Monday, February 26, 2007

March 1st is Self-Injury Awareness Day

Self-injury (SI) – is any deliberate, non suicidal behavior that inflicts physical harm on one's body to relieve emotional distress.

Self-injury does not involve a conscious intent to commit suicide, though many believe that people who harm themselves are suicidal.

People who SI are often trying to:

* Distract emotional pain
* End feelings of numbness
* Calm overwhelming feelings
* Maintaining control
* Self-punish
* Express thoughts that cannot be put into words
* Express feelings for which there are no words

Who engages in self-injury?

There is no simple portrait of a person who intentionally self-injures. This behavior is not limited by gender, race, education, age, sexual orientation, socio-economics, or religion. However, there are some commonly seen factors:

* Self-injury more commonly occurs in adolescent females.

* Many self-injurers have a history of physical, emotional or sexual abuse.

* Many self-injurers have co-existing problems of substance abuse, obsessive-compulsive disorder or eating disorders.

* Self-injures tend to have been raised in families that discouraged expression of anger, and tend to lack skills to express their emotions.

* Self-injurers often lack a good social support network.

What are the types of self-injury?

* Cutting
* Burning
* Picking at skin
* Interfereing with wound healing
* Hair-pulling
* Hitting
* Scratching
* Pinching
* Biting
* Bone-breaking
* Head-banging


Self-injury is often misunderstood. Self-injurers trying to seek medical or mental health treatment frequently report being treated badly by emergency room doctors and nurses, counselors, police officers and even mental health professionals.

Finding professionals who specialize in working with self-injury is IMPERATIVE. With proper treatment, new ways of coping will be learned and slowly the cycle of hurting will end.


American Self-Harm Information Clearinghouse
Mayo Clinic


Todd and in Charge said...

Interesting. I would imagine it takes a while to come up with this diagnosis.

Ian Lidster said...

I believe self-injury is one of the criteria to be used in diagnosis of Borderline Personality Disorder, is it not? I was once involved with a woman who was Borderline (diagnosed later) and her behavior in that regard was unnerving to me, to say the least. Very interesting, indeed.


Reiki 4 Life said...

thank you for the info. wondering if there are any immediate steps for a loved one to take to stop person from self injuring? I've worked with E/D children in schools who head banged...sometimes in Autistic or other types of disorders the person just gets so frustrated because they do not have the expressive language to indicate what is wrong/what they need, etc.

In other individuals I've seen they are so dissociative and disconnected form their bodies that the head banging helps them to realize where their body ends and the wall begins.

I would imagine in somer severely depressed individuals self injury would be to feel something, rather than the numbness that has taken over...or to escape their own emotional pain by focusing on a physical pain ( self-inflicted) instead. Or even I suppose because they feel the need to be punished.

It is so very sad. I could go on and on...and I seem to have already done so. thanks for the resources dr. deb.


Follow My Ink said...

Interesting article. I can't imagine the emotional pain a person experience in comparison to physically hurting themself. I recently saw a special on eating disorders where a young lady would cut her body to gain some kind of control over her own self worth. It was sad to see someone in such mental distress that they would result in self injury and believing they were actually in control.

HP said...

Thanks for highlighting such an important issue. I didn't realise there was an awareness day for this very misunderstood condition.

Anonymous said...

I suspect one of the big problems with treatment of self-injury is how it is taught to physicians. At my medical school, we basically were taught that (a) anybody who self-injures is borderline, and (b) that borderlines are not treatable and that you'd better watch out because they're going to sue you eventually. It doesn't exactly make you likely to treat self-injurers well when this is the introduction you get...

wolfbaby said...

I did not realize some of those behaviors were considered self injury. It's sad that people go through that.

Clare said...

Thanks for this Deb. There are many charities over here that deal with self-harm (as we call it over here) and they made a big link between those that self harm and young offenders.

It's good they have an awareness day on this subject.

Anonymous said...

I notice people in comments who describe knowing about this behavior as 'unnerving' and asking about immediate steps to take to 'stop' this behavior. This bothers me and makes me feel judged by people who don't even know me -- and all on account of a single behavior. If someone wants to do something for someone who engages in these behaviors, perhaps they could try to accept and understand instead of freaking out.

