We all want to live, survive, and avoid pain. Survival, adaptation, and self-preservation is a normal drive. Psychologists, however, encounter people who do not have suicidal thoughts, do not want to die, but deliberately harm their body and do acts of self-injury.

This perplexing behavior can be quite difficult to understand. The actual self-injury can take many forms. Some people cut themselves, burn themselves, pick out pieces of flesh, carve themselves, pull out hair, or find other ways to inflict pain. Destroying their own body without any desire to die is counter to maintaining good health and living a long life.

Psychologists also use the term self-mutilation for these actions, depending on how it is done. I am told that this is not a new phenomenon, and that it has been going on for hundreds or even thousands of years.

The most common method of self-injury is using something sharp like a knife, razor, scissors, broken glass, etc. The cuts may be hidden under clothing, but frequently may be found on legs, arms, or stomach.

The person may scrape or rub their skin until they draw blood. Burning with cigarettes, hot metal objects, or anything hot enough to burn may be selected. Piercing the skin with something sharp-pointed is yet another method. Other people have punched themselves, picked at wounds, bitten themselves, or pulled out hair or eyelashes.

One way that psychologists think about self-harm is to look at it in three levels of severity. If the behavior is not frequent and the behavior is not severe then it is called Mild. If the behavior tends to be more frequent and the injury more significant it is then called Moderate. If the behavior is very frequent and the injury is severe, resulting in some type of impairment, then it is called Severe.

The intent here is direct on-purpose injury to the self. There are, however, also indirect ways to injure yourself.

Some of the more common methods of self-injury are the indirect ways that people choose to harm their bodies. People doing indirect self-harm frequently don’t think that they are choosing to harm themselves, but harm to the body is often the result. Drinking alcohol, gluttony, smoking or chewing tobacco, eating high-fat and/or processed foods, and so on, surely does not help the body. The harm caused is unintended and indirect.

Does it really matter if the person intends to harm him or herself?

The ultimate result is still potentially self-damaging, and simply unhealthy.

When do thoughts of direct self-harm tend to occur?

They tend to occur when he or she is alone, and having some very negative thoughts. He or she may be angry, have a very bad memory, feel ashamed, feel rejected, or even have thoughts of self-hatred.

The acts of self-injury seem to occur most often in young adults and teenagers. Studies reportedly have generally found that the percent of adolescents that engage in direct self-injury ranges from thirteen to 45 percent, depending on the study. For those teens who have known psychological issues the percent can range from 40 to 60 percent.

This unfortunate behavior tends to emerge between the ages of 12 and 14. There is no standard therapeutic treatment for self-injury. A tailored approach designed for each person is the way it is done. There can be many roads to the development of self-injureous behavior because each person and their life experience is unique.

This was just a peek at this problem and the way psychologists may approach it. Obviously, psychotherapy is the appropriate choice, and the sooner the better.

— Dr. Joseph Switras provides clinical psychological services at United Health District in Fairmont to people age 5 and up.