inner pain by visibly incarnating it. Here they assume others can then better understand the severity of what they’re struggling with.
What makes this paradoxical is that many children and young adults lack fundamental language skills, so their reaching out can only be done through acting out. But substituting concrete, destructive behavior for more abstract, semantically meaningful diction isn’t that likely to illuminate their audience. On the contrary, their action, despite its powerful impact, tends to lead to an ambiguous, confusing, or downright baffled reaction.
6. To Get a Neurochemical High From Cognitively Negativist Lows
It’s been noted that a person can “indulge in” self-directed hate-bombing to get, well, bombed—though here the self-injurer isn’t becoming inebriated through alcohol but, ironically, through the feel-good hormones they automatically secrete in hurting themselves.
Counter-intuitively, performing self-damaging behaviors can prompt a certain exhilaration comparable to the excitement of seemingly perilous bungee jumping or parachuting out of an airplane.
As a daredevil adolescent, such a socially frowned-upon act might be executed to impress—or perplex—one’s peers, although as a strictly affect-regulation device, it’s much more likely done in secret.
According to B. Stanley and others (2010), what is implicated in NSSI are:
ß-endorphin and met-enkephalin, opioids acting upon receptors involved in mediating stress-induced and physical pain analgesia.
These chemicals can serve to calm down self-harmers, afford them some otherwise unobtainable pleasure, and act as a numbing agent—not just from physical pain but also, less directly, from emotional anguish.
Such positive effects suggest that, analogically, NSSI operates like a mood-altering drug. And that’s especially true for individuals harboring pronounced abuse and neglect histories, who consequently were saddled with depressed endorphin levels.
This, in turn, suggests the compulsiveness of self-injury—that in its instinctual drive to lessen pain, the autonomic nervous system can, on its own, manufacture these feel-good chemical remedies. And that’s (as a final paradox) at once lucky and unlucky, a blessing and a curse.
© 2023 Leon F. Seltzer, Ph.D. All Rights Reserved.
Flaherty, H. Treating adolescent nonsuicidal self-injury: A review of psychosocial interventions to guide clinical practice. (2018, Feb). Child and Adolescent Social Work Journal 35(7), 1-11. DOI:10.1007/s10560-017-0505-5
Gratz, K. L. (2003). Risk factors for and functions of deliberate self-harm: An empirical and conceptual review. Clinical Psychology: Science and Practice, 10(2), 192-205. https://doi.org/10.1093/clipsy.bpg022
Klonsky, E. D., Glenn, C. R., Styer, D. M., Olino, T. M., & Washburn, J. J. (2015). The functions of nonsuicidal self-injury: Converging evidence for a two-factor structure. Child and Adolescent Psychiatry and Mental Health, 9 Article 44. https://doi.org/10.1186/s13034-015-0073-4
Muehlenkamp, J. J., & Gutierrez, P. M. (2004, Spring). An investigation of differences between self-injurious behavior and suicide attempts in a sample of adolescents. Suicide and Life Threatening Behavior, 34, 12–23. https://www.suicideinfo.ca/resource/siecno-20040981/
Nock, M. K., & Prinstein, M. J. (2004). A functional approach to the assessment of self-mutilative behavior. Journal of Consulting and Clinical Psychology, 72(5), 885-890. DOI: 10.1037/0022-006X.72.5.885
Pickard, H. (2015). Self-Harm as violence: When victim and perpetrator are one., Ch 4 of Women and violence (eds. H. Widdows & H. Marway). London: Palgrave Macmillan. https://www.ncbi.nlm.nih.gov/books/NBK349101/
Ross, S., & Heath, N. (2002). A study of the frequency of self-mutilation in a community sample of adolescents. Journal of Youth and Adolescence, 31, 67–77. https://link.springer.com/article/10.1023/a:1014089117419
Self-Harm (Nonsuicidal Self-Injury Disorder). (2023, May 9). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/12201-self-harm
Stanley, B., Sher, L., Wilson, S., Ekman, R., Huang, Y-y., & Mann, J. J. (2010, Jul). Journal of Affective Disorders, 124(1-2), 134-140. doi: 10.1016/j.jad.2009.10.028. Epub 2009 Nov 25