Self-mutilation is defined as intentional injury to one's own body. It represents a repetitive act performed without the conscious plan to kill oneself. Self-mutilation may be also referred to as self-injury, self-harm or simply cutting. Usually it leaves marks or causes tissue damage. In most cases self-harm is a private act, although it may be done in groups.

There are many classifications of pathological self-mutilation. The Repetitive Self-Mutilation Syndrome (RSM) is one of the most common and concerning, especially when it comes to adolescents. RSM is referred to by many terms, including self-injurious behavior (SIB), parasuicidal behavior and deliberate self-harm.

Self-mutilation may involve burning or branding, hitting, cutting, skin picking, bone breaking, trichotillomania (hair pulling) and other similar activities. Of all these, cutting is by far the most common form. For a person that has never engaged in such activities, self-mutilations may be difficult to understand. Experts classify the condition as an impulse disorder, together with alcohol and substance abuse, suicide attempts, shoplifting and eating disorders.

Early studies of self-injury suggested that individuals who engaged in self-harm activities were usually people diagnosed with autism, schizophrenia, borderline personality disorder or dissociative identity disorder. After advanced research into the problem, self-mutilation in the modern world is seen as a problem concerning a wide range of people, though mostly adolescents. Studies have shown that 1 percent to 2 percent of the population engages in some kind of self-harm activity. A study in the United States has found that around 40 percent of college students have at least once engaged in self-mutilation, while some 10 percent have done it 10 or more times.

In general, self-injury may become a problem for anyone regardless of his or her gender, race, education, age, sexual orientation, socioeconomic status or religion. Still a number of common factors have been observed among people who engage in self-mutilation. Self-injurious behavior has been proven to occur more often among adolescent females; men and women who have suffered physical, emotional or sexual abuse; people with eating disorders or substance abuse symptoms; people who cannot express their feelings; and boys and girls raised in families where the expression of anger is generally suppressed.

People who engage in self-mutilation often aim to at least temporary relieve intense feelings, pressure or anxiety, to break emotional numbness or just to feel alive and real. Self-harm is also seen as a way to shift the focus of pain on the outside instead of on the inside or as a method to gain control over pain and learn to manage it. Other motives for self-harm may include seeking help in an indirect way, as well as a need to attract attention, to manipulate others or to make them care or feel guilty. Self-mutilation is also considered a reflection of self-hatred. Some people want to punish themselves for strong feelings that they were not allowed to express while they were children or for being bad in some way and undeserving.

Symptoms of self-mutilation include head banging, frequent cuts or burns with no explanation, finger or arm biting, needle sticking, self-scratching and punching and other. Low self-esteem, wearing long sleeves or pants in warm weather, relationship problems and poor performance at school, work or at home may be warning signs of self-injury. The presence of lighters, razors, or any other sharp and dangerous objects in a person's belongings may also be a signal.

Self-mutilation has been observed as a symptom of different personality disorders, bipolar disorder, schizophrenia, major depression, obsessive-compulsive disorder and other psychiatric illnesses. When an individual shows signs of self-injurious behavior, he or she needs to consult a mental health professional, who is experienced in the field of self-injury.

Various forms of treatment apply to the problem, depending on its progress and causes. Psychotherapy, cognitive-behavioral therapy, post-traumatic stress therapies, family or group therapy and other therapies can help a person to stop hurting him or herself. In certain cases, medications such as anti-depressants or anti-anxiety pills may be prescribed to reduce the initial impulsive response to stress. The treatment outcome for people engaging in self-mutilation depends on their emotional and psychological state. Finding the factors that trigger the condition are crucial for the treatment process.

Self-Mutilation: Selected full-text books and articles

The Tender Cut: Inside the Hidden World of Self-Injury By Patricia A. Adler; Peter Adler New York University Press, 2011
Self-Harm: A Psychotherapeutic Approach By Fiona Gardner Brunner-Routledge, 2001
Life after Self-Harm : a Guide to the Future By Ulrike Schmidt; Kate Davidson Brunner-Routledge, 2004
Mutilating the Body: Identity in Blood and Ink By Kim Hewitt Bowling Green State University Popular Press, 1997
The Romance of Risk: Why Teenagers Do the Things They Do By Lynn E. Ponton Basic Books, 1997
Librarian’s tip: Chap. 8 "Fathers and Daughters: The Cutting Edge"
Human Rights and the Search for Community By Rhoda E. Howard Westview Press, 1995
Librarian’s tip: "Shame and Self-Mutilation" begins on p. 144
College Students and Self-Injury: Intervention Strategies for Counselors By White, Victoria E.; Trepal-Wollenzier, Heather; Nolan, James Michael Journal of College Counseling, Vol. 5, No. 2, Fall 2002
Peer-reviewed publications on Questia are publications containing articles which were subject to evaluation for accuracy and substance by professional peers of the article's author(s).
Sadism and Masochism: The Psychology of Hatred and Cruelty By Wilhelm Stekel; Louise Brink Liveright, vol.2, 1953
Librarian’s tip: Chap. XV "Self-Mutilation and Self-Accusation"
Self-Injurious Behaviors: Assessment and Diagnosis By Kress, Victoria E. White Journal of Counseling and Development : JCD, Vol. 81, No. 4, Fall 2003
Peer-reviewed publications on Questia are publications containing articles which were subject to evaluation for accuracy and substance by professional peers of the article's author(s).
Relationships between Body Modifications and Very High-Risk Behaviors in a College Population By Burger, Terry D.; Finkel, Deborah College Student Journal, Vol. 36, No. 2, June 2002
Treating the Adult Survivor of Childhood Sexual Abuse: A Psychoanalytic Perspective By Jody Messler Davies; Mary Gail Frawley Basic Books, 1994
Librarian’s tip: Chap. 7 "Exposure to Danger, the Erotization of Fear, and Compulsive Self-Abuse"
Self-Injurious Behavior: A Bi-Modal Treatment Approach to Working with Adolescent Females By Stone, Judy A.; Sias, Shari M Journal of Mental Health Counseling, Vol. 25, No. 2, April 2003
Peer-reviewed publications on Questia are publications containing articles which were subject to evaluation for accuracy and substance by professional peers of the article's author(s).
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