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Self-injury is a pathology in which someone inflicts deliberate harm on him or herself, but not with the intent of suicide. This pathology takes a wide range of forms, and it is important to distinguish self-injury from both suicidal behavior and culturally or artistically appropriate activities, such as initiation rituals or tattooing. Women are around four times more likely to commit self harm than men, and self-injury is very common among young people, but the behavior can manifest at all ages.
This behavior typically emerges in response to stress, trauma, or depression. People inflict harm on themselves as a way of coping with situations which they feel no control over, and often they choose hidden sites of their body for their activities so that the self injury is not detected. In some cases, injuries may be more obvious, in which case the self-injury could be viewed as a cry for help, and self-injury can also develop into more serious suicidal behavior, so it is a cause for concern.
There are a wide number of forms of self-injury. People may cut or burn themselves, for example, or pick at their hair, skin, and nails. Some people deliberately ingest poison, engage in highly dangerous behaviors, or attempt to injure themselves by throwing themselves down stairs or hitting themselves with heavy objects. The behavior is often secretive, and injuries may be dismissed as “accidents” if the subject is questioned.
When self-injury becomes chronic, it is known as repetitive self-injury (RSI). In this situation, the patient often has no control over his or her self-injury, but instead feels a compulsion to engage in self harming behavior. In addition to being potentially psychologically harmful, this can also be physically harmful; self-injury can lead to infections and a variety of other health problems.
Patients who engage in such behavior can be treated in a wide variety of ways. As with other psychological conditions, it is important to intervene in a way which is supportive, and non-accusatory. Anti-depressant drugs may be prescribed to help the patient cope with stress, but talk therapy is also strongly encouraged. Some patients also benefit from more strenuous therapy which is designed to change their fundamental behavior patterns, and people may use tricks like promoting more beneficial behavior as an alternative to self-injury, or using a “buddy system” to ensure that the patient always has a friend to call when he or she feels like engaging in self-injury.