Are tattoos and piercings self-harm? What about full contact sports? This week I received a great question from @scan0017 about whether an intense work out routine could be self-harming as it does involve putting yourself through pain. As someone who has dealt with self-harming behaviors for almost 2 decades, I have found it hard to connect with people on this subject because so many have no idea what it is. So let’s talk about it.
Non-suicidal self-injury (NSSI) is hard talk about and engage with because so few know anything about. From friends and family to medical professionals, it remains a bit of black-box for many. In fact, even most people engaging in NSSI do not recognize their behavior as that. The problem is that you cannot address something if you don’t even know what it is. You cannot help those who suffer if you are blind to their suffering. This creates further isolation and confusion for people struggling and leaves their loved ones dumbfounded. So what is NSSI? And what is it not?
The words themselves makes a certain amount of sense: It is self-injury, so injury to self; and it is non-suicidal, so NOT done with the hope or goal of killing oneself. But that picture still leaves a lot unanswered. The term self-injury is sometimes swapped for terms like self-harm, self-mutilation, self-inflicted violence, or colloquially (and inaccurately) simply just “cutting.” It is the act of intentionally inflicting physical harm upon one’s own body—note that emotional self-harm is a related, but less studied behavior.
You may be asking “but what does it actually look like?” It is a good question, but does not have a clear answer. There is not yet a definitive set of behaviors that fall into this category, but the most common forms of NSSI are cutting or puncturing the skin, burning, biting, scratching, self-bruising (with fists or objects), and banging one's head or fist against an object. Some definitions have included behaviors such as pulling hair, excessive skin picking, and consuming toxic or harmful substances, but these are more often than not given different categories because the behavioral framework is different.
It may help to identify some behaviors that are not NSSI. Tattoos, piercings, full-contact sports, drug use, eating disorders, exercise, and stunts done as “showmanship” (think Jackass movies) and not usually considered self-harming behaviors. Even though most of them do involve some known and anticipated harm to your body, the motivation and psychological factors are different. It is not a hard and fast rule, but three questions I often ask are “Is the behavior performed with the intention to harm, as opposed to just resulting in harm as a known consequence?”; “Is the behavior socially unaccepted?” and “Is it done in secret and kept hidden from others?” If you answer no to any of the questions (meaning, It was not seeking the harm itself, it is socially accepted, or it is not kept hidden), then it likely is not NSSI.
The fact that NSSI is non-suicidal may sound counter-intuitive to people unfamiliar with the behavior. However, it is very common for people who self-injure to report that they actually do so as a means of relieving emotional pain. For me personally, it has been a suicide prevention behavior, albeit, a dysfunctional one. My goal is for more people to be willing and able to see not only self-harm behaviors in their own lives, but for others to gain an understanding and empathy for those who deal with NSSI. When something is confounding, foreign, and unknown, it is hard to enter in with genuine engagement and love. Sometimes we must engage out minds so that our hearts are equipped to do the soul-care work that is needed. There is hope. We are the solution.
Until next time, be blessed.
Sam
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This is definitely and interesting subject, and there are some gray areas indeed. I would not consider contact sports, piercings, and tatoos as self harm. However, I could see how any one of these, if done in the extreme, might be considered as such.
It ended up taking nearly a full year to heal, when it should have taken just a few weeks at most. I think she might have picked at it on occasion. And she never went to the doctor about it. So bizarre to me. And I don't relate I guess.
I don't know anyone who "cuts" per se, but I do know a couple of people who seem to deliberately do (or not do) things that end up causing their flesh and bones considerable harm.
I think this could branch anywhere from anorexia and eating disorders, to refusing to take medicine the Dr. requires for a certain ailment.
Cuts and bruises are unsightly. I wonder if some people want to harm themselves "under the radar" so to speak....
I met one gal who had this huge canker on her hand that was pre-cancerous. She was on medicaid and could have easily had it looked at. She was educated, but not able to work at that time due to health problems. And this lesion on her hand looked worse every time I saw her. She refused to have it looked at, and came up with really inadequate excuses as to why. She refrained from wrapping or treating it, and instead let it go exposed to the elements when it should have been covered and balmed. She went about almost like she was flaunting the wound -- not so much like she wanted attention for it, but like she was PROUD of it.
Most of the people in her life are "care-taker" kind of people. I guess she might garner some sympathy for her wounds. I don't know? It was just so foreign to me to have so much pride in such a terrible sore. I might have been embarrassed by it and done everything I could to fix it.
In a way, I look at this as a kind of self harm -- neglecting to take care of something that could easily have been helped.