How do you know if you or someone you know self-injures? This sounds like a strange question, but many people aren't sure if what they do is 'really' self-injury. Answer these questions:

1. Do you deliberately cause physical harm to yourself to the extent of causing tissue damage (breaking the skin, bruising, leaving marks that last for more than an hour)?

2. Do you cause this harm to yourself as a way of dealing with unpleasant or overwhelming emotions, obsessive thoughts, or dissociation?

3. If your self-harm is not compulsive, do you often think about self-injury even when you're relatively calm and not doing it at the moment.

4. Are you 'accident prone?'

5. Do you prevent your self-injuries from healing?

If you answered 'Yes' to #1 and #2, you are a self-injurer. If you answered 'yes' to #3 and #5, you are most likely a repetitive self-injurer. The way you choose to hurt yourself could be cutting, hitting, burning, scratching, skin-picking, hair pulling, banging your head, breaking bones, not letting wounds heal, drug/alcohol abuse or ingesting other lethal substances.”

In spite of the definition—self-injury— a.k.a. self-harm, self-mutilation, cutting, burning, SI, you are doing nothing shameful—you are maintaining psychological integrity with the only tool you have. It is a crude and ultimately self-destructive tool, but it works; you get relief from the overwhelming emotional pain—fear/anxiety/sadness/anger in your life.

• Five million Americans engage in some form of self injury. An estimated three million Americans purposely cut or burn themselves.

• 90% of self injurers begin self injury as teenagers.

• The average self injurer begins at age fourteen and continues with increasing severity until they either choose another coping mechanism or engage in healing their emotional wounds.

• Self injurers are victims of abuse—emotional, physical, sexual abuse or childhood neglect.

• Self injury is prevalent in all races and economic backgrounds.

• 60% of self injurers are female, 40% are male.

• Self injury does become an addiction as it provides a respite from the emotional pain for a short period—then the person repeats their self injuring behavior to again create the relief.

• People who self injure are not suicidal nor are they sick, weird, crazy, a freak or evil.

• Self injury is a solution to excruciating emotional pain.

Self injury is only a temporary solution. Self injury makes the person feel better, but only for a short period of time. The only way to feel better is to heal the emotional wounds, which prompts self injury as a coping mechanism. Their excruciating emotional pain is extremely elusive and there seems to be no other remedy than to create external pain as a distraction, albeit temporary.

People become very adept at hiding scars or explaining away self-injuring behavior. Look for signs such as: a preference for wearing concealing clothing at all times (long sleeves in hot weather), an avoidance of situations where more revealing clothing is the norm (refusal to wear shorts, swimsuit, short sleeves, etc), or frequent complaints of accidental injury—falling, slipping, scratches on arms or legs, frequent black and blue marks.

Talk therapy is inadequate to uncover the emotional pain, and heal the trauma trapped in muscles and tissue. To fully appreciate the depth of this pain, I will quote one of my clients, Even my blood hurts. A multifaceted healing process specifically focused on emotional, physical and sexual abuse recovery and diligent work is the most effective; wherein the survivor can replenish their emotional and spiritual identity and empowerment.