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Menstuff® has compiled the following information on
Self Injury. Survey: 17% at Cornell and Princeton purposely
cut themselves. March 1 is Self-injury
Awareness Day. 
19:24The Skeletons in My Closet But first a few words from Pink
Why do people
self-harm? Self-injury has traditionally been known as self-harm (SH), self-inflicted violence (SIV), self-injurious behavior (SIB), and self-mutilation, although this last term has connotations that some people find worrisome, inaccurate, or offensive. A broader definition can also include the phenomenon of those who inflict harm on their bodies by means of disordered eating, or compulsive tattooing or body piercing or impulsive non-lethal injuring. When discussing self-injury with someone who engages in it, it is suggested that one use the same terms and words which that person uses, e.g. "cutting". Self-injury is usually not associated with an attempt at suicide; the person who self-injures is not usually seeking to end his or her own life, but is instead hoping to cope with or relieve unbearable emotional pain or discomfort. A common form of self-injury involves making shallow cuts to the skin of the arms or legs. This is casually referred to as "cutting"; a person who routinely does this may be colloquially called "a cutter". Localized multiple cuts, especially those similar in appearance, are sometimes characteristic of cutting, but are not reliable indicators of self-injury. Less frequently, this behavior may involve cutting other parts of the body, including the breasts and sexual organs. Other examples of self-injury include:
A popular misconception of self-injury is that it is an attention seeking behavior. In truth, many people who self-injure are very self-conscious of their wounds and scars and go to great lengths to conceal their behavior from others. They may offer alternative explanations for their injuries or conceal their scars with clothing. In the strictest terms, self-harm is a general term for self-damaging activities (which could include alcohol abuse and bulimia), whereas self-injury refers more specifically to the practice of cutting, bruising, poisoning, overdosing (without suicidal intent), burning or otherwise directly injuring the body. Many people, including healthcare workers, define self-harm based around the act of damaging one's own body. It may be more accurate to define self-harm based around the intent, and the emotional distress that the person wishes to deal with. An example of this form of definition is provided by the self-injury awareness charity, LifeSIGNS. Neither the DSM-IV-TV nor the ICD-10 provide diagnostic criteria for self-injury. It is often seen as only a symptom of an underlying disorder, though many people who self-injure would like this to be addressed. Accurate statistics on self-injury are hard to come by since most self-injurers conceal their injuries Recorded figures tend to be based on hospital admissions, though more recently researchers have attempted to document the topography and correlates of the behavior in the general population. Studies based only on hospital admissions may hide the larger group of self-injurers who do not need or seek hospital treatment for their injuries. Many of these statistics show that more women seem to self-injure than men, and that it is more common among young people. One of the earliest studies into self-injury was carried out in 1986 by Conterio and Favazza, who estimated that 0.75% of the population exhibit self-injurious behavior. Half the sample had been hospitalized for the problem, and 97% of were female. It should be noted that more recent studies show the numbers of self-injurers to be more evenly split between female and male. A study of self-injurious behavior in college students published by Cornell University researchers in 2006 found that the most common methods of self-injury reported by both male and female subjects were scratching or pinching with fingernails or other objects to the point that bleeding occurred or marks remained on the skin (51.6%), banging or punching objects to the point of bruising or bleeding (37.6%), cutting (33.7%), and punching or banging oneself to the point of bruising or bleeding (24.5%). Female subjects were 2.3 times more likely to scratch or pinch and 2.4 times more likely to cut. Male subjects were 2.8 times more likely than female subjects to punch an object with the intention of injuring themselves. Male subjects were 1.8 times more likely to injure their hands, whereas female subjects were 2.3 times more likely to injure their wrists and 2.4 times more likely to injure their thighs. Self-injury is popularly assumed to represent a female phenomenon, and although there is some disputed support to this claim, the authors of the study believe that the popular association of self-injury with cutting may account for this belief. The WHO/EURO Multicentre Study of Suicide estimated that the average European rate of self-injury for persons over 15 years is 0.14% for males and 0.193% for females. For each age group the female rate exceeded that of the males, with the highest rate among females in the 15-24 age group and the highest rate among males in the 12-34 age group. Recently, however, it has been found that the female to male ratio, previously thought to be around 2:1, is diminishing – in Ireland it has been close to parity for a number of years. The Mental Health Foundation estimates the rate in the UK to be 0.77% , and that the majority of people who self-harm are aged between 11 and 25 years, with between 1 in 12 and 1 in 15 young people self-harming . A 2003 study commissioned by Samaritans found that more than 1 in 10 15-16 year olds in the UK have deliberately harmed themselves, and that girls of this