Physical pain has almost always been defined as the sensation which produces reactions of aversion; that is, an unpleasant experience that we try to avoid. It happens when our nervous system registers that certain cell tissue has been damaged and allows us to react in time to escape danger.
However, human beings do not always act consistently with this logic; in some cases, pain is something intentionally sought after, something that is achieved through self-harm. This idea is at the origin of the concept of non-suicidal self-harm..
What is non-suicidal self-harm?
Self-injury is easily associated with suicide attempts, but in reality, in many cases, the goal in mind when this occurs is not death itself: self-injury is valued in itself. and not as a means.
So, non-suicidal self-injury is the type of self-injury that occurs as a result of a learned dynamic of trying to reduce anxiety levels through practices such as cutting, biting, or hitting hard objects.
A mental disorder?
There is not a broad consensus on whether non-suicidal self-harm is itself a mental disorder or a symptom that can reveal its presence. In the DSM-IV diagnostic manual, it appears as a symptom related to borderline personality disorder, although in version V it appears as its own diagnostic label.
The truth is, this behavior is inherently harmful, but at the same time it can be considered a “minor ailment” which serves to alleviate a very high state of anxiety in which the root of the real problem lies.
Why does ANS occur?
What it is about achieving with the ANS is a feeling of momentary relief produced in part by the distraction of physical pain, which allows you to divert your attention from abstract ideas and still memories. more painful.
According to the logic behind non-suicidal self-harm, the mere possibility of experiencing something other than this type of anxiety and being a solution to rumination (looping thinking about something that is causing discomfort) is valued in a way. very positive.
In other words, to understand why non-suicidal self-harm appears as a pattern of learned actions, it is necessary not to consider the pain felt at the time of the injury, but the effect this pain has on a person who has been in pain for a long time for other reasons. In other words, it is not necessary to see the snapshot or the frozen image of self-harm, but the process of sensations and experiences that led to this result, because that is what allows us to consider the usefulness that the pain can have for the person. In that sense, it would look like trichotillomania.
There is also another explanation for the causes of ANS which links it to low self-esteem and a tendency to think negatively about yourself so self-harm would be a way to reflect this self-contempt through self-punishment. However, it is very possible that low self-esteem is another symptom of the underlying problem, and not the cause of non-suicidal self-harm.
The ANS as a predictor of suicide
If the purpose of the ANS is not to end his own life, it is true that his presence is a predictor of possible suicide attempts in the future.
A person who self-harms will be more likely to go on death, among other things because the “ritual” that can lead to this kind of event has already been assimilated and is more often thought of. Moreover, the same causes that lead to this learned behavior pattern can lead to the desire to die, either more or less rationally, or in the midst of a nervous breakdown.
Symptoms of non-suicidal self-harm
The most obvious symptoms of ANS are the scars that produce cuts and bites and the bruises that leave the bumps.
Cuts, which are very common, usually appear on the arms and legs, And therefore can be seen with a variety of types of clothing. Other forms of self-harm are more discreet. It usually starts with the parts of the arms and legs that are close to the chest, as these are the parts of the limbs that are easiest to hide and at the same time are not as sensitive as the front parts of the trunk (so long because the wound is not injured). inner part of the arms).
The profile of people who are injured
Non-suicidal self-harm is more common among young people: mainly adolescents and post-adolescents. This may be because the emotional instability produced by hormonal changes produces major and more severe anxiety attacks, added to the social type changes that appear at this stage of life: Doubts about his own identity, what we are going to study, problems in ephemeral relationships, etc.
In addition, certain personality traits are more common in people who engage in this type of self-harm. These are people with high impulsiveness and emotionality (Or sensitivity) who also have low self-esteem and value their abilities low and pessimistically.
Treatments and psychotherapy
The most effective psychotherapeutic options are those that fall under cognitive-behavioral therapy, that is, they involve both actions and thoughts. Specifically, Linehan Dialectical Behavior Therapy (CDT), Created specifically to treat cases of borderline personality disorder, has received extensive coverage.
The basis of these therapeutic approaches is to constantly postpone the timing of self-harm until it does not occur. It is a way of acting on a behavior reminiscent of drug addiction treatment.
In all cases, the role of psychologists is focused both on reducing the frequency and intensity of these behaviors and on learning ways of thinking and relating to others that allow move away from stress adaptively and without suffering. Likewise, a level of vigilance is maintained to detect times when suicidal thoughts may appear.