This may be the aspect of self-harm that is most puzzling to those who do not do it. Why would anyone choose to inflict physical damage on him or herself? There is evidence that self-injurers, when faced with strong emotion or overwhelming situations, choose to harm themselves because it brings them a rapid release from tension and anxiety. These situations cause an increase in physiological arousal, and self-injury quickly drops that level of arousal close to baseline. The self-injurer may feel release,but even if s/he feels guilty or angry afterward, it won't be an oppressive, pushing, demanding tension-filled feeling like it was before. More insights into the reasons behind self-injury can be gained from two valuable sources: objective and subjective.
Subjective: What self-injurers say SI does for them Miller (1994) and Favazza (1986, 1996). among others, discuss several possible motivations:
Escape from emptiness, depression, and feelings of unreality. In order to ease tension. Relief: when intense feelings build, self-injurers are overwhelmed and unable to cope. By causing pain, they reduce the level of emotional and physiological arousal to a bearable one.
Expression of emotional pain
Escaping numbness: many of those who self-injure say they do it in order to feel something, to know that they're still alive. Obtaining a feeling of euphoria Continuing abusive patterns: self-injurers tend to have been abused as children. Sometimes self-mutilation is a way of punishing oneself for being "bad." Relief of anger: many self-injurers have enormous amounts of rage within. Afraid to express it outwardly, they injure themselves as a way of venting these feelings. Biochemical relief: there is some thought that adults who were repeatedly traumatized as children have a hard time returning to a "normal" baseline level of arousal and are, in some sense, addicted to crisis behavior. Obtaining or maintaining influence over the behavior of others Exerting a sense of control over one's body Grounding in reality, as a way of dealing with feelings of depersonalization and dissociation Maintaining a sense of security or feeling of uniqueness Expressing or repressing sexuality Expressing or coping with feeling of alienation Miller also notes one explanation for why such a large majority of these patients are female: women are not socialized to express violence externally. When confronted with the vast rage many self-injurers feel, women tend to vent on themselves. She quotes the feminist poet Adrienne Rich:
