Self-Harm
Whether self-harm can lead to post-traumatic stress disorder (PTSD) can be a real worry for some individuals who have practiced self-harm, as well as their loved ones who continue to be concerned. The short answer is that self-harm does not cause post-traumatic stress disorder. Rather, it’s the other way around. Both PTSD and self-harm are trauma responses. While it is true that people sometimes harm themselves and then show symptoms of PTSD, the PTSD in these cases has typically been hidden and/or undiagnosed.
What Is Self-Harm?
Self-harm occurs when people hurt themselves in any one of a variety of ways, but the intention is not to die by suicide or leave themselves in a situation where they might die accidentally. Despite its destructive nature, self-harm is usually controlled behavior. Yes, it’s true that someone who exhibits this behavior might have problems with impulse control, but the self-harm itself doesn’t come from that. Rather, it’s a way that someone who experiences impulse control problems might use to exert a form of control over both those problems and the emotions they involve.
For example, someone who experiences anxiety related to an obsessive need to clean the house might practice self-harm, such as cutting or head banging, in order to use the pain as a method to concentrate on something other than the obsessive need to clean.
It’s important to note that self-harm and suicidal ideation are two separate and distinct things. However, people should be aware if someone in their friend circle or family is self-harming because the underlying condition that drives this behavior might also lead the person to have suicidal ideation.
What Is PTSD?
PTSD is a mental health condition. What triggers it differs from person to person, but the occurrence that triggers the condition is uniformly described as terrifying in one form or another. For example, some veterans who’ve had to do awful things during wartime might not be bothered by those actions, yet the physical abuse they suffered as children might have created deep scars. The opposite might also be true. In any case, the condition is real and must be treated like any other mental disorder.
By the same token, not every traumatic event will lead to PTSD. With the right kind of therapy and support, some people can work through their fears and other negative emotions to be able to deal with their particular trauma in time to avoid developing the condition.
Signs and Symptoms
People experiencing PTSD often have differing symptoms that depend on the kind of trauma and the person’s psychological makeup. For example, some people with PTSD experience what are known as “intrusive memories,” such as a soldier reliving a baby dying in an explosion whenever hearing a baby cry. This is the version of intrusive memories that includes flashbacks. Terrifying dreams are common, as are severe emotional distress and disquieting physical reactions. That soldier might, for example, vomit upon hearing a baby cry because of the memory associated with the explosion.
Another symptom is that some people avoid situations or other people to mitigate the reaction they expect to have upon coming into contact with such stimuli. An example might be someone who was abused as a child by man who had striking red hair, then avoiding all contact with red-haired men thereafter.
Often, people experiencing PTSD will feel intense self-loathing and hopelessness for the future. They feel unworthy and will withdraw from family and friends to “protect” their loved ones or “not be a bother.” Emotional numbness and listlessness, not to mention listlessness and/or an uncaring attitude about health or even life itself, are all indicative of PTSD.
The Relationship Between Self-Harm and PTSD
As previously mentioned, self-harm is rooted in the need to control negative emotions and feelings. It’s similar to the way that people in a different community use “curative kink” as a method to take back control from an abuser or rapist by controlling all aspects of their trauma in a safe zone with a trusted partner.
Similarly, self-harm becomes a temporary escape from the negative emotions and/or experiences. In this way, it’s similar to using illicit substances to achieve the same kind of escape. Additionally, people who self-harm express the idea that the practice grounds them in both the moment and reality. Drawing on the previous example of the soldier and the crying baby, that soldier might harm himself to reinforce the reality that the present-day crying baby is not the same baby as the one that was blown up. The issue with self-harm is that the emotions tend to recur with greater strength afterward.
The Importance of Therapy
You needn’t suffer in silence. Despite the lingering stigma associated with seeking treatment for mental health disorders, such help is available to those who seek it. You’re not crazy. You’re not disgusting or frightening. You have an illness and need help. This is no different than asking a doctor to prescribe an antibiotic for an infection.
