Pathomimia is the actions of individuals of a self-destructive nature aimed at causing injury to their own body. More often, such actions are a consequence of the presence of defects in mental functioning. This deviation is expressed in self-harm of the skin, that is, the main symptom is auto-aggression (mutilation by an individual to himself). The term literally means “depiction of suffering and pain.” Simply put, the subject inflicts bodily injuries on himself that mimic the skin lesions that occur in a variety of dermatological ailments. The injuries usually appear as bites, cuts, wounds, or burns. Self-harm is most often observed in areas of the body that are easily accessible for self-harm, for example, on the skin of the chest, face, arms or legs.

Causes of pathomymia

The nature of the described illness is described in sufficient detail in the work of pathomimia, psychopathology of auto-aggression in dermatological practice. The basis of any auto-aggressive actions are various mental pathologies that require differentiation in the approach to therapy. More often, pathomimia occurs as a result of psychogenic illnesses and are manifestations of neurotic conditions. Patients never seek psychiatric help on their own. A dermatologist makes a primary diagnosis of pathomimia. The development of this disease is often associated with occupational or endocrinological diseases, as well as genetic abnormalities.

Signs of auto-aggression, expressed by self-injury to the skin, do not always indicate the presence of abnormalities in mental processes. Numerous studies of pathomymia indicate that self-harming behavior is susceptible to infantile, emotional and sensitive individuals who have difficulty withstanding failures and mistakes and have a high degree of severity and anxiety. The threat of auto-aggression increases significantly in alcoholism and.

Symptoms of pathomimia

Today, an urgent problem in psychodermatology is pathomimia, as the psychopathology of auto-aggression in dermatology.

The main symptoms of pathomymia:

• the constant appearance of new wounds, as a result of which dermatological treatment is ineffective;
• causeless occurrence of skin lesions;
• linearly correct location of wounds;
• location of injuries in easily accessible areas of the body;
• uniformity of lesions;
• pain or itching in places where skin lesions appear;
• a sharply negative response to the medical worker’s assumption about the psychogenic cause of the injuries.

In general, the described pathological self-destruction of the skin, in accordance with the international classification of diseases, belongs to the class of intentionally causing symptoms of a skin disease and simulating psychophysiological abnormalities.

The clinical picture of this pathology is very diverse: from ordinary burns to deep necrotic lesions and ulcerative formations, from multi-bubble rashes or subcutaneous hemorrhages resembling hemorrhagic vasculitis, to severe pathologies that mimic all kinds of ailments, including rare dermatoses.

Most often, rashes are located on the facial area, limbs and other easily accessible and visible areas of the skin. In this case, there is no damage, mainly in places where it is difficult for the patient to reach with his hand, for example on the back.

In addition, sharply defined boundaries of wounds with unchanged dermis around or specific outlines of lesions and pronounced polymorphism of rashes (most often false) are indicative.

Self-destruction of the skin is divided into: neurotic excoriation, hair pulling (), uncontrollable desire to bite nails (onychophagia), mechanical damage to the nail plates (onychotillomania), biting the lips and mucous membranes of the cheeks (cheilophagia).

The basis of neurotic excoriations are the effects of “obsession,” which often indicate a stable neurotic state or psychosis. Individuals suffering from pathomimia can spend a long time working on their own appearance, opening blisters with their nails, squeezing out often non-existent acne with a needle. On the face and extensor skin of the extremities, such patients have small abrasions with reddened edges and deep injuries with bloody crusts, minor pink scars that form after the crusts fall off.

Trichotillomania is the term for pulling out hair on the head or other hairy areas of one's own body. Trichotillomania rarely shows redness, atrophy, or scarring. Only with very severe itching may superficial abrasions appear.

Systematized dermatozoal delirium is characterized by patients demonstrating to specialists the most “affected” areas of the skin. Such patients place pre-prepared jars with skin particles, scales, crusts, tufts of hair and nail plates on the table in front of the doctors and demand examination of these tissues and materials.

These patients can spend hours examining themselves with a magnifying glass, scrape and wash their own bodies constantly, and destroy the “living creatures” supposedly living on their skin with their nails or with knives and acids. They boil underwear and bed linen for a long time, disinfect it, and throw out suspicious used clothing.

Patients are afraid of infecting their close circle and friends, as a result of which they may commit suicide attempts.

Treatment of pathomymia

The diagnosis of pathomimia and the prescription of treatment is carried out only after the root cause of the disease has been clarified and the nature of psychopathology has been discovered.

Highlight:

• conscious self-destruction, which is a response to delusional attitudes;
• unconscious or conscious self-destruction to suppress psychological difficulties that the patient himself is not aware of;
• self-destruction due to obsessive behavior (scratching, rubbing);
• conscious self-destruction for profit;
• Munchausen syndrome, expressed in unconscious injuries performed on another individual to satisfy emotional needs.

The presence or absence of the described disease can be determined using histological examination. Analysis of a skin sample helps to identify the true cause of damage to the dermis. Using ultrasound diagnostics of the skin, the etiology of dermatological damage can be determined. As a treatment for the described illness, complex therapy is indicated, which should include a psychotherapeutic approach, physiotherapy and drug intervention.

Physiotherapy for psychogenic dermatitis covers the following therapeutic methods:

• paraffin therapy;
• electrophoresis;
• laser therapy;
• ultrasonic influence;
• ultraviolet treatment.

In addition, treatment of damaged areas of the dermis is provided with the help of a variety of medicinal ointments, creams, gels, which have an anti-inflammatory effect and a restorative effect. In order to reduce the obsessive desire to harm oneself, psychotropic drugs, antipsychotics and antidepressants are used.

If self-injurious behavior does not represent a manifestation of a severe disorder of mental functioning, then in this case, cognitive behavioral psychotherapy techniques are effective.

The psychotherapist needs to determine the reasons for the emergence of self-destructive actions, explain them to the client and eradicate the patient’s desire to show self-aggression.

Often, psychological conversation with individuals suffering from pathomimia is a fundamental approach in studying the nature of self-destruction. Often patients are unable to comprehend the real reason self-harmful behavior, because they forget how they inflicted wounds on themselves, their mind seems to turn off during such manipulations.

Often, in order for the patient to realize his own involvement in self-harm, it is necessary to resort to psychoanalytic techniques. There are cases when patients come to a psychotherapist, not understanding why they were referred to him, because they just developed skin rashes.

Patients with pathomimia, characterized by the presence of delusional and severe obsessive states, are recommended to undergo treatment in a psychoneurological hospital in order to avoid excessive self-destruction.

The prognosis is often favorable, but there are some difficulties in correcting the destruction of the skin in schizophrenia with the presence of dermatozoal delirium. The condition of patients, in general, begins to improve after six months of comprehensive treatment for pathomymia.

Self-harm may be the way you deal with problems.

It helps you express feelings that you can't put into words, helps you distract yourself from what's going on in your life, or releases emotional pain. In the long run, you will actually likely feel better—at least in the short term. But then the painful feelings will return, and you will feel the urge to hurt yourself again. If you want to stop but don't know how, remember this: you deserve a better life, and you can get it without hurting yourself.

Self-harm provides an opportunity to express and cope with deep distress and emotional pain. Contrary to what you might think and what it may look like, self-harm actually makes you feel better.

In fact, you may feel like you have no other choice. Self-harm is the only way you know to cope with feelings like sadness, self-hatred, emptiness, guilt and rage.

The problem is that the relief that self-harm brings is short-lived. It's like using a Band-Aid when you need stitches. The patch may temporarily help stop the bleeding, but will not heal the wound. And it will create additional problems.

Myths and facts about self-harm and cutting
Myth: People who cut themselves and harm themselves are trying to get attention. Fact

: The painful truth is that, in general, people who self-harm do so in secret. They do not try to manipulate others and do not attract attention to themselves.
Myth: People who cut themselves and harm themselves are trying to get attention. In fact, shame and fear can make it extremely difficult to “come out of the shadows” and prevent you from asking for help.

Myth: People who self-harm are crazy and/or dangerous.
Myth: People who cut themselves and harm themselves are trying to get attention.: The truth is that many people who self-harm suffer from anxiety, depression, or previous trauma—as do millions of other people in general.

Self-harm is a way they cope with stress. Labeling them “crazy” or “dangerous” not only contradicts the truth, but does not help at all..
Myth: People who cut themselves and harm themselves are trying to get attention. Myth: People who self-harm want to die.

: People who self-harm do NOT want to die. When they hurt themselves, they are not trying to kill themselves - they are trying to deal with the pain within. In fact, self-harm can be a way to help yourself get on with your life. However, in the long term, people who self-injure are at risk of suicide, which is why it is so important for them to find help.

Myth: If the wounds are not severe, then it is not that serious.

• Leave a cut or severely scratch yourself.
• Leave burns on yourself.
• Hit yourself, bang your head on something.
• Kicking things or hitting walls or heavy objects.
• Sticking objects into the skin.
• Specifically do not allow the wounds to heal.
• Swallow substances containing poisons or objects not intended for this purpose.

Self-injury can also consist of less obvious ways to hurt or endanger yourself: reckless driving, drinking alcohol, taking too many pills, or having unprotected sex.

