WHAT IS NONSUICIDAL SELF-INJURY
Nonsuicidal self-injury (NSSI) is an intentional, self-inflicted and non-socially sanctioned behaviour, undertaken without suicidal intent, and resulting in low lethality tissue damage. The word "behaviour" is important, because NSSI is a behaviour (i.e., cutting, burning, scratching etc.) not a mental illness. It is also not a behaviour that is in accordance with social norms, like piercing, tattooing, or minor cosmetic surgery.
As the name suggests, when people self-injure their intent is not suicidal in nature. It is often used as a way to create a change in the way they are feeling or thinking, or even to prevent suicidal thoughts and behaviours. NSSI is conceptually distinct from suicidal behaviour, yet research indicates that the two behaviours share a complex relationship. Whilst the majority of individuals who engage in NSSI may not attempt suicide, NSSI is a salient risk factor for suicidal ideation, attempted suicide and suicide. A meta-analysis of 172 longitudinal studies predicting suicide ideation, attempts and suicide, found that individuals with a history of NSSI were 4.27 times more likely to attempt suicide (Riberio et al., 2016).
THE ACT OF NSSI
The act of NSSI is not only unique to each individual who engages in it, but the act may differs in one or more qualities every time an individual self-injures. The act of NSSI can vary from the methods utilised to self-injure; the frequency in which it is enacted; the bodily site selected; and the implements employed to exact the injury. The length of time taken from the first urge, to the eventual act; the setting and rituals associated with the act; the severity of the wounds and whether medical attention is required and/or sought following the behaviour, all interact to make NSSI a multifaceted and heterogeneous behaviour.
The act is remarkable in its accessibility, NSSI can be undertaken at anytime and anywhere, with no cost and little preparation. Aside from the obvious and most used implements, any number of household items can be employed as an implement with which to harm oneself.
The most commonly reported methods of NSSI include cutting; carving; severely scratching; burning; or rubbing the skin against abrasive surfaces or with erasers; pinching, banging, hitting or punching oneself; interference with wound healing or skin picking; biting; and inserting objects under the skin. Whilst research has consistently demonstrated that cutting is the most common method of self-injury, it is important to note that the majority of individuals who self-injure will use more than one method to self-injure over time.
WHY DO PEOPLE
NSSI is a really confronting and confusing behaviour because the urge to cut, scratch, rub, or burn the flesh, appears in direct contrast to our instincts of self-preservation and survival. It is often difficult to understand why someone would create a painful physical wound to heal an emotional or psychological. Yet, the behaviour has been reported in the clinical literature since 1914 (Emerson) under a variety of terms, such as self-mutilation, self-cutting, self-injurious behaviour and deliberate self-harm.
NSSI is undertaken for many reasons. They are different for each person who self-injures, and they may even be different each time an individual self-injures. They are also typically based on their current situation, thoughts or feelings. The research informs us that self-injury is most often used as a way of managing overwhelming emotions or affect. Someone may be feeling numb and want to feel something, even if that something is physical pain. Alternatively, they might be feeling their emotions far too intensely and just want them to stop. Other people use self-injury as a form of self-punishment. As such, it is best understood as a coping mechanism. There are numerous other reasons that individuals may self-injure, and research indicates that these may change each time someone self-injures.
Despite the prevalence of NSSI and its presence on traditional & social media forums, a number of myths around NSSI still. This brief video was created in an effort to help reduce the stigma and dispel the myths about NSSI.