Why do people turn to self-injury? A new study connects the struggle to the mind-body divide
Self-injury puzzles researchers and patients alike. Northeastern psychologist Iris Berent links the problem with a blurred boundary between mind and body. The findings could help clinicians provide holistic care.
In Finnish lore, the goddess Kivutar stashes away pain in a mountain for safekeeping. And yet she’s also a healer, channeling it into rocks or boiling it down into a less potent form in a huge vat.
The complexity of pain — as well as the idea of changing one type into another — isn’t just the stuff of myths. Non-suicidal self-injury (NSSI) is a mental health condition that involves intentionally hurting the body to temporarily ease psychological distress. It affects as many as one in 5 adolescents worldwide, according to Northeastern psychology professor Iris Berent and her colleagues. But adults aren’t immune, either.
The whole thing is puzzling, Berent told Northeastern Global News.
“How come the infliction of pain on the body alleviates psychological pain?” she asked. “It doesn’t compute.”
In an Oct. 22 Scientific Reports paper, Berent and colleagues Chelsea Boccagno and Jill Hooley propose some answers. They show an association between NSSI and the way people intuitively perceive the relationship between their mind and body.
Most people lean toward dualism, a psychological bias that makes them see their mind as separate from their body — despite the fact that science says otherwise. In contrast, physicalism is a view that assumes both are made of the same stuff and lines up better with the scientific perspective.
Berent’s survey found that people with histories of more frequent self-injury leaned toward physicalism. While it can’t prove that this belief causes NSSI or provide specific recommendations, the study gives clinicians a valuable window into the mind of someone who self-injures. Experts noted this could help specialists build rapport and trust, making it easier to identify triggers and reframe urges before they lead to harmful behaviors.
After all, NSSI can be a lonely battle.
Most people learn to avoid pain. Tear open a bag of microwaved popcorn instead of heeding the warning about scalding steam and — ouch! — the lesson sticks. That’s an ancient evolutionary safeguard at work.
But for those engaging in NSSI, it’s not that simple.
“Non–suicidal self-injury is an attempt to manage emotions that feel unbearable, overwhelming, or impossible to communicate,” Shelli Qualtieri, founder of a therapy practice in Calgary, Canada, that specializes in counseling people struggling with self-injury, told Northeastern Global News.
Research points to shared brain circuitry between physical and psychological pain as a possible cause. Could the sting of the injury temporarily overwrite the emotional suffering underneath?
On one hand, it makes sense. Signals from the mind and body can be ambiguous, and getting physical and emotional wires crossed is familiar territory for many people. Ever felt “hangry” — a popular term for that extra “arrgh” that melts away with a slice of pizza?
The thing is, intuitive dualism keeps most people from interpreting physical and emotional pain as interchangeable. That’s what makes it adaptive, Berent explained. This intuition allows you to take stock of what you’re feeling and resolve the confusion.
“You stop to ask yourself, ‘Is this my mind or body?’” Berent said, adding that you then “stand a better chance of detecting whether what you feel is psychological or physical.”
Imagine you spot an engagement announcement from that ex who didn’t believe in marriage — while wearing new shoes that are shredding the skin off your heel. The double whammy might add up to a supremely bad day, but you probably won’t confuse the two sources of distress.
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If you have a natural bent toward physicalism, however, these boundaries get blurred, Berent and her colleagues propose. Emotional pain in particular becomes hard to define, leaving you with the “ugh, something’s amiss but I don’t know what” sensation.
That unease opens the door to self-harm as a way to feel something concrete and give the experience a name, Berent explained.
“Not knowing what happens to us is probably worse than even feeling pain,” she said.
The confusion doesn’t just apply to psychological pain, either. People who self-injure tend to have trouble teasing other feelings apart from bodily signals, too. Seeing the mind and body as part and parcel of the same perceptual stew could explain why the border gets murky, leading to distress.
To put all these theories to the test, Berent and her colleagues recruited participants with and without a history of self-injury. They then used some futuristic thought experiments to see where everyone landed on the dualism scale.
Say there was a way to make an exact replica of your body and brain, they proposed. What traits would it have?
A card-carrying dualist wouldn’t expect a replica to share their love for their dog, fondness for game shows or fear of spiders — all features of the ethereal mind. Physicalists, on the other hand, would imagine the entire bundle of characteristics getting forwarded along.
To make sure the physicalists weren’t just saying “yes” to everything on autopilot, Berent and her colleagues added another scenario.
Consider the afterlife, they asked. With all physical trappings out of the picture, which traits would be retained?
A true physicalist would answer “none,” whereas a dualist would implicitly contrast the two types of characteristics, saying those belonging to the psychic realm would persist into the great beyond.
Participants who reported recent self-injury tended to give the physicalist answers to both questions.
The team also found that the more physicalist someone who engaged in self-injury happened to be, the harder it was for them to explain what drove them to the behavior. The finding supports the idea that a struggle with naming and processing emotions in general sets the stage for NSSI, with challenges in identifying psychological pain as just one particular sticking point.
The connection offers a new lead in understanding why people self-harm.
Comprehending the possible mechanism behind the patient’s struggle could allow clinicians to help patients separate bodily signals from emotions and label what they’re feeling.
“This research reinforces the importance of treating the whole person rather than focusing on a single behaviour,” Qualtieri said.
