The Hidden Meaning of Self-Injurious Behavior

In this blog post, I look into the hidden meaning of self-injurious behavior from a psychoanalytic point of view and explore some of the common reasons why people harm themselves. I am using a broad definition of self-injury as any act, intentional or unintentional, i.e. conscious or unconscious, that is harmful to an individual, either physically or emotionally. 

First, let me just say this: I’ve come to realize that one of the reasons why I enjoy helping people, who self-injure, is because many of them exert a sense of admirable resilience and bravery – something they themselves may not be aware of but something that is definitely there. If you are one of those people, you may not think of yourself as brave and resilient but my experience shows otherwise. The self-injury often speaks to the amount of pain and trauma you may have overcome or are still dealing with and I find that ability to cope admirable.

I can’t help but feel admiration for such people,especially when they trust me with their stories and welcome me into their journey to feel better through the psychoanalytic cure. If you or someone you know has experience with self-harm, read along and I hope you find a sense of hope and strength.

Just like there are many forms of self-injurious behavior from cutting and burning your skin to binge drinking, starving oneself and sabotaging your relationships, there are many reasons why people do it.

I’ve spoken about this before but let me say it again:

from a psychoanalytic point of view, self- injury is an attempt to cope with the experience of psychic pain that has no other way of being expressed or spoken about.

In psychoanalysis, we welcome this attempt to cope and invite it to speak. We don’t try to control it or change it; we don’t interpret it or put it in a category. It’s unique for every person and we try to find its meaning with each individual patient. Many of us psychoanalytic psychotherapists have our own analysis to support the work we do with our clients and to guide us in listening to the unconscious expressed in the symptom.

And let’s be clear – it’s not just adolescents, who cut; adults do it too. The self-injury make take different forms, more adult forms such as substance abuse or debilitating workaholism, but self-injurious, nonetheless.

What could self-injury mean?

• Often times, we hear patients say that they self- injure so that they can feel relief or so that they can make themselves feel something in an otherwise numb state of mind.

• It could also be that people are harboring unconscious feelings of guilt and the self-injury is an attempt to punish themselves, physically or emotionally.

• Other times, people self-injure so that they can numb the emotional pain they feel so palpably on the inside. By hurting on the outside they can forget about the emotional pain on the inside that may be too much to handle.

• Self-injury could be an expression of anger, helplessness, aggression, pain or even sadness. It could be an attempt to take control when feeling you have none or an attempt to create a boundary and put limits to yourself .

Whatever the meaning, until the person can find an alternative way to cope, they’ll probably continue doing it.

Why are some other therapeutic approaches unsuccessful in the treatment of self-injury, especially for people, who have experienced trauma? Because the self-injury as a psychoanalytic symptom is a form of communication to the psychoanalytic therapist that relates a message. A message that something is wrong and is attempting to find a solution in the form of self- harm. If we try to shut it down with behavioral or psycho- pharmaceutical interventions, we are silencing the only way that our psyche has found to speak about its pain.

“Well, but I do want to stop doing this,” you might say, and yes, the reason why people seek treatment is BECAUSE they want to stop. In order for that to happen, we need to find a different path for the unconscious to express itself, a more creative and hopefully non-painful path. We do this in the therapeutic relationship.