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What is Nonsuicidal Self-Injury – Why Do People Self-Harm?
Self-harm is one of many parts of mental disorders that people don't want to talk about. That should stop.
Nonsuicidal self-injury (NSSI) is the current term for what was once known as self-harm, self-injury or self-mutilation. NSSI is a widespread problem and considerably more common than most people think. While numbers vary, it is thought that about 1 percent of the U.S. population self-harms in some way (although that estimate includes eating disorders which one would not typically classify as NSSI.)
What is Nonsuicidal Self-Injury (NSSI)?
NSSI is “the deliberate and direct alteration or destruction of healthy body tissue without suicidal intent; these behaviors range from skin cutting or burning to eye enucleation or amputation of body parts.” It’s worth noting that while body-modifications like piercings could be classified as NSSI they are typically considered non-pathological (although taken to their extreme may indicate an underlying pathology).
While most people engage in minor forms of NSSI like cutting or burning, drastic examples of NSSI are seen as well. And while NSSI is seen more commonly in women and in teenagers, NSSI is something that is engaged in by all genders and segments of the population.
Why Do People Engage in Nonsuicidal Self-Injury (NSSI)?
When considering why people engage in NSSI no one answer is going to suffice as so many people do it for so many reasons. However, “For approximately 90 percent of patients, NSSI decreases symptoms, most commonly untenable anxiety . . . depressed mood, racing thoughts, swirling emotions, anger, hallucinations, and flashbacks.”
In other words, NSSI is engaged in when extremely strong emotions well-up and it is perceived they can no longer be dealt with in any other way. NSSI is essentially a non-functional coping mechanism.
According to Current Psychiatry, factors associated with NSSI include:
- high levels of negative and unpleasant thoughts and feelings
- poor communication skills and problem-solving abilities
- abuse, maltreatment, hostility, and marked criticism during childhood
- under- or over-arousal responses to stress
- high valuation of NSSI to achieve a desired response
- need for self-punishment
- modeling behaviors based on exposure to NSSI among peers, on the Internet—ie, postings on YouTube—and in the media
The Stigma of Nonsuicidal Self-Injury (NSSI)
Unfortunately, even though we understand NSSI as a medical problem, stigma around it still persists. People who engage in NSSI don’t want to talk about it—and who can blame them—most people still look at these people like they’re “crazy.”
But people who engage in NSSI are not crazy at all. These people have simply developed a negative coping mechanism, likely in response to significant stressors. This coping mechanism likely saved their lives or their sanity at one point or another and thus has been a critical part of their wellness. It just so happens that, long-term, there are better coping strategies to learn.
Next time I’ll talk about how NSSI is treated.