First recognize that self harm is an addiction. It is categorized as a compulsive disorder. When one has it one feels the need to commit violent acts against oneself. A cutter or self injurer may pick at scabs or interfering with healing wounds, hitting oneself, burning, hair pulling, and other forms of self harm. There is a pattern to the behavior of a cutter, much like the pattern of a drug user. The self injurer feels strong emotions of anger and pain and can’t deal with them. The feelings build and build and they environment in which they live gives no outlet that is healthy for these emotions. The stress mounts. Cutting provides a release followed by guilt or shame. Yet a conditioning effect takes place. When the strong emotions arise again, the cutter is compelled to hurt again to cope. The self injurer covers the evidence with clothing and hides the tools used to inflict the pain. There is also a chemical reaction in the body driving the addiction. The body releases endorphins that act as natural pain killers. Some anti-depressant drugs that increase serotonin levels may reduce the drive to self-injure for some patients, but each individual must be evaluated individually. Not all who injure themselves do so for the same reasons.
At the same time, some would say that self cutting is ‘addiction like’ and not an addiction, because it is a compulsive act that is repeated despite negative consequences. It can coincide with other addictions, like drugs, alcohol and eating disorders. Some of the same underlying factors are involved with all addictions. They are all forms of unhealthy coping with life. All addictions involve signs of self loathing or numbness or an inability to express strong emotions that manifests in the self destructive action, whether it is taking drugs or cutting oneself. There is peer pressure to join the club and do the same unhealthy acts to fit in. And like all other addictions, the addict must be willing to get help for the help to be effective. Because it is an addiction though, the same kind of treatments that assist with curbing the urge to take one more drink, may also curb the urge to self mutilate or cut. The 12 step program may benefit someone who self harms.
Treatments need to be tailored to the individual as with any addictive behavior. The underlying reasons for the need to self inflict harm need to be addressed. Medication can be used to assist with underlying psychological conditions, from depression to anxiety. Cognitive behavioral therapy and psychotherapy can also help by teaching the self injurer how to cope with stress and relate with people in a healthy fashion. One who self injures or has an addiction needs to find alternatives to the urge to continue with the addiction. Stress management and interpersonal therapy can help with goals of building better relationships and raising self esteem. Recognize that the person cutting is in need of new ways to cope with stress. Self harm is not something that is bad, but something that needs to be recognized as something a person can learn to stop doing and start to feel good about life and in control again.