I am anonymous here because I don't talk about this on my blog. It is embarrassing and not something I walk around advertising. I am not a 'Borderline' personality and I am not insane. I am hurt. Horribly and greiviously injured and yet I am still trying to live a life. I have been beaten, tortured, raped... I could go on with it, but I won't. I will simply say that it offends me when people act as if someone is a freak for doing these things. What business is it of anyone else's if this is the tool that I have to be able to keep on living?

I have a home and a family to care for. I have business to take care of. I can't take care of things when I am numb and cannot concentrate. I cannot take care of things when I am dead inside or when I am very anxious and scared. I prefer this to being some kind of prescription junkie. I am not hurting anyone. No one knows about this except my husband, my therapist, and a few internet friends. I am not trying to damage myself or anyone else, I am simply trying to have something that a non-traumatized person takes for granted -- a life!! Is that so wrong? If you think it is, then ask yourself this -- are you hurting yourself? Do you drink, smoke an occasional joint, take pills, smoke cigarettes, stuff yourself with unhealthy food, cruise through your day loaded with caffeine? You are regulating your mood. Just like me.

Please understand me. I am not some kind of freak or nut. I am just a human being. A human being like you.

Dr. Deborah Serani said...

Dear Todd,
Until cuts or wounds are seen or reported, it is indeed difficult to diagnose this.

Dear Ian,
Sometimes Borderline issues are involved with SI but not always. SI can be very distressing for those who witness the behavior. But if you know that suicide is not the goal, but the expression of emotions is in the SI, then perhaps it won't be as scary to see.

Dear Reiki,
SI can take many forms as you point out. Once known, trying to keep a person safe is important. But balancing this is not easy.

Dear Follow,
Yes, it is difficult to see. But once a person realizes how the SI is not truly helping and can cause permanent damage, changes can be made.

Dear HP,
I believe that the UK and Australia highlight it as well, It is a grass movement Awareness Day.

Dear Anonymous,
You highlight a very important issue...that perhaps more education needs to take place among health professionals. I thank you for sharing your experience here in the comments. Borderline Disorder is treatable and manageable in many cases, but cutting does not always involve BPD. I often think of SI as a physical way to express what cannot be said in words. Once we offer patients new healthy ways to express emotions, the SI reduces.

Dear Wolfbaby,
There is much anguish for those who cannot find other ways to express themselves. I have found, though, that with a skilled professional, healing can occur. I have worked with many adult women and teens who cut.

Dear Clare,
Last year, the UK had a lot of press on SI Awareness Day. I haven't noticed much lately. I wonder if my searches are just not picking up the media lines about it.

Dear Anonymous,
If you are a regular reader of my blog you will know that I would never stand for such negative characterizations such as crazy, freak or nut. We are all human, and in my opinion, there is no such thing as normal. This post about SI is to help educate others so they can better understand the struggle a self-injurer moves through. SI is about trying to find a way to move through trauma. SI can cause injury and damage, so that is why it is important to find other ways to express or release emotions.


puhpaul said...

I was going to write something facetious, but decided against it. It is bewildering how many people out there (myself included) are suffering from some sort of mental illness. Thanks for bringing this to our attention.


ps Thank you for your kind words.

Talia Mana, Centre for Emotional Well-Being said...

Great article Deb
I'll post a link this on 1st March. Amazing how widespread the problem is.

Reiki, If I can jump in with a comment - The treatments for headbanging for autistic children are usually different as the motivation for the action is different. Most of the self injurers that I have interviewed have done it as either a way of relieving stress or as a way of feeling or experiencing emotion when they feel numb. I'm sure Deb can add to this...
Cheers Talia

Anonymous said...

Thank you for posting this important information.
I had a history of self-harm related to childhood trauma (physical abuse), and when I treated the PTSD, the self-injury stopped, too. I let myself be ruled by stigma and shame about how I was coping for far too long.

Jade said...

Great information for people to read up on in the mental health community. Thanks for bringing awareness to Self-Injury Awarenss Day.

Steve Harold said...

Thank you. I think your flow diagram is very useful for understanding what goes on for a self-harmer. Also in my experience a self-harmer, through abuse, has learnt to dislike/hate themselves, a form of self-abandonment, you might say.

Dreaming again said...

Once again, an important posting with interesting timing. I'll just leave it at that.

