Why Do People Self-Injure?

The majority of self-injurers are females between the ages of 13 and 30.

Self-injury usually begins around the age of 10-16.

4% of adults have self-harmed during their lifetimes. 1% do so chronically or severely.

Risk factors include conditions such as depression, anxiety, conduct disorders, substance abuse, and eating disorders. Diagnostically, self-injury is most closely associated with borderline personality disorder. Intrapersonal factors include low self-esteem, low impulse control, and ineffective problem-solving skills. Early childhood experiences such as abuse and emotional invalidation also contribute.

75% of self-injurers report that the motivation to do so came from within, as opposed to via suggestion from peers, media, etc. Common triggers include feeling rejected, feeling unfairly blamed, feeling inadequate, or feeling "wrong" in some way.

The link between prior abuse and self-harm is only modest - a challenge to the notion that self-harm necessarily represents a "reenactment of past abuse".

Self-injury is not necessarily predictive of suicide, however, 50% of self-injurers have attempted. Desensitization to pain and gore is a risk factor for suicide.

Self-injury comprises a number of functions and meanings, listed in order of frequency:

1. Emotion regulation - to alleviate intense/negative emotions (to lower emotional arousal)

2. Self-punishment - the direction of anger toward the self, a method of relieving self-criticism/feeling as though 'justice has been served' against the 'bad' self

3. A method of influencing or communicating to others

   1. Much less common than the first two motivations

   2. Self-injury can elicit affection and other reinforcing, caring responses from others. Please note that the desire for caring responses from others is not the same as "attention".

   3. Self-injury can indirectly express emotions or otherwise act as a substitute for interpersonal skills

4. A way to stop dissociation - to relieve states of numbness, unreality, or emptiness (to raise emotional arousal). "It makes me feel alive".

5. A compromise to defend against suicidal impulses

6. Sensation-seeking - can generate excitement, exhilaration, an addictive high

7. To underscore interpersonal boundaries - creates a sense of control over one's self and environment.

Source: https://pubmed.ncbi.nlm.nih.gov/17014942/