self-inury

[almaty 19]

Definition:

Self-injury is also termed self-mutilation, self-harm or self-abuse. The behavior is defined as the deliberate, repetitive, impulsive, non-lethal harming of one’s self. Self-injury includes but is not limited to: 1) cutting; 2) scratching; 3) picking scabs or interfering with wound healing; 4) burning; 5) punching self or objects; 6) infecting oneself; 7) inserting objects in skin; 8) bruising or breaking bones; and 9) some forms of hair-pulling. These behaviors, which pose serious risks, may be symptoms of a mental health problem that can be treated.

Incidence & onset:

Experts estimate the incidence of habitual self-injurers is nearly 4 % of the population, with an almost equal number of males and females, although more females present for treatment. Recent studies of high school and college students put the number at approximately one in five. The typical onset of self-harming acts is at puberty although it can be seen in young children as well as adults. The behaviors often last for 5-10 years but can persist much longer without appropriate treatment.

Background of self-injurers:

Self-injury is found in almost equal numbers in all ethnic groups. Nearly 50% report physical and/or sexual abuse during his or her childhood. Many report that they were discouraged from expressing emotions, particularly, anger, and sadness.

Behavior patterns:

Many who self-harm use multiple methods. Cutting arms or legs is the most common practice. Self-injurers may attempt to conceal the resultant scarring with clothing, and if discovered, often make excuses as to how an injury happened. A significant number are also struggling with eating disorders and alcohol or substance abuse problems. An estimated one-half to two-thirds of self-injurers have an eating disorder.

Reasons for behaviors:

Self-injurers commonly report they feel empty inside, over or under stimulated, unable to express their feelings, lonely, not understood by others, and fearful of intimate relationships and adult responsibilities. Self-injury is their way to cope with or relieve painful or hard-to-express feelings and is generally not a suicide attempt. However, relief is temporary, and a self-destructive cycle often develops without proper treatment.

Dangers:

Self-injurers often become desperate about their lack of self-control and the addictive-like nature of their acts, which may lead them to true suicide attempts. The self-injury behaviors may also cause more harm than intended, which could result in medical complications or death. Eating disorders and alcohol or substance abuse intensify the threats to the individual’s overall health and quality of life.

Diagnoses:

Only a licensed psychiatric professional can determine the diagnosis for someone who self-injures. Self-harm behavior can be a symptom of several psychiatric illnesses: Personality Disorders (esp. Borderline Personality Disorder); Bipolar Disorder (Manic-Depression); Major Depression; Anxiety Disorders (esp. Obsessive-Compulsive Disorder); as well as psychoses such as Schizophrenia.

Evaluation:

If someone displays the signs and symptoms of self-injury, a mental health professional with self-injury expertise should be consulted. An evaluation or assessment is the first step, followed by a recommended course of treatment to prevent the self-destructive cycle from continuing.

Treatment:

Self-injury treatment options include outpatient therapy, partial, (6-12 hours a day) and inpatient hospitalization. When the behaviors interfere with daily living, such as employment and relationships, and are health or

life threatening, a specialized self-injury hospital program with an experienced staff is recommended.

The effective treatment of self-injury is most often a combination of medication, cognitive/behavioral therapy, and interpersonal therapy, supplemented by other treatment services as needed. Medication is often useful in the management of depression, anxiety, obsessive-compulsive behaviors, and the racing thoughts that may accompany self-injury. Cognitive-behavioral therapy helps individuals understand and manage their destructive thoughts and behaviors. Contracts, journals, and behavior logs are useful tools for regaining self-control. Interpersonal therapy assists individuals in gaining insight and skills for the development and maintenance of relationships. Services for eating disorders, alcohol/substance abuse, trauma abuse, and family therapy should be readily available and integrated into treatment, depending on individual needs.

In addition to the above, successful courses of treatment are marked by 1) patients who are actively involved in and committed to their treatment, 2) aftercare plans with support for the patient’s new self-management skills and behaviors, and 3) collaboration with referring and other involved professionals.

