I desperately want to seek help for myself, but I have some concerns. This Disclaimer applies to the Answer Below Dr. Dombeck responds to questions about psychotherapy and mental health problems, from the perspective of his training in clinical psychology.
People mostly understand I think when someone becomes psychoticgets stuck in a deep depression or has mood swings. These are exaggerations of normal states of mind—everyone has felt blue at sometime or another—everyone has felt euphoric or energized at least once.
Though loose, psychotic-style thinking is not something that everyone has experienced directly, at least the idea that people can experience hallucinations and delusions is familiar to most. This basic understanding is not often there when people are confronted with someone who is cutting or burning or otherwise traumatizing themselves.
Trying to Understand Someone Who Self-Injures That acts of self-injury are so often bloody and horrifying that it makes it harder for people to be thoughtful about what these acts mean. There is a tendency to panic when you see someone you care about bleeding from self-inflicted wounds, or covered with scars.
Such panic interferes with thinking, and makes it harder for people to understand the motives behind self-injury. An act of self-injury which might make sense if understood as a suicide attempt become all the more difficult to comprehend when the self-injurious person denies that they are trying to kill themselves and is telling the truth.
So why do people self-injure? What are they trying to accomplish when they harm themselves? Release tension associated with strong emotions or overwhelming thoughts.
Feel something physical when they are otherwise dissociated and numb. Experience a temporary but intense feeling of euphoria that occurs in the immediate aftermath of self-harm. To Regain Control; To Shift Attention People sometimes harm themselves because by doing so, they are able to gain a subjective sense of control over chaotic internal emotions and thoughts.
Seizing this control involves shifting the focus of their attention away from something more troubling towards something less troubling.
Self-injurers sometimes use this pain sensation to override painful background chatter that fills their minds. For example, they may have been traumatized by a rape experience such that they have PTSD symptoms and constantly be replaying that rape in their minds.
By cutting themselves, they are able to refocus their attention on the pain of the cut and for a short while, experience relief from the rape trauma. To Release Tension A variation on the theme of regaining control, is the idea that people self-injure as a means of releasing tension.
An example will serve to illustrate. I read an account of a young woman who was consumed with suicidal thoughts which pushed her towards a compulsive feeling that she should end her life.
She coped with this compulsion by cutting herself, which refocused her attention, however temporarily, away from her suicidal ideation. To Return From Numbness Traumatized people sometimes cope with their trauma by dissociating.
Dissociation is a mental and emotional state where the normal unitary experience of consciousness gets chopped up into disconnected parts. Feelings can also be dissociated or detached from the events that provoked them such as occurs in Depersonalization Disorder.
So, a painful feeling associated with a traumatic memory might be detached from that memory such that the traumatized person remembers the event as though it happened in a movie; as though it happened to someone else and they were just watching it unfold, numb to the experience.The Journal of the American Board of Family Medicine estimates that 1 to 4 percent of adults and approximately 15 percent of teens in the United States engage in self-harm.
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