In a recent video, psychologist and PhD Erlend Mork talks about the phenomenon of self-harm - and about current help to get for those who struggle with this.

 Image: Dreamstime (with licence)


This is stated in an article on the website to the Norwegian Psychological Association [Norwegian Psychological Association, 2021][1]

 

What is self-harm?

Erlend Mork says that the most common form of self-harm is cutting, while other examples are burning or poisoning. Common is that self-harm is about harming oneself, but without wanting to die.

Self-harm most often starts at the age of 12 to 15 years - but both down to 10 years and up to 20 years is not uncommon, according to Mork. He elaborates:

For some, self-harm can persist for several years if they do not receive good help. The duration of self-harm is not very well studied, but when self-harm persists, many describe a cyclical pattern: They self-harm for a period, often triggered by a difficult life situation, then have periods of rare or no self-harm, and then start again by increased stress load.  

In the article on psykologforeningen.no they write:

Studies of the incidence among adolescents show that between 13 and 23 percent between the ages of 12-18 have had one or more episodes of self-harm. Most studies find that the incidence is highest in girls in their teens, but there is no doubt that boys and men also injure themselves. 

 

Why does someone do self-harm?

The background for self-harm varies from person to person, one must therefore investigate what is the basis in each individual case, says Erlend Mork. He says that there are still some things that often recur.

 

  1. Many people report that self-harm is often triggered in situations of overwhelming mental pain - by intense negative emotions such as sadness or anxiety. 
  2. Many people say that self-harm alleviates such feelings and makes them feel better.
  3. Others self-harm in connection with emotional numbness.
  4. Some state that self-harm can provide an experience of regaining or maintaining the feeling of control over the body, thoughts and emotions.
  5. Self-harm can also be a way to express feelings and communicate with others about how one is feeling. 

 

Vulnerability

According to psychologist Erlend Mork, there is often a particular vulnerability in those who self-injure themselves. He says that many who struggle with self-harm have experienced traumatic experiences, such as abuse and violence, in childhood and adolescence, and that self-harm is closely linked to other mental disorders such as anxiety, depression, substance abuse problems, and more. 

However, there is no evidence to say that all self-harm is linked to an underlying mental illness, or that everyone with self-harm has had traumatic experiences growing up, Erlend Mork emphasizes.

An important point is also that one can have a congenital vulnerability to self-harm.

Some people are probably more vulnerable by nature to react with strong emotional intensity to events and may have more difficulty calming down once they are emotionally strongly activated. Thus, they may also be more vulnerable to start self-harm.

 

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- There is available help

Psychological treatment is recommended for people with repeated self-harm and difficulties in regulating emotions, Erlend Mork explains.

Psychological treatment that has proven effective is characterized by helping patients to recognize, describe and accurately express emotions. The treatment involves working to understand the connection between emotions and impulsive / self-harming actions and teaching patients new strategies or skills to master intense and overwhelming emotions, relationships and situations without impulsive actions. 

But where to turn? To this the psychologist says:

The health nurse, youth health center and GP must have information about which suitable treatment options are available locally.

It is important to emphasize that today there is good help available for those who injure themselves. 

 

 

Different forms of help

 

  1. Psychotherapy

     

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    Psychotherapy / treatment is a process characterized by a time-limited contact between a therapist and a patient / client, in which specific problems are thematized and worked with. Include different therapeutic traditions (for example cognitive behavioral therapy (CBT), psychodynamic therapy, family therapy, and more)

    A useful source that evaluate the effectiveness of specific therapies for different mental health problems is the website to the Cochrane Institute [Cochrane Institute][2] .

     

  2. Online therapy

     

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    Online therapy is similar to traditional therapy or treatment, but is provided by digital means (either phone, video conference, or similar). Digital interventions can include a broader range of options, such as therapist-guided self-help programs online.

    The current research literature provide strong support for the adoption of online psychological interventions as a legitimate therapeutic activity [Barak et al., 2008][3] .

     

  3. Support / self-help groups

     

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    Support / self-help groups can take a variety of forms, from providing a safe and supportive social environment; more or less structured group meetings; information and guidance relating to how to use available help services; and a lot more.

    While it is difficult to know the effectiveness of such services, due to very different compositions of support and self-help services, the research generally show the self-help groups may have important benefits for the participants [Kurouz et al., 2002][4] .

     

  4. Helplines and chats

     

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    Different helplines and chats exist. Some helplines are specialized in providing you with information and guidance, while others are more specialized in providing emotional support. Some helplines are highly professional, while others are more based on voluntary workers, that merely wish to be a caring listener.

    It is difficult to evalute how effective such services are, and it probably depends on many factors. For example, while the state of the science regarding the effectiveness of crisis response services remains limited, overall results provide support for such services [Hoffberg et al, 2020][5] .

     

  5. Online communities and forums

     

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    Online communities and forums are options to get in contact with other individuals that struggle with something similar to you or someone you know. Some communities are moderated by professional health workers, while most of them are not.

    Online communities is traditionally not understood as a support or health service, but rather a social area - that may have the potential of being supportive for the individual that uses it. Importantly, research has shown that "people with serious mental illness report benefits from interacting with peers online from greater social connectedness, feelings of group belonging and by sharing personal stories and strategies for coping with day-to-day challenges of living with a mental illness. Within online communities, individuals with serious mental illness could challenge stigma through personal empowerment and providing hope. By learning from peers online, these individuals may gain insight about important health care decisions, which could promote mental health care seeking behaviours" [Naslund et al., 2016][6] .

    This seems to indicate that online communites should not be underevaluated as a potential resource to recovery, coping and enhanced quality of life for people affected by mental health problems.

     

 

Find help for self-harm and suicidality where you live

Please choose your location to find help for self-harm and suicidality where you live:

 

You can also browse from different options of help where you live:

 

References & Footnotes
  1. Norwegian Psychological Association, 2021: Norwegian Psychological Association (2021). Hva er selvskading? [What is self-harm?]. Retrieved the 10th of February 2021 from: https://www.psykologforeningen.no/foreningen/aktuelt/aktuelt/hva-er-selvskading 
  2. Cochrane Institute: Cochrane Institute: "Trusted evidence. Informed decisions. Better health." Retrieved 9th of February 2020 from: https://www.cochrane.org/
  3. Barak et al., 2008: Barak, A., Hen, L., Boniel-Nissim, M., & Shapira, N. A. (2008). A comprehensive review and a meta-analysis of the effectiveness of internet-based psychotherapeutic interventions. Journal of Technology in Human services26(2-4), 109-160.
  4. Kurouz et al., 2002: Kyrouz, E. M., Humphreys, K., & Loomis, C. (2002). A review of research on the effectiveness of self-help mutual aid groups. British Journal of Clinical Psychology33, 198-200.
  5. Hoffberg et al, 2020: Hoffberg, A. S., Stearns-Yoder, K. A., & Brenner, L. A. (2020). The effectiveness of crisis line services: A systematic review. Frontiers in public health7, 399.
  6. Naslund et al., 2016: Naslund, J. A., Aschbrenner, K. A., Marsch, L. A., & Bartels, S. J. (2016). The future of mental health care: peer-to-peer support and social media. Epidemiology and psychiatric sciences25(2), 113-122.