Webb Therapy Uncategorized Understanding self-harm, self-injury, and self-destruction

Understanding self-harm, self-injury, and self-destruction

What is meant by self-harm?

Self-harm is any behaviour that involves the deliberate causing of pain or injury to oneself without the intention to end your life. Self-harm can include behaviours such as cutting, burning or hitting oneself, binge-eating or starvation, or repeatedly putting oneself in dangerous situations. It can also involve abuse of drugs or alcohol, including overdosing on prescription medications. Self-harm is usually a response to distress, whether it be from mental illness, trauma, or psychological pain. Some people find that the physical pain of self-harm helps provide temporary relief from emotional pain (extract from Self harm (lifeline.org.au)).

People who engage in self-harm will profess that they have no intention of dying and that their self-harming behaviour is a coping strategy, however, there are incidents of accidental suicide. The act of self-harm can develop into an obsessive-compulsion experience which can be very difficult to stop, like addiction, without outside intervention. This can result in feelings of hopelessness and possible suicidal thinking. Like building a tolerance to a drug, when self-injury does not relieve the tension or help control negative thoughts and feelings, the person may injure themselves more severely or may start to believe they can no longer control their pain and may consider suicide.

The following extract by Tracy Alderman Ph.D explains the physiological response to physical pain:

“Physiologically, endorphins are released when we are injured or stressed. Endorphins are neurotransmitters that act similarly to morphine and reduce the amount of pain we experience when we are hurt. Joggers often report experiencing a “runners high” when reaching a physically stressful period. This “high” is the physiological reaction to the release of endorphins – the masking of pain by a substance that mimics morphine. When people self-injure, the same process takes place. Endorphins are released which limit or block the amount of physical pain that’s experienced. Sometimes people who intentionally hurt themselves will even say that they felt a “rush” or “high” from the act. Given the role of endorphins, this makes perfect sense” (Oct 22, 2009).

Please click on the link for the full article Myths and Misconceptions of Self-Injury: Part II | Psychology Today Australia

The first step is to distinguish between self-harming and suicidal behaviour by paying attention to a person’s underlying motivation. When working with self-harming behaviour it is important to remember that this behaviour serves a purpose. In collaboration with the client, try to identify what problem self-harm solves for the client. For example, from the client’s perspective:

  • To make me feel real (counteracts dissociation)
  • To punish me (temporarily lessens guilt or shame)
  • To stop me from feeling (when strong feelings are too dangerous)
  • To mark the body (to show externally the internal scars)
  • To let something bad out (symbolic way to try to get rid of shame, pain, etc.)
  • To remember
  • To keep from hurting someone else (to control my behaviour and my anger)
  • To communicate (to let someone know how bad the pain is)
  • To express anger indirectly (to punish someone without getting them angry at me)
  • To reclaim control of the body (this time I’m in charge)
  • To feel better

Tips for helping yourself in the moment
It can be hard for people who self-harm to stop it by themselves. That’s why it’s important to get further help if needed; however, the ideas below may be helpful to start relieving some distress:

  • Intense exercise for 30 seconds, 30 second break, repeat, up to 15 minutes – Exercising intensely will help your body mitigate unpleasant energy that can sometimes be stored from strong emotions. Transfer this energy by running, walking at a fast pace, doing jumping jacks, etc. Exercise naturally releases endorphins which will help combat any negative emotions like anger, anxiety, or sadness.
  • Delay — put off self-harming behaviours until you have spoken to someone.
  • Distract — do some exercise, go for a walk, play a game, do something kind for yourself, play loud music or use positive coping strategies.
  • Deep breathing — or other relaxation methods.
  • Cool your body temperature – Cooler temperatures decrease your heart rate (which is usually faster when we are emotionally overwhelmed). You can either splash your face with cold water, take a cold (but not too cold) shower, or if the weather outside is chilly you can go outside for a walk. Another idea is to take an ice cube and hold it in your hand or rub your face with it.
  • Listen to loud music
  • Call someone you trust or one of the services available like LifeLine 13 11 14, MensLine Australia 1300 78 99 78 and BeyondBlue 1300 22 4636 [see below].
  • You could write an email to yourself to express your emotions, or journal your feelings, if that’s something that might be effective for you.
  • Watch humorous Youtube clips

New, healthier coping strategies may not be as effective as the one you’re trying to replace so it may take practice. Bring lots of compassion to yourself, okay.

You may find that some of these strategies work in some situations but not others, or you may find that you need to use a combination of these. It’s important to find what works for you. Also, remember that these are not long-term solutions to self-harm but rather, useful short-term alternatives for relieving distress.

