For leaders in helping professions, it is not long before they encounter someone who engages in self-harm or non-suicidal self-injury (NSSI). It may be a one-time incident or a chronic ritual. It can look like cat scratches or may require medical attention. Only within recent history have researchers been able to look at the physiological and chemical differences in individuals who engage in self-harm. With more knowledge comes more understanding for parents, teachers, youth leaders, pastoral staff, and peers who often feel baffled, confused, and discouraged by the behavior. The more we know, the more we can help.
The Brain: Why Do People Self Harm?
In the limbic system of the brain, researchers saw a hyper aroused state in those who engage in NSSI. The limbic system involves emotional regulation. In a hyper aroused state, the individual is upset and agitated. This could be depression, anger, or stress. When the scientists applied painful stimuli, the hyper aroused state came down. The pain actually calmed. NSSI can be used to calm oneself. Is it recommended? Of course not, but it helps make sense of the common teenage assertion they actually feel better, calmer, a release, and/or relief after engaging in the behavior. One article described it as “popping a balloon”- instant relief.
Altered Chemical Levels: Is it Addictive?
Researchers have also found altered levels of the hormone, cortisol, in response to NSSI. They are uncertain if the behavior causes the altered levels or if the altered levels increase vulnerability for the behavior. Cortisol is associated with stress. It makes sense individuals who engage in NSSI often have difficulty managing their internal and environmental stress.
Researchers also found lower levels of endogenous opioids affecting pain perception and addictive behaviors in NSSI. There have been rumors NSSI can be addictive. If the endogenous opioid levels are lower, it is possible there is an addictive quality to some severe self-harm. Also, if pain perception is altered, there is potential truth in someone who engages in NSSI stating they don’t feel the pain of their actions.
Nutritional Deficiencies: A Successful Treatment
Research has found successful treatment of self-injury in increasing the Essential Fatty Acids (found in nuts, leafy greens, fish, flax seed, etc…) in the diet. People who engage in NSSI have lower levels of Essential Fatty Acids. In one research project, the control group was given a placebo while the other group was given Essential Fatty Acids regularly. After 12 weeks, the experimental group saw a marked decrease in depressed feelings and suicidal thoughts in comparison with the control group. Even adding a supplement, such as Omega 3 and 6 capsules (fish and flax seed oil), increases the amount of Essential Fatty Acids in the body. While improved nutrition may not cure all diseases, increasing Essential Fatty Acids may improve depressed moods and reduce suicidal thoughts.
Effective Counseling: A Crucial Part of Recovery
Counseling with self-harm is important. Self-harm is a symptom of a bigger issue. Don’t ever mistake it for a cry of attention. If it is a cry of attention, proactive, not reactive, attention needs to be given. Encourage counseling. Dialectical Behavior Therapy (DBT) is one of the most evidenced based forms of counseling treatment with self-injury. It may include group work in addition to individual therapy. Effectiveness is increased if the families are willing to engage with the therapeutic work too. If the therapist doesn’t use DBT, ask them if they would be willing to learn (by books or training). A counselor doesn’t need to be a DBT clinician to be effective as long as they are familiar with the basic principles and can use DBT when needed to decrease NSSI. Remember, even with the most effective counseling, NSSI is not a short term issue and there is no quick fix. DBT clinicians recommend preparing for 3-12 months before treatment is successful depending on severity, intensity, and duration of the NSSI.