On Impulse

Ever notice when we're upset our natural tendency is to think more upsetting thoughts? At times, we use this as a coping mechanism, to distract ourselves from the original issue. It's not the healthy way to deal with our emotions, but it works as a temporary solution. There are many such unhealthy ways to deal with anger, frustration and stress, some of them more harmful than most, and self-injury is the most common of these.
A typical example of self injury is cutting oneself, although burning, bruising, head banging, tearing out hair and other means are also used. Unfortunately, this form of dealing with stress has become extremely common amongst teenagers and pre- adolescents these days. It also remains the most confusing to their parents and guardians who often mistake it for suicidal behaviour.
Suicide however is not the intent in these cases. Self-injury is often the result of anxiety, depression, low self-esteem, self-image issues and a host of other emotional issues. A child may feel bullied at school, may be facing physical or sexual abuse at home or he/she may have suffered a heart break, it differs from person to person. At times, this type of behaviour is associated with certain psychological disorders, such as eating disorders, clinical depression and borderline personality disorder. Because it is done impulsively, it is classified by psychiatrists as an impulse control disorder, and if left untreated, it feeds into these illnesses, aggravating the symptoms.
It is an unfortunate truth that almost everyone knows or has heard of someone who cuts/hurts themselves or has at some point in their lives. The symptoms are often carefully masked and therefore difficult to identify. Scars will be present mostly on the arms and legs, head and torso. For cutters, the scars will be superficial, and often small linear cuts, parallel, like railway tracks. Frequent accidents that involve broken bones, a liking to sharp objects, wearing long sleeves and pants in hot weather to hide the injuries, spending long hours alone, having difficulty in interpersonal relationships, self derogatory comments such as “I am fat” or frequent questions about one's identity such as “Who am I?” are all tell tale signs of a person hurting themselves. Comments on helplessness, worthlessness, hopelessness, and emotional, behavioural instability are also red flags to watch out for.

It is very important to know that a person suffering from self injurious behaviour has a hard time expressing, understanding and controlling their emotions. The triggers for self injury are extremely complex, and as mentioned before, vary in each person. Through this behaviour a person basically tries to regain control over themselves and their situations and provide distractions from emotional turmoil through physical pain. Some are using it to communicate their internal distress to the outside world, while others do it to punish themselves. For them, the behaviour is addictive, much like a drug such as cocaine is to the abuser. Like a drug that releases endorphins, it brings a temporary sense of relief and leaves them wanting more.
Needless to say, this behaviour may lead to more serious, life threatening situations if one gets carried away or infected etc. In order to get help for this problem, it is important to acknowledge it is a serious matter and want to reach out for help. Parents tend to take their children to the emergency room or to the family doctor, who often confuse these symptoms with suicidal intentions. Therefore it is of utmost importance that a psychiatrist be consulted.
There are several types of therapies designed to deal with these issues such as cognitive behaviour therapy, which helps identify and replace negative beliefs and practices with positive ones, and dialectical behaviour therapy that teaches tolerance for distress and helps manage emotions and communication skills. Mindfulness based therapies help one live in the present and help process the behaviour of those around us more accurately and therefore relieves unnecessary anxiety. Psychodynamic therapy helps uncover the root of our emotional problems, hidden memories or past experiences through guided self-examination.
All this and a combination of family therapy, open interaction and group therapy with others who suffer similarly can help eventually overcome this disorder. The key is asking for help at the right time.

Anika Hossain is a reporter for the Features section of The Daily Star. She believes she can relate to those with mental health issues as she has worked as a residential counsellor in an asylum a few years ago.