age were nearly four times more likely to have self-harmed than boys. In a study of undergraduate students in the United States, 9.8% of the students surveyed indicated that they had purposefully cut or burned themselves on at least one occasion in the past. When the definition of self-injury was expanded to include head-banging, scratching oneself, and hitting oneself along with cutting and burning, 32% of the sample said they had done this. This suggests that this problem is not associated only with severely disturbed psychiatric patients but is not uncommon among young adults. In a study of psychiatric morbidity carried out in the UK, respondents were asked the question: "Have you ever harmed yourself in any way, but not with the intention of killing yourself?" This survey found an overall lifetime prevalence of 2.4%, this being 2.0% of males and 2.7% of females. About 10% of admissions to medical wards in the UK are as a result of self-harm, however the majority of these are for drug overdoses, with only 5 to 15% of this number being caused by cutting. In New Zealand, more females are hospitalized for intentional self-harm than males. Females more commonly choose methods such as self-poisoning that generally are not fatal, but still serious enough to require hospitalization. A number of social or psychological factors can be seen to have a positive statistical correlation with self-injury or its repetition. People experiencing various forms of mental ill-health can be considered to be at higher risk of self-injuring. Key issues are depression, phobias, conduct disorders. Substance abuse is also considered a risk factor as are some personal characteristics such as poor problem resolution skills, impulsivity, hopelessness and aggression. Many self-injurers grew up in an environment that discourages expression of anger. Abuse during childhood is accepted as a primary social factor, also losing a parent or loved one, along with troubled parental or partner relationships. Factors such as war, poverty, and unemployment may also contribute. However, some people who self-injure have no experience of these factors. Attempts to understand self-injury fall broadly into either attempts to interpret motives, or application of psychological models. Motives for self-injury are often personal, often do not fit into medicalised models of behavior and may seem incomprehensible to others, as demonstrated by this quote: "My motivations for self-harming were diverse, but included examining the interior of my arms for hydraulic lines. This may sound strange." Assessment of motives in a medical setting is usually based on precursors to the incident, circumstances and information from the patient however the limited studies comparing professional and personal assessments show that these differ with professionals suggesting more manipulative or punitive motives. The UK ONS study reported only two motives: “to draw attention” and “because of anger”. Many people who self-injure state that it allows them to "go away" or dissociate, separating the mind from feelings that are causing anguish. This may be achieved by tricking the mind into believing the pain felt at the time is caused by self-injury instead of the issues they were facing before: the physical pain therefore acts as a distraction from emotional pain. The sexual organs may be deliberately hurt as a way to deal with unwanted feelings of sexuality, or as a means of punishing sexual organs that may be perceived as having responded in contravention to the persons well being.(e.g., responses to child sexual abuse). To complement this theory, one can consider the need to 'stop' feeling emotional pain and mental agitation. "A person may be hypersensitive and overwhelmed; a great many thoughts may be revolving within their mind, and they may either become triggered or could make a decision to stop the overwhelming feelings." Alternatively self-injury may be a means of feeling something, even if the sensation is unpleasant and painful. Those who self-injure sometimes describe feelings of emptiness or numbness (anhedonia), and physical pain may be a relief from these feelings. "A person may be detached from himself or herself, detached from life, numb and unfeeling. They may then recognize the need to function more, or have a desire to feel real again, and a decision is made to create sensation and ‘wake up’." A flow diagram of these two theories accompanies this section. It is also important to note that some self-injurers report feeling very little to no pain while self-harming. Those who engage in self-injury face the contradictory reality of harming themselves whilst at the same time obtaining relief from this act. It may even be hard for some to actually initiate cutting, but they often do because they know the relief that will follow. For some self-injurers this relief is primarily psychological whilst for others this feeling of relief comes from the beta endorphins released in the brain (the same chemicals responsible for the "runner's high"). These act to reduce tension and emotional distress and may lead to a feeling of calm. As a coping mechanism, self-injury can become psychologically addictive because, to the self-injurer, it works; it enables him/her to deal with intense stress in the current moment. The patterns sometimes created by it, such as specific time intervals between acts of self-injury, can also create a behavioral pattern that can result in a wanting or craving to fulfill thoughts of self-injury. Another possible source of self-injury can be self-loathing, often as a means of punishment for having strong feelings that they were expected to suppress when they were children, or because they feel bad and undeserving, having previously been physically or emotionally abused and feeling that