other psychological factors influence Self-Injury-
Other factors influence, result from, and are related to Self-Injury. Some of these factors may contribute to your desire to hurt yourself, such as remembering traumatic events from your past. There are factors produced by self-injury such as feelings of shame and embarrassment. And some factors, such as eating disorders or substance abuse, coexist with self-injury.
It can be difficult to understand the different types of relationships other factors have with SI. They can be distinct problems, that coexist, but don't have any influence on each other. Or one factor may cause or encourage another factor. Or both the factors may be related and are part of a greater problem.
It's evident that the ways factors relate to each other can get a bit confusing. In your case, you may find that certain factors, such as trauma and an eating disorder, have any or all of types of relationships with self-injury. So, SI can influence (or be influenced), coexist with, and/or relate to other psychological disorders.
Trauma - A huge number of individual with self-injury have suffered some form of childhood abuse. "Significant correlations exist between both sexual and physical forms of childhood violence and SI. Other violence within the home has also been determined to be related to self-injury, as has emotional abuse." SI has also been linked to having witnessed or been part of ritual abuse. "The short- and long-term effects of abuse are far reaching and severe, impacting emotions, memories, relationships, self-esteem, behaviors, and even identity."
In some ways self-injury may be a reaction to abuse. "If you have endured and survived trauma or abuse, you can attest to the horror of these events." During episodes of abuse you have probably felt feelings of violation, helplessness, and powerlessness- as if you have little or no control over your environment or even your own body. You may be confused by the way in which you were treated. You may have felt even guilty. The psychological effects of trauma are so intense and severe that it became essential that you find a way to cope. Self-Injury may have helped you cope or deal with the aftereffects of your past traumatic experiences by giving you a way to escape negative feelings and to feel in control for once.
SI can be used for many uses. It may be a way of recreating some of the abuse you went through or witnessed as a child, allowing you to reenact the trauma through self-injury. Recreating previous traumatic experiences can be used as a way to symbolically alter the original course of the abuse, becuase when you hurt yourself, you are the one in control. This feeling of control can help change your reaction to these past abuses. By hurting yourself to recreate trauma, you are able to change from a situation where you felt helpless and powerless to one where you were in complete control, and had complete power.
Self-injury may also be used to relieve psychological tension. This extreme form of tension may directly result from past traumas ("as in the case of memories or flashbacks") or may indirectly result from past traumas ("such as an extreme reaction to loss or isolation"). You may experience moments when you are unable to get rid of painful images or memories of the trauma. At these times you may use self-injury as a way to get rid of these overwhelming memories.
Abuse and trauma both have so many related consequences, it is likely that you have used self-injury to cope with some of these. For example: if the people who were hurting you were the people who were the closest to you, you would not have been able to trust them. Or, because of the abuse you may have had to keep secrets from other friends and family members, which also interferes with your ability to connect with other people. You may also have used SI as away to lessen emotional pain related to the abuse. The lack of connection with other people, and the difficulty in trusting fosters the same feelings that lead to self-injury. "Because of the patterns set up in your abusive past, you may used SI to both replicate these patterns as well as control and relieve the accompanying intense emotional pain."
Boundaries - An area that is damaged by abuse, especially sexual abuse, is that of boundaries. "Boundaries are limits we place on ourselves and others that hlp us to maintain our sense of separateness and independence." When we are children we learn to separate ourselves from other people and to experience ourselves as a single, independent human being. A part of learning boundaries is determining what is ours and what is not ours. One of the things that children own is their body, they learn to believe that it is their own, and that no one else is allowed to touch, use, or disturb it without permission. These rules, or boundaries are often carried into adulthood. But children who have been abused often are not allowed or haven't had the chance to learn their boundaries. "Sexual or physical abuse leads to confusion over these very basic rules of ownership." Children who have been abused may learn that their body is to be hurt and abused or manipulated by others. They learn that their bodies are not their own. Their boundaries are variable or nonexistant.
Self-Injury allows people to experience their body as their own. In some way, it helps "illuminate or restore some basic boundaries lost due to childhood trauma."Hurting yourself may make you feel more real, more separate, more whole. You are the person who is hurting yourself. You are the one who is changing your body. "You, and you alone, are in charge of your body."
Dissociation - Dissociation is a big part of self-injury. But dissocation is also related to trauma or abuse. To survive abuse situations some people have to use dissociation as a tool. Dissociating from the physical or emotional pain may have helped you cope with the trauma. But, as an adult you have difficulty in regulating your dissociative states. SI is an effective way to control dissociation, letting you enter or end a dissociative state.
Eating Disorders - The relationship between SI and eating disorders is interesting and complex. Research has shown that most women who hurt themselves also have some type of eating disorder.
There are many types of eating disorder, but as of yet only two are recognized by the American Psychiatric Association as distinct and diagnosable problems: anorexia nervosa and bulimia nervosa. Anorexia nervosa is when an individual starves themselves to make themselves thin, resulting in body weight that is significantly lower than what is considered normal for that person's age and height. People with anorexia often have distorted views of their body shape and size. Bulimics, unlike anorexics who are extremely underweight, generally weigh within the normal range for their age and height. They engage in episodes of binging, or eating huge amounts of food while experiencing a feeling of lack of control over food intake, and some bulimics also purge, eliminate the food they ate by making themselves throw up, using laxatives, exercising excessively, or using another method. Fad diets and compulsive eating may also be considered as types of eating disorders.
As in SI, childhood trauma has often been experienced by those with eating disorders. An estimated one-third of people with eating disorders have experienced some type of trauma as a child. like SI, eating disorders may be a coping mechanism where you gain control. But there are many other factors that can lead to the development of an eating disorder. But this represents the most frequent roots of eating disorders.
Dissociation is also more common is people with eating disorders. If you have an eating disorder you may experience dissociative states similar to the ones felt when you hurt yourself. Actually, the overall pattern of an eating disorder is similar to that of self-injury. The cycle of bulimia is similar to the "Addiction Model". Negative emotions produce a state of tension, which leads to a state of dissociation, which then lead to an act of binging or purging, which then induces feelings of euphoria, which dissipates and leads to feeling of guilt, shame, or regret. Then the cycle continues.
If you have an eating disorder you may alternate between self-injury and the eating disorder. Or the two may occur simultaneously. Both may be used as a way of coping with great internal pain. And both can provide a way to relieve or release tension, a way to communicate to others your emotional state, to control dissociative states, and to physically express your internal pain. Eating disorders and self-injury have a great deal in common.
Trauma ------------> Dissociation -------------> Eating Disorder or Self-injury
Trauma or abuse leads to a tendency to dissociate, a coping mechanism that may have been crucial to survive the event physically and psychologically. The dissociation can, but doesn't always, lead to an eating disorder behavior or self-injury or both. Trauma is the common source for both these behaviors "and is responsible for the apparent relationship between eating disorders and self-injury. This does not mean that everyone that experiences trauma or that is abused will develop an eating disorder, or develop SI. And eating disorders and self-injury can develop without the presence of trauma. "It seems that both of these behaviors, while often stemming from common sources, also provide similar functions as coping mechanisms."
Substance Abuse - Substance abuse can mean the abuse of any drug (over-the-counter, prescription, or illegal), which includes alcohol, nicotine, and caffeine. These substances may be inhaled, ingested, or injected. It includes chemicals that are purposely inhaled with the intention of getting high.
Substance-related disorders is the general term that includes a wide variety of specific uses of substances and pattern of involvement with them. The terms that refer to the different degrees or impact that drugs have or your life are: substance use, substance abuse, and substance dependence. Also, the drugs may cause many side effects, such as imsomnia and brain damage, that lead to other problems. like self-injury, drugs are used to change our psychological or physical state. SI is typically used to change the way you feel: to decrease tension, increase euphoria, or alter you state of dissociation. And in this way, self-injury has similar effects to some drugs. Even though the two may serve a similar function they are not closely related.
