WP1 REVISED: A JOURNEY TO UNDERSTAND SELF-HARM
Self-harm is often misunderstood as a superficial negative behavior that is destructive to both mental and physical health; however, my personal experience has taught me that it is a complex reaction to deep-seated emotional distress. This understanding came through witnessing the struggles of a close friend grappling with the urge to self-harm, which she likened to an addiction.
From a young age, my friend endured traumatic experiences that left profound scars, manifesting as repetitive self-harming behaviors. Initially, I misinterpreted her actions as self-destructive tendencies that needed to be stopped physically. However, despite understanding my intentions to help, she often hid her self-harming behaviors from me. The more I tried to intervene by keeping a close watch or removing potential tools for self-harm, the more she withdrew. It became a distressing cycle — her increasing efforts to conceal her pain led to greater anxiety and further self-harm. This pattern left me feeling helpless and confused about the repetitive nature of her actions. Her behavior seemed to contradict her own desire for recovery, and each hidden episode of self-harm only added to the complexity of her emotional state.
I then realized that my approach was insufficient. It became clear that self-harm was not an issue to be simply managed with surveillance and restrictions; it was a manifestation of something much deeper and complex. I realized that focusing solely on preventing physical acts of self-harm without addressing the underlying emotional motivation was akin to treating the symptoms of a disease while ignoring its cause. This realization led me to explore the psychological underpinnings of self-harm more deeply. Why did she feel compelled to hurt herself? What emotional relief did it bring her? These questions guided my subsequent research and shaped the focus of this paper.
As we move forward, I’ll examine case studies that both witness and potentially explain complex emotional dysregulation associated with self-harm and discuss the importance of addressing both the psychological motives and the behaviors themselves. Through integrating personal observations with academic research, this essay seeks to provide a comprehensive understanding of self-harm as a complex response to trauma, and to advocate for more effective and empathetic intervention strategies.
The research study titled “Posttraumatic stress disorder and deliberate self-harm among military veterans: Indirect effects through negative and positive emotion dysregulation” offers a nuanced examination of the mechanisms that might link PTSD severity to deliberate self-harm, particularly among military veterans. (Raudales et al. 2020) This study identifies emotion dysregulation — both in terms of negative and positive emotions — as a pivotal factor that might explain the propensity for self-harm in individuals with PTSD. By analyzing responses from 465 trauma-exposed military veterans, the researchers discovered that PTSD severity indirectly relates to self-harm behaviors through the prism of positive emotion dysregulation, rather than negative. This distinction is critical because it highlights the complex role of emotions in PTSD and self-harm: it’s not just about managing negative emotions but also about how individuals handle positive feelings. Secondary analyses within the study further delineate specific domains of emotion dysregulation, such as difficulties in controlling impulsive behaviors when experiencing negative emotions, a lack of emotional clarity, and challenges in accepting and engaging with positive emotions. These findings propose that interventions for veterans with PTSD might benefit from addressing both negative and positive emotion dysregulation to effectively reduce the risk of self-harm. This study contributes to the broader understanding of PTSD and self-harm by suggesting that emotional responses, whether positive or negative, play a significant role in the behaviors of those suffering from PTSD, pointing towards more targeted and nuanced approaches for treatment and support.
In another research conducted by Miyako Shirakawa, a sexual abuse survivor describes her unconscious decision to work in the adult film industry, a choice later understood as a re-enactment of her past experience of sexual abuse. (Hirohata et al. 2002) This behavior is recognized as a more severe form of self-harm, reflecting her attempt to gain control over unresolved trauma.
This re-enactment exemplifies the repetition of trauma. The survivor’s entry into the adult film industry signifies not just a return to familiar pain but an unconscious effort to resolve past trauma through re-experiencing. This choice highlights the influence of unconscious patterns and disrupted attachment processes from her early life, driving her to environments that mimic those traumatic experiences. (“What Is Repetition Compulsion?,” n.d.)
Moreover, such behavior acts as a coping mechanism, providing a false sense of control and a way to manage overwhelming emotions, though it ultimately deepens the trauma. Recognizing this, interventions should focus not merely on preventing self-harm but on understanding and addressing these deep psychological issues. Effective support must target the roots of trauma, not just its outward manifestations, necessitating a move towards more empathetic and psychologically informed strategies.
Sue Austin’s analysis in her study, “Working with Chronic and Relentless Self-Hatred, Self-Harm, and Existential Shame,” investigate the therapeutic experience of a woman named Leah, who has suffered from bulimia, self-harm, and profound feelings of worthlessness. (Austin 2016) Austin employs Jung’s and Laplanche’s theories on the foreignness at the core of the psyche, using various analytic traditions to explore Leah’s deep-seated shame which manifested in persistent self-loathing.
