Reduce Self-Injury with Mindfulness
By John M. de Castro, Ph.D.
“In order to end self-harm, one needs to change one’s whole relationship with oneself, and how one sees oneself. A good starting point is with one’s thoughts. Mindfulness keeps one fully grounded in the present … in the presence of the action of the present moment. Mindfulness helps one to observe and note thoughts, positive or negative, without feeling the need to act upon them.” – Ian Ellis-Jones
Self-injury is “direct and deliberate destruction of one’s own body tissue in the absence of suicidal intent.” The most common self-injury methods are cutting, scratching, hitting a part of the body against a hard surface, and punching, hitting or slapping one’s self. It is a disturbing phenomenon occurring worldwide, especially in developed countries. Approximately two million cases are reported annually in the U.S. Each year, 1 in 5 females and 1 in 7 males engage in self-injury usually starting in the teen years. Frequently, untreated depression and other mental health challenges create an environment of despair that leads people to cope with these challenges in unhealthy ways.
Non-suicidal self-injury appears to be an individual’s attempt to cope with overwhelming negative emotions. Mindfulness has been shown to produce better regulation of emotions, where the mindful individual is fully aware of and feels the emotions, but can respond to them rationally and adaptively. Thus, mindfulness may be an antidote for self-injurious behavior. Indeed, one of the characterizing symptoms of Borderline Personality Disorder (BPD) is self-injurious behaviors and a mindfulness based technique, Dialectical Behavior Therapy (DBT) is the only therapy that has been shown to be effective in reducing the symptoms of BPD. So, it would be reasonable to investigate further the relationship between mindfulness, self-injurious behavior.
In today’s Research News article “Mindless Suffering: the Relationship Between Mindfulness and Non-Suicidal Self-Injury.” (See summary below). Caltabiano & Martin recruited undergraduate students and had them complete measures of mindfulness, including five subscales, observe, describe, act with awareness, non-judging, and non-reacting, and self-injurious behavior, and severity of self-injury. Surprisingly, over half of the participants indicated that they had engaged in self-injury sometime in their lives. To further investigate this phenomenon, the researchers separated and compared those participants who reported self-injurious behaviors to those who did not.
Participants who self-injured reported that they did so for a variety of reasons including emotion regulation, self-punishment, to mark distress, preventing dissociation, toughness, self-care, preventing suicide, boundaries between themselves and others, conformity, revenge, autonomy, sensation seeking, and peer bonding. Those participants who did not self-injure, compared to those who did, were significantly higher in overall mindfulness, and the mindfulness facets of acting with awareness, non-judging, and non-reacting. In addition, the self-injurers that evidenced less severe self-injury had higher mindfulness scores than those who had severe self-injuries. They also found that the higher the levels of mindfulness the lower the levels of using self-injurious behaviors to regulate emotions.
These are interesting results. But, it must be taken into consideration that the study was correlational and thus causation cannot be determined. But, the results clearly indicate that there is a strong significant relationship between mindfulness less self-injury. This suggest that a randomized controlled clinical trial should be performed to investigate the effect of mindfulness training on self-injurious behaviors to established whether mindfulness produces less self-injury and whether mindfulness training would be a useful therapeutic technique to treat people who self-injure.
It is interesting that the mindfulness facets of acting with awareness, non-judging, and non-reacting were the most strongly associated with low self-injury. This suggests that the reason that mindfulness may be effective is because it lowers the individual’s tendency to judge and react to their feelings.
So, reduce self-injury with mindfulness.
“mindfulness may be a beneficial element of prevention efforts for suicide, especially among those who have self-injured in the past.” – Alia Warner
CMCS – Center for Mindfulness and Contemplative Studies
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Caltabiano, G. & Martin, G. Mindless Suffering: the Relationship Between Mindfulness and Non-Suicidal Self-Injury. Mindfulness (2017) 8: 788. doi:10.1007/s12671-016-0657-y
Non-suicidal self-injury is a complex behaviour, disturbingly prevalent, difficult to treat and with possible adverse outcomes in the long term. Previous research has shown individuals most commonly self-injure to cope with overwhelming negative emotions. Mindfulness has been shown to be associated with emotion regulation, and mindfulness-based interventions have shown effectiveness in a wide range of psychological disorders. This research explored whether lack of mindfulness or problems in mindfulness are involved in self-injury. A non-clinical sample of 263 participants (17–65 years) completed an online survey measuring self-injurious behaviours and mindfulness. Differences in levels of mindfulness between individuals with and without a history of self-injury were investigated. Analysis of variance indicated mindfulness (overall and in terms of specific facets “act with awareness”, “non-judge” and “non-react”) was significantly lower in individuals with a history of self-injury compared to those without. Pairwise comparisons revealed current self-injurers reported significantly lower mindfulness than past self-injurers and non-self-injurers, with medium effect sizes of d = 0.51 and d = 0.77, respectively. In logistic regression, low mindfulness significantly predicted self-injury (B = 0.04, p < .001). These findings have clinical implications, suggesting that mindfulness-based interventions may assist individuals to give up self-injurious behaviours and may be an important part of prevention strategies.