they were deserving of the abuse. Another often overlooked area that can result in self-injurious behavior is processing disorders. Autistic-spectrum disorders, especially when undiagnosed, or misdiagnosed, can result in severe depression, anxiety and fluctuating behavior. The rising depression rates in the UK teenage population could be accounted for by the fact that there is no testing being carried out on the NHS for such disorders. If a person is diagnosed with depression and anxiety, the help available is most often medication and (arguably pre-scientific) therapy (such as psychodynamic therapy). This could mean that a large proportion of people with various processing disorders are unable to be diagnosed as such. It is arguable that the stress resulting from living with no support for an undiagnosed disorder, or being given inappropriate therapy, could lead to self-injurious behavior. Often, people with disorders such as autism are unable to feel certain stimulation, such as temperature, hunger and pain, in the same way as someone without a processing disorder usually would. In his book The Ultimate Stranger: The Autistic Child, Carl Delacato (1974) classified each sensory channel as being either hyper (too much stimulation gets in through the sensory channel for the brain to cope with) hypo (too little stimulation gets in through the sensory channel causing the brain to be deprived) and "white noise" (the faulty channel creates its own stimulus). A person with autism often displays behaviors to balance their sensory dysfunction. If, for example, a person was hypo-tactile, they may attempt to stimulate themselves by using methods that could be categorized as self-injury. There are many movements among the general self-injury community to make self-injury itself and treatment better known to mental health professionals as well as the general public. SIAD (Self Injury Awareness Day) which is set for March 1 of every year, is one such movement. On this day some people choose to be more open about their own self-injury, and awareness organizations make special efforts to raise awareness about self-injury. Some people wear ribbons to show awareness; commonly orange ribbons are used for this. Sometimes a red and black ribbon is also used, generally signifying a person who self-injures. Sometimes orange is used to represent those who self-injure, white for those who don't injure but show support and white and orange together show someone who is trying to stop or has stopped self-injury. A single white bead on an orange bracelet may sometimes be used for those who want to stop and several mixed white and orange beads is for those who have stopped. Self-injury may be an indicator of depression and / or other psychological problems. Therapy and skills training can be very useful for those who self-injure. The therapy module used will vary depending on the person's diagnosis and their individual needs. DBT, or Dialectical behavioral therapy can be very
successful for those with a personality disorder, and could
potentially be used for those with other mental illnesses
who exhibit self-injurious behavior. Cognitive Behavioral
Therapy is generally used to assist those with axis 1
diagnoses, such as depression, schizophrenia, and bipolar
disorder. Diagnosis and treatment of the causes is thought
by many to be the best approach to self-injury; but in some
cases, particularly in clients with a personality disorder,
this is not very effective, which is why more clinicians are
starting to take a DBT approach in order to reduce the
behavior itself. A person who is injuring themselves may be
advised to use coping skills, such as journaling or taking a
walk, when they have the urge to harm themselves. They may
also be told to avoid having the objects they use to harm
themselves within easy reach. People who rely on habitual
self-injury are sometimes psychiatrically hospitalized,
based on their stability, and their ability and especially
their willingness to get help. Why do people self-harm? People who hurt themselves most often start as teens or young adults. Because people who self-injure frequently hide their injuries from others, it can be difficult to identify. There are many different types of self-harm, which cause varying degrees of damage. All forms should be taken seriously. Why Do People Self-Harm? People self-harm for a variety of reasons. Understanding the reason someone is hurting themselves is often an important step to supporting them. Examples of reasons include:
Risks of Self-Injury Self-harm has physical, emotional, and social effects. Physical Effects
Emotional Effects
Social Effects
The risk of accidental death by self-injury is very real, and varies based on the method. Treatment and Recovery: How Do You Stop Self-Harming? It's normal to want to quit self-harming, but feel unable to. Even knowing the risks, many struggle to break themselves away from the cycle. But it is possible. Here are some of the key steps:
17 Quotes You Need if You're Struggling with Self Harm According to Mental Health America, 17-35% of college students engage in self-harm. Part of the reason we don’t know the exact numbers for sure is because of the intense stigma around the topic. Many people interpret self-harm as an way of “acting out” or “looking for attention." However, it’s important that we don’t stereotype-- pain does not discriminate and people of all ages and backgrounds can be at risk for self-harm. We’ve compiled a list of quotes that we hope will help you overcome pain and learn to love yourself. If you’re struggling with self-harm, text SOS to 741741 to talk with a trained Crisis Counselor. On Overcoming Pain
On Forgiving Yourself
On Loving Yourself
“Loving yourself…does not mean being
self-absorbed or narcissistic, or disregarding others.
