A common form of self-injury is shallow cuts to the skin of the arms or legs, or less frequently to other parts of the body, including the breasts and sexual organs. Since this is the most well-known, it is casually referred to as "cutting", though it may also involve punching, slapping, or burning oneself as well. The usual thought process behind self-injury is not to attempt Suicide, but to relieve unbearable emotional pressure, or some kind of discomfort. Self-injury is seen by some as attention seeking behavior, though many people who self injure are very self-conscious of their wounds and scars and go to great lengths to conceal their behavior from others. They may offer alternate explanations for their injuries or conceal their scars with clothing.
Strictly, self-harm is a general term for self-damaging activities (which could include alcohol abuse, bulimia, etc). Self-injury refers to the more specific practice of cutting, bruising, self poisoning, over-dosing (without suicidal intent, at first), burning or otherwise directly injuring the body. Self-harm is also a way for people to relieve the emotional pain of everyday life, especially in the case of teenagers, but not exclusively. People who self harm may hurt themselves with a favourite 'tool' or by whatever means available to "wipe out" the emotional distress that they feel inside.
It should be noted that many people, including Health Care Workers, define self harm based around the act of damaging one's own body, whereas it may be more accurate to define self harm based around the intent and the emotional distress that the person wishes to deal with.
Self-harm is more common than many people realise, especially in adolescents under stress. Self-harmers often feel a great amount of guilt as it is, so when encountering or discovering self-harm it is vital that support and understanding be shown, for the good of all involved.
In New Zealand, more females are hospitalised for intentional self-harm than males. Females more commonly choose methods such as self-poisoning that generally are not fatal, but still serious enough to require hospitalization.
About 10% of admissions to medical wards in the UK are as a result of self-harm.
It should be noted that statistics based on hospital admissions probably hide a much larger group of self-harmers who do not need hospital treatment for their injuries. Conterio and Favazza estimate that 750 per 100,000 population exhibit self-injurious behavior.
To complement this theory, one can consider the need to 'stop' feeling emotional pain and mental agitation. "A person may be hyper-sensitive and overwhelmed; a great many thoughts may be revolving within their mind, and they may either become triggered or could make a decision to stop the overwhelming feelings."
Alternatively self-injury may be a means of feeling something, even if the sensation is unpleasant and painful. Those who self-injure sometimes describe feelings of emptiness or numbness, and physical pain may be a relief from these feelings. "A person may be detached from himself or herself, detached from life, numb and unfeeling. They may then recognise the need to function more, or have a desire to feel real again, and a decision is made to create sensation and ‘wake up’."
A flow diagram of these two theories is here.
Self-harm may also give a feeling of being in control of one's own body, which could be especially important for survivors of Sexual abuse.
Self-injury may also be a means of communicating distress. This motivation is sometimes dismissed as "attention seeking" and has often been seen as the primary motivation. However, for many, the act of self-harm fulfils a purpose in itself and is not a means of communicating with or influencing others. Many who self-injure keep their injuries secret, while those who do disclose their injuries may be embarrassed and ashamed of their actions.
Those who engage in self-harm face the contradictory reality of harming themselves whilst at the same time obtaining relief from this act. For some self-injurers this relief is primarily psychological whilst for others this feeling of relief comes from the beta endorphins released in the brain (the same chemicals responsible for the "runner's high"). These act to reduce tension and emotional distress and may lead to a feeling of calm. A similar rush of endorphins is triggered when someone receives a Tattoo. In this way, one can become addicted to getting tattoos. Similarly, those who self injure may also become addicted to the endorphin rush.
As a coping mechanism, self-injury can become psychologically addictive because, to the self-injurer, it works; it enables him/her to deal with intense stress in the current moment.
A lesser form of this extreme act is, for example, hitting one's head on the table or pulling one's hair out. Although this is often used euphemistically, for those who do it serves the same purpose of deferring the stress experienced by the major cause by the pain from this secondary option.
There are certainly communities that are based around the subject of self harm, and they tend to focus around a message board with or without a main website. But there is not 'a community', there is not one Umbrella organisation that represents or speaks for people who self harm. There are many community sites of varying sizes that offer peer-support, emotional discussion, philosophical and psychological discussion, and general chit-chat.
There is some consternation as to whether such communities encourage and support self harm, however, such communities are known as Pro-SI and are separate from general SI Awareness communities.
There is anecdotal evidence that by being free to express feelings and SI related thoughts, that a person can understand their emotional world and reasons for self harming; people who no longer hurt themselves often continue to be members of SI Awareness Message Boards for some time after 'quitting' and offer support to those people who wish to move away from self harm.