Patients that psychologists frequently encounter are people who are cutting themselves. Cutting is a form of self-mutilation.

Cutting is not the only form of self-mutilation that people do to themselves. They may also burn themselves, pick pieces of skin out of their body, pull their hair out, or anything else that they can do to harm themselves. Self-mutilation is when a person deliberately harms and hurts themselves physically, but they are not trying to kill themselves or commit suicide. The objective is to cause pain.

Why would you want to cause yourself pain?

What are the dynamics of this behavior?

It can be an act of frustration and/or the desire to punish themselves?

The question is, punish yourself for what?

The natural response to someone punching you is to punch them back. If someone hurts you, you want to hurt them back.

What if you are in a situation where you can’t retaliate?

What if you are constantly picked on or bullied?

What if you have alcoholic parents who fight all the time and neglect you?

The person who is hurting you, neglecting you, or rejecting you in some form may be too big, too small, too weak, too strong, too sick, or maybe it is not even a person. It could be a system that you work in or learn in. You are helpless, you have no power to make their behavior stop, you are unable to protect yourself, and you are miserable.

Then what?

If you can’t hit back then you may punish yourself for being so inadequate, so weak, so unattractive, not smart enough, or not having the resources to deal with the situation and protect yourself. Since you can’t hurt or retaliate against the source of the pain, you injure yourself and hurt yourself. You punish yourself for being the way you are. You may see yourself as being pathetically inadequate. You are not strong enough, smart enough, pretty enough, attractive enough, and so on. Self-mutilation is a way of coping.

When the psychologist works with people who are doing these things,he will track and study the behavior. What they almost always find is that the person feels better after injuring themselves and causing pain. They hurt themselves to feel better. When | try to explain how this works to the parents of girls who are cutting themselves, the parents would naturally feel like | don’t know what I’m talking about.

How can pain make you feel better?

The rejection, abuse, and mistreatment is why they want to hurt themselves.

Why they injure themselves and keep injuring themselves over and over again is a part of the problem that is very frequently neglected. How does this work?

There is a system in the brain called the limbic system?

This system regulates the things you do and your feelings. The limbic system is rich in cortico-opioids, specifically the endorphins.

Endorphins are our own pain relievers produced in the brain to provide pain relief and pleasurable feelings to counteract the pain. Endorphins play a big role in self-arm, They are used to cope with pain. Endorphins are automatically produced when you experience pain. The endorphins released during self-injury reverse the feelings of distress that may be triggered by rejection, abandonment, or some type of abuse. Self-abusers frequently report feeling calm and relief after cutting, burning, or hurting themselves in some way.

A side reward is that repeated self-harm or suicide attempts can be rewarded not only by the endorphins, but by the frequent attention of family, friends, and various healthcare providers. The attention triggers even more endorphins. Basic psychology is that any behavior that is rewarded will continue at the same rate or increase in frequency. Because self-harm is self-reinforcing it can be very difficult to get a person to stop because that may be the only way they can directly control feeling better.

They can make themselves feel better whenever they want to feel better, in spite of the scarring that may result.

Psychologists know that the unfortunate things that are happening in the self-mutilator’s life that have led to this behavior must be dealt with.

However, the instant relief that accompanies the self-inflicted pain should also be addressed. The behavior will be rewarded long before attempts to stop it can be effective. believe the saying is that the provider is a day late and a dollar short.

— Dr. Joseph Switras provides clinical psychological services at United Health District in Fairmont to people age 5 and up.