Exploring the Connection Between Self-Harm and Trauma: Breaking the Cycle

According to Frontiers in Psychiatry, self-harm also known as self-injury, or non-suicidal self-injury (NSSI) has a lifetime prevalence between 17-22%. Despite the prevalence of self-harm, there is a great deal of stigma and myths that accompany it. Some self-harm myths or misconceptions include perceiving people who self-harm as attention seekers and manipulators. While in reality, there is a close relationship between self-harm and trauma.

Many of the myths about self-harm may be tied to misconceptions about its association only with teenagers and predominantly teenage girls. Often the challenges girls and teens in general experience are discounted because of myths about age and gender. Some believe children are too young to experience challenges with mental health and girls receive less support due to overt and covert gender biases. Yet, self-harm and trauma share a significant relationship that must be examined to better understand the roots of your self-defeating behaviors.

At The Guest House, we know the emotional turmoil of trauma often leads to harmful or unhealthy outward behaviors. Looking at the relationship between self-harm and trauma can be vital to understanding self-harm in your life. There will always be life stressors and experiences that will challenge you. However, with a greater understanding of self-harm and trauma, you can learn how to navigate and adapt to them. Through a holistic and individualized approach to care, you can find the tools you need to build resilience and recover.

Yet, you may still have questions about the relationship between self-harm and trauma, or you may question how to recognize if you engage in self-harm. Misconceptions about self-harm as cutting can distort your awareness of your own self-harming behaviors. You may also have questions about self-harm and trauma if you are not aware of the wide variety of trauma types that exist. Therefore, expanding your awareness of self-harm can provide insight into the intersection of self-harm and trauma.

What Is Self-Harm?

More myths about self-harm have led people to believe self-harm is only cutting. While cutting is a common type of self-harm, this misconception limits people with other forms of self-harm from receiving treatment. By deepening your awareness of the different types of self-harm, you can recognize the impact self-harm has had on your well-being. As MedlinePlus notes, self-harm happens when a person harms their body on purpose. Self-harm injuries can range from minor cuts and bruises to severe injuries like broken bones.

Listed below are some examples of different types of self-harming behaviors:

• Cutting yourself
• Burning yourself
• Hair pulling
• Skin picking
• Punching yourself or objects
• Reopening wounds before they heal
• Breaking your bones
• Bruising yourself
• Banging your head against things
• Biting yourself
• Scratching yourself
• Rubbing your skin raw

Many self-harm injuries can leave permanent scars that are not typically life-threatening. However, self-harm can lead to more severe injuries that can potentially cause serious health problems. Some of the severe injuries that can be caused by self-harm include:

• Infections
• Internal bleeding
• Organ damage
• Nerve damage
• Organ failure
• The loss of body parts, such as limbs

Looking at the life-threatening risks that can come with self-harm brings up another misconception about self-harm and suicide. Although self-harm can lead to life-threatening injuries, these efforts do not always equate to suicidal ideation. One of the key differences between self-harm and suicidal behavior is intention. Self-harm is typically always used as a coping tool to feel better, whereas suicidal behavior is an attempt to end distressing feelings and therefore the end of life.

Yet, where does the desire or need to self-harm come from and how do self-harm and trauma correlate? First, it is important to note that self-harm itself is not a mental health disorder. Many people who self-harm may have an accompanying mental health disorder like anxiety, depression, an eating disorder, or post-traumatic stress disorder (PTSD). However, self-harm can also occur without a mental health disorder. Some of the other reasons why you may engage in self-harm include:

• Substance misuse and abuse
• Low self-esteem
• Prejudice and discrimination based on marginalized identities
  • Sexual orientation
  • Gender identity
  • Race and ethnicity
• Adverse childhood experiences (ACEs)
  • Physical, sexual, and or emotional abuse
  • Emotional and or physical neglect
• Traumatic experiences in adulthood like abuse

Thus, self-harm is often an indication of challenges in coping with difficult emotions. At its core, self-harm is often used as a maladaptive coping strategy in an effort to reduce intense distressing emotions. Being overwhelmed by negative emotions leads you to use self-harm to temporarily alleviate those emotions. The temporary release from self-harm is associated with a state of calm and relief just to get through another day or week. Furthermore, the pain caused by self-harm is often used as a distraction from distressing emotions or a form of self-punishment.