Rather it means welcoming yourself as the most honored guest
in your own heart, a guest worthy of respect, a lovable
companion.” Margo Anand Self-Injury:
The Secret Language of Pain for Teenagers "You have so much pain inside yourself, you try and hurt yourself on the outside because you need help," --Princess Diana, 1996 Self-injury has not been a topic discussed over family dinner. Although self-injury has been plaguing lives for quite some time, with increasing incidences being cited in middle school and high school, it was not until 1996, when Princess Diana admitted to bouts with self-injury, that article, books, and television documentaries began to appear. Now, conversations about self-injury are appearing at the dinner table, despite its remaining distastefulness. Today, researchers are describing the phenomenon of self-injury among teenagers as "the deliberate, direct, non-suicidal destruction or alteration of one's body tissue" (Favazza, 1996), and quantifying it under three major categories: a) Major Self-Injury (the most rare form which usually results in permanent disfiguration), b) Stereotypic Self-Injury (which consists of head banging and biting), and c) Superficial Self-Injury (the most common which involves cutting, burning, and hair pulling) (Anonymous, 1999). Why would students purposely hurt themselves? Our personal research indicates that most students self-injure themselves because they are unable to handle intense feelings, and so they turn to self-injury as a way to express their feelings and emotions. We tell audiences, "Pain that is self-inflicted is pain over which a person has control. Just enough pain will cause a person to divert their attention away from the outside pain over which they have no control to the known pain they self-inflict." We like what psychologist Scott Lines so eloquently said, "The skin becomes a battlefield as a demonstration of internal chaos. The place where the self meets the world is a canvas or tabula rosa on which is displayed exactly how bad one feels inside." Research indicates that cutting is the most common method of adolescent elf-injury, and is usually done with razor blades, knives, or matches. In the following excerpt, note the priority system involved in cutting, and how this priority system centers on victim convenience (i.e., the ability to hide the injury the easiest). In the 1999 docudrama movie titled, Secret Cutting it was revealed that the most common parts of the body injured include (in ranked order) "the forearms and wrists, upper arms, thighs, abdomen, and occasionally, breasts and calves. The reason for the variation in the ranked locations is that those most concealed by clothing are the most preferred areas." Crucially important to the victim is concealment of the injury. By keeping self-injuries away from peering eyes, the adolescent can increase the ability to do it more often without interruption. The fact that self-injury has been so little documented until recently is due in part to the "almost expert awareness" on the part of the victim to be able to avoid detection. It is common to associate a great number of ancillary activities with self-mutilation, but differentiate between what is, and what is not harmful self-injury needs to be made. Adolescent activities such as skin piercing, tattoos, and group rituals fall into the category of simple adolescent trends. Although these activities fit the description of self-injury, the motivation to engage in these actions differs greater from intention physical self-injury. For instance, teens want a tattoo, and they do it for the tattoo or from peer pressure, and not the pain that is involved in the procedure. When a self-injurer cuts his or her skin it is to feel the pain, and not for the decorative results (Levenkron, 1998). We tell high school students that self-injury is a self-inflicted act most often used as a coping mechanism for relieving an unwanted emotion, or as Jimmy Buffet (1999) said in a song, "It's a permanent reminder of a temporary feeling." Basically, it is a way to alter a mood state by focusing pain in a controllable area of the body. Think of a child who is riding his or her bike right after a heated argument with a sibling. That child would still be feeling angry or upset about the argument. But if that child falls off the bike and skins a knee, the primary concern instantly becomes focused on the knee, not on the anger. Falling off the bike made the child focus on the feeling of physical pain, or the skinned knee. The emotional anger that the child was feeling on the inside has now seemed to vanish. Teens seek physical pain to distract themselves from
emotional pain. In popular culture we see ...
