Self-injury, also referred to as nonsuicidal self-injury (NSSI), is the intentional and self-inflicted damage of bodily tissue without suicidal intent.  These are behaviors not consistent with a culturally normative practice and don’t typically include tattoos or body piercing, unless they are intended specifically to damage the body.  Cutting of the skin is often the form most people associate with NSSI but other forms include scratching, burning, carving of the skin, punching or hitting yourself or other objects, putting objects under the skin, as well as other forms.

Severity (from superficial to permanent disfigurement) and location (visible to hidden) of the NSSI vary based on the function and intention of the behavior.   Self-injury can serve various functions for different people or for the same person at different times.  Some examples might be:

    • An attempt to manage overwhelming suffering by creating pain sufficient to disconnect from yourself
    • Conversely, to reconnect through pain to your body when you feel disconnected
    • To transfer a vague sense of emotional pain into more familiar physical pain
    • Managing trauma experiences
    • To feel a sense of control when things seem out of your control
    • To express through your body what feels impossible to express otherwise.

Nonsuicidal self-injury is most common in adolescents (17%) and young adults (13%) and diminishes in adulthood (6%).  Some studies find NSSI to be more common in females while others do not.  What is more consistently found is that females tend to begin earlier and continue longer.  Males tend to engage in more hitting of self and objects, or allowing others to hit them, and to do so under the influence of substances and in social settings.  Despite the common assumption that NSSI is more prevalent in certain races and socioeconomic groups, the research finds similar prevalence rates across racial and socioeconomic categories.  There is often overlap with other disorders such as borderline personality disorder, eating disorders, PTSD and complex PTSD, anxiety disorders, dissociative disorders, and other disorders.  Research suggests that NSSI does seem to be on the rise.

At the Chrysalis Center we understand that NSSI is complex and often very difficult to talk about.  It’s possible that you’ve hidden this for a long time because it feels embarrassing, scary, and you worry that you’ll be judged.  It might have begun as an attempt to feel a greater sense of control and mastery and now the very thing that was supposed to provide control has become something that causes you to feel you’ve lost control.  Consistent with our approach of moving beyond symptom reduction, we are interested not only in changing the behaviors but also in helping you understand the purpose and meaning of your self-injury.  You may feel confused about why you hurt yourself and our goal is to help increase your ability to think rather than just act, to replace reaction with reflection.  Ultimately, we want to help you develop a different relationship to your own body that is based in self-care rather than self-destruction.