Thank you for the prompt, detailed reply to my questions. I can certainly understand your apprehension about seeking help given the fear of being committed for your safety. Its an overwhelming prospect of which can produce added anxiety to the current concern. Nevertheless, I ask you to seriously consider getting help given its progressed to involuntary behavior. This means its getting harder for you to control and it will not stop without an intervention.
It is possible that someone may consider you a threat to yourself but I think most people are willing to work with you to decrease the behavior and discover the root of the problem before considering hospitalization. I'm concerned that if you do not seek some assistance now, what you fear will be actualized because you cannot stop it. Therapist want people to succeed in their own environment and usually give people that opportunity before considering inpatient.
As for the causes, there are many different reasons people self-harm. You mentioned that it started when you were in school as a way of coping with the stress
of school work. Its possible this behavior became a coping mechanism for anxiety, feeling out of control, or as you stated, perfectionist tendencies. Its any unhealthy coping mechanism but it sounds like it provided relief at some point but that has currently changed. People who are hard on themselves, as you described, attempt to manage the intense feeling associated with extreme, self-imposed expectations with self harm.
There have been many advances in the treatment and management of this disorder. You can change this kind of coping with behavior intervention, including meditation
, and medicine if necessary. Again, its important that you get some support. If it feels too scary to talk to someone individually, look for a group or online counseling to help you start. However, the ideal modality is face-to-face counseling. Please consider getting some support. You don't have to go through this alone.
I wish you luck and good health. Please let me know if there is anything else I can do to help.