Moreover, you may self-harm because of difficulties in your interpersonal relationships or to externalize your internal distress. The externalization of internal distress with self-harm is a way of communicating difficult to express emotions to ask for help. However, what does poor coping with distress highlight about self-harm and trauma? The co-occurrence between self-harm and mental health disorders like PTSD speaks to the relationship between self-harm and trauma. More awareness of trauma can give you a better understanding of the connection between self-harm and trauma.

The Relationship Between Self-Harm and Trauma

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), the initial reactions to trauma can vary across a wide spectrum of distressing reactions. From exhaustion, confusion, sadness, and anxiety to agitation, numbness, and dissociation, all these emotions are normal responses to trauma. However, your trauma response becomes problematic when those distressing reactions do not dissipate over time. You find yourself unable to stop thinking about the trauma and thus you may seek unhealthy coping behaviors to avoid, suppress, or alleviate experiencing the related distress.

As a result of difficulty coping with distress from trauma, you engage in self-harming behaviors. For example, many of the negative emotions that come with PTSD include anxiety, anger, and shame about your trauma. You may want to suppress flashbacks that disrupt your life or channel unfounded anger at yourself over the trauma. Therefore, self-harm and trauma are deeply intertwined with eroded resilience and or poor coping tools. The presence of poor coping skills in self-harm and trauma showcases the need to foster adaptive coping strategies.

By fostering adaptive coping mechanisms, you can help yourself navigate difficult emotions and experiences, and build resilience to future stress and trauma. Yet, how can you build healthy coping skills? How did you develop unhealthy coping strategies? Looking at coping styles can provide some insight into how you can build healthy coping skills to heal self-harm and trauma.

Understanding Coping Styles

As noted in the Industrial Psychiatry Journal, coping is broadly defined as the conscious effort to solve personal and interpersonal problems. Moreover, coping is an effort to master, minimize, or tolerate the stress or conflict you encounter in life. Within coping there are a variety of styles that have been classified within two different category types. Listed below are some of the ways coping styles have been classified:

Problem-Focused and Emotion-Focused Coping

• Emotion-focused coping is often linked to poor mental health
  • Healthy coping strategies can temporarily distract or tolerate your distress
    • Practicing mindfulness
    • Engaging in a hobby: painting, drawing, reading, gardening
    • Exercising
    • Focusing on a task or chore
    • Practicing relaxation techniques
• Problem-focused coping is often linked to better mental health
  • Healthy coping strategies can tackle challenges head-on to help eliminate your stress
    • Creating a to-do list
    • Reach out for support from trusted loved ones or a professional
    • Taking a step back to see the problem more clearly
    • Practicing time management
    • Setting healthy boundaries

Adaptive and Maladaptive Coping

• Maladaptive coping is perceived as negative for mental well-being
  • Rumination
  • Substance misuse and SUD
  • Process addictions: Gambling, sex and intimacy disorders, self-harm, disordered eating, shopping, and video games
  • Withdrawal and self-isolation
  • Long-term avoidance or distraction from the problem
• Adaptive coping is perceived as positive for mental well-being
  • Problem-solving: Learn to identify and resolve problems
  • Practicing yoga, meditation, and mindfulness
  • Engaging in physical activities
  • Cognitive restructuring: Identifying negative thoughts and replacing them with positive thoughts

Proactive and Reactive Coping

• Reactive coping, also called passive coping is typically associated with negative coping responses
  • Strategies that provide  immediate but temporary relief from your distress
    • Deep breathing
    • Muscle relaxation
    • Visualization
    • Readjusting goals
    • Searching for meaning in the situation
    • Looking for the positives in the stressor
• Proactive coping is typically associated with more positive coping responses
  • Strategies that help you effectively manage future obstacles you are likely to encounter
    • Planning for situations that could potentially derail the healthy choices you have made
      • Attending holiday parties after you have stopped consuming alcohol
    • Setting realistic goals after experiencing health challenges
    • Planning to help reduce distress and problems related to big life changes
    • Moving to another county, city, state, or country
    • Starting a new job
  • Pinpointing the things you need to do to achieve your goals
  • Engaging in goal management

Looking at the classification of coping styles speaks to the fact that coping styles are not so black and white. One style of coping is not inherently better or always guaranteed to give you the best set of tools; rather, effective coping strategies are made of several different styles you use in a variety of situations. The coping styles you use interchangeably can have both positive and negative effects.

