Self-embedding

[5] Self-embedding is similar to other forms of self-injury in that one of the purposes of engaging in the behavior is to relieve emotional distress by inflicting physical pain.

[9] Life stressors such as sexual abuse, witnessing family violence or experiencing a traumatic event have also been found to be associated with deliberate self-harm.

[2] The frequency and the presence of deliberate self-harm are correlated with the number of stressful life events adolescents report.

Adolescents with a history of deliberate self-harm report more stressful life events and those with higher rates for these experiences were more likely to repetitively engage in the behavior.

[10] Some of these factors include a history of childhood abuse, the presence of a mental disorder, poor verbal skills, and identifying with Goth subculture.

[1] About 2% of inmates each year engage in self-injurious behavior, which includes the insertion of foreign objects into the body.

[13] If a patient has multiple objects inserted in a certain area surgical removal is recommended unless the risks of surgery outweigh the benefits.

[8] Dialectical Behavior Therapy (DBT) aims to teach clients general coping skills and address any motivational obstacles to treatment.

[22] An alternative explanation for why deliberate self-harm provides relief is that it shifts attention away from the unpleasant emotions being experienced.

[23] The self-punishment hypothesis claims that deliberate self-harm can decrease emotional arousal by confirming an individual's negative self-concepts such as that they are bad or have done something wrong.

[23][24] Self-punishment is reinforced because it “alleviates distress associated with negative thoughts about oneself" and has the potential to lessen external punishment.

According to Nock's model self-injury is performed repeatedly because it is an immediate effective way of influencing one's social environment and regulating one's emotional and cognitive experience.

[10] These general risk factors also increase the likelihood of engaging in other maladaptive behaviors such as alcohol or substance abuse.

Intrapersonal negative reinforcement refers to self-injury being followed by a decrease or stop of aversive thoughts or feelings.

[10] Interpersonal positive reinforcement occurs when self-injury is followed by a desired social event such as attention or support.

[10] Finally, interpersonal negative reinforcement occurs when self-injury is followed by a decrease or stop of a social event.

[10] Many studies investigating the motives reported for engaging in self-injury provide evidence for this four-function model.

Albert Fish with 27 inserted needles
An X-ray image of Graphophone needles driven into the flesh by a psychiatric patient.