19:24The Skeletons in My Closet This researcher who studies
self-injury explains why people do it. And why he did
it. What do you think of when you hear the words "self-injury?" You probably think of a middle-class, teenage girl cutting herself to get attention. That's the cliché, and it's all kinds of wrong. Meet Dr. Stephen Lewis. "As a male, as an academic, I may not be the first person you think about when you hear the words "self-injury." He's been researching self-injury — we're most familiar with it as cutting or burning — for over 10 years. A quick definition: Self-injury is intentional damage to body tissue (that doesn't include body modifications like piercings, tattoos, and scarification) without suicidal intent. And far more people are doing it than you'd think. What he and other experts found might surprise you: Self-injury happens equally across gender, ethnicity, and socioeconomic lines. It's not just an issue in the U.S. either. Self-injury has emerged as a major global mental health concern. Here's something else that might surprise you: Lewis isn't just an academic expert. He's a life expert. He lived it. He used to self-injure, and he shared his experience with the world in his talk for TEDxGuelphU. It took some soul-searching before Lewis decided to tell his story publicly. In the end, he told me, "I wanted to convey a sense of hope to those who presently struggle. I wanted them to know they are not alone and that recovery is possible." "There is light at the end of the tunnel. As dark as it may seem, if you keep walking — you can find it," he says. Like Lewis (and myself), 1 in 5 adolescents has engaged in self-injurious behavior at least once, and a quarter of them have done it repeatedly. It can start as young as age 12. As Lewis put it, "Self-injury provided needed relief from that emotional turmoil I was feeling inside. It conveyed the words I could not." It's an attempt to relieve overwhelming feelings of sadness, distress, or self-loathing. Most often, people do it to externalize inner pain, to make it tangible, or to stop feeling numb. The relief that self-injury provides is only temporary, though, and it can develop an addictive quality: The longer it's used, the harder it is to stop (or to find another way to quell the pain). There's also a tolerance factor: The more you self-injure, the shorter the period of relief. It makes for a cycle that's incredibly difficult to break. So, how can we help stop the cycle of self-injury? Whether you're someone who has self-injured or not, one of the most important things we can do is educate ourselves: The false cliches and stereotypes we carry around about self-injury affect those who do it, too. When we characterize people who hurt themselves as crazy, manipulative, or attention-seeking, they're more inclined to feel ashamed and isolated. They live in fear of judgment, and that fear creates silence. This silence means that many people feel hopeless and alone. While self-injury isn't, by definition, a suicidal behavior, it does elevate risk for suicide. Without help, that silence and that hopelessness can be deadly. Self-injury is a habit that's hard to break. One of the first steps toward ending the cycle is for us to allow the conversation to happen. Four little words are all we need: "How can I help?" That's what turned things around for Lewis: "For me, this involved a willingness to not just ask for help, but to accept it —something I was not accustomed to. This help, for me, came from professionals. It came from friends, and it came from my family." His story ends well. My story — as a fellow self-injurer — ends well, too. All of these stories can end well. "Recovery is a process," said Lewis. "And not a linear one. I had good days and bad days, and on some bad days, I self injured again. But those bad days became fewer and farther between." Nobody should suffer alone. We all have baggage, but we each bear the weight of our burdens differently. We can help each other bear that weight if we're brave enough to listen and brave enough to start conversations that matter. This is how we find better ways to heal. This is how we create hope for those who need it the most. Want more information on self-injury? Take a look at the
Self-Injury Outreach
and Support website. Does Cutting Mean That Someone Is
Suicidal? Question: My teenage daughter has been cutting herself. Does this mean she is suicidal? Why does she want to hurt herself like this? Answer: While it might seem like she is hurting herself because she wants to commit suicide—after all, cutting the wrists is one method that people use to kill themselves—this isn't necessarily what her intentions are. People who injure themselves by cutting, scratching, burning and other methods of self-harm are often doing it as a way to relieve their emotional suffering. While it might seem counterintuitive that causing oneself physical pain could help emotional pain, many cutters report that this is exactly what happens. Cutting causes the release of chemicals called endorphins. Endorphins are the body's own natural painkillers and they help it to cope with the stress and pain associated with injury. They can also help dampen emotional pain. Other reasons that self-injurers often give for cutting and self-harm are: releasing anger, slowing down racing thoughts and coping with dissociation or flashbacks. When dissociation or flashbacks occur, the