Mental health services infographic

Related Post

Addiction TheoriesAddiction Theories

There have been various theories and models proposed over time to help us understand why individuals use alcohol and other drugs, and why some people become dependent or ‘addicted’ but not others. The following are several models or theories of addiction. They reflect the political, medical, spiritual, and social forces of those times in history.

The Moral Model

Alcohol and tobacco was introduced in the Western countries during the 1500’s. The widespread use and misuse of chemical substances resulted in a range of social problems and it was thought by some that substance use was “problematic” and “morally wrong” (Lassiter & Spivey, 2018). The moral model viewed AOD dependency as a moral and personal weakness that involved a lack of self-control, and was often viewed as a potential danger to society (Stevens & Smith, 2014).

The moral model considered addiction a “sin” and a result of free, yet irresponsible, choice. Therefore, many politically conservative groups, religious groups, and legal systems tended to punish the individual who uses AOD. The moral model or attitude towards addiction can still be seen today in certain cultures. Those who still believe addiction is morally “wrong” tend to perceive the most appropriate way to treat the individuals who use AOD are through legal sanctions, such as imprisonment and fines. For example, in many countries, drivers who are caught under the influence of alcohol or other drugs are not considered for treatment programs but instead receive court sentences as punishments (Fisher & Harrison, 2017).

This model has been rejected by alcohol and other drugs professionals as unscientific and contributes to the stigma surrounding addiction and substance use (White, 1991, cited in Fisher & Harrison, 2017).

The Disease Model

This model takes up the medical viewpoint and proposes addiction as a disease or illness that an individual has. It proposed that addiction is a disease that is progressive and chronic whereby the individual holds no control as long as the substance use continues. In other words, their addiction will continue to deteriorate with the continuous AOD (Thombs & Osborn, 2019). It also proposes that individuals who uses AOD can never be cured from addiction, though it can be readily treated through sustained abstinence such as self-help fellowships and treatment community. 

In the 1940s, Jellinek proposed a disease model in relation to alcoholism, arguing that it is a disease caused by a physiological deficit in an individual, making the person permanently unable to tolerate the effects of alcohol (Stevens & Smith, 2014). Jellinek identified signs and symptoms and clustered them into stages of alcoholism, as well as progression of the disease, which form the basis of 12-step or Anon-type programs (e.g., Alcoholics Anonymous and Narcotics Anonymous; Stevens & Smith, 2014). 

Under the disease model, treatment requires complete abstinence. Once an individual has accepted the reality of their addiction and ceased substance use, they are labelled as being in recovery, but are never ‘cured’ (e.g., “Once an alcoholic, always an alcoholic”; Thombs & Osborn, 2019). Whilst originally applied to alcohol dependency, it has now been generalised to other substances and many traditional substance use treatment models are based on this model (Capuzzi & Stauffer, 2020; Stevens & Smith, 2014).

The disease model offered an alternative to the moral theory, helping to remove the moral stigma attached to addiction and replacing it with an emphasis on treatment of an illness (Capuzzi & Stauffer, 2020). Disease theory helped to explain how some people experience the physiological effects of addiction such as dependence, tolerance, and withdrawal more than others, and how these mechanisms are caused by a biochemical abnormality in an individual which increases their likelihood of developing a dependency (DiClemente, 2018). 

While the disease model was well received by a range of professionals, many criticised it because research did not find that the progressive, irreversible progression of addiction through stages always occurs as predicted (Capuzzi & Stauffer, 2020). Additionally, many in the AOD field argued that the model did not address the complex interrelated factors that accompany dependency (Stevens & Smith, 2014). Finally, some professionals argued that the concept of addiction being a disease may also convey the impression to some individuals that they are powerless over their dependency and/or not responsible for the consequences of destructive addictive behaviours, which can be counteractive to treatment (Capuzzi & Stauffer, 2020).

Genetic and Neurobiological Theories

These theories suggest that some people may be genetically predisposed to develop drug dependency. For example, individuals usually begin substance use on an experimental basis. They then continue using because there is some reinforcement for doing so (e.g., a reduction of pain, experience of euphoria, social recognition, and/or acceptance, etc.). Some people may continue to use substances in a controlled or recreational manner with limited consequences while others progress to non-medical use and eventually develop a dependency. Why? Genetic and neurobiological theories propose that this is the result of a genetic predisposition to drug dependency (Fisher & Harrison, 2017). 

