A response to carlanee’s post about self-destructive behavior. It expands upon the basic concepts noted in the reply.
Most of the time, in the clinical world, it’s referred to as “self-injurious behavior”. That includes all kinds of harmful behaviors directed toward oneself across all diagnoses.
It’s fact that SIB (self-injurious behavior) is often a behavioral expression for emotions that have no other outlet. Many children with autism spectrum disorder engage in SIB. Most often, it is because they are developmentally delayed in the social and language domains. However, many times it does have the function of attention seeking behavior – but not in the way that some perceive it. It does not carry sole intentions of “acting out” in the role of negative reinforcement. It is a way of communicating, “I’m hurting. Please attend to the situation.”
But, SIB has many different functions in other diagnoses. SIB is absolutely complex in development, function, and reinforcement. Some people engage in the behavior as an outward expression of inward suffering, others do it for the adrenaline that it releases. But, most people who engage in SIB are never aware of the root cause that sparks the behavior, nor are they aware of the function.
Reader beware: The following section may be disturbing and trigger inducing. Discretion is advised.
I have been engaging in SIB since the onset of symptoms in my early teens. Nowadays, SIB is a widely covered social issue through media outlets. So, it is pretty easy for children and teens to get some ideas and tips. However, when I was young, SIB was very hush-hush. I did not get the idea from anywhere in particular. It just occurred to me.
It became a regular and highly ritualized behavior. Dark room, so it would look like I was sleeping. Music in the background, nothing in particular. Just some background noise not to raise suspicions. My knife and me. Because, it was easier to get a hold of a kitchen knife than it was to obtain a razor. Besides, that didn’t occur to me until later on.
I will refrain from detailing it any further. The development is obvious, and needs little explanation. However, I will explain the function and reinforcement. I have had well over a decade to study it and witness it in for myself, through myself.
SIB has multiple functions for me. First, for me alone, it is a physical manifestation of the pain I experience. Sometimes, there are no words to pair with it. There are no words in the world to make the feeling go away, and the behavior has become an impulse, rather than a carefully planned, ritualistic behavior.
Second, it is a form of self-punishment. This is the behavioral response to emotional neglect and abuse as a child. I had no confidants. There were no adults that existed in my life that I could relate this awful depression to. And when I attempted to do so with my own parents, it was dismissed. PMS, a phase, attention seeking behavior, imaginary, excuses. I’ve heard all of the rationalizations there are for depressive symptoms.
As a form of self-punishment, much like those of the clergy in the old church, it represented all of the punishment I deserved for being a bad person. A failure. For being insignificant and terrible enough to be unworthy of love. All that a despicable person like myself deserves is wounds. Terrible wounds that will bleed, and scab, and scar so that I might be reminded every time I look upon them.
SIB also serves as a mechanism for control. I have always noticed a pattern about the stimuli that prompts this behavioral reaction. I get to a point where I am overwhelmed, and my life is spinning out of control. I feel helpless and hopeless. The only thing I have control over is my own body, even when I cannot temper my emotions. This mechanism is dangerous, because it is the gateway to an abundance of other methods of SIB.
It is also a small part of the lingering, highly romanticized desire for death. Suicide is something else entirely, so I will leave that at that for the moment. In a way, it is like blood letting of the barbaric medicine practiced in medieval times. When a person was afflicted, blood letting was a common practice. It was though to purge toxins and evil from the body and mind.
And lastly, and most importantly is the addictive component. The act of SIB releases endorphins in the body. It allows the mind to focus on the most immediate pain it perceives, distracting from emotional suffering. Instead of being trapped with those emotions, the mind can be set free from that cage. It focuses on the real pain and the real injury. These endorphins, once the climax of the pain has been reached, take over. For a moment, a brief moment in time, the mind is empty. Everything is numb, with the exception of the radiating pain from the wound. It is similar to taking a drug to escape.
SIB is really a dangerous behavior for all of those reasons, and many more in the realm of somatic damage. I have incredible amounts of scar tissue, some still visible more than ten years later. Other bloggers have related worse to me. Nerve damage, lasting pain, etc. For those that engage in other types of SIB, the risk becomes even greater. Especially with ED and promiscuous behaviors. I am typically a very faithful person, remaining monogamous. (I am completely monogamous in my marriage. Don’t get the wrong idea. That was then, and this is now.) And I still ended up with HPV, causing me to have cervical cancer and two surgeries. The more partners, the higher the risk.
In summation, SIB has an seriously addictive component, and is not a substance, so it makes it harder to control. With a substance, a person can refrain from the substance itself. SIB is a little different because devices of self-harm exist everywhere, and can be carried out in a variety of ways. SIB can be most effectively treated with ABA techniques, mostly behavioral replacement with positive reinforcement. It is a long and difficult process, but it can be accomplished.