Self-Mutiltion and Borderline Personality Disorder

Self-Mutilation is Often a Secret People With BPD Keep Hidden

Depressed teen
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The content of this article may be very triggering if you engage in self-mutilation; please consider this carefully before reading on.

Self-mutilation is very difficult to understand if you have never experienced the urge to engage in this behavior yourself. If you have a friend or family member with borderline personality disorder (BPD) who self-mutilates, it can scary, confusing and frustrating. By understanding why self-mutilation occurs, you can help your loved one cope with these urges and act as a support network for her.

Definition of Self-Mutilation

Self-mutilation involves the direct and deliberate destruction or alteration of the body. Examples of these behaviors include cutting, burning, sticking oneself with needles and severe scratching.

Self-mutilation is usually very different than other self harming behaviors. Research has shown that individuals who engage in self harm are usually not trying to kill themselves when they engage in the behavior, although some may report that they have mixed feelings about the intent of the act. This is not to say that people who engage in self-mutilation are not suicidal; many people who self mutilate also have suicidal thoughts or even make suicide attempts. In addition, in cases of very severe self-mutilation, people have died from their injuries.

Why People Engage in Self-Mutilation

Many believe that people engage in self-mutilation to get attention. This is a myth.

Most people who self harm do it in private and make sure that the marks or scars are hidden. They often will wear long sleeves to cover these signs.They are often ashamed of the behavior and keep it a secret. Particularly for those with BPD who have rejection sensitivity, they worry continuously about people finding out about their secrets.

Research has shown that most people self mutilate in order to help regulate internal experiences such as intense emotions, thoughts, memories and physical sensations.

Who Engages in Self-Mutilation?

Unfortunately, self-mutilation is a common behavior, particularly among those with BPD. One study found that about 40% of college students have engaged in self-mutilation at least once and about 10% have engaged in self-mutilation 10 or more times. Evidence suggests that men and women engage in self-mutilation at equal rates.

People who have experienced maltreatment during their childhood, such as through sexual abuse or neglect, or who were separated from a caregiver in childhood, are at greater risk for self-mutilation than the general population.

How Is Self-Mutilation Treated?

Because self-mutilation is often an attempt to manage intense feelings, cognitive behavioral treatments for self-mutilation focus on helping the person find new, healthier ways of managing emotions and thoughts. For example, one cognitive behavioral treatment for borderline personality disorder, dialectical behavior therapy, addresses unhealthy attempts at coping by helping the patient learn and practice a new set of coping skills.

In some cases, a doctor may prescribe medications to help regulate emotions and feelings and decrease the urge to self-harm.

What To Do If A Friend or Loved One Self Mutilates

If you are going to talk with your friend or loved one about self-mutilation, it's important to do it in a non-judgmental fashion. Approaching them calmly and with care can make the person feel heard and understood.

Before talking with a loved one, it may be a good idea to consult with a therapist who specializes in treating BPD and self-mutilation. He can give you professional advice on the best way to approach the situation without frightening or upsetting your loved one. 

Get Treatment for Self-Mutilation

If you or someone you know is struggling with self-mutilation, there are a variety of treatment resources available. These articles cover more about how to find a therapist and the types of therapists available:

How to Find a Therapist

Type of Therapists and Mental Health Providers

Sources:

Gratz KL, Conrad SD, & Roemer L. "Risk Factors for Deliberate Self-Harm Among College Students." American Journal of Orthopsychiatry, 72:128-140, 2002.

Gratz KL. "Emotion Dysregulation in the Treatment of Self-Injury." Journal of Clinical Psychology: In Session, 63:1091-1103, 2007.

Gratz KL. "Risk Factors for and Functions of Deliberate Self-Harm: An Empirical and Conceptual Review." Clinical Psychology Science and Practice, 10:192-205, 2003.

Linehan MM. Skills Training Manual for Treating Borderline Personality Disorder. New York: Guilford Press, 1993.

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