Leah’s case highlights the psychological processes underpinning self-harm and shame. The analysis reveals how Leah’s behaviors — self-harm and bulimia — are external manifestations of an internal conflict driven by unresolved shame and a desperate need to connect with her emotionally distant father. This connection was perceived by Leah as the only way to feel loved and valued, thus trapping her in a cycle of self-destructive behaviors as a form of communication.
Austin describes a pivotal moment in therapy when Leah recognizes that her self-harming behaviors and self-hatred are not just literal expressions of internal pain but are deeply tied to her unmet needs for parental affection and acceptance. This recognition shifts the therapeutic focus from symptom management to exploring and addressing the roots of Leah’s emotional turmoil.
Leah’s case underscores the importance of a therapeutic approach that integrates an understanding of the patient’s life narrative and emotional injuries. Therapists are encouraged to look beyond the physical manifestations of self-harm and to address the psychological and emotional foundations of such behaviors. Austin’s work with Leah shows that healing involves making conscious the repressed emotions and traumas, providing patients with the means to understand and articulate their feelings, thereby reducing the need for self-harm as a form of expression.
Building on the individual experiences discussed in the case studies, it’s essential to understand self-harm from a broader theoretical perspective. This behavior is not solely a response to personal trauma but reflects deeper, unresolved psychological needs.
From a general theoretical phycology perspective, self-harm often emerges as a mechanism to break through emotional numbness, allowing individuals who feel detached due to past trauma to experience physical pain as a way to feel alive. Additionally, it serves as a form of self-punishment for those who feel unworthy or guilty, reflecting deep-seated feelings of inadequacy. This behavior also functions as a distraction from overwhelming negative emotions like anxiety and sadness, providing a temporary escape from distressing mental states. Lastly, self-harm acts as an emotional regulator; the physical act triggers a release of endorphins, offering a fleeting sense of euphoria or relief from intense emotional pain, which is quickly followed by guilt and shame, thus perpetuating the cycle. (“Four Reasons Why Individuals Engage in Self-Harm | Psychology Today,” n.d.)
To conclude, we have explored the complex phenomenon of self-harm through personal anecdotes, detailed case studies, and a broader examination of the underlying psychological motivations. The discussion highlighted that self-harm is not merely a physical manifestation of distress but a multifaceted response to unresolved emotional and psychological needs. Each case study provided insights into the deep-seated reasons behind self-harm, demonstrating the importance of a nuanced understanding of this behavior beyond its physical aspects.
Effective treatment for self-harm must address both the behavior and its root causes. It is imperative to explore and understand the emotional injuries that lead individuals to self-harm, which involves integrating therapeutic approaches that focus on emotional regulation and coping mechanisms. The goal is not only to cease the behavior but also to resolve the underlying emotional turmoil, facilitating a more stable and healthy mental state.
Ultimately, this approach fosters a more empathetic understanding of self-harm, advocating for interventions that are both compassionate and informed by a deep understanding of the individual’s emotional complexity.
Citation
Austin, Sue. 2016. “Working with Chronic and Relentless Self-Hatred, Self-Harm, and Existential Shame: A Clinical Study and Reflections (Paper 2 of 2).” The Journal of Analytical Psychology 61 (4): 411–33. https://doi.org/10.1111/1468-5922.12241.
Hirohata, Sayuri, Takako Konishi, Miyako Shirakawa, Chiaki Asakawa, Nobuaki Morita, and Yoji Nakatani. 2002. “[Posttraumatic stress disorder in victims of sexual assault — related to depression or physical symptoms].” Seishin Shinkeigaku Zasshi = Psychiatria Et Neurologia Japonica 104 (6): 529–50.
Raudales, Alexa M., Nicole H. Weiss, Svetlana Goncharenko, Shannon R. Forkus, and Ateka A. Contractor. 2020. “Posttraumatic Stress Disorder and Deliberate Self-Harm among Military Veterans: Indirect Effects through Negative and Positive Emotion Dysregulation.” Psychological Trauma: Theory, Research, Practice and Policy 12 (7): 707–15. https://doi.org/10.1037/tra0000962.
“Four Reasons Why Individuals Engage in Self-Harm | Psychology Today.” Accessed April 28, 2024. https://www.psychologytoday.com/us/blog/happiness-is-state-mind/202103/four-reasons-why-individuals-engage-in-self-harm.
Verywell Mind. “What Is Repetition Compulsion?” Accessed April 28, 2024. https://www.verywellmind.com/what-is-repetition-compulsion-7253403.