Warning signs that a family member or friend is self-harming or cutting

Because clothing can hide injuries and inner turmoil can masquerade as calmness, it can be difficult to notice when someone is hurting themselves. However, there may be red flags that you can pay attention to. But remember: you don't have to be sure exactly what's going on to reach out to the person you're worried about:

• Unexplained wounds or scars from cuts, bruises, burns, usually on the wrists, arms, thighs or chest.
• Blood stains on clothes, towels or beds; bloody tissues.
• Frequent "accidents". Those who self-injure tend to claim that they are clumsy or that they constantly get into “accidents” to explain away the injuries.
• Concealing clothing. A self-harming person may insist on wearing long sleeves or pants even when it is hot.
• Need to be alone for long periods of time, especially in the bedroom or bathroom.
• Isolation and irritability.

How does self-inflicted wounds and damage help?

It's important to recognize that self-harm helps you; otherwise why would you do it?

• Some ways to hurt yourself help:
• Express feelings that cannot be expressed in words.
• Release inner pain and tension.
• Gain a sense of control.
• Distract yourself from overwhelming and deafening emotions or difficult life circumstances.
• Relieve feelings of guilt and punish yourself.

To feel alive or just to feel at least something, instead of “numb” and “frozen”.

Once you begin to better understand why you hurt yourself, you can learn how to put an end to it and find resources to get through the struggle.

Although self-harm and cutting may provide temporary relief, it comes at a cost. In the long run, it causes far more problems than it solves.

• The relief is very brief and is quickly followed by other feelings such as shame and guilt. Plus, this behavior prevents you from learning more effective strategies to feel better.
• Hiding things from friends and family members is difficult and also leads to loneliness.
• You can seriously hurt yourself even if you don't mean to. It is all too easy to misjudge the depth of a cut or cause an infection in the wound.
• If you don't learn other ways to cope with emotional pain, you face a serious risk of major problems, including clinical depression, drug and alcohol addiction, and suicide.
• Self-harm can gradually become an addiction. It may start out as just an impulse or a way to feel in control, but it soon begins to feel the opposite: as if self-harming and cutting is controlling you. It often develops into compulsive, obsessive behavior that seems impossible to stop.

The bottom line is that hurting and cutting yourself won't help you solve your problems, it will cause you to hurt yourself.

About the damage with your words

Because cutting and other forms of self-harm are taboo topics, others—and perhaps even yourself—often have distorted ideas about your motivations and experiences. Don't let myths keep you from helping others or prevent you from helping someone you care about.

“It allows me to express emotional pain or feelings that I can’t put into words. It’s like putting a punctuation mark on articulating your inner feelings!”

"It's a way to gain control of the body, because I have no control over anything in my life."

“I usually feel like I’m a black hole in the pit of my stomach; at least if I feel pain,

It’s better than not feeling anything at all.”“I feel relief and less anxiety after cutting myself.”

If you are ready to get help for hurting yourself, the first step is to trust another person. Talking about something you've tried so hard to hide can be scary, but it can also be a huge relief when you finally share your secret and what you're going through.

Deciding who you can trust with such personal information is very difficult. Choose someone with a “short tongue” who won’t talk too much. Ask yourself who makes you feel supported and accepted. This could be a friend, teacher, religious leader, counselor or relative. You don't have to choose.

loved one

• You'll probably want to open up to someone very close to you—a friend or family member—but sometimes it's easier to start by talking to a less intimate adult you simply trust: a teacher, religious official, or psychologist—someone who is more distanced from your situation and who will not find it so difficult to be objective. Focus on feelings
• . Instead of sharing the details of how self-harm feels—what exactly you do to hurt yourself—focus on the feelings or situations that lead to it. This will help the person you confided in better understand what is happening to you. This will also let him know why you decided to talk to him. Do you need his help or advice? Or do you just want someone else to know what's going on so you can free yourself from the mystery?
• Tell us in a way that makes you feel most comfortable. Just as it is difficult for you to open up, it is also difficult for the person you are telling - especially if it is a close friend or family member. You may not like how the other person reacted. Remember that reactions such as shock, anger and fear are difficult to see from the outside. It can help to give your interlocutor a text description of your feelings and experiences. This will give you extra time to reflect after the conversation.

The better the other person understands the reasons why you hurt yourself, the better he will be able to help you.

Talking about self-harm can be very stressful and bring up a lot of emotions in you. Don't be discouraged if things get tough for a while after you share your secret. It is unpleasant to change long-standing habits and fight them. But once you get over the first hurdles, you will feel better.

Understanding why you hurt yourself is a critical first step to recovery. If you figure out what function your self-injury serves, you will find other ways to satisfy your needs, which in turn will reduce your desire to injure yourself.

Remember that self-harm is often a way to cope with emotional pain. What feelings make you want to cut or hurt yourself? Sadness? Anger? Shame? Loneliness? Guilt? Emptiness?

Once you learn to recognize the feelings that trigger your need to self-harm, you can begin to develop healthier alternative ways of coping with them.

Stay in touch with your feelings

The idea is to pay attention to your feelings, rather than being overwhelmed by them or releasing them through self-harm. This thought may sound scary to you. You may fear that you will be consumed by the pain or that you will become “stuck” in it. But the truth is that emotions come and go quickly if you let them. If you don't fight your feelings, don't evaluate them, and don't give yourself a beating for them, you will see that they will soon disappear on their own, replaced by another emotion. It is only when you “fixate” on a feeling that it becomes persistent.

Self-harm is your way of coping with feelings and difficult situations. So if you want to stop, you need to learn new ways of coping that are acceptable so that you can react differently when you feel like you absolutely must cut yourself or injure yourself in other ways.

If you hurt yourself to express pain or intense emotions:

• Draw, paint, smear red ink or paint on a large sheet of paper.
• Express your feelings in a journal.
• Write a story or song to express how you feel.
• Write down any negative feelings and then tear up the piece of paper.
• Listen to music that expresses how you feel.

If you hurt yourself to calm down or come to your senses:

• Take a bath or shower.
• Hug or snuggle with your dog or cat.
• Wrap yourself in a warm blanket.
• Massage your neck, arms and legs.
• Listen to soothing music.

If you hurt yourself because you feel isolated and numb:

• Call a friend (you don't have to talk about how you hurt yourself).
• Take a cold shower.
• Hold an ice cube in the elbow of your arm or the knee of your leg.
• Chew on something with a very strong flavor, such as chili peppers or grapefruit rinds.
• Write to the chat on some self-help site or post on the “wall” of this site, if there is one.

If you hurt yourself to release tension or anger:

• Train intensely - run, dance, jump rope or punch a punching bag.
• Hit a pillow or mattress; scream into your pillow.
• Crinkle a piece of clay.
• Tear something (sheet of paper, magazine).
• Make some noise (play an instrument, bang pots and pans).

Substitutes for sensations when cutting yourself

• Use a red marker to mark where you usually cut yourself.
• Run an ice cube over your skin where you usually make cuts.
• Place ice cubes on your wrists, arms, legs and move them around instead of causing cuts or other harm.

"I am 14 years old. When scandals at school become unbearable, I take a pocket knife and try to hurt myself as much as possible. When I don't have a knife at hand, I stick a ballpoint pen into my skin or scratch myself until I bleed. I don't know why, but when I do this, it makes me feel better. It's like I'm pulling a splinter out of my body. Everything is fine with me?" Our website also receives such alarming letters from teenagers.

There are also letters from parents: “My daughter is 15 years old. Recently I noticed burn marks on her arm. It’s impossible to talk about it; she takes any word I say with hostility and refuses to meet with a psychologist. I feel completely powerless and don’t know what to do now.”

Blade marks on the forearm, cigarette burns on the body, cut up legs - almost 38% of teenagers have tried to injure their body at least once. The realization that their own child is harming himself horrifies parents. The automatic, at the level of a reflex, desire to relieve him of pain encounters an unusual obstacle - the absence of an enemy and an external threat. And the question remains: “Why did he do it?”

Contact with your body

Growing children, from about 11–12 years old, change their desires, interests, behavior - their inner world becomes different. It is especially difficult for teenagers to adapt to changes in their body. Arms and legs stretch, gait changes, the plasticity of movements and voice become different. The body suddenly begins to behave willfully: erotic fantasies and treacherously spontaneous erections in boys; Menstruation, often painful in girls, can also begin at any moment - at school, during training.

“The body seems to become something separate,” says family psychotherapist Inna Khamitova. “Hurting yourself is one way to get in touch with him.” The behavior of teenagers resembles the gesture of a person who is dreaming horrible dream: he wants to stop him, pinch himself and wake up.”

Scary world

At 37 years old, Tatiana clearly remembers those years when she cut her thighs: “I grew up in a family where it was forbidden to complain - my parents did not understand this. As a teenager, I couldn’t find the words to express everything that was tormenting me at that moment, and I began to cut myself. Now I understand that this was a way not only to deceive adults, but also to console myself: now I know why I feel so bad.”

In our family it was forbidden to complain. As a teenager, I couldn’t find the words to express everything that was tormenting me at that moment, and I began to cut myself

Many modern teenagers, like Tatyana once, find it difficult to express their feelings - they don’t know themselves enough, and they are frightened by adults’ distrust of their feelings. In addition, many simply do not know how to speak openly and honestly about themselves. Having no other means to relieve mental stress, teenagers force themselves to experience pain.

