Tuesday, November 3, 2009

Self-Injury

When I first discovered self-injury among people I knew, I was ignorant of ways to help. This week, as part of the Tuesday series focusing on a specific illness, I am going to share a general overview of self-injury.

Erasing the Distance shares this information in our on-site training for school faculty and staff. The training covers several common illnesses, as well as activities for building general knowledge about mental illness, and skills for listening and responding in case a student approaches a teacher for assistance.

Teachers are in a unique position to help students that may be at risk, but we can all benefit from educating ourselves on what self-injury is and why someone might engage in this behavior. In fact, there are quite a bit of misconceptions about self-injury. For example, people of all ages suffer from self-injury, and self-injury is actually not an attempt at suicide. So what is it? Read on for more facts. We look forward to continuing the conversation.

~ Oriana at Erasing the Distance


Self-injury

FACTS

Self-injury is repetitive behavior in which a person damages their body without the intention of suicide. While suicide is not the intention of self injurers, as time goes on, injuries become more frequent and intense and may lead to accidental death.

Methods:

  • Cutting
  • Burning
  • Hitting
  • Severe skin scratching
  • Preventing healing of wounds
  • Using other objects to cause bodily harm

Most self-injurers use multiple methods and report that they do not feel pain.

Why someone might self-injure:

  • To gain relief when experiencing psychological and emotional pain or stress.
  • For a temporary distraction from intolerable emotions.
  • To feel a sense of control over feelings and situations that might otherwise be unbearable.
  • For some who experience chronic feelings of emptiness and emotional numbness, self-injury is carried out as a way to feel something, even if the result is physical pain.
  • To express internal distress and despair in an external way, for those lacking a healthier manner of communicating those emotions.
  • To exert control over their bodies.
  • To feel grounded in reality (instead of detached, depersonalized, or dissociated).
  • To punish themselves (some believing they deserve punishment for having good feelings, others for believing themselves to be "evil" and still others in the hope that self-punishment might avert worse punishment from some outside source. )
  • To create a visual “story” of past abuse they have experienced so someone will “hear” their pain.

Clues that someone is a self-injurer:

  • Unexplained cuts or bruises
  • Low self-esteem
  • Arms and legs are always covered such as wearing long sleeves and pants in warm weather, hiding scratches or scars.
  • Some studies show that there seems to be a link between eating disorders and substance abuse and self-injury.

Self-injury

TREATMENT

  • In-patient treatment at a facility with professionals trained in working with self-injurers
  • DBT (Dialectical Behavioral Therapy)
  • Integrating healthy coping skills
  • Developing a supportive network

WHAT TO DO

  • Refer them to the school psychologist or social worker for assessment. Their behavior could potentially be a call for help.
  • Support the person without supporting the behavior.
  • Don't avoid the subject. In fact, bring it up. You could say: "I know that sometimes you hurt yourself, and I'd like to understand it. People do it for so many reasons. If you could help me understand why you do it, I'd be grateful." If they don’t want to discuss it, don't push it. Let them come to you once you’ve brought it up.
  • Be available.
  • Set reasonable limits. You could say: "I care about you greatly, and it hurts too much to see you doing that." Avoid saying: "I can't deal with you if you keep cutting yourself!"
  • Show them through your words and actions that they don't need to self-injure to get you to care about them.
  • Distract them. Take the initiative. Be specific.
  • Do spontaneous acts of kindness.
  • Offer physical safety.
  • Speak calmly and non-judgmentally.
  • Express love and concern.
  • Listen.
  • Educate yourself on self injury.

WHAT NOT TO DO

  • Express anger or disgust.
  • Tell them to just stop.
  • Confiscate implements. This can just push them to be more creative.
  • Punish or guilt. This can feed the self-hatred that can lead to self-injury.
  • Think of it as "just a phase" or "just for attention.”
  • Assume you know the reason why they are self-injuring.
For more information about self-injury, check out the book Bodily Harm by experts Karen Conterio and Wendy Lader, Ph.D, or visit S.A.F.E. Alternatives online by clicking here.

Photo with pencil by flickr user "BlueOut"
Photo "light chaos" by flickr user Kevin Dooley:

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