What has become obvious to me as I research the mental health literature is that the differences among many mental health disorders are not great.  In some cases, it is only the order in which the symptoms manifest and the title of the publication that seems unique.  Each compulsive, destructive behavior begins in a setting of intolerable and frightening vulnerability.  Only its manifestations differ.

If the self-harm is skin injury, we call it cutting.
If it is an eating disorder, we call it anorexia — or obesity.
If it is vague somatic discomfort and fatigue, we call it fibromyalgia.
If it is self-injurious, judgmental, mercurial, and self-damning, we call it Borderline Personality Disorder.
If it is a search for amnesia, we call it drug or alcohol abuse.
If it is goal-driven anxiety, we call it obsessive-compulsive disorder or work addiction.
If it is compulsive sexual activity, we call it sex addiction.
If there was an identifiable, overwhelming, life-threatening, provocative event, we call it burnout or posttraumatic stress disorder.
If the patient looks normal to the observer, we call it body dysmorphic disorder.

Childhood trauma is at the root of many types of self- harming behaviors.  This is the thesis that I explore and support with new research in Childhood Abuse, Body Shame, and Addictive Plastic Surgery: The Face of Trauma, out this month.