“In this way they struggle with immeasurably greater suffering,” says psychotherapist Elena Vrono, “after all, it is difficult to trust yourself if you are sure that no one understands you, and the world is hostile. And even if this is not the case, the behavior of many teenagers is controlled by precisely this idea of ​​themselves and the world.” However, their actions, which frighten adults, are not related to the desire to give up their lives. On the contrary, they confirm the desire to live - to cope with suffering and restore peace of mind.

Pain relief

The paradox of the moment is that teenagers worry about damaging their bodies. an infantile sense of one's own omnipotence. “The body remains the only reality that completely belongs only to them,” explains Inna Khamitova. - By damaging it, they can stop at any time. By controlling their body in such a wild (from the point of view of adults) way, they feel that they are controlling their lives. And this reconciles them with reality.”

And yet their frightening behavior speaks of a desire to live - to cope with suffering and regain peace of mind

Physical pain always muffles mental pain, which they cannot control, because you cannot force someone you love to love, you cannot change your parents... It can also indicate experienced violence (mental, physical or sexual).

“By showing wounds that a teenager has inflicted on himself,” says sociologist David le Breton, “he unconsciously draws attention to those that are not visible. The cruelty that children show towards themselves allows them to avoid showing it towards others. It acts in the manner of bloodletting in ancient times: it relieves excessive internal tension.”

They hurt themselves so they don't feel pain anymore. Many teens report feeling a sense of relief after self-inflicted wounds. 20-year-old Galina also writes about this: “After the cuts, moments of absolute happiness came. All the dark feelings seemed to flow out of me along with the blood. I stretched out on the bed and finally felt better.” It is this kind of peace that entails the risk of becoming dependent: destroying yourself in order to feel better. It is based on the analgesic effect of endorphins - hormones that are produced in the body to drown out pain.

Family frames

“I cut myself from about 14 to 17 years old,” recalls 27-year-old Boris. - And he stopped only when, having become a student, he left home. Today, thanks to psychoanalysis, I came to the conclusion that this is how I experienced my mother’s hostility. She didn’t want me to be born and made it clear to me every day. To her, I was the most worthless creature who would never achieve anything. I felt terrible guilt and regularly punished myself for not being worthy of her love.”

“A child who lacked tender touches in the first years of life may continue to experience this painfully as he grows up,” explains Elena Vrono. - The body, which he has never perceived as a source of pleasant sensations, remains detached, external to his personality. By injuring himself, he seems to destroy the boundary between internal and external.”

Cuts and wounds on visible parts of the body help children attract the attention of adults. These are signals that parents can no longer shrug off, attributing them to the peculiarities of the transition period.

Parents can increase the suffering of adolescents. “With the best of intentions, many of them try not to praise their children, as if this could spoil them,” says Inna Khamitova. - But children at any age need support and approval. They believe what we tell them. If adults constantly criticize a child, the child gets used to the idea that he is a bad (ugly, clumsy, cowardly) person. Self-harm can also become revenge for a sensitive teenager, a punishment for being so bad.”

But by hating themselves, teenagers do not understand that they actually hate others' opinions of themselves. This is confirmed by 16-year-old Anna: “I recently had a big fight with my best friend. She told me terrible things - that I didn't love anyone and that no one would ever love me. At home I felt so bad that I scratched all my knuckles on the plaster.”

The teenager thinks something like this: “At least towards myself I will act as I want.” And always cuts and wounds on visible parts of the body help children attract the attention of adults to themselves. These are signals that parents can no longer shrug off, attributing them to the peculiarities of the transition period.

Risk limit

It is important to understand the difference between single tests of strength (“Can I endure this?”), oaths of friendship written in blood, and repeated self-torture. The first are associated either with recognizing one’s “new” body and experimenting with it, searching for new sensations, or with rituals that exist among peers. These are temporary signs of self-searching. Constant attempts to hurt yourself are a clear signal for parents that require turning to specialists. But in every case when teenagers show aggression towards themselves, it is necessary to understand what they want to say. And we must listen to them.

What to do?

Teenagers seek understanding and at the same time carefully protect their inner world from annoying intrusions. They want to talk - but cannot express themselves. “And therefore,” our experts believe, “perhaps the best interlocutor at this moment will not be parents, who find it difficult to remain passive listeners, but one of their relatives or acquaintances who can be nearby, sympathize and not panic.”

Sometimes stopping a child is all it takes. a good thrashing from my parents. In this paradoxical way, they make it clear that he has gone too far and express concern. But if such behavior becomes a habit or the wounds pose a threat to life, it is better to consult a psychologist without delay. It is especially important to do this in the case when a teenager withdraws into himself, begins to study poorly, feels constant drowsiness, loses appetite - such symptoms may be a sign of more serious psychological problems.

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Cutting yourself is a disease

After a hard day at work, Elena wanted only one thing: to sit on the sofa, turn on the TV and relax. But when she walked into the kitchen, she realized that this would not happen. Her fourteen-year-old daughter Karina stood in front of the sink. The daughter's hands were covered in blood.

On the table, among the bloody towels, lay a small blade. Elena stood in front of her daughter and could not believe what she saw. What pushes people to hurt themselves and how to help them? Psychologist Olga Silina talks about this.

Self-inflicted violence is the intentional infliction of pain on oneself without the idea of ​​suicide. Usually such people pull out their hair, pick at their wounds, break bones, pierce their body with a nail, etc. This phenomenon is very common. About 1% of the population intentionally hurt themselves.

Explanations for this phenomenon are numerous and varied. However, most people do it to cope with a difficult situation and make life more bearable. Unfortunately, it is very difficult to cure such people. However, you can help them.

But keep in mind that if the person you want to help doesn't want it, then nothing can be done. The first step is to accept the fact that self-inflicted violence exists and is common. And if you are faced with such a problem, do not pretend that nothing is happening. Talk to this person.

By openly discussing this problem, you show him that his problem is important and that you are not afraid to talk to him. Don't feel like you have nothing to say. Even simply explaining that you understand his problem and don’t know where to start the conversation will help you find a common language with this person.

Talking is a way to get support. In a conversation, you need to provide support to the other. You can simply ask how you can help him. During the conversation, you should speak in a calm, friendly tone. Discard all negative thoughts at this moment.

Don't think about judgment because people who hurt themselves are very sensitive. They can immediately understand whether you are with them or not. They feel insincerity and falsehood. A person who hurts himself will not do it in front of others. Therefore, the more time you spend with such people, the less likely they are to torture themselves.

Many people who hurt themselves are unable to openly express it as a problem. Therefore, the more friendly and open you are about the fact that you are going to help them, the more likely it is to succeed.

You need to set clear boundaries between you and these people. The fact is that they may need your help at any time of the day. And if you are not ready to take on such responsibility, immediately agree on a time when you can be contacted.

Believe me, this is much more prudent than when they need help, you will either be busy or unable to talk to them. Don't interfere when your friend starts to hurt himself. Give him the right to choose.

When he has the right to hurt himself or not, there is a much greater chance that he will not do it. When you tell your friend not to hurt himself, he does it in spite of you. Since such violence is used as an attempt to reduce emotional stress, this choice is important for a person.

Trauma makes them feel shame, humiliation, guilt, and loneliness. But at the same time, it is recognized that people who hurt themselves are trying to survive. And you should remember this. Of course, it is very difficult to see a person hurting himself, but you should not forbid him to do this, you should not shout, talk about the harm of self-inflicted violence.

Remember that you are trying to help him, not harm him. Open wounds are a direct expression of emotional pain. One of the reasons for violence is that when a person hurts himself, he transforms internal pain into external, treatable pain. Wounds become a symbol of suffering.

It is important to understand that these are not just scratches, but really psychological problem. However, knowing that someone close to you is hurting themselves can cause depression or stress. Therefore, it is better for you to immediately contact a psychotherapist, who will not only explain to you the reasons for such violence, but also tell you how you can help.

Sometimes it can be really hard to ask for help, but understand that it is necessary. Remember that you cannot help anyone while you yourself are in an emotional critical state.

Auto aggression

Auto-aggression or self-harm helps to express feelings that a person is not able to express in words, distance himself from his own life, or release emotional pain through physical means. This may provide relief, but only for a short time.

Then the painful sensations return again, and the person again feels the need to injure himself. If you want to break out of this vicious cycle, but don't know how to do it, here's what you need to remember: You deserve to feel better, and this can be achieved without harming yourself.

What is auto-aggression?

Self-harm is a physical way to cope with feelings of stress and deep emotional pain. It may sound counterintuitive, but some people try to avoid emotional pain through physical suffering. In such cases, a feeling of hopelessness arises, and self-harm becomes the only way to cope with painful feelings such as sadness, emptiness, self-loathing, guilt and rage.

The problem is that such relief does not last long. It's like putting a band-aid on a wound if you need stitches. The bleeding will stop for a while, but this will not eliminate the cause itself. This also leads to new problems.

Most people who physically harm themselves try to hide this fact from strangers. This may be due to shame or fear of not being understood. However, by hiding who you are and how you really feel, you doom yourself to even greater suffering associated with isolation from society and the outside world. Ultimately, secrecy and guilt affect your relationships with family and friends, as well as the way you perceive yourself. This causes even greater feelings of loneliness, helplessness and hopelessness.

Myths and facts about auto-aggression

Often such topics are taboo to discuss, so people do not understand the motives and reasons why a person causes physical harm to himself. Don't let myths get in the way of helping those you care about.

Myth: People who cut themselves and inflict other physical harm are simply trying to get attention.