Hope you have a terrific week Dr. Deb.

alan said...

I remember when I was young reading of Native American cultures where "cutting" was a ritual of mourning, and knowing there was just no way I could ever do that. Having heard of people doing it to themselves now, like so many other things, makes my heart ache for them...I know there are lots of other ways we hurt ourselves, but that one really gets to me!


candi said...

very good article as a self harmer it usually makes me angry to see what people write on the subject. you are never going to make a loved one immediatly stop. that is what my husband tried to do before we were married. A few months later though the urge rose again. Each day is a struggle but we are making it through. However unfortunantly most are labeled as borderline. I am do i think i am? no.

Patient Anonymous said...

I'm a cutter. Not a habitual one but I have been in the past and I have blogged about it.

Thanks for posting about this Deb as I had forgotten about the "Awareness Day." I knew of it but as always--the memory conks out.

A lot of interesting comments here. Yes, a lot of times self-harm can be attributed to BPD but it isn't always. And not everyone with BPD self-harms. I am not diagnosed with BPD.

I've also engaged in other self-injurious behaviour since childhood that probably needs to be reviewed in a psychiatric setting (head banging, wall punching.) It's just that the cutting came later as an adult.

For the most part, I couldn't express what I was feeling, was in a lot of pain and just couldn't "get it out."

There does need to be more education and less stigma surrounding this--absolutely. People need not fear the self-harmer. We're okay. I promise.

And try no "pity" us too much either. I know it's hard to understand being in such pain to actually inflict *that much* pain on yourself etc... but unless you've actually been there...well, then you'd truly know and it really wouldn't seem that pathetic or sad at all. It's just another thing we need to cope with.

Don't get me wrong. I'm not trying to sound condescending. This is just such a touchy issue with me and I've really had it with people recoiling and acting in such unbelievable ways (on top of everything else regarding being "disordered.")

Dr. Deborah Serani said...

Dear Paul,
I really do believe that we are all human, and in being so, no one is perfect. I hope that you continue to recover from your loss. So sad.

Dear Talia,
Getting the word out helps others to understand SI. Thanks for doing that.

Dear Anonymous,
Wonderful to read that addressing your own unique traumas helped to dimish SI. Rock on!!

Dear Jade,
I try to highlight such things here. Thanks for visiting again.

Dear Steve,
The diagram isn't mine. It is from LifeSigns.

Dear Dreaming,
So glad it could be helpful. We seem to be on the same wavelength as of late.

Dear Alan,
Yes, I read that as well. SI has a long history in our world.

Dear Candi,
I appreciate your comments and think it is so great that you shared them here.

Dear PA,
I have been there as a SI, so I know what it's all about. Never would I cast a shadow on cutting or any other SI behavior. I am a teacher at heart and understanding is my mantra. Read my post on "Alexithymia". Many people who SI often experience this. Thanks for sharing your narrative here :)


Id it is said...

That is so interesting...I know many who pick the skin around their nails. I had no clue that it could well be an act of self-injury. Is it always interpreted as such because some of them don't pick it all the time

Anonymous said...


Thanks for this post.

Reiki, you asked about how to stop a self-injurer from self-injuring. My answer would be to solve the underlying problems which make them want to self injure...but that's a long job. If you find yourself trying to deal with self-injury in a friend or loved one, try the "family and friends" board on the "Bodies Under Siege" forum: BUS is a forum where self-injurers can get support and help in recovery, and where family and friends can learn more about self-injury and get support in dealing with the distress it causes them. You might also find useful info at

Deb, I hope you don't mind me posting those links. BUS has given me so much support over the years and played such a crucial role in helping me recover that I'd really like to be able to lead others to that place.

One final thought... People self-injure for many reasons. Some of them have been abused. Some haven't. Some have BPD. Some haven't. Some dissociate. Some don't. The most important thing I would like anyone to learn from SIAD is that each self-injurer is an individual and a whole person. Self-injury is something they do, not their personality. Self-injury is something they do for their own combination of reasons, not something that automatically entails causes A, B, and C.


Nancy said...

Very interesting info. My college daughter friend is into "Scarification". I do not know if this falls into the same category as self-injury but my daughter is very worried about her friend. One of her home made scars got infected and she would not seek medical attention and it settled into her bone "osteo myelitis". She ended up in the hospital for a week.
Thanks again

Michelle said...

