Why do I cut myself

Why people hurt themselves

In the case of psychological abnormalities, it is often obvious attempts by young people to harm themselves that alarm parents and teachers. Attention and approach to those affected are then required.

Mental health problems are more common than in public, especially during childhood and puberty. "According to figures from Germany, 15 to 22 percent of children and adolescents up to the age of 18 show at least one psychological problem. Eight to 14 percent show significant restrictions that require treatment," says the head of the Vienna Outpatient Clinic for Child and Adolescent Psychiatry at SOS- Children's Villages.

In contrast, there are still very limited treatment options in private practice in Austria. According to Kienbacher, there is not yet a single health insurance contract for a child and youth psychiatrist in Burgenland and Styria. There is one treaty in Salzburg, two in Tyrol and Carinthia, eight in Lower Austria, six in Vienna, five in Upper Austria and 3.5 in Vorarlberg (equivalents).

Broad spectrum

The Viennese child psychiatrist Christian Kienbacher said: "Around 1.7 million people under the age of 20 live in Austria. Around 170,000 of them are clearly mentally ill. Only around 36,000 of them are being treated." According to the so-called MHAT study, just under 24 percent of ten to 18 year olds in Austria currently have psychological problems. Across this age group, such problems occur in almost 36 percent.

Parents and teachers often get excited when children or adolescents suddenly start to harm themselves. "Scoring" and "cutting" are often in the foreground, but there is a wide range of such behavior. In the current classification of mental illnesses, this behavior was included and defined as a separate illness for the first time: Within one year, at least five episodes of deliberate damage to the body surface (cutting, burning, stabbing, etc.) that is socially unacceptable (not a mere tattoo, etc.) ) and without intent to commit suicide. Mostly it is not an expression of suicidality, says Kienbacher.

This is not completely unusual, as the child and adolescent psychiatrist explains: "There is almost no person who does not at some point show self-harming behavior." It is not for nothing that people say that a situation is "to tear your hair out". In the Catholic Church, self-flagellation was used in Easter customs from the eleventh century and was forbidden at the Council of Constance in 1417. In the Muslim religion this is practiced as part of the Ashura festival.

Women more often affected

Amy Winehouse, Angelina Jolie, Marylin Manson, Johnny Depp or Princess Diana - they all stated that they also exhibited self-harm. In the general population the frequency is 0.7 percent, among the mentally ill it is 4.3 percent. Scoring is the most common form at 64 percent. According to different studies, women are two to nine times more likely to be affected than men.

"The frequency over a lifetime is 25.9 percent," says Kienbacher. Anyone who bites their cheek or lip under stress, bites their nails or inflicts pain through pinching etc. ultimately also belongs in this category. This behavior obviously has a function for the psyche. "Self-harm without suicidal intent serves to regulate the effect in the sense of relief," says the child and adolescent psychiatrist.

The age distribution when children or adolescents show non-suicidal self-harming behavior for the first time indicates problems around puberty: The peak age at the beginning is 13 years (25 percent), 14 years (37.5 percent) and 15 years ( 12.5 percent). Before and after, far fewer young people start doing it, say the experts.

Action without intent

"Triggers in young people are above all disappointment in relationships, hurt and rejection, social isolation, failure to become independent, establishment of sexual relationships and 'contagion' through a peer group," says Kienbacher.

It is noticeable, however, that in 96 percent of the cases of non-suicidal self-harming behavior there are also other psychological problems. If such actions are registered for the first time, one should react with calm and caution. Often the actions are impulsive and not very intentional at first. Trying out other affect regulation mechanisms and training alternative strategies works best. It can also just be the agreement to wait before harming oneself when the impulse arises.

Music, relaxation techniques and the ability to quickly contact someone you trust or a therapist in the event of a crisis help you through the critical time. Of course, other mental illnesses that are also present should be diagnosed and treated, and triggering factors such as alcohol and drugs (lowering the inhibition threshold) should be avoided. "Calm and unexcited behavior with reduced curiosity," advises Kienbacher parents and educators. Keeping calm helps to establish trusting contact and to plan the next steps. (APA, May 30, 2018)