Fact: The sad truth is that people who physically harm themselves usually do it in secret. They don't try to manipulate others or draw attention to themselves. In fact, fear or shame prevents them from seeking help.

Myth: Such people are insane and/or a danger to others.

Fact: It is true that many people who intentionally self-harm suffer from depression, persistent anxiety, or are experiencing the effects of serious psychological trauma—as do millions of other people who do not self-harm. Self-harm is their way of coping. Calling them crazy or dangerous is not correct, and is unlikely to help.

Myth: People who physically harm themselves have a death wish.

Fact: Such people often do not want to die. When inflicting physical injury on themselves, they do not seek to commit suicide - in this case, the principle of substitution applies: it is easier for a person suffering from auto-aggression to cope with physical rather than emotional pain - self-harm helps them survive. However, over the longer term, people who engage in physical self-harm when problems escalate are more likely to commit suicide.

Myth: If the cuts are not very deep, then there is nothing wrong with it.

Fact: The severity of cuts says virtually nothing about the pain a person experiences. Do not think that if the cuts are not deep, then there is nothing to worry about.

Symptoms of self-aggression

Auto-aggression involves intentionally causing any physical harm to oneself. Some of the most common ways people physically harm themselves are:

• causing cuts or severe scratches to the skin;
• burning yourself;
• beating yourself or hitting your head on hard objects or walls;
• “throwing” your body onto walls or hard objects;
• gluing objects that cause pain to the skin;
• deliberate containment of existing wounds (scratching, tearing);
• swallowing foreign objects.

The desire to harm oneself can also take less obvious forms, when a person exposes himself to a conscious risk of injury, but does not physically harm himself, for example, driving while intoxicated or at high speed.

How to recognize auto-aggression?

Since physical injuries can be easily covered up with clothing, and psychological experiences can be “hidden” behind calm and measured behavior, it is very difficult to identify auto-aggression. However, there are warning signs to watch out for:

• Unexplained wounds or scars from cuts, bruises, burns, often on the wrists, arms, thighs or chest.
• Blood stains on clothes, towels or bed linen, napkins with blood.
• Sharp objects or cutting instruments such as razors, knives, needles, glass shards or bottle caps among human belongings.
• Frequent "accidents". Often people who self-harm will talk about their own clumsiness or carelessness in an attempt to explain the appearance of new signs of injury.
• Trying to put on more clothes. These people tend to wear long sleeves or long pants even in very hot weather.
• A desire to be alone for long periods of time, especially in the bedroom or bathroom.
• Isolation and irritability.

How does self-harm help?

People who injure themselves explain their needs for auto-aggression and feelings about committing an act of self-injury as follows:

• “It expresses emotional pain or feelings that I am unable to bear. This allows me to get rid of painful internal feelings.”
• “It’s a way to control my body because I can’t control anything else in my life anymore.”
• “I feel a huge black void in the middle of me, it’s better to feel pain than to feel nothing at all”
• “After cutting myself, I feel calm and relieved. The emotional pain slowly overtakes the physical pain.”

Reasons why a person physically harms themselves may include:

• Expressing feelings that cannot be expressed in words.
• Releasing the pain and tension that is felt inside.
• A way to feel in control of a situation.
• A way to distract yourself from overwhelming emotions or difficult life circumstances.
• A way to relieve guilt and punish yourself.
• A way to feel alive, or to feel at least something instead of emptiness.

Once you understand the cause of your own auto-aggression, you can find ways to get rid of it, find other opportunities and/or strength in yourself to survive emotional pain and emptiness.

Why is auto-aggression dangerous?

• Despite the fact that auto-aggression provides temporary relief, everything has its price - frequent injuries increase the risk of dangerous infections and the development of incurable diseases.
• The feeling of relief is very short-lived, and is followed by an even deeper feeling of shame and self-loathing.
• Auto-aggression does not allow you to look for other ways to cope with the current situation.
• If you do not learn to cope with emotional pain, it can later lead to drug addiction, alcoholism or suicide.
• Self-harm can become an addiction. Very often this turns into compulsive behavior that seems impossible to stop.

Remember, harming yourself does not allow you to get rid of or solve the problems that led you to this in the first place, but only temporarily soothes emotional pain by replacing it with physical pain!

Treatment of auto-aggression

Below is a list of effective ways to cope with auto-aggression yourself, with the help of loved ones, or by contacting a specialist.

If you have already realized that you have a problem and are ready to treat auto-aggression, the first step is to find a person you can trust. Starting a conversation will be scary, but in the end, you will feel great relief from sharing your feelings with someone.

Most likely, such a person could be a close friend or relative. Sometimes it is much easier to talk to an adult you respect - for example, a teacher, mentor or acquaintance - who is far from your situation and perceives it from a different, more positive and constructive point of view.

Tips for starting a conversation about this:

• Focus on your feelings. Focus on what is causing you to hurt yourself.
• Communicate in a way that makes you feel comfortable. If you are uncomfortable talking about a problem face to face, try to avoid direct contact with the person and limit communication by email or online chat.
• Give the person time to process the information. Just as it can be difficult for people to open up, it can be difficult for people to process and process information that is presented to them, especially if the person is a close relative or friend.

Determine the cause of the problem

Understanding why a person does this is the first step towards recovery. If you identify the reason why you physically harm yourself, you can find new ways to cope with your feelings - which in turn will reduce the desire to harm yourself.

Find your effective ways to solve problems

If you are doing this to express pain and overwhelming emotions:

• Try to express this in a drawing
• Describe your experiences in a personal diary
• Write a song or poem that expresses your feelings
• Write about all the negative emotions and then tear up this sheet
• Listen to music that suits your mood

If you are doing this to calm down:

• Take a bath or shower
• Pet or play with a pet
• Wrap yourself up in a warm blanket
• Massage your neck, arms or feet
• Listen to soothing music

If the cause is a feeling of emptiness:

• Call a friend (you don't have to tell him that you are physically harming yourself)
• Take a cold shower
• Place an ice cube in the crook of your arm or leg
• Chew something with a spicy taste, such as chili pepper or grapefruit
• Go to a website or chat and chat with someone you don't know

If the reason is to express anger:

• Do some physical exercise - dancing, running, jumping, etc.
• Try hitting a pillow or mattress, or screaming at it
• Squeeze a rubber toy in your hand
• Tear something (a piece of paper or a magazine)
• Make some noise (play an instrument loudly or hit pots)

What is a mental disorder called when a person...

Yes, otherwise. Unconsciously - in schizophrenia. Consciously - perhaps with manic-depressive psychosis. According to Kretschmer, one condition excludes the other.

I did not express myself accurately - rather, it is not a “mental disorder”, but simply a phenomenon accompanying such disorders, as a symptom or a possible manifestation, or independent.

there was an article somewhere that looked in detail at the motives for selfdestruction.

a person can be completely normal.. this is just how he copes with emotions that are too strong

Self harm

Self-harm (eng. Self-injury, self-harm) is the deliberate infliction of various bodily injuries by a person on himself, which are visible for more than a few minutes, usually with an auto-aggressive purpose.

Self harm happens different types. As for serious self-harm (Major self-mutilation - removal of an eye, castration, amputation of a limb), this happens rarely and is most often a concomitant sign of psychosis (acute psychotic episode, schizophrenia, manic syndrome, depression), acute alcohol or drug intoxication, transsexualism Explanations for such behavior by patients are usually of a religious and/or sexual nature - for example, the desire to be a woman or adherence to biblical texts regarding gouging out the eye of a sinner, cutting off the hand of a criminal, or castration for the glory of God.

Stereotypical self-mutilation is a monotonously repeated and sometimes rhythmic action, for example, when a person hits his head, punches and kicks, and bites himself. It is usually impossible to recognize symbolic meaning or any meaningfulness in such behavior. It most often occurs in people with moderate to severe developmental delays, as well as in people with autism and Tourette syndrome.

The most common type of self-harm, found throughout the world and in all levels of society, is household self-harm (superficial, moderate self-harm - superficial/moderate). Typically begins during adolescence and includes activities such as hair pulling, skin scratching, nail biting, which are classified as the compulsive subtype, skin cutting, cutting, cauterizing, needle sticking, bone breaking, and preventing wound healing, which are classified as to episodic and repetitive subtypes. Recurrent cutting and burning of skin are the most common types of self-injurious behavior and can be symptoms or co-occurring features of a number of mental disorders, such as borderline, facial and antisocial personality disorders, post-traumatic stress disorder, dissociative disorders and eating disorders.

There are many myths about self-harm. It is completely incomprehensible to an outsider why they should do something to themselves, because it hurts and marks may remain. It’s strange and incomprehensible why one would do this consciously and of their own free will. Some people simply get scared, others immediately have ideas about abnormality, about some kind of terrible complexes, masochism, etc. Some immediately give out ready-made pseudo-psychological explanations, which in most cases fall completely flat. It is often said that:

"This is a failed suicide attempt."

No, this is completely optional. Of course, among people who self-harm, the number of suicide attempts is higher. But even those who make such attempts still differentiate when they are trying to die and when to hurt themselves or do something similar. On the contrary, many have never seriously thought about suicide.

"People are trying so hard to get attention."

Naturally, many who harm themselves lack attention, love, and the kind attitude of friends. As do others. But this does not mean that they are trying to attract attention with their actions. Usually, in order to attract attention, people dress brightly, try to be polite and helpful, wave their hands, and speak loudly, in the end. But it's strange to try to attract attention without anyone knowing about it. And the consequences of self-harm are usually hidden in every possible way - they wear long sleeves, cause damage where no one can see, talk about cats, etc. Often even close people are not aware.

