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Physical Scars Concealing Emotional Pain: A Glimpse at Self-Destructive Behaviours

Self-harm is not a topic often discussed with ease. Hend Hegazi sheds some light on the motivations behind it and the attitudes needed to tackle substance abuse, self-injury and eating disorders.

Each one of us has her own way of dealing with stress, frustration and everything else that emerges on the extreme side of our emotional spectrum. Many of us call a friend and vent over coffee or ice-cream. Some of us turn to exercise and run until our legs can’t carry us anymore. Some of us clean meticulously and scrub until you could eat from the floor. But some of us feel too alone to share our problems with anyone. Some don’t find respite in any of these methods. And for this group, they may seek relief through more destructive coping mechanisms, such as substance abuse, eating disorders or self-injury.



Individuals who indulge in smoking or substance abuse may have made their initial attempts out of peer pressure or curiosity. Wanting to fit in with their friends or fearing being an outcast, they took their first puffs, not fully realising the dangers lurking behind the door which had just opened. Certain drugs become addictive rather quickly and just the introduction of one narcotic can easily lead to experimenting with others. Some smokers continue with the habit to try to keep their weight down or to escape from emotional problems. Research has shown that there is a strong link between substance abuse and mental health. Difficult home life – perhaps because it increases one’s psychological instability – also increases a person’s risk for abusing.



The physical downfalls of smoking and substance abuse are infinite and long lasting. Emphysema and cancer immediately come to mind, but certain drugs can lead to heart damage, kidney failure, stroke and even death. But it’s not enough to try to convince a user to stop for these reasons; if one does not recognise that she has a problem, she may not make any attempt to alter her behaviour. Furthermore, even if a person does admit to having a problem, addiction is a physical condition which cannot simply be overcome through sheer willpower. An addict must seek professional help if she is to stand a genuine chance at recovery. Medical professionals can prescribe medications to alleviate symptoms of withdrawal, provide counselling and, depending upon the results of a psychological evaluation, may also recommend psychiatric medications.



Just as an individual’s primary involvement with narcotic use may be triggered by peer pressure, similarly, eating disorders may initially transpire by one’s desire to obtain an ideal weight. Women often succumb to the media’s fantasised version of thinness; add to the scene a poor self-image, difficulty handling stressful situations, strained relationships, a feeling of having no control over one’s life, past experiences with sexual/physical abuse or issues with depression or anxiety and a woman becomes highly at risk for developing an eating disorder.



There are three main types of eating disorders: anorexia nervosa, bulimia and binge eating. Anorexia nervosa is the condition in which a person eats far less than his/her recommended daily intake, almost to the point of starvation. This is often accompanied by an obsession with exercising. Bulimia is characterised by bouts of overeating, followed immediately by vomiting. Bulimia victims may also use laxatives regularly to aid in rapid emptying of the bowels. Binge eating is when a person consistently over-eats. A person with an eating disorder may be hesitant to eat in front of others, constantly talk about losing weight, exercise excessively and frequently visit the bathroom directly after meals.



While eating disorders can cause severe health problems, those who seek help, whether on their own or through the urging of loved ones, find that health care professionals work with them to determine specific treatment plans. Such regimens include dietary counselling, psychotherapy and psychiatric medications. Critical conditions may require a period of hospitalisation.



Specialists believe there is a link between eating disorders and self-injury, possibly because of the similar psychological status of those who exhibit each behaviour. As the term indicates, self-injury is when an individual inflicts physical pain upon oneself. The forms of self-injury range from hair pulling and biting to cutting, burning and even breaking bones. Some reasons a person may self-injure are to express emotions such as depression, to escape from emotional pain and to attain a sense of control over any aspect of one’s life. Often, self-injury bestows a temporary sense of relief from emotional issues. Once that relief subsides, however, the shame and guilt that follow fuel a vicious cycle which may lead to more fatal actions. Persons who self-injure may spend increased time alone, communicate feelings of helplessness or worthlessness and perpetually have bumps, bruises, cuts or burns.


It is important to note that in each of the three groups of self-destructive behaviours – substance abuse, eating disorders and self-injury – a commonality between the victims is their feeling of hopelessness and depression. Treatments for all three groups include psychotherapy and psychiatric medications. Through psychotherapy, patients learn healthy methods to cope with distress and emotional pain, such as exercise, relaxation techniques and channelling their energy to the arts. Psychiatric medications can curb depression and anxiety so that the motives for engaging in self-destructive behaviours are diminished.


The glaring similarity of the fragile mental states of individuals who exhibit self-destructive behaviour forces us to question the origin of these mental problems. Research suggests there may be some genetic link or perhaps an unstable home environment. And while we cannot alter our genes, it is within our power to provide more accepting, loving homes. Allah (SWT) tells us in the Holy Qur’an that we should not inflict harm upon ourselves: “And spend in the way of Allah and do not throw yourselves with your own hands into destruction. And do good; indeed, Allah loves the doers of good” (Al-Baqarah:195). But does that mean that we should shun those who behave self-destructively? Undoubtedly, The Most Forgiving, Most Merciful absolves even the most gruesome sins, so who are we to disdain those who err?



Reproach of these individuals is not likely to have a beneficial effect on their behaviours. On the contrary, this may heighten their feelings of isolation and depression, causing them to submerge themselves further into destructive actions. We must be acutely aware that substance abuse, eating disorders and self-injury are all results of strained mental and emotional states. If we are to combat these harmful behaviours, we must nurse these vulnerable psyches. To do so, perhaps we must re-evaluate the condition of our relationships with our loved ones who exhibit these behaviours. Perhaps we should go out of our way to make them truly believe they are loved unconditionally. It’s possible that they may feel as though we judge them, when in fact there is only one Judge (SWT) and it is not our place to judge any of His creatures. It is our responsibility to extend a helpful, loving hand to those in need. We must make sure they know that we refuse to allow them to bring damage upon themselves. We must make sure they know that we will always accept and love them and invest in seeing them flourish.



Mayo Clinic: Self-Injury


National Health Service: Eating Disorders


WebMD: Substance Abuse


Hend Hegazi is an Egyptian American freelance writer and editor with a degree in biology from Smith College. Her first novel, Normal Calm, was published in January 2014 by FB Publishing. Her second novel, Behind Picket Fences, was released in July 2016. Hend currently resides in Alexandria, Egypt with her husband and four children. To check out her books, keep updated with her writing, or contact her, please visit her website, www.hendhegazi.com.





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