Factors being considered by researchers in the genetic transmission of dependency on alcohol include neurobiological features such as an imbalance in the brain’s production of ‘feel good’ neurotransmitters or in the metabolism of ethanol, which is the key component of alcohol (Stevens & Smith, 2014). Other researchers explored genetic differences in temperament and personality traits which they argued may lead to certain individuals becoming more vulnerable in the face of challenging environmental circumstances, leading to AOD use (Stevens & Smith, 2014). Genetic predispositions such as these may explain why some individuals develop dependency on AOD while others in similar situations do not.

The Psycho-dynamic Model

This model proposes that substance use may be due to an unintentional response to some difficulties that an individual experienced in their childhood. This explanation is based on the theory that was put forward by Sigmund Freud, whereby the problems of whether we are able to cope with difficulties as adults are linked to our childhood experience. Many counselling approaches today are based on this theory which aim to seek understanding of people’s unconscious motivations and to enhance how they view themselves (Capuzzi & Stauffer, 2020).

The Psycho-dynamtic model also believes that AOD use is often secondary to a primary psychological issue. In other words, alcohol and other drugs is a symptom rather than a disorder, and AOD use is a means to temporarily relieve or numb emotional pain. For example, an individual suffering from depression might self-medicate with stimulants to relieve the enervating effects of depression or manage their anxiety by using benzodiazepines (Fisher & Harrison, 2017). 

There is evidence to support this model, whereby childhood traumatic events are associated with mental health problems and substance use disorders. Wu et al. (2010) conducted a study among 402 adults who were receiving substance use disorder treatments. They revealed that almost all (95%) of the participants experienced one or more childhood traumatic events, and 65.9% of them experienced emotional abuse and neglect from their childhood. The authors also reported that the higher the number of childhood traumatic events experienced, the higher the risk of substance use disorders and mental health problems such as post-traumatic stress disorder. 

Personality Traits

Some theorists suggest that certain individuals have certain personality traits that are linked to AOD dependency. For example, dependency on alcohol has been associated with traits such as developmental immaturity, impulsivity, high reactivity and emotionality, impatience, intolerance, and inability to express emotions (Capuzzi & Stauffer, 2020).

Social Learning Model

This model suggests that social learning processes such as observing other peoples behaviours (i.e., modelling) and cultural norms are important in the process of learning behaviours. Albert Bandura proposed Social Learning Theory which would argue that substance use is initiated by environmental stressors or modelling people around you with “perceived status”. For example, a child observes their parents use alcohol in social situations and the child is therefore more likely to perceive that AOD use for social situations is appropriate (Harrison & Fisher, 2017); the association between socialisation and alcohol has been established.

The social learning model also recognises the influence of cognitive processes such as coping, self-efficacy, and outcome expectancies. Some researchers are currently focusing on how an individuals expectation of the effects of drugs influence the pattern of AOD use and resulting dependency. Russell (1976, cited in Wise & Koob, 2013) suggested that dependency on substance is not only chemical (biological) but also behavioural and social in nature. 

It has also been suggested that substance use occurs when an individual thinks substance use is a coping mechanism. This can be learned from television and film, social medial, peer influence, or messages from caregivers during childhood. The individual hopes the AOD use will relieve from them from stress (Stevens & Smith, 2014). 

Socio-cultural Model

Different from the previous models, the socio-cultural model perceives substance use as an issue of society as a whole instead of focusing only on the individual. People tend to overestimate the influence of internal and psychological factors while underestimating the external and environmental factors, even among some alcohol and other drugs workers (Gladwell, 2000, cited in Lewis, Dana, & Blevins, 2015). Thus, this model highlights the importance of how society shapes substance use behaviours, such as cultural attitudes, peer pressures, family structures, economic factors, and more (Bobo & Husten, 2000). For example, Coffelt et al. (2006) found that parents’ alcohol use are associated with their children’s drinking behaviour, whereby when the adult’s alcohol problems increased, the likelihood of their adolescent child’s alcohol use increased. 

The Biopsychosocial Model

Substance use behaviour cannot be explained or understood scientifically or spiritually based on a single variable, antecedent, or “cause”. Biological, psychological, learning, social and cultural context all contributes to explaining why addiction develops and maintains. The interactions between these factors are presented in The Biopsychosocial Model – arguably the most commonly used model to explain addiction today. The model suggests that substance use and the progression of substance dependency can be explained by recognising that the body and mind are connected within a social and cultural context (Skewes & Gonzalez, 2013).

The model allows any combination of biological, psychological, social and cultural factors to contribute to AOD misuse and dependency, rather than a single dominating factor. This is much more holistic and integrative when attempting to understand the determinant of addiction (Stevens & Smith, 2014).