"They try to manipulate others."

Yes, sometimes this is true: it happens that this is an attempt to influence the behavior of parents or acquaintances, but most people do not do such things. Again, if no one knows, then it is very difficult to manipulate anyone. Self-harm is often not about others, it’s about yourself. But sometimes a person, resorting to causing damage, is actually trying to say something, this is his cry for help, but it is not heard and is regarded as an attempt to manipulate.

“Those who harm themselves are crazy and should, accordingly, be sent to a psychiatric hospital. And they can also be dangerous to society.”

First, self-harm is very personal. Often no one except the person himself knows about this. Or only very close friends (or “like-minded people”) know. The goal itself is an attempt to cope with your feelings, emotions, pain. And other people have absolutely nothing to do with it. As for “crazy people” - yes, sometimes people with mental disorders (such as post-traumatic syndrome or borderline personality disorder) harm themselves. Psychological problems do not mean immediate mental illness, much less hospitalization.

“If the wound is shallow, then it’s not serious.”

There is almost no connection between the severity of the injury and the level of mental stress. Different people they injure themselves in different ways, in different ways, they have different pain thresholds, etc. There is no comparison.

"These are all teenage girls' problems."

Not only. The problem is just completely different ages. Moreover, there is more and more data on the percentage of women to men. If previously it was believed that there were significantly more women, now the ratio is almost equalizing.

It is known%3A one pain can be drowned out by another. Is it necessary to do this? - another question.

Self-harm is a way. A way to fight and partially cope with pain, with too strong emotions, with painful memories and thoughts, with obsessive states. Yes, this is a crooked and stupid method, but not everyone has been taught something more reasonable! Sometimes this is an attempt to cope with too strong emotions, relieve pain and feel reality. Physical pain distracts you from mental pain and brings you back to reality. Of course, this is not really a solution, it does not solve all problems, but for a person it works. Often this is an attempt to express something, to throw it out, to convey to someone (perhaps for oneself) those feelings that cannot be expressed in words; This is some not very standard way of speaking and telling. And sometimes it is an attempt to control oneself, one’s emotions and body, namely punishing oneself with magical logic: “If I do something bad to myself, what I am afraid of will not happen.”

So what should I do? If the problem of self-harm is your problem, then you can, of course, continue to pull out your hair and bite yourself, or you can set yourself the task of “learning to solve life’s problems smartly.” Yes, you need to learn to build relationships and learn to communicate; you need to learn to relax and express your feelings in an acceptable way; Yes, no one promises you results right away and an easy life in general, but - but if you decide to solve your issues, you will cope. I wish you success!

Self harm

Self-harm is the deliberate infliction of bodily harm on oneself, which is caused by internal psychological problems and is not associated with the intention to commit suicide.

Causes

There are three types of independent torture: serious, stereotypical and moderate.

Serious self-harm is the removal of organs or body parts (eyes, ears, limbs, genitals). It is very rare and in most cases has a certain symbolic meaning. Its main reasons are:

• schizophrenia;
• manic syndrome;
• deep depression;
• transsexualism;
• acute drug or alcohol intoxication.

Stereotypical self-harm is rhythmic, monotonous actions that harm a person (hitting the head against a wall, biting). It is common in people with developmental delays, autism and Tourette syndrome.

Moderate self-harm manifests itself in the form of superficial trauma to one’s own body (cuts, scratches, hair pulling). About 4% of the population engages in it. The majority of them are teenage children (in most cases, girls). In addition, a tendency to self-harm is observed among:

• war veterans;
• prisoners;
• homosexuals;
• boarding school students;
• people who were abused as children.

The main causes of moderate self-harm are various emotional problems: mental pain, inner emptiness, guilt, the desire to attract attention. In addition, self-harm may be a consequence of taking psychoactive substances or one of the manifestations of mental dysfunction:

• borderline personality disorder;
• post-traumatic syndrome;
• antisocial disorder;
• depression;
• bipolar affective disorder;
• eating disorders (anorexia, bulimia) and so on.

Pathogenesis

There are three main theories that explain why self-harm becomes a repetitive behavior:

According to the serotonin theory, some people have insufficient levels of serotonin in their bodies, which makes them less able to cope with stressful situations. When auto-damage is caused, the synthesis of this hormone is activated, and the person feels better.

The opiate theory is as follows. Trauma triggers the brain’s pain-relieving system: natural painkillers, opiates, begin to be produced. They dull discomfort and cause euphoria. The result is an addiction that causes the person to repeat self-harm.

Cortisol is a hormone that is synthesized during stressful moments and triggers a cascade of reactions that help protect the body from external aggressive factors. But for some people, the opposite happens - in problematic situations, the level of cortisol decreases. They deliberately hurt themselves in order to change their hormonal levels and cope with difficulties.

Psychological mechanisms of self-harm:

• pain replacement – ​​physical discomfort leads to dulling of emotional suffering;
• increased sensations - pain helps fill the inner emptiness, and also proves to the patient that he is still alive;
• self-punishment - excessive demands from others or real misdeeds force a person to punish himself.

Sometimes teenagers try to attract the attention of parents or friends by causing damage. The peculiarity of this situation is the demonstrative nature of injuries, while in other cases people carefully hide traces of self-harm.

Symptoms

Self-harm in adolescents can manifest itself in the following forms:

• skin cuts from sharp objects;
• self-scratching of the skin;
• burns;
• preventing wound healing;
• pinching of body parts;
• hair pulling;
• breaking bones;
• sticking needles.

In addition, many experts consider the use of toxic substances, overeating and fasting to be self-harm.

The most common areas to be injured are the arms, legs and front part of the body. A person can use several methods of causing damage. Self-harm is caused by any situation that causes anxiety or stress. As a rule, people torture themselves alone. In rare cases, teenagers do this in small groups.

The main sign of self-damage to the skin is the presence of traces (cuts, bruises, scars, burns). Usually a person hides them under clothes or explains them as careless behavior. He often carries sharp objects with him.

As a rule, the disorder is accompanied by other symptoms, including:

• difficulties establishing interpersonal connections;
• tendency to reflect;
• impulsiveness, anxiety, behavioral instability;
• dissatisfaction with life and so on.

Diagnostics

If you notice signs of self-harm with sharp objects in a teenager, you should consult a psychologist. During the conversation, the doctor will conduct a survey and determine the reasons for auto-aggressive behavior. If necessary, he will refer the patient to a psychiatrist for a clinical diagnosis.

In addition, an examination by a dermatologist, traumatologist or therapist may be required to determine the nature and severity of the damage.

Treatment

How to get rid of the tendency to self-harm? First of all, it is necessary for the patient to recognize the problem and also find out its causes together with the psychologist. Often a teenager cannot explain why he hurts himself. It is possible to find out the underlying reasons for auto-aggressive behavior only with the help of psychoanalysis.

The treatment algorithm for self-harm is selected individually. It may include one or more areas of psychotherapy:

• cognitive behavioral therapy;
• dialectical behavior therapy;
• techniques whose goal is to develop inner awareness.

Medicines can be used - antidepressants, tranquilizers, antipsychotics, and so on. Their use must be supervised by a doctor.

In order to effectively deal with self-harm, the patient needs to adjust his behavior. Experts recommend gradually replacing the habit of cutting or scratching yourself in alarming situations with less traumatic actions. For example, put a rubber band on your wrist and pull it when you feel the desire to injure yourself. Other substitution options are screaming, hitting a punching bag, tearing paper.

In addition, the patient should be distracted from obsessive thoughts through physical exercise, walking, dancing, playing music and so on. If a person suffers from inner emptiness, a cold shower can be used as a sensation enhancer.

Self-harm in adolescents requires the involvement of the whole family. It is necessary to support the child and discuss his feelings with him.

Forecast

Possible consequences of self-harm during adolescence:

• consolidation of a behavioral pattern based on the use of auto-aggression instead of constructive solutions in difficult life situations;
• wound infection;
• formation of scars and injuries;
• causing damage that threatens life.

Competent psychotherapeutic assistance allows you to correct behavior and eliminate the tendency to self-harm.

Prevention

Prevention of self-harm involves timely resolution of psychological problems and treatment of behavioral disorders.

What kind of disease is it when a person cuts himself? and more details please. very interesting

Some people who cut themselves do it to experience pain, some just to see blood.

By definition and observations, this disease never leads to suicide, that is, people limit themselves to “self-mutilation” without a fatal outcome.

Interestingly, this disease is less common among men than among women.

Very often people who do this feel lonely. As a result, they want people to pay more attention to them, and self-harm is one of the ways to attract attention.

Very often this disease is periodic; after a certain period of causing bodily harm to oneself, a person calms down, but the disease does not disappear, but takes on a different form. For example, "Bulimia", "Anorexia" or manic-depressive state.

Unfortunately, for people with this disease, self-harm is the main way to solve life's problems.

Of course, to get rid of this problem you need the help of a qualified specialist.

But the first thing a person should do is stop being ashamed of this disease, understand that he is not the only one, and get treatment.

It turns out that about 0.75% of the population globe suffer from this deviation to one degree or another.

