Self-Harm: Addiction or Obsession?


Self-harm, like drinking and using drugs to drown emotional pain, can become a dangerous addiction.

Recent studies estimate that one in every 200 American girls between the ages of 13 and 19 cuts herself regularly. Additionally, about 4 percent of adults in the U.S. engage in self-harm.

What Is Self-Harm?

Self-harm can be anything from cutting, burning, head banging, scratching and even scab-picking, and is considered to be an impulse-control disorder. This means that a person does not have the ability to resist acting on impulsive thoughts. Usually these thoughts are associated with trauma, depression, anxiety and/or low self-esteem. Although cutting does not start at any particular age, it is mostly seen in teens.

Researchers have also discovered that self-harm can be as addictive as a narcotic. When the body feels pain, the brain releases endorphins to soothe and to give us a boost to take action and get out of harm's way.

"When a person cuts, it calms them down, and that registers in the brain as a calming mechanism," explains Dr. Paul Hokemeyer, a sober doctor and expert on the topic of self-harm.

According to Hokemeyer, cutters find relief in the transition from emotional pain to physical pain. On a certain level, physical pain is observed as an absolute, when the uncertainty of emotional pain appears too overwhelming for a person.

Obsession or Addiction?

There is still much debate on the risk of self-harm and how it should be treated. Christopher Murray, a New York City-based clinical social worked who works with people in recovery, declares that cutting is more of an obsessive compulsion than an addiction. Murray states the difference lies in the fact that "addictions are physiological in that the body develops tolerance to an external substance, while compulsions are behaviors that are obsessive in nature. There are no external substances associated with cutting."

Hokemeyer agrees with Murray's ideas, but also insists that self-harm exhibits many of the behaviors he has seen in addicts as well. When looking for addictive patterns in a person, Hokemeyer looks for "craving for the substance, loss of control once the thought to use arises in the mind of the person and continued use in spite of negative consequences," which are behaviors he affirms cutters exhibit as well.


Recovering from an addiction to cutting is not simple and can be even more difficult than overcoming a normal substance addiction. Because this addiction is less prevalent and carries a big social stigma, it can be hard for cutters to find help. Many people struggling with this also feel a sense of shame and tend to guard and hide this behavior. However, there are things that can be done.

Hokemeyer states that cognitive behavioral therapy, which looks at the self-loathing and self-critical behaviors of cutters, has proven to be successful. Additionally, dialectical behavioral therapy and psychotherapy have also proven helpful as they also address the emotional and psychological roots of cutting. Hokemeyer stresses that ultimately, more efforts need to be made to find answers about self-harm and how it can be treated.



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