We all harm ourselves. Whether it’s knowingly eating the entire carton of ice cream or enduring the agony of one more mile in a training run. I make no distinction between the good and bad pains we choose for ourselves because it is the fact that we choose them that matters far more than what the pain is. I have almost a dozen tattoos but no piercings because I don’t see any value in having a piercing. Whereas, I thoroughly enjoy my ink enough to pay for the time of the artist and endure the excruciating pain the art requires.

Like suicide, self-harm is a term society approaches with extreme indirectness. Most people see pain as something to be avoided and have a difficult time imagining why a person might hurt themselves intentionally. When you get right down to it, self-harm is easily understandable but because it feels icky we lean away from it and debase those who perform it, which only adds to the problem. My introduction into self-harm began with pulling hair out of my arms. This behavior is known as trichotillomania, and it is most often associated with stressful conditions. We’ve all experienced that feeling of being so stressed we want to tear out our hair, but why is this so common?

My experience is that this is an easy way for a stressed person to gain control, however minor, of the agony they’re feeling. I pulled out individual hairs on my arms and luxuriated in the tiny aches. I was pleased to hurt because it was hurt that I chose. Life can be absurdly painful, and it is the pain we cannot control or mitigate that can lead to a desire to inflict harm on the self.

I didn’t stop at pulling my hair. My anxiety drove me to up the pain index and I began punching the roof of my Jeep. One day I was so full of energy and uncontrollable pain that I launched my fist into the roof and felt a glorious explosion of pain in my knuckles. Hooked after that experience, I spent much of my time at red lights denting impressions of my knuckles into the upholstery. Was this healthy? No. I merely traded one pain for another, and while this allowed me to gain a measure of control it lasted only until my knuckles couldn’t take the punishment anymore.

This behavior is more formally known as pain offset relief, where some kind of pain is used to bring about a short burst of euphoria. My best analogy for this is a hard workout. The feeling of the workout can be pure agony, but there is a time afterward where you feel bliss due to the cascade of feel-good chemicals flooding your body. Same concept, just on a smaller scale. Please do not mistake my analogy as an endorsement of self-harm. A hard workout has long-term benefits for the body and the mind, while punching walls, pulling hair, or cutting is habituation to short-term relief from underlying pain.

Cutting is where most people go when thinking of those that self-harm. Popular media focuses on cutting because of the shock value, as it is shocking behavior. I have a deep aversion to cutting myself, but I have experimented with cutting. There are two sharp white scars on my left shoulder from when I took a pairing knife to my skin. See - shocking!

Most people can relate to wanting to hit something or tear their hair out, even if they don’t do it, but cutting skin tends to be a hard limit. There is a strong evolutionary drive that compels us to maintain the integrity of our skin. Fear of the pain, the sight and feeling of blood, and the risk of infection all combine to keep most folks from willingly drawing a blade across their body. And yet, approximately 17% of adolescents have engaged in non-suicidal self-injurious behavior (NSSI). Further, “females are more likely to engage in self-cutting, […] while males are more prone to deliberately bruising themselves, hurting themselves while taking a substance, or having others hurt them.” This tracks fairly well with my personal experience and the make-up of those I was in group therapy with over the years.

Chosen pain still hurts, but because I initiated that pain it becomes more understandable, more controllable, and more my own. The pain from my anxiety and the ever-present weight of my depression are not something I choose to endure, I must endure them and that is the critical difference.

Younger people, in my opinion, do not have enough long-term coping mechanisms to deal with a massive uptick in life stresses. The amount of high schoolers I interact with that discuss their experiences with NSSI is deeply troubling. They have limited means of managing their stress because so much of their lives and the expectations of others is so future-focused. Get to college, get a good job, and then you’ll be happy. That is not how this works. I’d much rather us spend time acknowledging the problem of self-harm in these significant developmental years and teach people startlingly effective means with which to calm themselves.

School is about to start across the country, and young people are about to get more stressed. I train students and those in their care better methods to deal with this stress, which I know will help lower the percentage of individuals engaging in NSSI because that is behavior I haven’t done in years. Click on the image below to visit mentallyagile.com/contact and schedule a talk or workshop.