Therapy gives you the opportunity to talk with someone about the problems you are having. Your therapist will work with you to determine the reasons underlying your self-harm, PTSD, or both. Together, you can strive to lessen the severity of the condition to a tolerable level and develop coping strategies for those times when the trauma seems overwhelming. Also, if the overwhelming feeling begins to be too much, you can reach out to our hotline for immediate help.
Kinds of Therapy
Cognitive Behavioral Therapy
Cognitive behavioral therapy (CBT) is a method the therapist uses to help you “think about thinking.” The focus is on the present and how you think about both your trauma and your thoughts and feelings about it and how it affects you. The therapist will help you try to make sense of both the trauma and your response to it.
The idea is to provide structure throughout a limited number of sessions. During those sessions, your therapist will also help you devise ways of setting and attaining goals. Those can be accomplishments to aim for, and each accomplishment puts another tool into your toolbox when it comes to dealing with your trauma and its associated feelings. During sessions, you’ll also learn how to identify negative feelings and emotions and then assess their effects on you from different angles.
Dialectical Behavioral Therapy
Dialectical behavioral therapy focuses on opposites. For example, you’ll learn two strategies that seem to contradict one another. First, you’ll work on accepting the situation in which you find yourself with your trauma. Then, you’ll learn to work toward changing some things to combat that which you’ve already accepted.
Depending on how severe the trauma and accompanying mental health condition, there may be as many as four stages in which people might find themselves. The first involves feeling miserable about the trauma and its responses. If you’re in this stage, then the treatment will focus on gaining control of the feelings associated with the trauma.
The second stage finds you generally struggling with life in what’s often described as “a state of quiet desperation.” You might have control, but you’re still miserable. Your therapist will work with you to gain emotional fulfillment from that which is good in your life.
Stage Three involves “starting over” after gaining mastery over the feelings of either or both of the first two stages. The idea is to find peace and happiness while acknowledging that unhappiness is a natural part of life as long as you don’t allow it to consume you. Some people experience a spiritual awakening, which is Stage Four. They might need such an awakening to provide purpose to their existence. In all DBT treatment programs, mindfulness and the regulation of emotions are the cornerstones of success.
Group Therapy
In group therapy, several people meet with two or more therapists. Generally, the clients meeting in a group therapy session will have either the same condition as the others or a similar condition. The idea is to form positive emotions through solidarity and to gain an understanding of one’s condition through shared experiences and the feeling that “I’m not alone in this.”
Normally, group therapy falls into one of two categories: process-oriented or psychoeducational. In the former, the focus is on the interpersonal interactions between the group members, which foster and then bolster healthy connections. It’s not unusual for the clients to choose each session’s topics rather than leaving all such decisions to the therapists.
The psychoeducational focus is on the therapist’s teaching skills, such as anger management or emotional regulation. As these sessions’ goals are more concrete than process groups’ goals, psychoeducational groups generally last for a shorter time.
Eye Movement Desensitization and Reprocessing
Eye Movement Desensitization and Reprocessing (EMDR), is a noninvasive therapy in which the therapist uses a series of lights to gain and focus the client’s attention during a session. The goal is to help you modify the way you store traumatic memories in your brain. Whereas normal events create memory patterns in the brain in a structured way, traumatic events are formed in chaos. The synaptic connections don’t form normally, and part of the distress you feel because of your trauma is from the chaos of memory formation. The use of lights in this form of therapy is designed to rewire the memories into normal memories, thus reducing their harmful effects.
The theory behind EMDR has been borne out in more than 30 peer-reviewed studies, and EMDR is a powerful tool in the treatment of both trauma-induced self-harm and PTSD. In fact, up to nine in 10 trauma survivors have reported few or no residual effects of PTSD after a few EMDR treatments, sometimes only three sessions.
The Final Word
Of course, no method of therapy will work for everyone, and these four methods are not the only forms of therapy that exist. If you believe you need mental health help, and your doctor agrees, then you can receive a referral from your doctor to a therapist or to a group of therapists for treatment. It’s crucial that you are forthcoming and honest in discussing your feelings with your therapist(s). If you hide anything, then the treatment you receive might be ineffective or counterproductive. Remember, seeking help for a mental illness is a sign of strength.
Reach out to us at our free, 24/7 National Depression Hotline for immediate assistance or answers to your questions.
