Frequently Asked Questions
What is Self-Inflicted Violence (SIV)?
SIV refers to specific forms of violence--such as cutting, hitting, burning, scalding, or punching--directed at one’s own body. It does not suggest that the person hurting his or her own body intends to injure or mutilate him or herself. These violent acts occur for many reasons, and may be viewed as self-protective depending on the circumstances. SIV most often serves as a coping mechanism to manage many of the severe aftereffects of historical trauma such as intense emotion and distress, dissociation (a psychic disconnection of one’s core from one’s physical self), and/or flashbacks of abuse or other traumatic experiences. The acts of SIV produce a psychic numbing of the feelings and serve to reconnect the body with the spirit of the person.
Why call it Self-inflicted Violence?
SIV is a descriptive term that does not suggest a specific intention for the behavior. Previously used terms to describe this form of self-injury (such as self-mutilation, deliberate self-harm, delicate wrist cutting, parasuicidality, etc.) are either not accurate or allege that the person’s motivation for the behavior is intentional injury.
Why do people do this? Isn’t it to get attention?
People use SIV because it helps them manage what feels unbearable in the moment. There is a great deal of intensity behind the acts of SIV. Feeling states such as profound despair, anguish, rage or terror, or a fear of losing oneself or being swallowed by traumatic flashbacks or re-enactments are just some of the stressors leading to SIV. It is commonly believed, inaccurately so, that people self-injure in a simplistic and manipulative way to get attention from others. While the wounds of SIV are often upsetting to others and do attract attention, many people who live with SIV keep this a secret. The attention one receives for self-injury is rarely a compassionate response. Often people are shamed for self-injury; sometimes people are institutionalized if the behavior is misinterpreted as a suicide attempt. Those seeking medical care are sometimes chastised and it is not unheard of for people who seek help for cuts to be stitched without the use of anesthetic.
Are people who hurt themselves trying to die?
No, SIV is separate from suicidality. It is not uncommon, however, for people who live with SIV to also consider suicide at times, particularly if they have histories of severe childhood abuse. For people with these multiple struggles the SIV often serves as a stress- relief valve and actually helps defer the suicide attempt.
Are people who live with SIV crazy or sick? Why hurt yourself more when you are already struggling?
People who live with SIV are not crazy or insane, although many receive various psychiatric labels if they enter the mental health system. People injuring themselves are not intending to increase their pain, they are struggling to manage it. The physical injury from SIV is of much lesser intensity than the emotional pain leading to it. Most people who cut or punch themselves do not feel physical pain at the time as their emotional wounds are so great and they feel disconnected from their bodies.
How do you stop SIV?
People stop living with SIV when they no longer need it, when the reasons they turned to it in the first place are in the process of being healed, and when they expand their options for managing them. Some people focus directly on learning alternatives for SIV and find that useful. Other people never focus directly on managing self-injury and find that it fades away as they work through the trauma issues that brought out the triggers that led to SIV. The common denominator learned from people who have left SIV behind them is that each person determined their journey regarding SIV. Coercion from persons or institutions was not effective in helping people stop SIV; in fact, it oftentimes increased not only the SIV but exacerbated other sequelae of trauma. Force, even if apparently well-intentioned, if most often retraumatizing.
What am I supposed to do if I care about someone who lives with SIV?
It is important to acknowledge how intense it is to learn that someone you love lives with SIV. Compassion, for yourself as well as the other person, is crucial. It is tempting to search for a way to control the person’s SIV to make the discomfort go away. This often leads to disconnection and secrecy and causes more anguish in the long run. It is important to honor the other person’s way of coping and to honor your own limits in addressing the issue. It is often helpful to look at ways that you can connect with the other person, such as looking within yourself for the ways that you might behave self-injuriously, ways that might seem more socially acceptable. What all of us crave is a compassionate listener, someone who can walk beside us during our times of struggle, and this is true for those who live with SIV as well as those who care about them.