Buy one beautiful flower |
Make one space in a room pretty |
Light a candles and watch the flame |
Set a pretty place at the table, using your best things, for a meal |
Go to a museum with beautiful art |
Go sit in the lobby of a beautiful old hotel |
Look at nature around you |
Go out in the middle of the night and watch the stars |
Walk in a pretty part of town |
Fix your nails so they look pretty (even "real men" can do this) |
Look at beautiful pictures in a book (I have several photography books that are wonderful for this, one of which is just photos of children) |
Go to a ballet or other dance performance, or watch one on TV |
Be mindful of each sight that passes in front of you, not lingering on anything |
Listen to beautiful or soothing music, or to invigorating and exciting music (many people recommend that country music be avoided, since the lyrics tend to be depressing). Classical can be very good, since there are no lyrics to trigger specific thoughts |
Pay attention to the sounds of nature (waves, birds, rainfall, leaves rustling) or listen to tapes of nature sounds (I use a whale song tape, and a rain forest tape) |
Sing your favorite songs |
Hum a soothing tune |
Learn to play an instrument |
Call 800 or other numbers to hear a human voice |
Be mindful of any sounds that come your way, letting them go in one ear and out the other |
Use your favorite perfume or lotions, or try them on in the store |
Spray fragrance in the air |
Light a scented candle |
Put lemon oil on your furniture |
Put potpourri in a bowl in your room |
Boil cinnamon |
Bake cookies, cake, or bread |
Smell the roses |
Walk in a wooded area and mindfully breathe in the fresh smells of nature |
Have a good meal |
Have a favorite soothing drink such as herbal tea or hot chocolate (no alcohol) |
Treat yourself to a dessert |
Put whipped cream on your coffee (or, if you're like me, your cereal, toast, ice cream, rocks, put whipped cream on almost anything and I'll eat it) |
Sample flavors in an ice cream store |
Suck on a piece of peppermint candy (or other flavors that you like - hard candy is recommended, though, since for many people soft candies can be triggering) |
Chew your favorite gum |
Get a little bit of a special food you don't usually spend the money on, such as fresh-squeezed orange juice |
Really taste the food you eat; eat one thing mindfully |
Take a bubble bath |
Put clean sheets on the bed |
Pet your dog or cat |
Have a massage (I think everyone should do this at least monthly, with a professional that you trust - there are people who specialize in therapeutic massage specifically to release body memories, etc.) |
Soak your feet |
Put creamy lotion on your whole body |
Put a cold compress on your forehead. Or wrap your face in a very warm, damp facecloth (wonderfully relaxing) - my kids and I have done this before dinners sometimes - it really calms everyone down |
Sink into a really comfortable chair in your home, or find one in a luxurious hotel lobby |
Put on a silky blouse, dress, or scarf (satin or velour is also great, even for men) |
Try on fur-lined gloves or fur coats in a department store (artificial furs, please) |
Brush your hair for a long time |
Hug someone |
Experience whatever you are touching; notice touch that is soothing |
Lack of role models and invalidation - most people who self-injure were chronically invalidated in some way as children (many self-injurers report abuse, but almost all report chronic invalidation). They never learned appropriate ways of expressing emotion and may have learned that emotions are bad and to be avoided. |
Biological predisposition - evidence is accumulating that indicates self-injurers have specific problems within the brain's serotonergic system that cause an increase in impulsivity and aggression. Impulsive aggression, combined with a belief that expressing it outwardly is unthinkably bad, might lead to the aggression being turned inward. |
Studies have suggested that when people who self-injure get emotionally overwhelmed, an act of self-harm almost immediately brings their levels of psychophysiological tension and arousal back to a bearable baseline level. In other words, they feel a strong uncomfortable emotion, don't know how to handle it, and know that hurting themselves will reduce the emotional discomfort quickly. They may still feel bad, but they don't have that panicky, jittery, trapped feeling. |
Escape from emptiness, depression, and feelings of unreality. |
In order to ease tension. |
Relief: when intense feelings build, self-injurers are overwhelmed and unable to cope. By causing pain, they reduce the level of emotional and physiological arousal to a bearable one. |
Expression of emotional pain |
Escaping numbness: many of those who self-injure say they do it in order to feel something, to know that they're still alive. |
Obtaining a feeling of euphoria |
Continuing abusive patterns: self-injurers tend to have been abused as children. Sometimes self-mutilation is a way of punishing oneself for being "bad." |
Relief of anger: many self-injurers have enormous amounts of rage within. Afraid to express it outwardly, they injure themselves as a way of venting these feelings. |
Biochemical relief: there is some thought that adults who were repeatedly traumatized as children have a hard time returning to a "normal" baseline level of arousal and are, in some sense, addicted to crisis behavior. |