physical sensations of pain are a way for the person to ground themselves back in reality. While I can't say for certain whether your daughter is experiencing any thoughts of suicide, one thing I do feel fairly certain of is that she is going through quite a bit of emotional turmoil and needs your help and support. You will need to do what you can to ensure that she gets professional treatment with both medications (to help quell the feelings that are driving her urges to hurt herself) and therapy (to help teach her better ways to deal with her feelings). Please be aware that this is not just a passing phase that she is going through or a cry for attention. You should take this quite seriously. Cutting can be very addictive and hard to stop without assistance. There is also the risk that she may accidentally hurt herself more seriously than she intends to. Sources: Alderman, Tracy. "Myths and Misconceptions of Self-Injury: Part II." Psychology Today. Sussex Publishers, LLC. Published: Ocobert 22, 2009. Accessed: June 28, 2015. Ferrales, Diana and Sonja Koukel. "Teens and Self-Cutting (Self-Harm): Information for Parents: Guide I-104." New Mexico State University. New Mexico State University Board of Regents. Accessed: June 28, 2015. Lohmann, Raychelle Cassada. "Understanding Suicide and Self-Harm." Psychology Today. Sussex Publishers, LLC. Published: October 28, 2012. Accessed: June 28, 2015. It concerns me that you are, probably
unintentionally, aiding the concept that girls are the only
ones that self-harm. While you do use the word "people" at
times, I have yet to find a comment from you that says that
boys self-harm a about the same rate as girls, though their
self harm is more around burning and scratching. With
heading like "Does someone who cuts herself want to die?
makes it look like victomology and does not address the ral
issue that it's not just a girl's issue by any means. How
different would that article and others you write, to
acknowledge the surprising statistic that self-harm is about
equally practiced by girls and boys. Wouldn't your readers
be shocked by that information? Changing the title of
that article to "Does someone who cuts themselves want to
die?" would give you a chance to talk about the issue
of equality and differenecs and bring this hidden fact to
light. depression.about.com/od/selfinjury/
Talk with your
kids about cutting
Injuring yourself on purpose by making scratches or cuts on your body with a sharp object, enough to break the skin and make it bleed. The latest aggregated research has found generally similar rates of self-harm between girls and boys. People may cut themselves on their wrists, arms, legs, or bellies. Some people self-injure by burning their skin with the end of a cigarette or lighted match. Cutting is a way some people try to cope with the pain of strong emotions, intense pressure, or upsetting relationship problems. They may be dealing with feelings that seem too difficult to bear, or bad situations they think can't change. This practice has long existed in secrecy. When cuts or burns heal, they often leave scars or marks. Cuts can be easily hidden under long sleeves. But in recent years, movies and TV shows have drawn attention to it -- prompting greater numbers of teens and tweens (ages 9 to 14) to try it. Go to any school and ask, 'Do you know anyone who cuts?' Yeah, everybody knows someone. That might be a great way to start a conversation What Parents Should Do When parents suspect a problem, they are usually at a loss of how to approach their child. Be direct with your child. Don't act out of anger or let yourself become hysterical. But express concern. Say, 'We're going to get help for you.' It's better to err on the side of open communication. The kids may not talk until they're ready. It's better to open up the door, let them know you're aware of this. That you're not going to punish them, that you're just concerned. And if they don't come to you, go to someone. Some parents mistake cutting for suicidal behavior so the kid gets dragged into the ER which often is a hostile environment for the cutter. Many kids who are not suicidal at all are being evaluated and even hospitalized as suicidal. Psychotherapy should be the first step in treatment. Ask if the therapist has any expertise working with self-injurers. Some therapists have a fear reaction to it. The therapist needs to be comfortable with it. The ultimate lynch pin is -- the child has to decide they're not going to do this anymore. Any ultimatum, bribery, or putting them in a hospital is not going to do it. They need a good support system. They need treatment for underlying disorders like depression. They need to learn better coping mechanisms. Parents can help by providing emotional support, helping identify early warning signs, helping kids distract themselves, lowering the child's stress level, and providing supervision at critical times. But a parent can't do it for them. It takes a certain level of resource to be able to stop cutting, and many kids don't have those resources. They need to stay in therapy until they get to that point. Kids who develop this behavior have fewer resources for
dealing with stress, fewer coping mechanisms. As they
develop better ways of coping, as they get better at
self-monitoring, it's easier to eventually give up this
behavior. But it's much more complicated than something they
will outgrow. What is cutting?