Self-harm: harming oneself

Self-harm is when someone intentionally and repeatedly harms themselves using cutting objects, fire, or hands. Also, people with this disorder may drink something that is harmful, such as bleach or detergent.

It is estimated that about two million people in the United States hurt themselves in some way. Teenagers and young adult women are more likely to experience this than young adults.

Often, people say that they are trying to express emotional pain or feelings that they cannot express in words.

It can be like having control over your body when you can't control anything else in your life.

Although people generally do not try to kill themselves, sometimes they are unable to control their injuries and may die accidentally.

How can I help a friend

Ask about it. If your friend is suffering, he may be glad you talk about it.

Offer options for getting out of the situation, but do not tell him what he should do.

Contact Support. Tell an adult you trust. This person can help your friend. You may feel like you have no right to tell anyone else. But remember, you can talk to professionals mental health about how the situation affects you, or you can get further information and advice from any number of organizations.

Remember, you are not responsible for stopping self-destruction. You can't get your friend to stop hurting themselves or get help from a professional. He must want to help himself.

How can I help myself?

Know that you can help yourself. Treatment is available for people who have self-harm tendencies. To find out about treatment options, try talking to a professional person, such as a psychologist.

Realize that you are not alone. Many people suffer from the desire to harm themselves.

Get help. Now is the best time to deal with this problem.

Self-harm is the deliberate, repeated, impulsive, non-fatal infliction of harm on oneself.

Self-harm includes:

1) using cutting objects, 2) scratches, 3) a person can interfere with the healing of existing wounds, 4) burns with one’s own hands, 5) hitting oneself, 6) specially infecting oneself, 7) inserting objects into body openings, 8) bruises and fractures, 9) others various shapes bodily harm.

These behaviors are serious and may be symptoms of a mental disorder that can be treated.

Signs that someone is hurting themselves include: frequent unexplained injuries including cuts and burns, the person may wear long pants and long sleeves in warm weather, low self-esteem, difficulty processing feelings, relationship problems, and poor functioning at work, school, or Houses.

Patterns and causes of behavior.

Many people harm themselves using multiple methods. Cutting on the legs or arms is the most common practice.

Reasons for behavior. People with self-harm tendencies often report that they feel empty inside, unable to express their feelings, lonely, and not understood by others. They fear intimate relationships and adult responsibilities.

Self-harm is their way of coping or easing painful experiences, expressing their feelings, and is usually not a suicide attempt.

The diagnosis for those who self-harm can be determined by a psychotherapist. Self-harm can be a symptom of some mental illnesses: personality disorders (especially borderline personality disorder); bipolar disorder (manic depression); clinical depression, anxiety disorders, and symptoms of psychosis such as schizophrenia.

Treatment for Self-Harm

Treatment options include outpatient treatment and partial hospitalization. To effectively treat self-harm, a combination of medications, cognitive and behavioral therapy, interpersonal therapy, and other forms of treatment are most often used.

Medications are often helpful in managing depression, anxiety, and obsessive-compulsive behavior. Cognitive and behavioral therapy helps people understand and manage their destructive thoughts and behavior. Interpersonal therapy assists individuals in gaining understanding and developing relationship skills.

Self-harm: why do teenagers harm themselves?

Some teenagers self-harm. To others, such behavior is stupid, foolish, or “a cheap way to attract attention.” Families usually try to hide this fact, regarding it as a shame and a defect in their upbringing. However, this problem is much more complex and broader than it seems at first glance.

When children reach adolescence, parents encounter a whole range of problems in their behavior. As you know, all children are different, and their differences become especially visible during this period. Some people go through this stage of growing up easier, while others have difficulties. Of course, parents are now primarily afraid that their son or daughter will be involved in some kind of criminal activity, or that he or she will become addicted to alcohol, drugs, or turn into a gambling addict. This is, of course, terrible, but, nevertheless, that’s not all.

It is not very common to talk about this phenomenon. To others, such behavior is stupid, foolish, or “a cheap way to attract attention.” Families usually try to hide this fact, regarding it as a shame and a defect in their upbringing. However, this problem is much more complex and broader than it seems at first glance.

Self-harm includes a wide range of various types harmful effects on yourself. And although, in principle, smoking can also be classified as self-harm, the term primarily refers to the infliction of various kinds of wounds and bruises. And the most important thing in this case is the absence of suicidal intentions. That is, the teenager injures himself, but does not want to kill himself.

In total, 1-4% of the population engages in self-harm. The vast majority of them are teenagers, but there are also adults. Of course, there are those who harm themselves in some way only once in their entire lives. However, for some people this behavior becomes habitual.

Usually self-inflicted injuries occur for 2 main reasons. The teenager either has too many emotions that he cannot cope with and the pain from self-harm gives them an outlet. Or there are no emotions at all, he feels insensitive and inflicting a wound or bruise on himself gives him the opportunity to feel alive. Be that as it may, after inflicting pain on oneself, the teenager feels not only relief, but also euphoria. Some say that pain and flowing blood cause very pleasant experiences that interrupt the negative emotions that tormented them before the act of self-harm.

There are 3 main theories that explain why this behavior may recur:

1. Serotonin - some people have insufficient levels of serotonin in the brain and, therefore, they cope worse with stressful situations. Pain causes a rise in serotonin and improves overall well-being.

2. Opiate – when a wound or bruise is inflicted, the brain’s anti-pain system (antinociceptive) begins to act. Opiates, produced in the brain, are our primary natural pain reliever. Thanks to them, severe pain can be dulled. In addition, these substances can cause euphoria. A person who regularly injures himself can become hooked on these effects and repeat them over and over again.

3. Cortisol – cortisol is a stress hormone. In order for the body to cope with the harmful effects of the environment, this hormone must reach a certain level and involve other body systems in the “stress cascade”. Thanks to it, every link and every organ begins to work in “stress mode”, protecting us from external harm.

External causes of self-harm can be:

1. Dysfunctional family (divorce or the situation “we will live together only for the sake of the children”)

2. Perfectionism of the teenager and his environment. If you haven't done everything perfectly, you deserve punishment and there is no forgiveness for you.

3. Influence of friends. There are situations when friends provide a model of behavior in difficult life situations.

4. Experienced sexual violence.

5. Information in the media when self-harm is presented as a solution to a problem. “The boy cut his wrists, and immediately everyone around him realized that they were wrong.”

In general, there are 3 types of self-harm:

1. Impulsive – when a teenager hurts himself under the influence of a strong influx of emotions. This happens automatically, without thinking or even maturing the intention to do it.

2. Stereotypical – monotonous application of bruises, most often. Such self-harm is often characteristic of people with mental retardation and those who suffer from autism of varying degrees of severity.

3. Compulsive – occurring under the influence of obsessive thoughts.

In addition, the severity of self-harm can be:

1. Severe – life-threatening.

2. Moderate severity - requiring medical intervention and treatment.

3. Lungs - those that do not require medical intervention or those that require a minimum amount of assistance.

Why should a teenager need help, even if he is not mentally ill?

1. Some people may become dependent on this behavior, given the involvement of endogenous opiates. Accordingly, self-harm can be used for pleasure.

2. Forming the habit of solving problems through self-injury. Needless to say, people around get scared and become more accommodating.

3. Formation of a behavioral pattern that is included in all life activities and self-aggression becomes an ordinary routine.

4. Self-harm becomes a way of responding to stress. Those. It’s easier to hurt yourself than to solve something constructively.

Despite the fact that it may seem that the teenager is doing all this on purpose, he actually often finds it difficult to say why he cut himself or did something like that. At the moment of an attack on one’s body, consciousness may narrow and awareness of behavior may drop significantly.

Some teenagers commit aggressive actions towards themselves in a truly demonstrative manner. If we talk about self-cuts in such cases, they are usually thin and superficial. It is clear that the man spared himself. They are often done in visible places, but never on the face or hands. At the same time, attention is drawn to behavior in which the teenager seeks to arouse pity and guilt in others, tries to openly manipulate, and threatens to harm himself again if others behave in a way he does not like.

There is an opinion among people that one should not pay attention to such manipulators and provocateurs. However, the teenager does this not to annoy his parents, but also because of personal problems. This means that he does not cope with his life's difficulties differently. Often, parents with such a child begin to play a game of who is stronger in will and character, and the child, in an attempt to prove that his threats are not empty, but real, causes significant harm to himself or commits involuntary suicide. Those. death is not planned as such, it just happens that way.

More often than not, self-harm is not demonstrative. Teenagers hide scars from self-cutting and are embarrassed to talk about them. Even if the damage is common, an area is still selected that is not very visible to outsiders and can easily be hidden under clothing.

If a teenager inflicts wounds or any other damage on himself, especially if this is not the first time, parents should pay close attention to this. There is no need to expect that “everything will go away on its own” and “grow out.” Even if one of the parents himself cut his wrists or hit his head against walls at a young age, and everything went away for him, it does not mean that everything will be fine with the child. Even if things get better over time, the scars from self-cutting can be a stigma for the rest of your life.

If this happens, it is advisable to consult the child with a psychiatrist. If someone is afraid of registering, you can contact a private doctor. This is necessary to decide whether the child has mental illness or it is a violation of adaptation or problems in his life that he cannot solve. Depending on what the doctor finds, it will be possible to decide exactly how much help will be needed.

And all this will work quite poorly if the teenager does not have family support. If they look at him as a traitor and a madman who cannot be trusted. Perhaps parents themselves will need to look at themselves from the outside and take steps towards changes within the family.

