Self-mutilation in people with posttraumatic stress disorder (PTSD self-mutilation), and in general, is deliberate and direct self-harm, such as cutting or burning, with the intent to injure or destroy body tissues. Self-mutilation (also called self-harm or self-injury) isn’t an attempt at suicide, but it does result in injury severe enough to cause tissue damage.
From my own personal experience, it brings me great relief from stress. This week I have been under a lot of stress from decision making regarding whether or not to proceed with historicial reporting of child sexual abuse reporting to the police. I have been provided with a contact with the police in Ireland who I have made initial contact with who has outlined what is involved. It has caused enormous numbers of flashbacks and reliving of the trauma and I just don’t know that I can go through with it. Apart from suffering from Complex PTSD (CPTSD), I also suffer from Dissociative Identity Disorder (DID) and this pressure has upset my alters. In particular, it has upset my mother alter who is the one who causes me self-harm and suicidality.
On Wednesday morning I had an appointment to see my GP. I was plagued by mother alter to cut and punish myself for the abuse that the men had perpetrated against me. She blamed me for letting them do it. I kept switching in and out of her alter. When I entered the waiting room I went straight into the bathroom and got out a razor blade and began cutting my forearm deeply. I then just calmly pulled down my sleeve and came back out into the waiting room and waited for my appointment time still dissociated. I remained in that condition until the doctor called me in. She immediately saw the condition I was in, saw the blood and realised what had happened. She called my husband in. By that stage, I had come out of my mother alter and too realised what had happened. She was fantastic, spoke to me gently, stitched me up and did not blame me in anyway. We talked through what had happened and decided that now was not the time to proceed with a prosecution as I was not able for the pressure. I felt instant relief. I do want to come forward but the time has to be right and I have to be well enough mentally. My DID has to be under control and my CPTSD has to be stable as do the flashbacks.
Reasons for Self-Harming
It appears that deliberate self-harm is a way of expressing and managing negative emotions, such as anxiety, sadness, shame, and/or anger. Deliberate self-harm may also provide a temporary escape from emotional pain. However, although it may bring a kind of temporary relief from painful emotions, the emotions may return and intensify afterward.
People who have PTSD may use deliberate self-harm as a way of “coming to”–getting back in touch with the present moment (also called “grounding”). In this form of PTSD self-mutilation, when people with PTSD experience dissociation or flashbacks, they may do self-harm, such as cutting or burning, to “shock” their bodies back into the present moment and end the dissociation or flashbacks.
What Does Self-Harm Look Like?
While more severe cases of self-harming may be obvious, many people injure themselves secretly and hide the resulting wounds or scars. As a result, it may not be obvious that someone is self-harming until a major issue arises. Self-mutilation behaviors may include:
- Severe scratching
- Punching oneself
- Biting oneself
Cutting, skin-carving, severe scratching, head-banging, and punching oneself are some of the most common methods of self-injury.
Treatments for Self-Harm
Deliberate self-harm is a seriously injurious behavior. The injury itself may be serious, requiring medical care, and untreated injuries may become effective. Unless a self-harming person gets treatment to help stop it, the mutilations may get more severe over time. Of course, self-harm is not a cure for any of the unresolved emotions that cause the behavior; as a result, self-mutilation is unlikely to resolve itself.
The most common treatment for self-harming is psychological therapy. Although self-harm is associated with other issues, therapy is most effective when it focuses specifically on self-mutilation. Once the behavior is managed, it is possible to address the underlying trauma and emotional distress that caused it.