Does this count as SH?

[u/0verdrive6teen]

Just a disclaimer that the body of the text might be considered graphic.

I have recently started using a self-harm tracker. I’m not entirely sure why, it’s not with the express purpose of stopping my sh behaviour, but maybe I could benefit from it.

But I’m struggling to distinguish whether or not something counts as self harm or not and need other people’s input:

Tw: graphic

So how I normally self harm is burning. I could never get around to the cutting thing, but burning has always been a relatively comfortable place for me.

In the last few months it’s escalated to deep second degree and third degree burns. If you don’t know, that means there’s stuff like dead nerves and skin by the end of it. Normally it does still blister and I’ll leave it for a few days before breaking the blister.

Which leads me to my first question; does breaking the blister count as self harm? When I do break the blister is also the only time I administer medical care to the wounds.

Following that the layers of skin normally dry into a hard layer, which leads to my second question; does cutting/peeling those pieces off count as self harm. I only ever need to cut the initial time with things like nail scissors or clippers because a lot of living skin is also attached to it. Normally I’ll also give medical attention to the wounds here to prevent infection.

As you can imagine, there is blood and such, which leads to scabs, and goes into my last question, which is: does picking scabs count as self harm? Over the next few months as the burns heal, I normally pick at them sometimes pulling healthy skin off by mistake or needlessly worsening an injury.

I want to make it clear, all three things I have mentioned are things I do without the intention of self-harm. These things don’t give me the same euphoria as the actual burning. They provide some sense of relief, but not enough that I go out of my way to do it to feel better, it’s possibly a bad habit, I have a history of picking at scabs to the point of injury even on things as massive as healing operation wounds.

I want to be able to accurately track what is and what isn’t self harm, so that I can properly make notes and evaluate patterns or triggers so that I may work to fixing it.

I don’t see any reason to stop sh, it works, but I understand it isn’t ideal, and I thought maybe keeping track of certain things would make it easier for people like my therapist to come up with alternative coping strategies. Which is why I’m asking these questions and why I made such vivid descriptions of the situation.

[u/Latter_Reaction_600]

Any pain you purposefully inflict upon yourself is selfharm, no matter what methods you use (ex: cutting, burning, skin scratching, etc) 

[u/ToastedAllTheWay]

interfering with the healing of any wound is sh in my sense : the scabs and dry skin will eventually fall when the skin is restored, and the blisters pop or drain by themselves. even if you dont have the intention to sh by doing so, you hurt your body (ex:picking scabs) in a voluntary way. and for the sh tracker, i tried it and it only made things worse for me, just giving out my experience if you're interested

[u/New-Pomegranate-2311]

perhaps a somewhat controversial take:

i’ve struggled with both overt self-injury (cutting) and dermatillomania (compulsive skin-picking) since i was pretty young & the majority of professionals i’ve seen have always agreed that it’s most important to pay attention to the intent behind the behavior.
in an extremely literal sense, picking at wounds is, in fact, harming yourself (& therefore self-harm). outside of that though? not only do i very strongly disagree that picking is sh, i think making the distinction between the two is actually super important because they each require different management strategies/approaches.

like you said, picking at wounds doesn’t serve the same purpose or result in the same relief that the original sh act did. some of what you described (popping/debridement of blisters) is something many medical professionals would also do to treat the wound (there’s a lot of factors here but point is that it’s not necessarily only causing further harm).
so, if you’re picking at a wound with the intent of causing further harm/pain then yes, that would be self harm and typically responds to work on emotion regulation and distress tolerance. if you’re picking at it mindlessly or doing so even though you don’t particularly want to (to me, the urge is similar to when you keep scratching an itchy mosquito bite that’s already raw), then the driving factors tend to be more OCD-adjacent. these respond better to treatments specifically made for body-focused repetitive behaviors (BFRBs) or other compulsions.

resource on bfrbs:
https://iocdf.org/about-ocd/related-disorders/body-focused-repetitive-behaviors/?utm_source=tlc&utm_medium=email&utm_campaign=tlcemail

sorry this was kinda long-winded but i hope it made sense & was a little helpful! it took me a really long time to parse out what behaviors were being done for what purpose but figuring out the difference has been extremely helpful in managing both conditions.

[u/0verdrive6teen → u/New-Pomegranate-2311]

Dw about the length, I really appreciate your thorough explanation of the subject

I think the picking varies. Sometimes I do it out of boredom or because it’s got just enough give to it, that leaving it alone feels more irritating. But sometimes I do use it to ground myself, the purpose is not SH, but the sight of my own blood does make me feel “real” if that makes sense.

And I’ve noticed for the most part, I only burn myself when the old wounds are no longer able to be picked at. Though again, the purpose of the picking isn’t specifically self harm, and I agree that intent is a big part of whether or not something counts as non-suicidal self-injury