I believe as one of the SI anonymous bloggers posted -- in some ways we all practice self-injury -- whether it's through drinking, smoking, doing drugs, overeating, overexercising, being workaholics practicing unsafe sex, staying in abusive relationships etc. Sadly, we use these as forms of coping to just get through life.

Michelle said...

BTW -- love the lightened, upbeat look of your blog!

Dr. Deborah Serani said...

Dear ID,
I would not put all behaviors like that in a total SI category.

Dear Gwylan,
Happy that you offered other links. And you echo what I feel, each and every person has a unique narrative and history.

Dear Nancy,
Oh my, yes. That is SI. This is why SI can be dangerous and life threatening. I do hope that your daughter's friend continues to heal.

Dear Michelle,
In a figurative sense, yes, I'd agree that in some way we all do something. The blog needed a nice color change, I agree!


J.I.P said...

we know what its liek to self injure we hjave a body filled with scars because of it. We know professionals treatment of us when we have no choice to get medical treatment.
The problem we see is that medicos who treat self injurers with such loathing, we have heard a doctor say to his nurse " well if she were going to do it youd think she would do it right ( as in all self injurers are suicidal ) which isnt the case.
When doctors do this to their patients, the patients do what we do usually now, cover thme up ourself and hope it doesnt get infected. And thats a sad state to be in.

Belizegial said...

Dr. Deb, thanks for pointing me in the right direction on this issue. I know of a young adolescent here in Belize who has this problem and it bothered me as to why she ended up this way. This is not atypical of what Belizeans do to cope with emotional stress. Your post helped to clarify the issues which lead to SI.

Sid said...

What bothers me most is when people say that this behaviour is done simply to get attention. While this might be the case for a select few, I believe this is a very private act for the majority of us. I started self-injuring over 25 years ago as a young teen but no one had a clue I did it until 2003. My exhubby didn't even know about it and I'd spent 11 years with him.

I now talk about it occasionally on my blog, but certainly not as a way to garner any sympathy or attention. I do it solely so people can get an understanding of where someone is at mentally and emotionally to do harm to themselves like that.

As for treatment, you mentioned that it is imperative to find someone that specializes in treating SI. Unless you have lots of money or extremely excellent mental health insurance coverage, good luck with that. With so few mental health resources available, it's nearly impossible to find someone that specializes in SI.

Anonymous said...

yeah no offense Deb but I am getting pretty fed up with being told get the proper treatment for this get the proper treatment that- HOW?!?!?!?! if you dont have major medical insurance or a hefty income or NO income so you qualify for special programs it is absolutely ridiculous to think your average layperson can pay for psychiatrists, therapists and medications. Just HOW are they supposed to do this? will somebody please tell me that?

Lynn said...

I can totally understand the last comment. If I had not been extremely fortunate in being able to successfully sue an abuser, I wouldn't even have my therapist. I can't really work anymore. Even though I have a therapist who understands trauma, I sometimes still lose the battle with the 'subject of discussion'. Sheesh. I can't even type those words.

Fallen Angels said...

"With proper treatment, new ways of coping will be learned and slowly the cycle of hurting will end." The key word in that sentence is *slowly*! It IS a VERY slow least it has been for us. With times of no SI for months followed by periods of daily SI, then back to none for weeks or months. I know my situation is slightly different since it is compounded by DID, but I'm pretty sure it's a very hard process for anyone who SI's.

For anonymous two comments up... it's not hopeless! Remember that...or try to. Yes it is very hard to find help (true for everyone by the way), but it's not impossible. There's county mental health, free clinics, medi-cal/medicaid (depending on where you are located), providers with sliding scales, online support forums (a very good one is mentioned above, another is at psychcentral), if you have ever been a victim or witness to a crime Victim/Witness programs will pay for therapy. If you need meds and can't afford them, pharm companies have "indigent patient programs"...meaning you fill-out the paperwork and the doc sends it to them and the meds are free, docs also get samples...I have been getting one of my meds as samples for over a year. Also, if you are disabled, then you qualify for medicare...18 months from the date the disability started. I am on SSDI and medicare coverage started for me 2 months after SSDI started. This was because the date of application is not the date of disibility...the date you stopped working is. Medicare only pays 50% of mental health charges, but my T reduces the remaining balance so that I only pay what the average co-pay is (she does this for all medicare only patients). So there are options out there, it's hard to find them, but not impossible.