Emma's friends had noticed something strange as well. Even when the weather was hot, Emma wore long-sleeved shirts. She had become secretive, too, like something was bothering her. But Emma couldn't seem to find the words to tell her mom or her friends that the marks on her arms were from something that she had done. She was cutting herself with a razor when she felt sad or upset. Injuring yourself on purpose by making scratches or cuts on your body with a sharp object — enough to break the skin and make it bleed — is called cutting. Cutting is a type of self-injury, or SI. Most people who cut are girls, but guys self-injure, too. People who cut usually start cutting in their young teens. Some continue to cut into adulthood. People may cut themselves on their wrists, arms, legs, or bellies. Some people self-injure by burning their skin with the end of a cigarette or lighted match. When cuts or burns heal, they often leave scars or marks. People who injure themselves usually hide the cuts and marks and sometimes no one else knows. Why Do People Cut Themselves? It can be hard to understand why people cut themselves on purpose. Cutting is a way some people try to cope with the pain of strong emotions, intense pressure, or upsetting relationship problems. They may be dealing with feelings that seem too difficult to bear, or bad situations they think can't change. Some people cut because they feel desperate for relief from bad feelings. People who cut may not know better ways to get relief from emotional pain or pressure. Some people cut to express strong feelings of rage, sorrow, rejection, desperation, longing, or emptiness. There are other ways to cope with difficulties, even big problems and terrible emotional pain. The help of a mental health professional might be needed for major life troubles or overwhelming emotions. For other tough situations or strong emotions, it can help put things in perspective to talk problems over with parents, other adults, or friends. Getting plenty of exercise can also help put problems in perspective and help balance emotions. But people who cut may not have developed ways to cope. Or their coping skills may be overpowered by emotions that are too intense. When emotions don't get expressed in a healthy way, tension can build up — sometimes to a point where it seems almost unbearable. Cutting may be an attempt to relieve that extreme tension. For some, it seems like a way of feeling in control. The urge to cut might be triggered by strong feelings the person can't express — such as anger, hurt, shame, frustration, or alienation. People who cut sometimes say they feel they don't fit in or that no one understands them. A person might cut because of losing someone close or to escape a sense of emptiness. Cutting might seem like the only way to find relief or express personal pain over relationships or rejection. People who cut or self-injure sometimes have other mental health problems that contribute to their emotional tension. Cutting is sometimes (but not always) associated with depression, bipolar disorder, eating disorders, obsessive thinking, or compulsive behaviors. It can also be a sign of mental health problems that cause people to have trouble controlling their impulses or to take unnecessary risks. Some people who cut themselves have problems with drug or alcohol abuse. Some people who cut have had a traumatic experience, such as living through abuse, violence, or a disaster. Self-injury may feel like a way of "waking up" from a sense of numbness after a traumatic experience. Or it may be a way of reinflicting the pain they went through, expressing anger over it, or trying to get control of it. What Can Happen to People Who Cut? Although cutting may provide some temporary relief from a terrible feeling, even people who cut agree that it isn't a good way to get that relief. For one thing, the relief doesn't last. The troubles that triggered the cutting remain — they're just masked over. People don't usually intend to hurt themselves permanently when they cut. And they don't usually mean to keep cutting once they start. But both can happen. It's possible to misjudge the depth of a cut, making it so deep that it requires stitches (or, in extreme cases, hospitalization). Cuts can become infected if a person uses nonsterile or dirty cutting instruments — razors, scissors, pins, or even the sharp edge of the tab on a can of soda. Most people who cut aren't attempting suicide. Cutting is usually a person's attempt at feeling better, not ending it all. Although some people who cut do attempt suicide, it's usually because of the emotional problems and pain that lie behind their desire to self-harm, not the cutting itself. Cutting can be habit forming. It can become a compulsive behavior — meaning that the more a person does it, the more he or she feels the need to do it. The brain starts to connect the false sense of relief from bad feelings to the act of cutting, and it craves this relief the next time tension builds. When cutting becomes a compulsive behavior, it can seem impossible to stop. So cutting can seem almost like an addiction, where the urge to cut can seem too hard to resist. A