References:

  1. Bobo, J. K., & Husten, C. (2000). Sociocultural influences on smoking and drinking. Alcohol Research and Health, 24(4), 225-232. 
  2. Capuzzi, D., & Stauffer, M. D., Sharpe, C. W. (2020). History and etiological models of addiction. In D. Capuzzi, & M. D. Stauffer (Eds.), Foundations of addictions counseling (pp. 1-22). Pearson Education.
  3. Coffelt, N. L., Forehand, R., Olson, A. L., Jones, D. J., Gaffney, C. A., Zens, M. S. (2006). A longitudinal examination of the link between parent alcohol problems and youth drinking: The moderating roles of parent and child gender. Addictive Behaviours, 31, 4, 593-605. https://doi.org/10.1016/j.addbeh.2005.05.034 
  4. DiClemente, C. C. (2018). Addiction and change: How addictions develop and addicted people recover. The Guilford Press.
  5. Fisher, G. L., & Harrison, T. C. (2017). Substance abuse: Information for school counsellors, social workers, therapists, and counsellors. Pearson Education. 
  6. Lassiter, P. S., & Spivey, M. S. (2018). Historical perspectives and the moral model. In P. S. Lassiter, & J. R. Culbreth (Eds.), Theory and practice of addiction counselling. (pp. 27-46). Sage Publications. 
  7. Lewis, J. A., Dana, R. Q., & Blevins, G. A. (2015). Substance abuse counselling. Cengage Learning.
  8. Skewes, M. C., & Gonzalez, V. M. (2013). The biopsychosocial model of addiction. In P. M. Miller, A. W. Blume, D. J. Kavanagh, K. M. Kampman, M. E. Bates, M. E. Larimer, N. M. Petry, P. D. Witte, S. A. Ball (Eds.), Principles of addiction: Comprehensive addictive behaviours and disorders (pp. 61-70). Academic Press.
  9. Stevens, P., & Smith, R. L. (2014). Substance abuse counselling: Theory and practice. Pearson Education. 
  10. Teesson, M., Hall, W., Proudfoot, & Degenhardt, L. (2012). Addictions. Taylor & Francis Group.
  11. Thombs, D. L., & Osborn, C. J. (2019). Introduction to addictive behaviours. The Guilford Press. 
  12. Wise, R. A., & Koob, G. F. (2013). The development and maintainance of drug addiction. Neuropsychopharmacology, 39, 254-262.
  13. Wu, N. S., Schairer. L. C., Dellor, E., & Grella, C. (2010). Childhood trauma and health outcomes in adults with comorbid substance abuse and mental health disorders. Addictive Behaviors, 35(1). 68-71. https://doi.org/10.1016/j.addbeh.2009.09.003 

How do psychologists conceptualize defence mechanisms today in a post-Freudian society?How do psychologists conceptualize defence mechanisms today in a post-Freudian society?

Multiple theorists and researchers since Freud have independently converged on the same concept of psychological defences because of the potential utility of the concept.

Alfred Adler, known for emphasising the importance of overcoming feelings of inferiority and gaining a sense of belonging in order to achieve success and happiness, developed a similar idea which he called psychological “safeguarding strategies.”

Karen Horney, who believed that environment and social upbringing, rather than intrinsic factors, largely lead to neurosis, described “protective strategies” used by children of abusive or neglectful parents.

Leon Festinger developed the well-known concept of “cognitive dissonance,” proposing that inconsistency among beliefs or behaviours causes an uncomfortable psychological tension leading people to change one of the inconsistent elements to reduce the dissonance (or to add consonant elements to restore consonance).

Carl Rogers, who was one of the founders of humanistic psychology, known especially for his person-centred psychotherapy, discussed the process of defence as “denial and perceptual distortion”.

Albert Bandura, known for ground-breaking research on learning via observation and social modelling, and the development of social learning theory, conceptualized defences as “self-exoneration mechanisms.”

The influential psychiatrist George Vaillant organized defences on a scale of immature to mature, defining them as “unconscious homeostatic mechanisms that reduce the disorganizing effects of sudden stress.”

Current discussions of coping mechanisms and emotion regulation embody the idea of defences as well. Is a defence mechanism merely a learned internal process manifested in our behaviour to protect us – or our ego – from pain? Is a defence mechanism a merely a coping mechanism to resolve internal stress?

Whatever you believe the answers to be, we can cultivate, learn, and practice adaptive, context-specific and generalised coping strategies that will aid self-development that can improve our health, relationships, self-esteem, workplace performance, and stress management skills.