For example, unhealthy coping skills may include throwing and smashing things when you are angry or overeating when you are sad. Whereas, healthy ways to deal with anger and sadness may include deep breathing to relax and problem-solving skills to address challenges. Further, the presence of self-harm and trauma together does not necessarily stem from one unhealthy coping style. Unhealthy coping in self-harm and trauma can be rooted in different sources, such as:

• Examples of unhealthy coping strategies witnessed in childhood
  • Parents or caregivers
  • Other important adult figures
• Childhood adversities
  • Limited resources
• Lack of or limited mental health literacy (MHL) resources
• Differences in cultural upbringing
• Lack of or low-quality social support

Despite the factors that may contribute to poor coping styles, it is important to remember that good coping takes practice. Everyone experiences difficult emotions like anger and sadness, and everyone has different coping tools they use to deal with those emotions. Therefore, the opportunity to learn healthier coping skills to respond to self-harm and trauma is always possible.

Healthy Ways to Cope With Self-Harm and Trauma

It is important to remember that everyone is different, so coping strategies that work for a friend or peer may be different for you. Thus, working with your clinician can help you find healthy coping strategies that make sense for you and your needs. Listed below are some examples of healthy coping strategies that could be effective for you:

• Prioritize your self-care
  • Spend time in nature
  • Develop a sleep routine
  • Eat nutritious foods
  • Get regular physical activity
  • Spend time doing things you enjoy
  • Try out new activities and hobbies
• Find creative outlets like drawing, writing, and making music
• Reach out to and lean on your loved ones for support
• Make a list of trusted people you can reach out to when you are having a hard time
• Engage in grounding techniques
  • 5-4-3-2-1 method: Name 5 things that you can see, 4 things you can feel, 3 things you can hear, 2 things you can smell, and 1 thing you can taste
• Have compassion for yourself
  • Reduce negative self-talk
  • State things you like about yourself
  • Develop a mantra
• Increase your body awareness with a body scan
• Give back to your community through volunteer work
• Build a toolbox of coping skills to effectively respond to triggers
  • Deep breathing techniques
  • Relaxation techniques
  • Meditation techniques
• Participate in mutual support groups
  • Learn from and find inspiration in your shared experiences with peers

With healthier examples of coping strategies, you can start taking steps toward healing your self-harm and trauma. Coping skills alone will not solve every challenge you experience, but with support, you can start building a foundation for resilience to self-harm. Now with professional support, you can continue to learn and build on your healthy coping skills for your long-term recovery.

Breaking the Cycle of Self-Harm and Trauma at The Guest House

At The Guest House, we recognize that effective recovery from self-harm and trauma starts with holistic care to meet the unique needs of each individual. Traditional programs that have a beginning and end mindset, leave little space to address your specific experiences and needs for healing. Many traditional programs focus on stopping the behavior rather than addressing the root cause of the self-harm. Thus, not addressing self-harm and trauma together leads to a temporary fix that only treats you at the surface level.

When the roots of your distress are left unaddressed, the door to relapse is left open. It becomes easy to fall back into self-defeating habits and behaviors. Long-term recovery must recognize and treat you as a whole person in mind, body, and spirit. Therefore, we provide a wide range of diverse therapy options that can be customized and combined to create a recovery plan that best meets your needs.

Whether you are experiencing co-occurring mental health disorders or SUD, there are holistic and evidence-based therapies, along with therapeutic modalities to match your needs. From individual cognitive-behavioral therapy (CBT) and group therapy to art therapy, meditation, and yoga, there is plenty of room to find your right path to healing. With individualized treatment, you can not only heal self-harm and trauma but also what lingers with you in your scars. Through holistic support, you can learn how to adapt to and live with your scars and accept setbacks without judgment. You have the freedom in a safe, non-judgmental space to explore new therapies and engage creatively to heal as a whole person.

Unaddressed trauma can contribute to unhealthy coping strategies like self-harm. You may gravitate toward self-harm to alleviate or suppress distress. However, self-harm can cause a variety of life-threatening injuries and does not truly resolve the pain of trauma. Therefore, learning how to build healthier coping styles can help heal self-harm and trauma. By learning how to utilize a variety of effective coping styles like problem-focused and adaptive coping can help you respond to trauma and other life stressors in healthier ways. As a result, at The Guest House, we provide a wide range of holistic therapies and modalities like individual therapy and meditation/yoga to help you build resilience and find healing for long-term recovery. Call us at (855) 483-7800 today.