Of course I am assuming you are in the United States...if you aren't, then all but the online support forums may be mute.

Atypical said...

I found the chart interesting but felt that it didn't show the whole picture. I have cut myself on a number of occasions, but didn't feel calm/relieved/alive/able to function. I have felt frightened. I have felt horrified. I have felt confused. I have felt angry.

I went on a self harm website for a while to help me deal with this. The people there were friendly, but didn't seem to see things the same way I did. They found self harm useful and I didn't. I wanted to know how to make sure it didn't happen again.

It's a couple of years since I last cut myself, and so long as I stay sane, I hope that it will stay that way.

Anonymous said...

I am someone who used to self injure alot when I was younger. I have stopped for a while but have recently started up again. I want to know if this is something that could be passed on to my children? I always talk to them and support them but what worries me is that my son is very sensitive and lacks self cofidence even though I have always let him know how special, smart, handsome and important he is but it seems that he is more like me than what I ever wanted him to be.

Dr. Deborah Serani said...

Dear JIP,
It is so sad that many professionals do not truly understand SI.

Dear Belize,
So glad the post helped.

Dear Sid,
In the US, many specialists offer their services for free, Pro Bono. Contacting local psychological associations and asking for the pro bono service coordinator can help a person get in touch with a specialist. Often, the psychologist can help find a psychiatrist willing to do pro bono work or at a reduced fee It does take elbow grease, for sure.

Dear Anon,
See what I wrote just above to Sid. It does take some work, but hopefully you will be able to find a specialist who will work with you at no fee or a reduced fee. There are prescription plan assocaitions that will give medication free to individuals who do not have insurance. It takes a lot of work to coordinate all of this, but it can be done. I hope you can find the right resources to help you make this happen where you live. I have many pro bono cases, but must see others for a fee so I have some income. There are times that I cannot add another pro bono patient to my caseload. I feel such heartache when that happens.

Dear Lynn,
There are other aveneues that can help a person find care. Patient pharmaceutical assistance programs, Pro Bono chapters of psycholgoical associations. It is fortunate that you were able to sue your abuser. Not only a financial gain, but perhpas justice as well.

Dear FAllen,
Yes, in the US the Crime Victim Bureau in your state can help. Good point!

Dear Atypical,
You are not atypical in your response. I have worked with many cutters and they have reported similar feelings.

Dear Anon,
It sounds to me like you are giving your children the tools to express and identify emotions. That is SO wonderful. Cutting does not have any research data that indicates it is genetic, so I do not believe you will pass this on.


Patient Anonymous said...

Hi Deb, thanks for your comments.

Yes, I have indeed read your post on Alexithymia in the past. I have broached this topic with my therapist and she doesn't buy it.

I also brought it up in my last psych eval and/but I have other *issues* that need clarification with (pseudo-Aspie traits, the ADD diagnosis, the ongoing bipolar, the SI) that I also need assistance with on so I'm real puzzle.

I will be bringing all of them forward with psych eval #2 coming up next month.

I really have no clue what to make of myself. The last psych said he'd try and make something "cohesive" to send to my doc. Ha. Guess I stumped him.

Sorry, wandering off topic as I tend to do.

Clare said...

Hi Deb

We have the Self Injury Day here too as I read an interesting article about it yesterday in one of the free London papers on the tube. It's a good way of getting publicity as the papers have such a big audience and a real mixture of people. Just thought I'd let you know as you said you hadn't heard anything about it being over here this year.

dawn said...

hey dr.deb how are you?

i remember thinking when i was really young how alone i felt becuse of my SI. in fact, the 1st time i had ever met, in real life, someone else who SI was my second year of college(1999).

I think it's great that people are starting to see what it's like for us. the way people view SI now, is VERY different than the way it was viewed even 5 years ago, i think.

thank you for doing this post :)

Anonymous said...

Deb, thanks for writing about this. I used to SI but don't anymore. It's not safe for me to do it. I'm not willing to deal with the aftermath of a spouse finding out. So I take my anti-anxiety meds instead and hope the feelings that lead to the SI calm down.

