Remuda Ranch

Self-Injury and Eating Disorders

Self-injury, particularly cutting on oneself, is becoming more prevalent in the US, especially in those with eating disorders.

Self-injury is when individuals cause physical harm to themselves on a repetitive basis, without suicidal intent. In terms of a psychiatric diagnosis, it falls under the realm of an impulse control disorder. Although cutting is perhaps the most common form of self-injury, self-injury takes a variety of other forms, including head banging, skin picking, biting, repetitious rubbing or scratching, hitting, or burning with anything from a cigarette lighter to a curling iron. Typically, the injury is caused on the arms or legs, even though other body parts can be targeted.

Certainly, the most commonly posed question is “why?” As with most psychiatric illnesses, the behaviors involved with the disorder are mystifying to those who see them happening and often to those who engage in them as well.

Although eating disorders and impulse control disorder are completely separate from one another, they often manifest together. In fact, at Remuda Programs for Eating Disorders, a full 50% of our patients engage in self-injury. The “why” usually falls into one of a few categories.

Self-Punishment

The need to punish oneself is usually connected to feelings of great shame and inadequacy. The person feels that she doesn’t do things well enough. The focus is sometimes the eating disorder itself. She feels she hasn’t displayed enough discipline and should be “better” at being bulimic or anorexic. This shame leads to anger at oneself, which leads to a need for self-punishment, often expressed through self-harm.

Diversion/Distraction

If an individual also suffers with Post Traumatic Stress Syndrome, she might find herself thinking about or remembering things that were highly traumatic. In order to return to the here and now and reground in the present, she may self-injure. The pain will distract her from thoughts or emotions that are deemed even more painful.

Relaxation

Strange as this may seem, self-injury can have a relaxing quality for the person; this is physiological in nature. The brain releases chemicals to combat the pain caused by the self-injury. These chemicals are soothing in nature. The person’s tension and stress level are reduced.

In trying to understand self-injury or endeavoring to deal with a person who engages in the behavior, it is important to remember that a person self-injures because it works. Cutting, burning, or biting actually serves a true purpose, a real function in their life. They usually do not do it for attention, or because it is the “in” thing to do – they do it because it helps them feel better. Often, it provides release, allows the person to feel calm and less anxious. And because it works, there is an addictive quality to it. The behavior can be eliminated, but it must be replaced with a different, healthier, behavior.

Self injury can be an extremely complex issue; therefore, professional help is definitely recommended. For more information, contact Remuda Programs for Eating Disorders at 1-800-445-1900.