Non-suicidal self-injury, the act of deliberately harming one’s own body without suicidal intent[1], has been called a “silent epidemic.”[2] Affecting upwards of 13% of adolescents[3], this phenomenon challenges us with its apparently anti-human quality. Human nature is to protect oneself in every sense at all costs – so why do many elect to engage in self-violence? More relevantly, is this something that has reached the frum community as well? And how can we stop this “silent epidemic”?

These questions were brought to my attention while conducting a study examining the coping skills of addicts. Comparing behavioral addictions, such as self-injury and disordered eating, with substance addictions such as drug and alcohol addiction, I sought to discover similarities in coping techniques. What I found was surprising, saddening, and even frightening. In a sample of over 200, 38.5%[4] of participants who indicated “Judaism” as their religion reported having engaged in self-injury at some point in their lives. More astonishing than the prevalence were some of the comments at the end of the survey, and I knew I could not ignore this information. I read through comments such as: “[I] enjoy the pain like a pleasure pain, it has become a habit that I can't stop. It's only after I do [it] that I feel bad about myself” or “[I am] trying to replace my emotional pain with physical pain. I didn't want to feel my emotional pain anymore.”

Self-injury affects children as young as 7 years old, although the typical age of onset is 12. On a global scale, it affects females as well as males, although each exhibits different types of self-injury[5]. There are many reasons why even young children choose to physically harm themselves, including mental illness, trauma and abuse. However, in looking at the sheer numbers, it must be understood that this is no longer an activity exclusive to the extremely ill. This silent epidemic is more rampant than anorexia or bulimia; it is more invasive than obsessive-compulsive disorder or borderline personality disorder[6].

This behavior may be understood as an inability to regulate emotions. When we experience emotions, we have different skills by which we regulate that experience. If someone is incapable of regulating an emotional experience, that experience can become overwhelming. This is what is called “emotion dysregulation.” Many self-injurers describe this experience as being so intense that some form of release from the tension is needed.

Self-injury can provide that release. The human experience of distress results in a fight-or-flight response. The body prepares to defend itself or to escape by raising the heart rate to be able to run faster, dilating the pupils to see better, sweating to cool down the body, drawing the blood from the extremities to the central organs. This is fantastic for someone running from vicious lions. If people experience this frequently, however, it can become painful. The human experience of pain is cushioned by the release of pleasure chemicals in the brain known as endorphins. This pleasure in the place of pain, this release from tension, can become so rewarding that the process of hurting oneself can become habitual, even addictive.[7]

Self-injury is dangerous for a number of reasons. Those engaging in this behavior are clearly at a risk of severely hurting themselves. They are also at a higher risk for suicide, for a number of comorbid disorders, and for substance abuse. Additionally, this behavior can become a social contagion, spreading amongst peers, as it becomes an experimental method of coping. Individuals who learn to use this behavior to regulate themselves will be challenged to find more effective ways of coping, ways that do not cause themselves harm. It is interesting that greater importance of spirituality and religion has been found to be associated with lower rates of self-injury[8].

It is possible that this phenomenon is purely a secular one, however, based upon the research, it appears that this is not so. In speaking with educators and administrators of both high schools as well as middle schools, self-injury is a problem that eventually must be dealt with. These sorts of issues are challenging to tackle and have traditionally, both in the secular and frum worlds, taken time to be recognized and to be understood, and for methods to be put in place to prevent and deal with them. My question is: Why wait?

As principal investigator of Lander College’s study on Risk Factors and Resiliency for Non-suicidal Self-injury in Orthodox Jewish Adolescents, my aim is to not only gain insight into the frequency of nonsuicidal self-injury in frum children and adolescents, but also to acquire a sort of image of the factors that place a child at risk of such behavior. A method of prevention may then be instituted in schools to address the specific needs of our youth based on the collected data. Further, if within our religious community, there is a link between spirituality as a coping technique and rates of self-injury, then we are equipped with yet another tool in the prevention of self-injurious behaviors.

As Orthodox Jews, we have Torah to guide us; we are not left to figure out the answers on our own. However, until a problem is acknowledged, it cannot begin to be resolved. B’ezras Hashem, this problem should be dealt with appropriately and eradicated from our community quickly.

Chaya Berger has done research at the NY Obesity Research Center and at the Emotion and Self-Regulation Laboratory. She currently is conducting a study under the guidance of Perella Perlstein, Psy.D. She has published in Touro’s Journal of Experimental Psychology.
References:

Bare, I. (Director), Hamlyn, M. (Writer). (2010). The Silent Epidemic [Documentary].

Barrocas, A. L., Hankin, B. L., Young, J. F., & Abela, J. R. (2012). Rates of nonsuicidal

self-injury in youth: Age, sex, and behavioral methods in a community sample. Pediatrics, 130(1), 39-45.

Berger, C. L., & Cohen, A. (in press). Distress Tolerance as a Coping Skill in Addicted

Favazza, A. R. (1989). Why patients mutilate themselves. Hospital and Community Psychiatry, 40, 137-145.

Kress, V., Newgent, R., Whitlock, J., & Mease, L. (in press). Spirituality, life

satisfaction, and life meaning: Protective factors for non-suicidal self-injury. Journal of College Counseling.

Nock, M. K. (2010). Self-Injury. Annual Review of Clinical Psychology, 6(1), 339-363.

[1] Favazza, 1989

[2] Bare & Hamlyn, 2010

[3] Nock, 2010

[4] Berger & Cohen, in press

[5] Nock, 2010; Barrocas, Hankin, Young, & Abela, 2012

[6] Nock, 2010

[7] Nock, 2010; Favazza, 1989

[8] Kress, Newgent, Whitlock, & Mease, in press