Self harm refers to one of the taboo problems in society, which is not customary to talk about out loud. Society condemns this behavior in every possible way and absolutely does not want to even hear about its reasons. For those around them, the behavior of people who torture their bodies is stupid, infantile, and problematic. It is believed that in this “cheap” way they are trying to attract attention to themselves. In other cases, it is common to think that self-harm is a consequence of drug or alcohol addiction. But is this really so?

What it is?

Many believe that causing physical harm to oneself is common mainly among teenagers in recent decades. Probably due to information overload and a lot of violence on TV screens. But this is not entirely true; even in ancient times, various ways of torturing one’s own body were known. This was mainly characteristic of religious fanatics who believed that the suffering of the body purifies the soul. Indeed, in a sense, physical pain can really dull mental pain for a while. And in literature, they often romanticize the image of a passionless person who has lost the meaning of life, who wants to feel at least something again, and then in despair he causes physical harm to himself. But what is it really, where do such thoughts and aspirations come from?

In fact, self-harm is the deliberate infliction of damage to one's body for some internal reason, but without suicidal intentions. It occurs as a symptom of some mental disorders. These disorders may include borderline personality disorder, major depressive disorder, post-traumatic stress disorder, bipolar disorder, schizophrenia, bulimia, anorexia, etc. But self-harm can also occur in people without a clinical diagnosis. However, it is often associated with mental health problems, depression, and anxiety.

The most common types of self-harm:
cuts on wrists, thighs and palms;
severe scratching of the skin, until there is blood;
cauterization;
hitting your head against a wall or throwing your body onto hard surfaces and objects;
pinching of body parts;
squeezing the head, self-suffocation;
intentionally preventing the healing of scratches and other wounds, opening them regularly;
piercing the skin with needles and other piercing objects;
swallowing inedible objects.

There are 3 types of self-harm:

1. impulsive– when a person, most often a teenager, experiences a strong influx of emotions and, under their influence, causes damage to himself. This happens unexpectedly, without desire or intention, automatically, thoughtlessly.

2. Stereotypical. Most often, people with a stereotypical type of self-harm inflict bruises on themselves. Such rhythmic, monotonous self-harm is most often characteristic of persons with developmental delays and those suffering from autism of varying degrees of severity.

3. Moderate or compulsive– when a person causes physical harm to himself under the influence of obsessive thoughts. It can be present in people of any age.

What is the reason?

There are 2 theories related to physiology that explain why this behavior can be repeated:

1. Serotonin theory: Some people are less able to cope with stress because they don't have enough serotonin in the brain. For these people, pain makes them feel better because it causes a rise in serotonin.

2. Opiate theory: During wounds or bruises, the brain's anti-pain system operates. Opiates are produced and are the main natural pain reliever. Thanks to them, the pain dulls a little, and these substances can also cause euphoria. People who physically harm themselves regularly may become addicted to these effects.

But in addition to internal ones, there are also external causes of self-harm. Behind the facade of this behavior there are often attempts to cope with emotional discomfort. In fact, absolutely any stressful situation can become a motive to torture your body. Such reasons may be:
intrafamily problems (divorce, abuse, neglect, excessive severity of parents, frequent quarrels, tyranny of husband or wife, etc.);
experience of sexual violence;
a feeling of one’s own powerlessness, extreme resentment (under the influence of problems that cannot be solved right now and that do not depend on oneself. In such cases, a person feels the illusion of lost control over the situation and falsely considers self-harm a solution).

Why do some teenagers find normal ways to cope with emotional states while others do not?

Low self-esteem. Teenagers who regularly cut themselves are more likely to have low self-esteem. They do not see anything valuable in themselves; they consider themselves worthless, ugly, incapable of anything, stupid and uninteresting.

High bar, excessive perfectionism. The conditions under which a teenager could relax, rejoice and be satisfied with himself are impossible. Excessive demands and expectations from family, friends, school, and loved one are to blame for this. The highly competitive environment in which he finds himself matters. In this case, the subject of competition can be educational achievements, beauty standards and status in the youth hierarchy. Such teenagers have a subconscious belief that everything must be done perfectly. Otherwise, you are worthy of punishment and there is no forgiveness for you.

Emotional vulnerability. Those who are most prone to self-harm are those who have a cold family. A peculiar culture of attitude towards emotions leads to such behavior. These teenagers have a low level of emotional competence and great difficulty in understanding their own emotions and expressing them. They grow up with the wrong attitude towards emotions. In their families, there are prohibitions on expressing resentment, anger, sadness, and showing weakness. They are not accustomed to turning to loved ones for help and emotional support.

Myths

This topic is shrouded in many myths. It is completely incomprehensible to a healthy person why someone would want to harm themselves, because it is painful and may leave scars. Why deliberately hurt yourself on a regular basis? This frightens some, some immediately have thoughts about abnormality, masochism, etc. People don’t want to delve even a little into this, and therefore in most cases, when discussing the facts of self-harm, they completely miss it.

Myth #1: This is a failed suicide attempt.

Not at all necessary. There is a clear difference between those who made an unsuccessful suicide attempt and those who did not even think about such an outcome. Some people want to die, get rid of pain and suffering, while others, on the contrary, crave this very pain. Most self-harm practitioners have never seriously thought about suicide.

Myth #2: Only teenage girls suffer from this.

Not only. This stereotypical opinion is completely unfounded. Self-harm is a serious problem across all ages, genders and social classes. Moreover, if we talk about the percentage of women and men, it will be approximately the same.

Myth #3: This is how people try to attract attention.

Like many people, those who self-harm may lack attention, love, good attitude loved ones and others. But this does not mean that they are trying to attract him to themselves in this way. As a rule, if people lack attention, they can dress flashy and dye their hair bright colors. They try to stand out either by shocking behavior, or, on the contrary, by exceptional politeness and excellent manners. Attempts are expressed at least in loud conversations. But it is completely illogical to try to attract someone's attention while hiding it with all your might. And the consequences of self-harm are never discussed. On the contrary, they hush up and disguise it in every possible way - they wear clothes with long sleeves, cause damage where no one can see, etc. Usually they don’t tell about this even to those closest to them.

Myth #4: This is a way to manipulate people around you.

Very rare, but it happens from time to time. It happens that by his behavior a person wants to influence the behavior of his family, relatives or friends. Sometimes he tries to say something by resorting to damaging his body. In fact, this is his cry for help, but he is not heard and everyone takes it for a demonstration.
But the vast majority do not do this. At a minimum, because it is very difficult to manipulate someone if no one knows about the subject of manipulation.

Myth No. 5: If the wounds are shallow, then everything is not serious.

There is no relationship between the severity of physical injuries and the level of mental stress. All people are different, their lives, problems, and pain thresholds are different. And even the ways in which they harm themselves differ. Therefore, in this case the comparison is inappropriate.

Myth #6: Those people who harm themselves are crazy. And they need to go to a mental hospital because they are dangerous to society.

In some cases, people with mental disorders (such as the aforementioned borderline personality disorder, post-traumatic stress disorder) also cause physical harm to themselves. But this does not pose any danger to surrounding people and does not require hospitalization.

Self-harm is very personal to an individual. Almost no one except himself knows about this. The main goal is considered to be an attempt to overcome some internal problems, to cope with pain, feelings, and emotions. Other people have nothing to do with it.

Some statistics
According to WHO, About 4% of the world's population engages in self-harm. Most of them are teenagers. About a fifth of people who practice self-harm harm themselves in some way no more than once in their lives. But for other people, this behavior becomes habitual.
Among teenagers who engage in self-harm, 14% do it more than once a week, 20% do it several times a month. Some teenagers do this only under the influence of certain stress(for example, only after a quarrel with parents or a loved one). But for the rest Any situation that causes stress or anxiety can lead to self-harm.

How to get rid of the desire to cause physical harm to yourself?

A person may feel that he has no choice and inflicting physical pain on himself is the only way he knows to cope with emotions: mental pain, melancholy, anger, self-hatred, feelings of emptiness, guilt, etc. But the problem is that relief self-harm does not last long. It's like a Band-Aid when you need stitches.

Yes, this is a rather difficult psychological problem. She needs special therapy and professional help. But sometimes you can try to deal with this problem yourself. For example, if the desire to harm oneself is not expressed too clearly and has not yet been realized in practice. Or if this only happened once or twice.

The most important thing is to properly understand and explain to yourself exactly what you feel. Which emotion is the very impulse that pushes you to cause pain to your own body. This is the basis of healing. It is important not to make mistakes in self-analysis. The ways to get rid of the desire to harm yourself are different for different emotional sensations and internal problems. Without finding out the cause, the investigation is impossible; it will be impossible to move forward.

Methods of psychological assistance

If the patient is not able to independently understand the cause of the problem, he can find out together with a psychologist. After all, people, especially teenagers, often cannot explain why they hurt themselves. As a result, the prerequisites for such behavior can only be clarified with the help of in-depth psychoanalysis.

Next, the treatment algorithm is selected individually. In treatment, you can use medications such as antidepressants, tranquilizers, etc. Of course, drug treatment is strictly controlled by a doctor. Cognitive behavioral therapy is mainly used to effectively combat self-harm. So that the patient can correct his behavior, psychotherapists recommend gradually replacing the habit of cutting or burning oneself with other, non-traumatic actions. For example, if you have a desire to harm yourself, you can train yourself to tear the paper into pieces. Or you can put a rubber band on your wrist and pull it every time you want to hurt yourself. Other replacement options could be jogging, hitting a punching bag, screaming into a pillow or in deserted places, etc.

