Deliberate self harm and personality disorders - What hope for change?

Individuals suffering from complex personality disorder may experience extremes of mood swings and tension that generates feelings of helplessness and indeed hopelessness. This is often in response to adverse events or unpleasant experiences. In their bid to address the ensuing distress they may engage in a number of behaviours some of which may successfully dispel the tension and others less so. What ever the action or behaviour, it is often the case that if it relieves the distress it is likely to be repeated in the future. This pattern may soon become established. In some cases the behaviour may be safe and effective with no untoward consequences.

Some people may relieve tension and distress by contacting a friend or family member for a chat. Others may go for a short walk or listen to their favourite music. In some, they may find going for a quick run or a game of basket ball helps. The idea is that by engaging in an activity that generates a physiological change in terms of energy state, we are able to trigger biological processes to override our emotional tension from psychological distress.

In persons who have developed less safe ways of managing tension such as self-injurious behaviours or deliberate self harm, they are inadvertently applying similar principles of energy state "reset". Unfortunately such maladaptive actions may become entrenched and ultimately negatively reinforces a pervasive or negative sense of self.

Psychologist recognise what has been referred to as maladaptive or dysfunctional defence mechanisms. Such 'ego' defences tends to generate 'unconscious' thoughts reinforcing unhelpful beliefs about the self which leads to spontaneous, sometimes reckless decisions.

Defence mechanisms include:

Repression Regression Projection Projective identification.

 Thinking  biases and deliberate self harm 

There are various forms of thinking 'biaises' - that is, a way of seeing our self or the world, not based on evidence or facts. Recognising our thinking style or biaises can be helpful in modifying what may have been an uunhelpful pattern of behaviour. Thinking biaises: All or none thinking,- this is also referred to as seeing things as either 'black or white'. There is difficulty considering possible middle ground or compromising by giving the benefit of doubt. Selective abstraction - zooming in on one aspect of a thought or situation and ignoring all other elements that may be relevant in the overall outcome of the event. Jumping to conclusion. The proverb 'Look before you leep' comes to mind. It is sometimes a challenge when angry to not overreact to a provocation. Jumping to conclusion before all the facts are considered is a frequent cause of major errors especially in relationships. Some people have employed a number of measures to manage this difficulty. Magical thinking Turning against the self