The Psychology of Gossiping – in a snapshotThe Psychology of Gossiping – in a snapshot

Gossiping is a universal social behaviour that involves the giving and receiving of information about others, generally perceived as having a negative effect on social groups and it is commonly sensationalistic in manner. The psychology of gossiping encompasses various aspects of human behaviour, including social interaction, communication, and interpersonal relationships.

Gossiping serves several psychological functions, such as forming and maintaining social bonds, establishing group norms, and conveying social information. Understanding the psychology of gossiping requires an examination of the underlying motivations, cognitive processes, and social dynamics involved in this behaviour.

One of the primary psychological functions of gossiping is its role in social bonding. According to evolutionary psychologists, gossiping may have evolved as a mechanism for monitoring and regulating social relationships within groups. By sharing information about others, individuals can establish and reinforce alliances, as well as identify potential threats or allies within their social networks. Gossiping also serves as a form of social currency, allowing individuals to exchange information and build rapport with others.

Furthermore, gossiping can be driven by intrinsic motivations related to curiosity and entertainment. People are naturally drawn to stories about others, particularly those involving conflict, romance, or scandal. This inclination toward sensationalistic narratives reflects the human tendency to seek novelty and emotional arousal through storytelling. From a psychological perspective, gossiping can be seen as a means of satisfying these innate cognitive and emotional needs.

In addition to its role in social bonding and entertainment, gossiping serves as a mechanism for transmitting social information and enforcing group norms. Through gossip, individuals communicate expectations and judgements regarding behaviour, values, and social roles within their communities. Gossip can function as a form of informal social control by publicly sanctioning or condemning certain behaviours, thereby influencing the conduct of group members.

The psychology of gossiping involves considerations of ethical and moral implications. While gossip can facilitate social cohesion and information sharing, it can also lead to negative consequences such as reputational damage, interpersonal conflict, disharmony, and breaches of privacy. Understanding the psychological mechanisms underlying gossiping can shed light on the ethical dilemmas associated with this behaviour and inform strategies for promoting responsible communication within social contexts.

Gossiping can indeed be malicious, as it involves spreading rumors or information about others that may be harmful, untrue, or damaging to their reputation. Malicious gossip can have serious consequences for the individuals involved, leading to damaged relationships, loss of trust, and even psychological harm. It is important to understand the impact of malicious gossip and the ethical considerations surrounding the spread of such information.

Malicious gossip is often driven by negative intentions, such as jealousy, resentment, or a desire to harm someone’s reputation. It can take various forms, including spreading false information about an individual’s personal life, career, or character. In some cases, malicious gossip may be used as a tool for bullying or manipulation, with the intent to undermine someone’s social standing or credibility.

The effects of malicious gossip can be far-reaching. It can lead to strained relationships, social ostracism, and damage to one’s professional reputation. In extreme cases, it can even result in legal action if the spread of false information causes tangible harm to an individual’s livelihood or well-being.

In summary, the psychology of gossiping encompasses various psychological functions, including its role in social bonding, entertainment, information transmission, and norm enforcement. By examining the underlying motivations, cognitive processes, and social dynamics involved in gossiping, researchers can gain insights into the complexities of human social behavior and interpersonal communication.

References:

Adler, R., & Proctor II, R. F. (2014). Looking out/looking in (14th ed.). Cengage Learning. (Print)

Dunbar, R.I.M. “Gossip in Evolutionary Perspective.” Review of General Psychology (Print)

Foster E.K., & Campbell W.K. “The Psychology of Gossip: A Review.” Social Psychological Review (Print)

Kniffin K.M., & Wilson D.S. “Evolutionary Perspectives on Gossip.” Social Psychology Quarterly (Print)

Kowalski, R. M., Limber, S. P., & Agatston, P. W. (2012). Cyberbullying: Bullying in the digital age (2nd ed.). Wiley-Blackwell. (Print)

Manning, J., & Levine, L. J. (2016). The psychology of social media: Why we like, share, comment and keep coming back. Routledge. (Print)

Robbins M.L., & Karan A. “Gossip: The Good, The Bad & The Ugly.” Journal of Applied Social Psychology (Print)

Salmivalli, C., & Graham-Kevan, N. (Eds.). (2019). Intimate partner violence: New perspectives in research and practice. Routledge. (Print)

Smith, P., & Steffgen, G. (Eds.). (2013). Cyberbullying through the new media: Findings from an international network. Psychology Press. (Print)

Sommerfeld R.D., & Jordan J.J. “The Evolutionary Foundations of Gossip.” Biological Theory (Print)