Anorexia & Self-Injury

Woman struggling with doctors who don't understand diversity in eating disorders

As many as 4% of adults and 15% of teenagers report engaging in self-injurious behaviors such as skin cutting, head-banging or hitting, or burning [1].

For individuals struggling with mental illness, these behaviors are even more common, leading many researchers and mental health professionals to research these behaviors further to understand better the relationship they may have to emotional distress.

Understanding self-injurious behaviors as they relate to Anorexia Nervosa (AN) can be especially helpful, as they are highly prevalent in individuals with disordered eating beliefs and behaviors, with prevalence rates ranging from 25% to an astounding and saddening 55% [2].

Individuals diagnosed with eating disorders that engage in self-injurious behaviors show a higher severity of eating disorder behaviors [2].

Emotion-Regulation

Many clinicians and researchers believe that self-injurious behaviors in individuals struggling with eating disorders are, at least partly, due to emotion-regulation difficulties. Emotion regulation refers to an individual’s ability to attend to, evaluate, and modify emotional states and is commonly reported among those diagnosed with eating disorders [2].

Individuals experiencing emotion-regulation difficulties may develop maladaptive coping strategies in an attempt to deal with negative emotional states. Many researchers also theorize that “symptoms of AN such as food restriction, excessive exercise, and purging behavior(s) represent attempts to regulate emotional states [2].

Self-harming behaviors are also viewed as a harmful coping strategy that individuals develop to cope with emotion-regulation difficulty. One study found that self-injurious behaviors in individuals with eating disorders often results in a vicious cycle.

The study determined that, when individual and social risk factors combine with psychiatric or thought-based risk factors, individuals experience emotional distress. In an attempt to soothe this, they, therefore, engage in either one, or both, maladaptive coping skills, resulting in an increase of thought-based risk and, therefore, more emotional distress [2].

Self-Injurious Behaviors & Suicidality

Lady sitting on the beachIt is important to note that, while engaging in self-harming behaviors is a risk factor for suicide, it is not always “about that.” Many individuals report that they are not engaging in these behaviors in an attempt to take their own lives, but instead, use it as “their way to cope with or relieve painful or hard-to-express feelings [1].”

Even so, they are behaviors to be taken seriously, as they increase an individual’s risk of death from suicide, open individuals up to infection or injury, and, ultimately, only act as a temporary solution that will not provide long-term relief.

Just as the maladaptive and harmful coping skill of AN behaviors need to be discussed and treated with specialized professionals, so too, do self-injurious behaviors.

If you struggle with these behaviors, you are not alone. Talking to your treatment team or support system about how to learn more effective and long-term emotion regulation and communication strategies can help you to move forward from these behaviors into a more joyful life.


Resources:

[1] Unknown (2019). Self-injury. Mental Health America, Retrieved on 03/27/2019 from http://www.mentalhealthamerica.net/self-injury.

[2] Smithuis, L. et al. (2018). Self-injurious behavior in patients with anorexia nervosa: a quantitative study. Journal of Eating Disorders, 6:26.


Image of Margot Rittenhouse.About the Author: 

Margot Rittenhouse, MS, PLPC, NCC is a therapist who is passionate about providing mental health support to all in need and has worked with clients with substance abuse issues, eating disorders, domestic violence victims, and offenders, and severely mentally ill youth.

As a freelance writer for Eating Disorder Hope and Addiction Hope and a mentor with MentorConnect, Margot is a passionate eating disorder advocate, committed to de-stigmatizing these illnesses while showing support for those struggling through mentoring, writing, and volunteering. Margot has a Master’s of Science in Clinical Mental Health Counseling from Johns Hopkins University.


The opinions and views of our guest contributors are shared to provide a broad perspective on eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer a discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Published on March 29, 2019.
Reviewed & Approved on March 29, 2019, by Jacquelyn Ekern MS, LPC

Published on EatingDisorderHope.com