Special Project- Trigger Warning: Self Injury

This project should in no way be taken as medical advice, please talk to your doctor/medical professional instead.

Self-injury is a phrase that conjures a lot of different images in different individuals minds and remains a taboo subject despite the growing awareness for mental health problems across the globe. This subject is of high interest to me because of personal experience; not only in my own life but in others around me; and the sheer amount of people that this problem affects really fascinates me because of its unspoken nature. In this project I want to explore the causes of self-injury and what can be done to curb the increase in occurrences amongst young people.

Biopsychology and biology have drawn me to the biological side of self-injury; and how genes, hormones and our neural networks can determine our risk of developing a self-injury addiction. Adolescence, puberty, is the peak age for a self-injury habit to arise; an obvious cause that many point to are the increasing amount of hormones in the blood stream of teenagers. However, a more influential cause may be sitting inside of an adolescences brain. In early puberty; the amygdala and the cortex are not connected fully; this is important as the amygdala processes emotions and the cortex is involved in logical thinking. In an adult brain where these two are connected; emotions can be dealt with in a logical and healthy way, such as talking to a friend or exercising. However, when these two components are not fully connected, they dont communicate well and so irrational responses to emotions occur, including self-injury.

Another biological explanation for self-injury is an evolutionary mechanism that prevents us from collapsing with pain so that we can escape the source of our injury. Endocannabinoids are neurotransmitters that bind to receptors in the brain to block pain and calm extreme emotions, these chemicals are naturally produced however are very similar to THC found in cannabis. From an evolutionary perspective this is useful in order for us to be able to flee a dangerous situation despite an injury, however humans that self-injure have found a way to use this process in an identical way to a drug. When a person self-injures, endocannabinoids are released that produce a calming effect which counters the extreme emotions they are experiencing. This relief from psychological suffering provides positive reinforcement for repetition of the behaviour and thus a cycle of self-injury begins. Recent research from the Journal of Affective Disorders also found significantly lower levels of opioids in the bodies of self-harmers, suggesting that those who self-injure do so to boost their natural opioid levels.

There are also cognitive reasons for self-injury; professor of psychology at Harvard University, Matthew Nock, suggested four main motives for self-injury: relieving tension or negative emotions, stopping numbness caused by depression, communicating for help, or stopping others from bothering them.

Another theory, this time from a behaviourist perspective, called the Four Function Model (FFM) is presented by Bentley et al., it consists of four reinforcement processes that facilitate and contribute to self-injury:

‘Automatic negative reinforcement: self-injury reduces aversive affective or cognitive states

Automatic positive reinforcement: self-injury serves to generate positive feelings or stimulation

3) Social negative reinforcement: self-injury facilitates escape from social situations or remove interpersonal demands

Social positive reinforcement: self-injury elicits attention, facilitates access to resources, or promotes help-seeking behaviour

With the rise of mental health awareness throughout the world; I feel that this project is an important tool for promoting a type of therapy that supported me and changed how I thought when I was suffering. DBT is a relatively new form of therapy, developed in the 1980s by Dr Marsha Linehan to treat her patients suffering with Borderline Personality Disorder (BPD). Classic DBT is intense, I had to attend multiple therapy sessions a week as well as a group session in a hospital with a lot of homework, however the skills I have learned from it are still frequently used today. I personally believe that every one of us would be benefitted from completing a short, simple DBT course, which is why I advocate for the teaching of these skills to the general public.

DBT treats many of the factors of self-injury discussed in this project; one that stood out for me as a budding psychologist interested in the neurobiology of mental disorders is the idea of ‘Emotional Mind, ‘Logical Mind and ‘Wise Mind. ‘Emotional Mind is reactive to current situations and makes decisions based on the core needs of the individual, it doesnt plan ahead for consequences of actions. ‘Logical Mind is rational and uses facts to make decisions, it doesnt take emotions into account and plans ahead. The healthy mix of these two minds is ‘Wise Mind, this mind takes both emotions and logical decision making into account to produce a mindful and rational response to a situation. After further research into the neural causes of self-injury; this technique of separating the ‘minds corresponds to the lack of connection between the amygdala and cortex in early adolescence; the amygdala being the ‘Emotional Mind, the cortex being the ‘Wise Mind and the communication between the two being the ‘Wise Mind; I personally believe that this technique promotes the strengthening of connections between these areas of the brain; aiding rational and mindful decision making.

Another technique taught in DBT is TIPP: temperature change (e.g. holding an ice cube), intense exercise, paced breathing and progressive muscle relaxation. This method of emotional control is a way of providing the boost of endocannabinoids that self-injurers seek, however in a safe manner.

In conclusion; I believe that DBT techniques are too important to just be kept within the walls of a psychiatric facility. I strongly advocate for the teaching of these strategies to the wider population to promote good wellbeing. I would also like to reach out to those reading this now; please research DBT skills and communicate them to your friends, they have provided me with skills that possibly saved my life.

Thank you for reading.