Self-Harm and OCD
What is Self-Harm?
Self-harm, also known as self-injury, is the act of purposely abusing your own body through methods like cutting or burning. Self-harm is said to affect 4% of adults, 15% of teens and 17% – 35% of college students in the United States.
People who self-harm frequently say they feel empty, lonely or misunderstood. They are often under or over stimulated by things happening around them. Harming themselves is a coping mechanism for dealing with these emotions. They tend to be embarrassed by their self-harm behaviors, and will try to hide marks or scars with long clothing, even in warm weather.
Nonsuicidal self-injury falls under "conditions for further study" within the DSM. Kati explains it's categorization and what it means.
How does it relate to suicide?
Self-harm and suicide aren’t always related, but those who self-harm may accidentally cause more injury than anticipated. This occasionally results in medical complications or death. For those who self-harm over long periods of time, they may become increasingly desperate about their lack of control and addictive behavior. This can cause sufferers to become suicidal.
Self-harm isn’t a mental illness. It’s a behavior that indicates a lack of healthy coping skills. Other mental illnesses are associated with it like depression, borderline personality disorder, eating disorders and post-traumatic stress disorder (PTSD).
To learn more about overlapping disorders, also known as comorbidity, head here.
How does it relate to OCD?
Self-harm can be both a response to OCD and its own subtype of the disorder. Some OCD sufferers self-harm as a means of dealing with their intrusive thoughts. It serves as a coping mechanism for their anxiety. Self-harm OCD is when a person has unwanted and repetitive thoughts about harming themselves or someone they love. They live in fear of losing control and acting on the images in their head. When this happens, they might distance themselves from others and potential triggers by sleeping in a different bed than their partner, throwing out all the knives in their home or limiting the time they spend around loved ones. This distance can quickly lead to depression.
People self-harm to relieve pain. The part of your brain that’s involved in the pain experience is the same for physical and emotional pain. For instance, when you cut, your brain becomes distracted from the emotional pain and focuses on the physical pain instead.
What Can I Do About it?
If you’re experiencing intrusive thoughts about self-harm, or currently engaging in self-harm, know that you’re not alone. Treatment is possible. Therapy is an effective way to manage intrusive thoughts, and Exposure Response Prevention (ERP) Therapy is the most highly recommended option. ERP is when you voluntarily expose yourself to the source of your fear over and over and over again, without acting out any compulsion to neutralize or stop the fear. By repeatedly facing something you’re afraid of, you force your brain to recognize how irrational it is.
There are other treatment options as well. Mindfulness-based Cognitive Behavioral Therapy, also known as CBT, teaches people to identify, understand and change negative thinking patterns and behaviors. Patients are taught problem-solving skills during therapy lessons and then instructed to practice them on their own time in order to build positive habits.
If you know someone who suffers from self-harm or self-harm OCD, the best thing you can do is talk to them about it. Lend an ear and a helping hand. It’s important to not cast judgement or offer reassurance.