~Deb said...

Wow Dr. Deb, you hit a nerve on this topic! (Not in a bad way either though…) You provoked a lot of thought on what we may feel isn’t a ‘self inflicted wound’ or self punishment in some sort of way.

I think it’s safe to say that a lot of people self-punish in various ways. For instance, just like what anonymous said, alcohol, drugs, overeating, or anything out of moderation. Excessive things lead to excessive outcomes.

Even for myself, I find that when I’m stressed out, I will constantly pick at my cuticles. (Then drag my bum to the manicurist to fix it up and make it look nice!) But, it’s still inflicting pain upon myself due to outside stressors.

I drink when I’m stressed. After work or a stressful day, I’m like, “MARTINI TIME!” And yes, I will overdo it occasionally, which means that I am trying to numb the pain of stress away.

As humans, we are disappointed with the outcome of our lives sometimes, or more so than we think. We want to subconsciously punish ourselves for not being exactly what we wanted to be.

You know when you get a burn or cut somewhere, and someone says, “Squeeze the inside of your thumb area so you won’t feel the pain so much over there?” It’s the same concept. Getting a shot at the doctor’s office – I grip my hand so I can feel the tension somewhere else.

It’s all the same. And, as I’ve heard, when someone is at the extreme and decides to take their own life, usually, when they’re right in the midst of killing themselves, the last thought that goes through their mind is, “I don’t want to do this!” And then it’s too late.

I’m sure you already know this as a professional though. But it’s interesting the way the mind works and how we self-punish ourselves relentlessly – even if we are in the psychotherapy world.

And sometimes, the more we understand it, the more we do it.

I want to be a cat in my next life Doc! ;) They at least get 9 chances!

Godwhacker said...

One could argue that drug abuse and casual sex could fall into this category. While the scares may not be as apparent, they can be equally destructive and deadly.

Thanks for putting the hard questions out there.


Meow said...

What an interesting post, Deb. It's important to be aware of this sort of behaviour, as it is becoming more prevalant (or perhaps just more out in the open), from what I am aware of. It's great that there is an Awareness Day for it.
Have a great weekend.
Take care, Meow

Cheesemeister said...

I love how ER and ambulance crews treat people who self injure as disdainful. Someone close to me who is emergency personnel once sat right in front of me talking about how people who do this should just "finish the job." Little did he know my wrists were cut to hell and I was a zombie because I was living in a state of perpetual panic after having been sexually assaulted. It made me feel worse than ever about myself.

Dr. Deborah Serani said...

Dear PA,
Every person is a unique individual and the issue of diagnosis often is not a good fit. What I mean by this is diagnostic categories are static things, and don't allow for ranges and dimensions. Think of yourself as singular, and that diagnosing what you experience will always leave something amiss. I tend to view diagnosis of psychological and psychiatris issues as imperfect.

Dear Clare,
Oh, thanks for letting me know!

Dear Anon,
So glad that the meds help.

Dear ~Deb,
I always hope that the more one understands, the more one can offset destructive behaviors. But, you are right, sometimes other things like resistance get in the mix and make things rough.

Dear Godwhacker,
Self destructive behaviors may be part of the human experience. Scars, visible or not, always tug at my heartstrings.

Dear Meow,
Cutting, in particular, is at its highest rate in the US and UK. I imagine it is similar in Australia.

Dear Cheese,
Wow, your comment made my angry and simultaneously sad. I also know a few EMS workers who call people who cut "frequent fliers". I tend to put them in their place with saying something snarky or completely hostile whenever I hear them talk like that. While I try to educate when ignorance is afoot, sometimes my temper won't allow me to be professional. Y'know?


Marj aka Thriver said...

Thanks for alerting us to this. I was too out of it to get a post up about SI Awareness Day this year. Thanks, too, for the note that it is NOT the same as suicide attempts. I see the two as quite different!

Dave_MSW said...

Great post Deb. People need to understand that SI is just a bit more shocking way to cope with overwhelming feelings. SI is very misunderstood and stigmatized even within some agencies.

A local partial hospital program, a competitor of ours, won't admit someone with SI, they refer them routinely for inpatient treatment, even when there is no imminent risk of serious harm! Hospitalization when it's not needed is hardly helpful and can complicate recovery.

