How and Why Do Those With Borderline Personality Disorder Hurt Themselves?

People with Borderline Personality Disorder sometimes engage in acts of self harm. These acts of self harm are wide ranging; they’re also dramatic and startling in many cases. These behaviors include:

• Blunt force trauma: This type of self harm includes banging one’s head on a hard surface, punching oneself, and using a hammer or other tool to inflict damage and pain to the body.
• Cutting: This is one of the most common and widely known types of self harm that those with BPD engage in. Cutters use a variety of tools such as scissors, razor blades, knives, needles, and broken glass. Scars often result and many people who cut try to cover up their injuries while some people actually try to put them on display.
• Burning: People resorting to this tactic use cigarettes, matches, lighters, and hot objects to burn themselves. They usually only burn a small area each time, but the resulting scars can often occur over a large part of the body.
• Intentional accidents: Folks who set themselves up for accidents may not look like they’re trying to hurt themselves, but their failure to take even the most basic, reasonable precautions tips you off to their true motives. These people often end up in far more than their share of mishaps and investigation often reveals that they set ladders on obviously unstable ground or fail to use essential safety equipment.
• Miscellaneous self injurious behaviors: These include swallowing harmful objects, inserting objects into body cavities, hair pulling, consuming harmful chemicals, pushing one’s eyeballs, or biting one’s body.

You’re probably wondering what the motivation is for these various acts of self harm that seemingly would result in no gains for the person who does them. The answer to your question is that there is no single motivation for self harm. Both mental health professionals and those with BPD have suggested a variety of possible motivations including:

• To distract from emotional pain: You can’t underestimate the unbearable nature of inner pain experienced by those with BPD. Although the pain from self injurious acts rarely matches the internal, emotional pain, it does pull one’s attention away from the overwhelming emotions for a little while.
• To meet other needs: In most cases, it’s not so much a need for attention as it is a need for basic nurturance and support from others. In some cases, it appears that people engage in self harming acts in order to obtain care and concern when they lack the skills or knowledge for obtaining those needs in healthier ways.
• To punish themselves: Sometimes people with BPD appear to harm themselves out of a profound feeling or belief that they deserve punishment and abuse. Sometimes this belief appears to be related to the fact that they were abused as children and believed they deserved the abuse. Thus, they continue the pattern of abuse on themselves, thereby reenacting the abuse over and over again.
• To get back at someone: Many people with BPD have trouble expressing anger in healthy ways. Thus, they will hurt themselves to make other people feel badly for something they did or said.
• To feel better: When the body is injured, the brain releases a type of pain killer known as endorphins. Endorphins are similar to morphine and reduce pain and distress. Thus paradoxically, one may engage in self harm in order to regulate emotions and feel better. If that motivation sounds bizarre, consider the fact that many of us in New Mexico report loving to consume hot to really hot chili peppers in abundance. Why? It seems chili peppers causes a release of endorphins.
• To feel almost anything other than numbness and emptiness: Many of those with BPD say that they have a constant feeling of “unrealness.” They say they feel out of it and/or dissociate. Pain feels “real” and allows them to connect to the world for a while.

Again, motivations vary from person to person and some people no doubt have several motivations from the above list. Still others may have motives we have not covered. Fortunately, there are treatments for self harm that appear to work for many people. These take time and professional help. Although it’s interesting and often productive to sort out a person’s motivations for self harm, it may not be necessary in all cases to fully understand the motivations for the behavior in order to change it.