A few months prior to her death, Princess Diana confessed that the strain of her marriage had caused her to throw herself down the staircase and cut herself with razors, penknives, and lemon cutters.  Why would a princess, who was admired by the whole world for her beauty, grace and compassion, turn upon herself and assault her body in this manner?  .  

Princess Diane explained it in an interview with the British Broadcasting Company (BBC), "You have so much pain inside yourself, you try and hurt yourself on the outside because you need help."  The Princess felt that an act of self-injury is a cry for help.  This view is confirmed by many self-injurers.   They feel that blood is the voice of their pain, pain that they find hard to express in words.  Blood is a "bright red scream," as one self-injurer told author Marilee Strong.  She gave that title to her book about self-injurers, A Bright Red Scream.  
Princess Diana's disclosure has brought attention to this secretive disease.  Disclosures regarding self-injury are now reaching an epidemic proportion.  According to a recent report in Time magazine, each year two million Americans are estimated to purposely cut or  burn themselves, break their bones or mutilate themselves in some other way.  

Self-injurers don't necessarily want to kill themselves.  For example, a lady who, since her teen years has been hospitalized at least once a year for self-inflicted injuries, sees her act of self-injury as a "coping mechanism."  After a serious act of self-injury, she said, "I didn't want to die.  What people didn't understand was that this was my way of staying alive."     

When I was in clinical training, I had read in psychology text books that an act of self-injury such as wrist cutting is a tension-release mechanism.  I didn't truly understand or believe it until I happened to work with a lady who had cut her wrists several times.  She was admitted to an inpatient psychiatric unit where I worked a psychologist.  One evening, after having a "stormy" conversation with her mother, she became highly upset and agitated.  I got word and went to see her in the patients' kitchen where she was furiously pacing and crying.  

As I walked in, she asked me to "do something" to stop her from hurting herself.  I took that to be her way of seeking attention and manipulating the members of staff until she drew my attention to her hands.  I saw her hands literally drawing in and shaking.  Her wrist was throbbing like a pulse that almost "jumps out" of the wrist in high fever.  

She seemed helpless against her own hands that seemed to have taken on a life of their own.  This was a vivid demonstration of tension in her whole body and mind, but more focused in her hands and wrists.  Witnessing this, I had no doubt that had she been left alone, she would have cut her wrists in a violent manner.  Fortunately, it ended without harm.  I walked her through a relaxation technique until her hands had wrists (and her mind and body) had calmed down.  

It is easy to dismiss self-injurers as manipulators and attention seekers but understanding their motive and pain is most challenging.  An even harder task is coming  up with an alternative behavior so they can release their tension in a harmless manner.  

It is estimated that more than half of self-injurers are abused or neglected as children.  Therefore, as children they have felt unwanted and unlovable.  They did not or could not form good peer relations.  Some were habitually teased and ridiculed by their peers, thus increasing their isolation in school and at home.  They had felt lonely as children.  Sometime during the teen years, at the height of their anger towards their own self and others, beset with negative self-worth, deep despair, and hopelessness, they decided to injure themselves.  In order to avoid enduring those painful feelings, they preferred to inflict physical pain upon themselves.  

Some experts who have treated self-injurers believe that when they learn to take responsibility for and control over their actions, they can discover respect and love for themselves.  In the words of a treated self-injurer, "I feel I have a choice not to do this (injure self).  And I have a choice now to let myself feel."      
 
 

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