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~ Self-Harm ~

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"Self-harm" refers to the deliberate, direct destruction of body tissue that results in tissue damage. When someone engages in self-harm, they may have a variety of intentions; these are discussed below. However, the person's intention is NOT to kill themselves. You may have heard self-harm referred to as "parasuicide," "self-mutilation," "self-injury," "self-abuse," "cutting," "self-inflicted violence," and so on.

Common myths about SI:

bullet self-injurers have a death wish.
bullet self-injury is a failed suicide attempt.
bullet self-injury is done for attention or to manipulate others.
bullet self-injury is a teenage fad.
bullet self-injurers are freaks, etc.

Some reasons why people engage in self-harm:

bullet  To distract themselves from emotional pain by causing physical pain
bullet  To punish themselves
bullet  To relieve tension
bullet  To feel real by feeling pain or seeing evidence of injury
bullet  To feel numb, zoned out, calm, or at peace
bullet  To experience euphoric feelings (associated with release of endorphins)
bullet  To communicate their pain, anger, or other emotions to others
bullet  To nurture themselves (through the process of healing the wounds)

Who engages in self-harm?

Only a handful of empirical studies have examined self-harm in a systematic, sound manner. Self-harm appears to be more common in females than in males, and it tends to begin in adolescence or early adulthood. While some people may engage in self-harm a few times and then stop, others engage in it frequently and have great difficulty stopping the behavior4. Several studies3,5,6 have found that individuals who engage in self-harm report unusually high rates of histories of:

bullet  Childhood sexual abuse
bullet  Childhood physical abuse
bullet  Emotional neglect
bullet  Insecure attachment
bullet  Prolonged separation from caregivers

At least two studies have attempted to determine whether particular characteristics of childhood sexual abuse place individuals at greater risk for engaging in self-harm as adults. Both studies reported that more severe, more frequent, or a longer duration of sexual abuse was associated with an increased risk of engaging in self-harm in one's adult years7,8.

Also, individuals who self-harm appear to have higher rates of the following psychological problems2,4,6:

bullet  High levels of dissociation
bullet  Borderline personality disorder
bullet  Substance abuse disorders
bullet  Posttraumatic stress disorder
bullet  Intermittent explosive disorder
bullet  Antisocial personality
bullet  Eating disorders

If you have a friend or relative who engages in self-harm:

It can be very distressing and confusing for you. You may feel guilty, angry, scared, powerless, or any number of things. Both of the books mentioned above contain chapters for friends and family members. Some general guidelines are:

bullet  Take the self-harm seriously by expressing concern and encouraging the individual to seek professional help.
bullet  Don't get into a power struggle with the individual-ultimately they need to make the choice to stop the behavior. You cannot force them to stop.
bullet  Don't blame yourself. The individual who is self-harming initiated this behavior and needs to take responsibility for stopping it.
bullet  If the individual who is self-harming is a child or adolescent, make sure the parent or a trusted adult has been informed and is seeking professional help for them.
bullet  If the individual who is engaging in self-harm does not want professional help because he or she doesn't think the behavior is a problem, inform them that a professional is the best person to make this determination. Suggest that a professional is a neutral third party who will not be emotionally invested in the situation and so will be able to make the soundest recommendations.

2. Zlotnick, C., Mattia, J.I., & Zimmerman, M. (1999). Clinical correlates of self-mutilation in a sample of general psychiatric patients. The Journal of Nervous and Mental Disease, 187, 296 - 301.
3.
Gratz, K.L., Conrad, S.D., & Roemer, L. (2002). Risk factors for deliberate self-harm among college students. American Journal of Orthopsychiatry, 72, 128 - 140.
4.
Simeon, D., & Hollander, E. (Eds.). (2001). Self injurious behaviors: Assessment and treatment. Washington, DC: American Psychiatric Press.
5.
Van der Kolk, B.A., Perry, J.C., & Herman, J.L. (1991). Childhood origins of self-destructive behavior. American Journal of Psychiatry, 148, 1665 - 1671.
6.
Zlotnick, C., Shea, M.T., Pearlstein, T., Simpson, E., Costello, E., & Begin, A. (1996). The relationship between dissociative symptoms, alexithymia, impulsivity, sexual abuse, and self-mutilation. Comprehensive Psychiatry, 37, 12 - 16.

Excerpts taken from http://www.ncptsd.va.gov/facts/problems/fs_self_harm.html
by Laura E. Gibson, Ph.D., The University of Vermont

 

Links:

National Mental Health Association
Fact sheet on Self-injury
http://www.nmha.org/infoctr/factsheets/selfinjury.cfm

Secret shame
Is a comprehensive website with links to research, self-help information, referral information, and information for families and friends.
http://www.palace.net/~llama/psych/injury.html

BUS Web Board - Bodies Under Siege
An online forum for people who self-harm and friends and family. I've joined up years ago there is a section for adults past college age along as a section for younger self-harmers.
http://buslist.org/phpBB/

Self-Injury.net
Gabrielle A young and talented web mistress has put together one of the best web sites on self-injury and writes of her own battles.
She has one of the best FAQ sections I have found at one place. I suggest anyone interested in Self-injury/self-harm to explore this web site.   Friends and family should also read the info found @
http://self-injury.net/familyandfriends/

SIARI Self-injury and Related Issues
A large self-injury resource.
http://www.siari.co.uk/

 

 

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