Keep up the great work!

Dr Dork said...
This comment has been removed by the author.
Dr Dork said...

Sorry - typo above.

I would add to the list of self-injury mechanisms, Deb: drinking, drugging, overexercising, feasting and fasting.

I'm no psych and no expert, to be sure, but SI can perhaps be indirect, in many ways, yet still similarly driven, would you think ?


Scorpio said...

I found your site quite by accident and wanted to add my 2 pence. Luckily I have never been in hosp or anywhere else despite cutting since 12yo. I grew up in a very abusive household, and started selfharming with a compass at 12ish. I only got control over it around 97 and it still hasn't stopped but is a lot less frequent and minor now.
I was so lucky to have a long term disability, so the hosp I was under from 95 had a psyc team liased as a lot of people with arthritis esp from childhood get depressed. It was through them I met Mel a psychiatric nurse in the UK, she didn't help much with most of my long term probs as we are only allowed short term counselling at many hosps in the UK, but she helped me understand my self-harm and put me in touch with the two major self-help groups in the UK that have literature from people who used to SI.
I wish I understood how she did it, so I can help my sister, but she taught me how to control it and not let it control me.
The most imp thing is NEVER try to force someone to stop, or make them feel guilty for it. The shame and guilt I think is what makes this such a hidden prob, and its places like this that help the most to show what it is really like.

Mel taught me, that for me it was a self-preservation method, I only cut when I get so down I am almost suicidal, it acts like a pressure release, by self harming I am trying to Not commit suicide, and it releases the stress so I can cope. Once I realised why I did it she showed me how to recognise in myself the diff between when I WANT to and when I NEED to. Its like wanting a drink cos your stressed when you know you shouldn't cos you have a big exam, and slowly, I stopped doing it when i wanted to and only when I needed to. She said once you get control, you'll find other ways to deal with the stress that brings on the wanting, and eventually wont need to. She also gave me resources for how to care for myself after.
After 19 yrs I rarely do it anymore and when I do it is v little and more like a cat scratch.

The bit that helped the most was realising Mel was right when she said 'you shouldn't feel guilty for doing it, you should be proud, you found a way to survive living in hell, when all you wanted to do was give up'

Just my thoughts. I have a poem I wrote about the subject if you're interested let me know.

Dr. Deborah Serani said...

Dear Marj,
They ARE different.

Dear Dave,
Wow, I can't believe that hospital! Same to you for keeping mental health issues out there in the blogworld. Yours is wonderful.

Dear Dr. Dork,
Yes, all those behaviors are self injurious and destructive. I think the term Self Injury needs greater clarification. It has been called Self-mutiliation Disorder, which I think fits the symptoms better. Actual mutiliation to the skin and muscles, tissues is what this post is really about. But semantics aside, anything we do that is destructive to your souls, psyches and bodies is self-injury.

Dear Scorpio,
Kudos to you for finding what symbolic meaings your SI behavior had. It is the most important thing! I hope you continue to heal and thank you for sharing your story with us all. Yes. Send a link to the poem.


Wendy C. said...
This comment has been removed by the author.
Wendy C. said...

I used to self-injure (cutting) back when I was a teen. It was something I would do in the quiet and safety of my own room while my parents fought, screamed and hit each other in the living room...the behavior went away when I moved out of the house as at 16 and I began to heal inside and out. I do still habitually pick at my fingertips/nails...but it seems more like a plain old habit, rather than anything pathological.And yes, I did suffer from anorexia back in those days too. Thankfully, no longer a problem there either.

Dr. Deb said...

Dear Wendy,
Thnaks for sharing your story. It can help others feel they are not alone.


Vanessa said...

Thank you so much for spotlighting a disorder that is very much misunderstood and under researched. I have struggled with self-injury for more than 30 years. Over the course of many years of working with a therapist, I have come to understand some of the motivating factors behind my behavior. As a result, I have just celebrated my first year of being injury free! I am sharing my story in the hopes of reaching out to others who may also be struggling. I would encourage readers to visit my blog and offer their comments.

Anonymous said...

I didn't realize some of those are considered self-injury. It never occurred to me that what I do when I have panic attacks is SI.

Diary To Blog said...

Recently started, within a year. Not a good sign I suppose. But what else to do with the pain? the pain, the pain...