Self-Injury in Borderline Personality Disorder
How to Prevent Self-Mutilation and Calm Intense Emotions
Sep 14, 2009
Self-injury is a major factor in the diagnosis of borderline personality disorder (BPD). Although non-BPD individuals also may cut or otherwise hurt themselves, they usually do not have the other characteristics of BPD such as chronic fear of abandonment, difficulty establishing identity, and high impulsivity, according to Do I Have Borderline Personality Disorder? by Lisa DeLuca.
BPD is diagnosed when a person has at least five of the symptoms listed in DeLuca's article. Those symptoms can be used to identify possible causes of self-injury, as well as ways to prevent self-mutilation behaviors like cutting or burning.
Causes of Self-injury
Possible causes of self-injury may be found in the diagnostic criteria for borderline personality disorder:
- Low Self-Esteem – A person who dislikes him or herself may want to impose punishment through self-injury.
- Dissociation – If the individual starts to feel disconnected from his or her body, self-injury may be the attempt to reconnect.
- Extremely Intense Emotions – Self-injury can be used to block off intense emotions which may be frightening. According to Helpguide.org, if the individual with BPD does not have appropriate coping mechanisms, he or she may turn to forms of self-mutilation like cutting.
How to Prevent Self-Mutilation and Calm Intense Emotions
Persons with personality disorders may have great difficulty gaining the insight necessary to calm their own emotions. However, it is not impossible, according to Self-injury Support, an organization designed to provide alternatives to self-injury.
Once the person has decided that self-injury is not the best way to cope with emotions, there are two types of coping strategies that can be used to prevent self-injury. The first kind is simply holding on, essentially doing nothing, until the urge to self-injure passes.
- Breathing – Concentrating on the act of breathing can slow down the person's impulses, allowing the emotion to "cool off."
- Sitting on the Hands – This method of avoiding a dangerous action is often advised in 12-step programs. When the person knows intellectually that self-injury is unhealthy but has a hard time resisting the impulse, sitting on his or her hands may do the trick.
- Leaving the Area – Most people with BPD self-injure in private; if they go to a public place, this puts a natural barrier in front of the impulse to self-mutilate.
The other strategy to stop self-mutilation involves the substitution of a healthier action in place of self-injury.
- Self-Soothing – Doing something that soothes the senses will soothe the mind as well. The person with BPD should try to include as many senses as possible. Items can be placed in a crisis bag for easy access. For example, the bag may included a scented candle or perfume, a favorite non-perishable food, an mp3 player, photographs of things that help the person feel happy, and something nice to touch – perhaps imitation fur or a soft blanket. Self-soothing helps to boost self-esteem as well.
- Meditation – It can be very difficult to meditate when the person with BPD has the urge to self-injure. A recorded meditation is advisable. It should include soft, soothing music and gentle instructions to calm emotions and regulate breathing. The person may choose a mantra instead, but calming music is still important.
- Crisis Plan – At a time when the person has balanced emotions, he or she should make a crisis plan. Later, when emotions threaten to escalate out of control, leading to self-injury, instructions for action are readily available.
One way the person with BPD could make the plan is to write it on a 4x6" index card. The card would contain reasons not to self-injure, phone numbers of supportive people, positive statements about him or her self, and perhaps a list of other actions that have been helpful in the past.
After Calming the Emotions
These strategies of preventing self-injury are merely the beginning – they are something similar to putting band-aids on a stab wound. The underlying emotions must be felt and expressed safely. As Colin Ross, M.D., founder of the Ross Institute for Psychological Trauma, says, "Feel your feelings and stay safe." This principle can help individuals with BPD become healthier.
Anyone who thinks he or she may have borderline personality disorder, or is having a problem with self-injury, should seek professional attention immediately. Even a person who is not actively suicidal can accidentally cause his or her own death during self-injury.
This article is for general information only. It is not meant to be a substitute for medical or mental health care. People with troubling symptoms should seek the advice of a health care or mental health professional.
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