[JenT 0]

Oh brother Dean.... some of that going on in my daughter's high school. Very sad indeed.

Jen

Edited February 9, 2007 by JenT

[almaty 19]

sister jen, first i hope your week-end is great....and all is going well ...

i agree, i have seen many "cutters' usually starts in teens and female ....a way of gaining contriol over stressors...

[JenT 0]

sister jen, first i hope your week-end is great....and all is going well ...

i agree, i have seen many "cutters' usually starts in teens and female ....a way of gaining contriol over stressors...

Thanks brother Dean.... weekend WILL be great as soon as I leave work. My youngest turned 12 last Friday and we've having a house full of 11-12yr olds for a sleepover birthday party. I love parties!

Stress.... I just went through the scheduling of classes with my 9th grader. It's unbelievable these days. When I was to hs, I had a choice of 'maybe' 1-2 electives. Everything else was scheduled for me. These days, kids have career tracks to choose from, the decision whether to go for an International Baccalaureate diploma, etc.... too many decisions about their future too soon, IMHO.

[one...two...tree 2,762]

Brother Dean, what about teeth grinding at night?

[JenT 0]

That would be me.... stress again.

[heishe 2]

Sometimes I scratch my boyfriend because it helps me express complex and intense emotions. PLEASE WON'T SOMEONE HELP ME! Also there might be biting. :(

[one...two...tree 2,762]

That would be me.... stress again.

Jinky has it so bad that she wears a mouth guard at night. I'm hoping that we can cure her of it when she gets here - maybe hypnotherapy.

[Thingee 0]

That's the SO's one condition about the move. I have to buy a mouthguard. I've actually changed the shape of my teeth slightly. Alas, those things are NOT cheap.

[almaty 19]

That would be me.... stress again.

Jinky has it so bad that she wears a mouth guard at night. I'm hoping that we can cure her of it when she gets here - maybe hypnotherapy.

a mild anti-anxiety agent ( low dosage) will do the trick..i know klonapin is used for feet jerking/leg twitching/teeth grinding

Edited February 9, 2007 by almaty

[almaty 19]

sister jen, first i hope your week-end is great....and all is going well ...

i agree, i have seen many "cutters' usually starts in teens and female ....a way of gaining contriol over stressors...

Thanks brother Dean.... weekend WILL be great as soon as I leave work. My youngest turned 12 last Friday and we've having a house full of 11-12yr olds for a sleepover birthday party. I love parties!

Stress.... I just went through the scheduling of classes with my 9th grader. It's unbelievable these days. When I was to hs, I had a choice of 'maybe' 1-2 electives. Everything else was scheduled for me. These days, kids have career tracks to choose from, the decision whether to go for an International Baccalaureate diploma, etc.... too many decisions about their future too soon, IMHO.

i understand the stressors with high school..i raised my son alone, from age 1 to the time at age 19 he went into the army...i remember all the issues/hoops at school, especially his freshmen year ( 9th grade) hassles...i have emapthy..

aw sister jen. i know how hard it is to pursue your goals, with yongsters, but go for it....i am not going to tell you not to over-due it, cause knowing you, it is your way.. peace to you and your family...your friend and brother ...dean

Edited February 9, 2007 by almaty

[ChristinaM 0]

Why did you post this, Brother Dean? Just to raise awareness?

[brnidokiegurl 0]

Also what about those that dont necessarily hurt themselve but target their own usually small children. Doing things to put them in the hospital only to glorify themselves as the ones that are taking care of them so good, only to bring attention to themselves.

[Welshcookie 17]

my son was a cutter big time, dx with schizoprenia in his mid teens....he stopped cutting but discovered piercing, he has at last count 30 piercings I always felt he swapped one self injury for another.

But on a lighter note, he turned 20 yesterday and is the happiest I have known him for a long time