When It’s Not An Accident: Self-Injury Awareness Day

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iStock_000015585688SmallI recently received an email informing me that Saturday, March 1, is Self Injury Awareness Day. Never having heard of such a thing, I took to the interwebs and learned that, sure enough, it is in fact a thing. I’m sorry that such a day is necessary but it is, so perhaps we should take a few minutes to talk about this serious matter from a Jewish perspective.

Before we talk about self-injury, let’s first talk about injury in general. The Torah discusses wounding ourselves and others in a variety of places. For example, when Moshe saw two Jews fighting, the Torah tells us that “He said to the evil one, ‘Why are you hitting your friend?’” (Exodus 2:13). Rashi there explains that the man was considered evil just for raising his hand, even before striking the other person.

Similarly, a person who is being whipped by the court as a punishment is sentenced to a certain number of lashes. The Torah warns us (Deuteronomy 25:3) that we may not strike him more than the designated amount. The reason given is “So that your brother should not be degraded in your eyes.” Before he receives his proper punishment, the Torah calls him “wicked.” After he receives the designated number of lashes, his debt is paid and he is once again referred to as “your brother.” Accordingly, it is forbidden to strike him. All the more so we may not hit someone who never deserved to be whipped at all!

When it comes to self-injury, the Torah tells us not to make gashes in our skin as a consequence of mourning (Leviticus 19:28). This is not intended to limit the prohibition to mourning; it’s merely an example of a circumstance in which people used to do such a thing. The Sefer HaChinuch tells us that to cut oneself for no reason at all is even worse than doing it out of grief.

The Talmud in Baba Kama (91a) suggests other reasons that we may not injure ourselves. These include the Torah’s prohibitions against spilling one’s own blood, wanton destruction and sinning against oneself. The Talmud in Makkos (21a) rules that it is prohibited to cut oneself, either by hand or with an instrument. Cutting oneself is even considered an idolatrous practice since we see that it was practiced by the prophets of the idol Baal as part of their service (I Kings 18:28).

The book of Job (1:21) gives us the popular expression “The L-rd giveth and the L-rd taketh away.” Our bodies are on loan from G-d and it is our responsibility to return them to Him in good condition. Finally, the Torah tells us, “You are children to Hashem, your G-d, therefore do not cut yourselves….” There are many other sources that address our obligations when it comes to our health and safety.

Now that we’ve established the importance of protecting ourselves in Judaism, let’s discuss the phenomenon of self-injury. (Disclaimer: your humble author is not a mental-health professional. This data is being presented strictly for informational purposes and not with the intention to diagnose or treat any individual. Please consult with your own physician or a qualified therapist if you suspect that a problem of self-harm exists.)

Self-harm is a broad category that includes such varied behaviors as eating disorders and drug abuse. Self-injury is one specific type of self-harm, commonly referred to as cutting, though it can include much more than that. Self-injury is any deliberate, non-suicidal behavior that a person uses to inflict physical harm on him- or herself. This can be done not only by cutting, but by burning, banging, overdosing, and in other ways. It’s often used as a coping mechanism to deal with emotional pain. Self-injury provides temporary relief but it does not address the underlying issues. It can therefore escalate in terms of frequency and severity. It is not generally used as an attention-getting mechanism. In fact, those who self-injure typically become adept at concealing their injuries.

The causes of self-injury are many and varied. It can be because of bullying, pressure at school or family troubles. It is not caused by any type of music (no matter how noisy us old fogeys may find it), nor is self-injury the private disorder or any particular demographic. There is no one-size-fits-all but risk factors can include depression, anxiety, low self-esteem and physical, emotional or sexual abuse. Warning signs can include out-of-character behavior, sudden withdrawal from one’s social group, and bullying others, as well as cuts, burns or marks that do not appear to be accidental in nature, frequent accidents, and omnipresent bandages on one’s arms. If someone suddenly insists on wearing long sleeves and pants in the August heat, that may be a red flag.

As mentioned, self-injury is not generally used as an attention-getting gambit. Since self-injury is inherently dangerous and tends to escalate, it is extremely important that it be taken seriously. The self-injury is really the symptom, so the underlying emotional issues must be investigated and addressed.

Just as parents should learn to recognize the warning signs of such disorders as anorexia and alcohol abuse, it behooves them to learn about self-injury and to discuss it with their children. Schools should have appropriate action plans and parents should work together with school counselors and other professionals to address such issues, should they arise.

Remember that self-injury is not a conscious choice, so telling a child to “knock it off” or threatening consequences isn’t going to be effective. Likewise, being told that such behavior is against the Torah isn’t going to effectively deter a religiously-observant Jew who is caught up in a cycle of self-harm. If anything, since perfectionism can be an underlying cause of self-injury, such an approach is as likely as not to exacerbate the situation.

(One might ask, if we shouldn’t take the approach that self-injury is prohibited by the Torah, why did I spend so much time establishing that it is? Good question! I’m glad you asked. Just because informing someone that it’s prohibited is a counterproductive measure in terms of treatment, that doesn’t mean that we shouldn’t know what’s what. And who knows? Perhaps it can serve as a deterrent to someone who is considering self-harm. But for those who are already caught up in the cycle, a sermon would do more harm than good.)

When it comes to health and safety, we have an obligation not only to protect ourselves but to look out for others as well. The Torah tells us such things as “Do not stand idly by while another person is in danger” (Leviticus 19:16) and “your brother shall live along with you” (Lev. 25:36). The Babylonian and Jerusalem Talmuds each have a dictum informing us that saving another person’s life is equivalent to saving an entire world (Sanhedrin 37a and 4:9, respectively). We really have to be as concerned for others’ welfare as for our own. With understanding, communication and emotional support, it is possible to recover from tendencies to self-harm. Let us help those who need it to get professional assistance and may we be able to provide them with that sorely-needed understanding, communication and emotional support.

Self-injury is a serious and dangerous habit. This article only introduces the basics of risk factors and warning signs, and we are barely able to address treatment options at all. We encourage parents, educators and youth workers to familiarize themselves with this condition through consultation with physicians, mental health professionals, and reputable online resources.

The words of this author reflect his/her own opinions and do not necessarily represent the official position of the Orthodox Union.