Self-injury

Abstract

Self-injury is now recognized as a form of behaviour in its own right, distinct from self-harm and attempted suicide. It can be defined as a behaviour that involves deliberately injuring one’s own body, without suicidal intent and with or without pain. Self-injury takes many different forms, with cutting the most common. Although its prevalence is impossible to determine accurately, self-injury is common, widespread, and probably on the increase. Self-injury is in general more common in younger women, but men and older women also self-injure. The causes are multifactorial, with biological, psychological, and social explanatory theories. Self-injury does serve many different functions for the individual, acting as a way of coping with stress, regulating unpleasant emotions, calming and comforting, relieving a sense of guilt, restoring a sense of reality, and providing a means of communicating distress to others. Hospital studies suggest that those who self-injure or cut themselves receive worse services than those who poison, and yet may be at greater risk of repeat self-harm and even eventual suicide. Treatment must always be based on positive attitudes to the self-injurer and proceed via a detailed individual formulation. Choice of therapy is determined by the underlying causes of the behaviour.