Reducing self-injury behaviours: Identify and address the motives

In my practice as a Calgary psychologist and a Cochrane psychologist, among the most challenging issues I encounter is clients engaged in self-injury behaviours such as cutting or burning oneself.  Referred to as non-suicidal self-injury (NSSI), these behaviours are not engaged in for the purpose of taking one’s life. However, they are often precursors to later suicide attempts and are most commonly displayed by adolescents.

To help these clients, my strategy is first to identify the reasons they are engaging in self-injury behaviours. Several people may engage in identical self-injury behaviours for very different reasons. Pinpointing the motivating factors for each individual is the key to helping them reduce and eliminate such behaviours.

In the following sections, I will identify the most common motivators for self-injury behaviours and how I and other therapists help clients to address the behaviours by targeting these motivators.

Self-punishment due to self-loathing

Some people engage in self-injury behaviours because they literally hate themselves and feel they deserve punishment as a result. Helping the person to change this negative view of themselves is key to reducing self-injury behaviours in these cases.

Avoiding the pain of difficult emotions

Emotions like anxiety, depression, frustration, guilt, and anger are difficult for many people to face. Self-injury can numb a person to the experience of these unpleasant emotions. Helping the person develop skills to face these emotions removes a key motivator for self-injury behaviours.

A self-soothing strategy

This self-injury motivator focuses on the notion that for some people, these behaviours serves as stress management tools which help them to soothe and calm themselves. Giving the person alternative means to self-soothe can reduce the tendency to use self-injury for this purpose.

A release of endorphins

For other people, self-injury behaviours create an experience of pleasure through the release of endorphins. Helping the person practice safe ways to simulate these feelings can lessen the use of self-injury behaviours when this motive is present.

Avoiding dealing with difficult life situations

Sometimes we are faced with having to deal with life situations with which we feel unable to cope. One way to avoid having to deal with these situations is by engaging in self-injury behaviours. Giving the person coping skills to increase confidence that they can cope with difficult life situations can lessen their tendency to use self-injury behaviours as a form of avoidance.

A cry for help and attention

Some people have difficulty getting the attention of those close to them—sometimes because they have trouble communicating their needs and at other times because those close to them do not pay attention to their needs. In these instances, self-injury behaviours serve a ‘social signaling’ function. Helping these people find constructive ways to get the attention of those close to them is the key to helping these people reduce their self-injury behaviours.

If you or someone close to you engages in self-injury behaviours, there is help available.

-Dr. Pat