Obtaining or maintaining influence over the behavior of others |
Exerting a sense of control over one's body |
Grounding in reality, as a way of dealing with feelings of depersonalization and dissociation |
Maintaining a sense of security or feeling of uniqueness |
Expressing or repressing sexuality |
Expressing or coping with feeling of alienation |
"Most women have not even been able to touch this anger except to drive it inward like a rusted nail." |
As Miller says, "Men act out. Women act out by acting in." Another reason fewer men self-injure may be that men are socialized in a way that makes repressing feelings the norm. Linehan's (1993a) theory that self-harm results in part from chronic invalidation, from always being told that your feelings are bad or wrong or inappropriate, could explain the gender disparity in self-injury; men are generally brought up to hold emotion in. |
Objective: What the researchers have found |
People who self-injure tend to be dysphoric -- experiencing a depressed mood with a high degree of irritability and sensitivity to rejection and some underlying tension -- even when not actively hurting themselves. The pattern found by Herpertz (1995) indicates that something, usually some sort of interpersonal stressor, increases the level of dysphoria and tension to an unbearable degree. The painful feelings become overwhelming: it's as if the usual underlying uncomfortable affect is escalated to a critical maximum point. "SIB has the function of bringing about a transient relief from these [high levels of irritability and sensitivity to rejection]," Herpertz said. This conclusion is supported by the work of Haines and her colleagues. |
In a fascinating study, Haines et al. (1995) led groups of self-injuring and non-self-injuring subjects through guided imagery sessions. Each subject experienced the same four scenarios in random order: a scene in which aggression was imagined, a neutral scene, a scene of accidental injury, and one in which self-injury was imagined. The scripts had four stages: scene-setting, approach, incident, and consequence. During the guided imagery sessions, physiological arousal and subjective arousal were measured. |
The results were striking. Subject reactions across groups didn't differ on the aggression, accident, and neutral scripts. In the self-injury script, though, the control groups went to a high level of arousal and stayed there throughout the script, in spite of relaxation instructions contained in the "consequences" stage. In contrast, self-injurers experienced increased arousal through the scene-setting and approach stages, until the the decision to self-injure was made. Their tension then dropped, dropping even more at the incident stage and remaining low. |
These results provide strong evidence that self-injury provides a quick, effective release of physiological tension, which would include the physiological arousal brought on by negative or overwhelming psychological states. As Haines et al. say |
Self-mutilators often are unable to provide explanations for their own self-mutilative behavior. . . . Participants reported continued negative feelings despite reduced psychophysiological arousal. This result suggests that it is the alteration of psychophysiological arousal that may operate to reinforce and maintain the behavior, not the psychological response. (1995, p. 481) |
In other words, self-injury may be a preferred coping mechanism because it quickly and dramatically calms the body, even though people who self-injure may have very negative feelings after an episode. They feel bad, but the overwhelming psychophysiological pressure and tension is gone. Herpertz et al. (1995) explain this: |
We may surmise that self-mutilators usually disapprove of aggressive feelings and impulses. If they fail to suppress these, our findings indicate that they direct them inwardly. . . . This is in agreement with patients' reports, where they often regard their self-mutilative acts as ways of relieving intolerable tension resulting from interpersonal stressors. (p. 70). |
Herman (1992) says that most children who are abused discover that a serious jolt to the body, like that produced by self-injury, can make intolerable feelings go away temporarily. |
Brain chemistry may play a role in determining who self-injures and who doesn't. Simeon et al. (1992) found that people who self-injure tend to be extremely angry, impulsive, anxious, and aggressive, and presented evidence that some of these traits may be linked to deficits in the brain's serotonin system. Favazza (1993) refers to this study and to work by Coccaro on irritability to posit that perhaps irritable people with relatively normal serotonin function express their irritation outwardly, by screaming or throwing things; people with low serotonin function turn the irritability inward by self-damaging or suicidal acts. Zweig-Frank et al. (1994) also suggest that degree of self-injury is related to serotonin dysfunction. |
Those who self-injure may have personality characteristics that increase the likelihood of their self-injury. Haines and Williams (1997) found that self-mutilators reported more use of problem avoidance as a coping strategy and perceived themselves to have less control over problem-solving options. This feeling of disempowerment may in turn be related to the chronic invalidation many self-injurers have experienced. |