Therapy For Self-Harm
We can understand the basic psychological mechanism of self-harm in the same way as we understand harmful acts directed towards others. Both cases represent a misguided attempt to find relief from free-floating, hard to understand psychic pain by channeling it into concrete, easier to understand physical damage.
And whether this physical damage is directed towards Self or others it’s supported by the rationalization that the party on the receiving end deserves it. In the case of self-harm consciously experienced internal feelings of guilt, worthlessness, and unlovability act as justification. In the case of other-harm these same feelings of guilt, worthlessness, and unlovability exist but they’re projected onto some external entity where they again serve as justification for the harmful act.
Therefore a good counterintuitive therapeutic place to start with people who have engaged in, are engaged in, or are contemplating self-harm is to make the humanistic case that there’s little difference between self-harm and other-harm. Any conversation about humanity has to include the self-harmer as a human being too, who doesn’t get a free pass to harm Self while respecting the physical rights of everyone else. That line is arbitrary, it’s a result of our Western individualistic way of thinking where we each exist in our own little unique bubbles while the vast bubble of humanity exists somewhere out there, separate and distinct from us. If you respect the right of others to a dignified existence free from the threat of physical harm then you must respect your own right to a dignified existence free from the threat of physical harm. It doesn’t matter where the threat originates.
The brunt of the therapeutic work then lies in confronting and challenging those deep seated feelings of guilt, worthlessness, and unlovability while tracing them back to their source, which is usually abuse, trauma, or abandonment suffered in childhood or adolescence.
But whether abuse, trauma, or abandonment are present in the life history or not, we must all deal with psychic pain cued off by human existence itself. We don’t have a choice when it comes to human suffering, we’re all made to suffer in many different ways many times throughout the course of our lives, regardless of our individual situations. Where we do have a choice is in how we channel the psychic pain caused by this suffering, We all feel compelled to turn those free-floating, hard to understand feelings into something more concrete but we can accomplish this transformation through productive action too, through creative work and service, for example.
Self-harm is a bad solution to the problem of human suffering, to the problem of free-floating psychic pain. It may produce some relief in the short-term through the mechanism of feeling like justice has been served but it’s absurd to expect any destructive action to reduce suffering over the long-term. Destructive action causes suffering it doesn’t reduce it.