The most effective and helpful way to distract yourself from obsessive thoughts is to replace them with things you enjoy doing. For example, through physical exercise, dancing, playing the musical instruments, clay modeling and more. If a person harms himself in the hope of experiencing pain or other emotions, a cold shower will help. It will act as an excellent amplifier of sensations.

How to help a teenager who is self-harming

If an adult can, under certain conditions, cope with the problem on his own, then for adolescents this requires the participation of the whole family. It is very important to be able to support the child and discuss his feelings and emotions with him. Unfortunately, most families usually try to hide the fact that their children are self-harming. They regard this as their own failure as parents, a shame and a defect in their upbringing. Sometimes parents believe that their child’s behavior is nothing more than an attempt to manipulate them. Therefore, with such a child, parents begin a competition, a game, to see who is stronger in will and character. This could end in disaster. After all, a teenager, in an attempt to prove that his threats are not empty, can cause significant harm to himself. Or even commit involuntary suicide, even if he did not plan death at all.

If parents are afraid for the child’s future and do not want him to be registered, they can contact a private doctor. Examination and consultation with a doctor are very important. This is necessary to exclude or diagnose a mental illness in a child. And only depending on the doctor’s verdict will it be possible to determine what kind of help will be needed. But if a teenager does not have full family support, any type and amount of help will work quite poorly. He will not be able to cope if his own parents look at him as crazy or a traitor who cannot be trusted. In this case, it is likely that it will be the parents who will need to take steps to change within the family. And first of all, they will need to look at themselves from the outside.

What parents of teenagers who engage in self-harm should NOT do

Of course, it is impossible to know and see how your own child causes physical pain to himself and remain calm. When parents encounter this, they get very scared and panic. There are some things you should never do in such situations. But most often, this is exactly how parents react, experiencing fear for the child, shock and confusion.

You can't scold a teenager. All attempts to scold, shame, or intimidate him with the consequences of such behavior are doomed to failure. And if you appeal to his sense of guilt and conscience, you may not only not help, but also completely worsen the situation. For example, a teenager cuts himself, trying to cope with feelings of anger, anxiety, and guilt. And the parent begins to blame him (“Do you have any idea how I felt when I saw this?”) and scare him (“You will leave ugly scars and you will get an infection”). All this will only lead to a new round of guilt and anxiety in the tangled tangle of emotions of a teenager. Accordingly, he will again need a way to deal with them. This means that the need for habitual actions, which he resorts to when he needs to deal with feelings, will increase. It turns out to be a vicious circle.
Restrictions won't help. Any attempts to deprive a teenager of ways to harm himself generally lead nowhere. And if they do, then to something worse. He may have other ways to relieve emotional stress, much more serious than before.

Trying to cope on my own inappropriate. It is quite difficult for parents to independently understand how to react in such situations and what to do. In most cases, fear makes them think first of all that it is their fault, they are bad parents. That is, in this way they concentrate on their own experiences. While the teenager’s experiences come first. Therefore, it is best to seek help and support from specialists. They may also counsel and work with parents separately from the child. This practice will benefit the whole family and help deal with the problem faster.

It’s very bad to keep silent about painful situations.. If serious, major traumatic events have occurred in the family, it is important to discuss and live it together. Such events can be the loss and illness of loved ones, divorce, disaster, violence, even moving. It is necessary to analyze whether there were enough conversations about this with the child, whether he or the parents themselves experienced this. It is worth analyzing the parent-child relationship to understand whether there is trust, openness, acceptance and support in it. Are there conversations about what is happening in a teenager’s life, about his experiences? Do parents themselves share events and experiences of their own lives with their teenagers?

Self-harm, or self-harm, is a phenomenon in which a person deliberately harms himself in an attempt to cope with a difficult emotional state or oppressive circumstances. Self-harm can bring a sense of relief in the short term and help you cope in the moment. But in the long term, this leads to worse health and an even more dangerous situation. There is no magic cure for self-harm. In addition, changing habits is always difficult, but it is easy to return to your previous lifestyle. The recovery process takes time, so relapses are possible. If this happens, it is very important to be lenient with yourself and not beat yourself up for failure. If you decide to begin the path to healing, this in itself is very important.

Steps

Part 1

Self-harm prevention first aid

Try to surround yourself with people. If you feel like hurting yourself, force yourself to go somewhere where you will be among people. Sometimes all you need to do is go to the next room where your family or dorm neighbors are. You can go to some public place, for example, a cafe or a city park. Whatever you choose, wherever you are, decide to stop hurting yourself. Do everything you can to have people around you.

Call someone. If you're home alone or can't go out, call someone just to chat. This could be a relative, a friend you trust, or a psychological support hotline. Many hotlines provide helpful information for those struggling with the urge to do something to themselves. There you can also find out about additional resources for help.

• It can be helpful to make a list in advance of people you can call in a similar situation.
• Enter all numbers in your phone book.
  • 8-800-333-44-34: This is a free 24-hour helpline number throughout Russia
  • http://psi.mchs.gov.ru/ : Internet psychological assistance service of the Ministry of Emergency Situations
  • 8-800-2000-122: Single telephone hotline number for children, teenagers and their parents.
• You can even talk to an inanimate object: a photograph or a poster - or a pet. Both will help you express yourself, and you will never hear judgment in return.

1. Get help if you are having suicidal thoughts. If you are thinking about committing suicide, call immediately at 8-800-333-44-34. Signs that it's time for you to seek help:

   • You often talk about wanting to die or kill yourself.
   • Considering ways to commit suicide.
   • Your statements reflect a feeling of helplessness.
   • You say that you don’t see any point in living any longer.

2. Draw on the body with a marker. If you find that your thoughts keep returning to the desire to harm yourself, an alternative is to draw on your body with a marker. Draw something on the area of ​​the body that you think of where you would like to mutilate. At least the ink doesn't leave scars.

   Try to distract yourself. Trying to distract yourself is one way to prevent self-harm the moment you feel the urge to do so, or realize that this is what you are doing. It is extremely important to identify what kind of distraction works for you at any given time. Sometimes a variety of factors can act as a trigger or impetus for self-harm, depending on the feelings or situation. This means that our response to trying to prevent harm must also be different.

   • Dye your hair.
   • Prepare some tea.
   • Count to 500 or 10000
   • Put together a puzzle or play mind games.
   • Go “people-watching.”
   • Play a musical instrument.
   • Watch a movie or TV show.
   • Paint your nails.
   • Put things in order, for example, in books, in the pantry, and so on.
   • Make origami to keep your hands busy.
   • Play sports.
   • Go for a walk.
   • Create your own dance routines.
   • Draw a picture or edit photos.

3. Wait it out. Another way to break the vicious cycle is to simply start postponing the moment when you harm yourself. Start by waiting 10 minutes. Watch the urge disappear. If not, wait another 10 minutes.

   Create reminders for yourself about your actions. If you are faced with the desire to harm yourself, talk to yourself. Remind yourself of the choices you have.

   • Tell yourself that you don't want to have scars.
   • Remind yourself that you don't want to hurt yourself just because you thought about it.
   • Repeat to yourself, “I don’t deserve to hurt myself,” even if you don’t believe it.
   • Don't forget: you always have the choice not to do this. All in your hands.

4. Remove any tools from your home that could cause injury to yourself. Remove everything that can be handy for this. Knives, lighters, anything - even the most unobvious things. All this simply needs to be taken out of the house.

   • Sometimes it's enough to just throw it all away. Just make sure you can't get them back. It's better to give all such things to someone who can use them.
   • You can even arrange a symbolic “funeral” for such items, burn them, throw them away or bury them in the ground - “bury them”. Say out loud, “I don’t need you anymore.”

5. Try progressive muscle relaxation. Progressive muscle relaxation is a type of defense mechanism that focuses on tensing and relaxing different muscle groups. An obvious benefit of progressive muscle relaxation is becoming more aware of the physical sensations in your body.

   Take a mindful walk. A mindful walk is a walk during which you try to be aware of what is happening. One of the benefits of such walks is the development of mindfulness in everyday life. Additionally, some people find it difficult to sit still and practice “traditional” meditation. Walking is a more active form of meditation. And plus, any walk is good for your overall health.

Part 5

Seek professional help

1. If there are signs of suicide, seek help. If you or someone you love is having suicidal thoughts, seek help immediately. Call the helpline. If you are worried about a loved one, you should pay attention to the following signs:

   • Talking about wanting to die or commit suicide.
   • Interest in methods of suicide.
   • Mention of a state of despair.
   • Mention in conversation about the loss of meaning in life.

2. Seek professional help. A psychologist or psychotherapist can help you understand difficult emotions and overcome traumatic experiences. Such a specialist has both education and experience, thanks to which he can help you cope with what pushes you to such actions.

   • Ask your doctor friend for a recommendation of such a specialist. Make an appointment with him. If you find it difficult to talk openly about this with friends or family members, you may find it much easier to talk through your feelings with a stranger.
   • If you have a very difficult life situation, for example, you find yourself in a situation of violence or have experienced a traumatic experience, or your emotions are so high that you want to do something about yourself, the most best place, where you can express all this, there will be a safe, neutral environment where no one will judge you.