Tuesday, February 23, 2010

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
* Embedding items under skin


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. For more information, check out American Self-Harm Information Clearinghouse, First Signs and LifeSigns

Lloyd, K. (2010). Understanding Repeated Self-Injury: A Multidisciplinary Approach The Psychiatrist, 34 (2), 77-77 DOI: 10.1192/pb.bp.109.026534


Becca said...

This information is sound, and ridiculously accurate. I enjoy how your posts surrounding particular subjects are not partial to gender (such a self-injury), but also put in a nice, succinct format for those who are unfamiliar with the subject to understand. Wish I could access that paper you posted at the bottom! I don't have fifteen bucks lying around to read it, though.

Students find it overwhelming to be honest with any adult, or their peers because of the stigma of such disturbing behavior. One organization, I believe, is doing an incredible job of making students feel they're not alone, that they matter, and that what their feeling is more normal than they perceive, and that help is available. You might want to check out a Florida based organization called To Write Love On Her Arms.
They're doing incredible things for those that previously wouldn't ever think of getting help for their issues of cutting, suicide, and depression.
What makes getting help bearable is knowing that you're not alone, and this organization acts as a support net, a social network of sorts.

One of the sources you sited gave an important bit of information: it's integral to understand that for the person that self-harms, their behavior actually serves a purpose.
When the general public begins to understand that, we might have less stigma. Ideally, anyway.
I've been in therapy for almost a year struggling to work through being a cutter for six years. Some days suck. and others, I'm successful.

Thanks again for this information.

Dr. Deb said...

Dear Becca,
A day at a time, right? So often, the body serves as a canvas for our emotional pain. TWLOHA is a great organization, and the story behind it is inspiring. I wish you ease and insight as you move through this. It's hard some days, I know.

Awake In Rochester said...

I use to work with a young lady who had cut marks on her upper arm. Looks like she used a razor blade. I hope she got help for it. Good info Doc!

Deb said...

A very long time ago, I dated a girl who I visited at college, and she would cut her upper arm if we broke up or got into an argument. She wouldn't do anything other than that, but it disturbed me a lot. I didn't get it because I never learned about it or was taught what that was. But now as I'm older, I see that whenever I'm stressed out, I pick at my cuticles to the point of bleeding sometimes... Could that be a form of self-injury? Many people do this too... Hrmm...

tracy said...

Thank you, Dr. Deb, for posting about this topic and making the information available to all. i could especially relate to the way some Emergency Department personal relate to cutting, etc. One of the times i had to had to have sutures on my forearm , the doctor who did them barely spoke a word to me, i could tell how didgusted he was with me...so was/am i. My forearms are covered with scars that will always be there, as well as my legs....some people n e v e r learn, i guess.
Well, thank you for letting me ramble...!
PS My Psychiatrist/therapist prefers the term "Self-Mutilation", because the term "Self-Injury" sounds too soft, i guess...i really like him, he is very patient and compassionate with me, and am doing some very good work with him...i guess that's just one thing we disagree one...or maybe he thinks the "harsher" word will somehow make me "change" ....or is more "realistic" what do you think?

STAG said...

My employee had this problem. We both recognized it, and recognized that it was a compulsion. She told me that I was the only person who would just shrug my shoulders and say "whatever floats your boat". She felt it might possibly be nothing more than a way to open a dialogue with those in her life that mattered. (though who really knows why one does anything...grin!) I suggested that if she wanted to get my attention she should damage some of my tools. Tools can be replaced. Something clicked and whenever she would run a drill unaccountably in reverse, or try to cut steel with scissors for no reason any of us could fathom, we would down tools and take a little walk, and she would "reset".

Cutting was a symptom of something far deeper than it seemed. This little story is only one small facet of the diamond of her personality.

Anonymous said...

My son's GF cuts herself. Depression runs in her family and I know from personal experience that keeping a secret about something like this is the worst thing to do..so,I told her mum after my son told me. The GF is pissed off course but she's getting proper help so I not care:)
Right is right and I wouldn't change a thing. These kids keep too many dangerous secrets.

Lily said...

I fit into every category that was listed as someone who engages. My reasons tend to follow the left side of the graphic. Probably won't be surprised to find out I cut. It has something that has resurfaced with a vengeance for me these last 5 weeks. So much so that my t actually has been able to get me to open up about it. I don't remember how she got it out of me, but she's known about it since I've been going to her. I just never let any discussion happen. I don't want to talk about it. It's been the overwhelming focus in my posts for the past month. Somehow she's managed to keep me talking about it, even though I am hating every minute of it...

Crazy that you posted this in the midst of all of my SI madness. Thank you for making me feel a little more sane.

Anonymous said...

I've been SI free for 1 year and 8 months now and some days I don't even think about it and other days it's all I can think about. I'm so glad to see sites like TWLOHA helping to redude the stigma around this subject. Thank you for posting this, Dr. Deb.

tracy said...

Somehow makes me wonder if i should do something to "celebrate"?

Raine said...

a good post-thanks

Barbara said...

Thank you once again for bringing something so important to light. When I met a cutter ten years ago I had never heard of it. I learned a lot from her and she's since quit and become a counselor.

Belizegial said...

Dr. Deb, I never understood why adolescents cut themselves. This information has shed much light in this matter. It pays to keep an open line of communication with the teens in your life. Sometime all they want is a sounding board for their feelings and ideas.

Amega said...

I found your post really useful.Great information. Thank you.

Marj aka Thriver said...

Thanks, as usual, for raising awareness, Dr. Deb!

I appreciate that you included the list of SI behaviors. For a long time, I did not realize that scratching was truly self-injury. So often times, we only hear about "cutting." I also appreciate that you clarify that it is not suicidal behavior. There seems to be confusion in that area as well.