Until my last stint in residential treatment, I never though of self-injury as being contagious. Maybe this is because when I was younger, I couldn’t imagine hurting yourself. I hated getting a shot, letting alone the thought of self-harm. In my mind, it was something that crazy people did.
Now, unfortunately, it’s something that I struggle with (although I’m doing much better than a year ago). However, I noticed in residential treatment that when one or two people would self-injure, suddenly there would be a flare-up of self-harm… including individuals who had never done such a thing before.
I did a little research on this, and found some interesting information:
“It is widely assumed that NSSI is contagious, although lack of empirical data necessarily limits our capacity to test this assumption. Nevertheless, studies of contagion among adolescents in clinical settings demonstrate the tendency for NSSI to spread in a population – and the presence of self-injury in media, such as in music, movies, and newspapers, has increased dramatically in the past several years.”
The study gives several reasons for this:
- the shaping of norms
- providing social reinforcement of behaviors
- providing (or limiting) opportunities to engage in the behavior
- facilitating or inhibiting the antecedents for the behavior
Personally, I think that self-injury has become more socially acceptable than it was 10 years ago. It’s still not looked upon in a positive light, but it’s more common and easily recognizable. There’s a huge stigma attached to it, but maybe a little less judgment. As far as “providing social reinforcement of behaviors,” I think of that as showing the pain that someone is going through. A lot of the time people don’t know about emotional pain… but self-injury makes it more real an communicates “Hey, I’m not okay. Something is wrong.”
There’s also a great PDF (free full text) on The Influence of Social Contagion and Technology of Non-Suicidal Self-Injury, which I highly recommend that you take a few minutes to read.
Self-Injury and Subculture Status:
“Two patients in this study stated that cutting did not relieve any anxiety or anger, but rather were influenced by the self-injury of others because they themselves did not want to feel like outsiders. There was also an instance wherein a patient was treated by others with contempt and accused of being a fake. Two of the four patents who acted accusatory toward the “faking” patient had co-occurrences with this patient’s one instance of self-harm. This may indicate that there are social rules that must be abided by during instances of contagion, which may bring meaning or value to these events.”
“…because of the nature of psychopathology and individual (developmental) differences in psychological functioning, it is likely that only some portion of the population would be susceptible to instances of self-injury contagion under normal circumstances.”
Like with everything, not everyone is predisposed to self-injurious behavior… but with the first point, I think it’s interesting (and unfortunate) that even individuals who weren’t inherently driven to self-harm engaged in the behavior anyway, because it was a sign of sickness. As competitive as eating disorders are, self-injury (kind of like the existence of trauma) someone makes you “sicker” than the rest.
My final thoughts:
There is a lot more research out there, but my big question is — does the learned self-injury continue after discharge? Or, is it limited to that residential / inpatient subculture? Many individuals learn to purge during treatment, and end up swinging to bulimia or purging anorexia, but I have no idea if that is the same situation with self-injury. I’d love to hear your thoughts.