Many people begin and continue using drugs as a way of regulating their moods. When you feel angry, or depressed, you may wish you had a way to change how you feel. Drugs do this effectively, although they have a large number of sometimes dangerous or lethal side effects. Many of us use one chemical or another at a time to regulate our moods and physical state.
The use of substances such as caffeine, alcohol, and/or nicotine is widely accepted by society and is more common than the use of other drugs, such as marijuana, cocaine, etc. Most of us have a type of substance to help us get through the day. However, most of these substances are legal and "culturally sanctioned," which makes them more difficult to identify, accept, understand, or recognize as a problem.
The relationship between self-injury and substance abuse has not been identified or understood very well. In part, this is because a lot of substance abuse goes unrecognized. You probably don't think of yourself as a drug addict, or dependent on drugs. And you may not even realize that you are changing your state of being with chemicals, such as drinking coffee to stay awake in class or at work.
Most people who hurt themselves do not use or abuse illegal substances. Fewer than one-third of people who hurt themselves have ever tried street drugs. In fact, the majority of acts of self-injury do not occur under the influence of any substance, legal or illegal. The reason for this is that substances and self-injury are both short-term ways of coping. Different people have different ways of coping. And some ways work better than others on different occassions. Using drugs and hurting yourself at the same time is unnecessary because both present a temporarily effective way to cope. If you have found something that works you don't need to use another coping mechanism because the immediate problem is solved.
Suicide - Suicide is the ending of life. Chronic feelings of depression and anxiety can lead to someone deciding to end their life. Suicide is often the result of overwhelming feelings of hopelessness and helplessness and of great psychological discomfort. In some cases the psychological pain comes from overwhelming and enescapable physical pain, as in the case of the terminally ill. Suicide is used to end psychological pain, people who attempt or succeed in killing themselves are not looking for a way to adapt to their psychological state. "In contrast, self-injury is used to cope--to adapt to severe psychological discomfort.
SI is not used to make life-threatening injuries. You hurt yourself so you can feel better. This is a goal that is infinitely different from that of suicide, which is to feel nothing at all. "The means, intent, and often the result of self-injurious acts are vastly different than those of suicide. Self-injury is not a mild form of suicide, nor is it a suicide attept gone awry. Instead, SI is a means of coping during a time of intense or overwhelming distress.
Borderline Personality Disorder - Of the large variety of psychiatric diagnoses self-injury is most often associated with borderline personality disorder (BPD). Borderline Personality Disorder is the only psychological diagnosis that specifically identifies self-injury as a criteria for diagnosis, with the exceptions of trichotillomania (the pulling out of hair) and sexual masochism (which can involve SI activities). Because of this some psychologists might diagnose some self-injurers with borderline personality disorder, only because of this one behavior. Because of the lack of diagnoses you may have been incorrectly diagnosed with BPD.
Borderline personality disorder has many criteria for diagnoses other than self-injury. "Personality disorders---whether borderline or another type---are characterized by long-term patterns of behavior that leads the person to feel distressed or impaired in some matter. Usually these patterns of behavior will affect functioning in several areas of life, including employment or school, social relationships, and/or personal well-being. In general terms, BPD is characterized by chronic, intense instability and chaos. This instability can present itself in the realms of identity, relationships, moods, and impulsivity."
People with BPD fluctuate between extremes. Unlike most people, people with BPD view the world in terms of black-and-white, all-or-nothing experience. They usually feel life is either great or terrible, effortless, or hopeless; but nothing in the middle of these two extremes.
Also, people with BPD do things to undermine their own success. Just before completion, goals are thrown aside. Graduation, relationships, and promotion may be tossed aside before successful completion. Behaviors that are self-defeating such as substance abuse, overspending, and physical altercations are common.
Lives of people with borderline personality disorder are chaotic. When life gets too calm or stable, they will begin to experience feelings of tension, vulnerability, and anxiety. Rather than experience these negative feelings they will seek out new chaos. So their life is a cycle of creating and repairing chaotic situations.
For people with BPD self-injury is a direct response to overwhelming psychological pain. It is a way of relieving and releasing intense emotions they experience at calm times in their lives. Also, SI is a way of releasing the feelings of fright they get from thoughts, memories, and emotions during their moments of calm. It also keeps these feelings at bay. Dissociation that may come with the self-injury may end those overwhelming emotional states.
Also, the injuries produced by self-injury are another chaos to focus on for those with BPD. These wound allow the attention of the person to be transferred from the original, distressing emotions to the new emotions and experiences that stem directly from the self-injury. Basically, self-injury plays a complex and interesting role within people with borderline personality disorder. "Self-injury, for a variety of reasons, acts as an agent for producing internal states which are better able to be tolerated.
Dissociative Identity Disorder - Formerly called multiple personality disorder (MPD), dissociative identity disorder (DID) occurs when a person has two or more individual and complete personalities. Each of these identities, or as they are commonly known, alters, has its own personality, it's own memories, it's own style of thoughts, it's own history and temperament. And some of these personalities may be unaware of the presence of the others; and other personalities are aware of and communicate with other different and distinct personalities. An estimated half (only roughly estimated) of people with dissociative identity disorder have between two and ten alters or personalities.
In some ways a person with DID is sort of like an extended family, except that it is a family that is inside of only one individual. "Each of the 'family members' has a distinct personality with particular strengths and weaknesses. One family member may be very artistic, one may excel at business, one may be depressed, one anxious, one angry. There may be children, adults, and adolescents. Some family members may be male, some female, some heterosexual, and some homosexual. Within the family, some of the members may communicate well with each other, some may communicate ineffectively, and some may not communicate with each other at all."
Dissociative Identity Disorder generally occurs in individuals who experienced intense trauma and abuse as a child, often trauma that began before the age of three. Severe physical and sexual abuse is often experienced by those with DID. Also, ritual abuse is associated with dissociative identity disorder.
Dissociation is the psychological mechanism that allows someone to form and maintain different personalities. Since both abuse and dissociation are often connected with self-injury, it is not uncommon for dissociative identity disorder to coexist with SI.
Self-injury serves many purposes for people with DID. In addition to the usual large variety of functions that SI serves, "it has particular applications among individuals with dissociative identity disorder." First, is the ability to control dissociation. Since high levels of dissociation often occur in dissociative identity disorder, control is important.
Sometimes SI is used to prevent another alter or personality from emerging. The physical feelings of self-injury may be enought reminder of reality to keep some personalities from coming out.
SI can also be used to induce the emergence of a certain personality. One personality may be in such physical or emotional pain that they need someone else to take over. This can be either purposeful or accidental.
Also, violence can occur between different alters. Many indivuals with DID have one alter that is angry, violent, and abusive. This identity may take its anger out on another alters- which in reality are their own physical selves.
Self-injury also occurs because of dialogue between different identities. Sometimes, one identity will produce and internal voice that directs another identity to hurt her- or himself. Depending on the strength of this alter, this may lead to an episode of self-injury.
Because of the high level of dissociation associated with DID it is not uncommon for an alter to find wounds they cannot remember causing. The inability to remember may actually be as disturbing as the actual injury. A common characteristic of this disorder is the inability to recall important events or information. This inability to remember may lead to feelings of anger and frustration, helplessness, and despair. And, as you probably know, these are often feelings that cause an episode of self-injury. "Thus the severity of the dissociation involved with dissociative identity disorder, as well as both the causes and results of this dissociation, will affect the likelihood of SI activities and sometimes the extent of the injuries also."
DID is an extreme and complex type of psychological problem. If you know or suspect that you have dissociative identity disorder, and you want help with that or your SI, it would be best for you to seek professional help so you can treat the root of these issues.