behavior that starts as an attempt to feel more in control can end up controlling you. How Does Cutting Start? Cutting often begins on an impulse. It's not something the person thinks about ahead of time. Shauna says, "It starts when something's really upsetting and you don't know how to talk about it or what to do. But you can't get your mind off feeling upset, and your body has this knot of emotional pain. Before you know it, you're cutting yourself. And then somehow, you're in another place. Then, the next time you feel awful about something, you try it again — and slowly it becomes a habit." Natalie, a high-school junior who started cutting in middle school, explains that it was a way to distract herself from feelings of rejection and helplessness she felt she couldn't bear. "I never looked at it as anything that bad at first — just my way of getting my mind off something I felt really awful about. I guess part of me must have known it was a bad thing to do, though, because I always hid it. Once a friend asked me if I was cutting myself and I even lied and said 'no.' I was embarrassed." Sometimes self-injury affects a person's body image. Jen says, "I actually liked how the cuts looked. I felt kind of bad when they started to heal — and so I would 'freshen them up' by cutting again. Now I can see how crazy that sounds, but at the time, it seemed perfectly reasonable to me. I was all about those cuts — like they were something about me that only I knew. They were like my own way of controlling things. I don't cut myself anymore, but now I have to deal with the scars." You can't force someone who self-injures to stop. It doesn't help to get mad at a friend who cuts, reject that person, lecture her, or beg him to stop. Instead, let your friend know that you care, that he or she deserves to be healthy and happy, and that no one needs to bear their troubles alone. Pressured to Cut? Girls and guys who self-injure are often dealing with some heavy troubles. Many work hard to overcome difficult problems. So they find it hard to believe that some kids cut just because they think it's a way to seem tough and rebellious. Tia tried cutting because a couple of the girls at her school were doing it. "It seemed like if I didn't do it, they would think I was afraid or something. So I did it once. But then I thought about how lame it was to do something like that to myself for no good reason. Next time they asked I just said, 'no, thanks — it's not for me.' " If you have a friend who suggests you try cutting, say what you think. Why get pulled into something you know isn't good for you? There are plenty of other ways to express who you are. Lindsay had been cutting herself for 3 years because of abuse she suffered as a child. She's 16 now and hasn't cut herself in more than a year. "I feel proud of that," Lindsay says. "So when I hear girls talk about it like it's the thing to do, it really gets to me." Getting Help There are better ways to deal with troubles than cutting — healthier, long-lasting ways that don't leave a person with emotional and physical scars. The first step is to get help with the troubles that led to the cutting in the first place. Here are some ideas for doing that: .Tell someone. People who have stopped cutting often say the first step is the hardest — admitting to or talking about cutting. But they also say that after they open up about it, they often feel a great sense of relief. Choose someone you trust to talk to at first (a parent, school counselor, teacher, coach, doctor, or nurse). If it's too difficult to bring up the topic in person, write a note. Identify the trouble that's triggering the cutting. Cutting is a way of reacting to emotional tension or pain. Try to figure out what feelings or situations are causing you to cut. Is it anger? Pressure to be perfect? Relationship trouble? A painful loss or trauma? Mean criticism or mistreatment? Identify the trouble you're having, then tell someone about it. Many people have trouble figuring this part out on their own. This is where a mental health professional can be helpful. Ask for help. Tell someone that you want help dealing with your troubles and the cutting. If the person you ask doesn't help you get the assistance you need, ask someone else. Sometimes adults try to downplay the problems teens have or think they're just a phase. If you get the feeling this is happening to you, find another adult (such as a school counselor or nurse) who can make your case for you. Work on it. Most people with deep emotional pain or distress need to work with a counselor or mental health professional to sort through strong feelings, heal past hurts, and to learn better ways to cope with life's stresses. One way to find a therapist or counselor is to ask at your doctor's office, at school, or at a mental health clinic in your community. Although cutting can be a difficult pattern to break, it
is possible. Getting professional help to overcome the
problem doesn't mean that a person is weak or crazy.
Therapists and counselors are trained to help people
discover inner strengths that help them heal. These inner
strengths can then be used to cope with life's other
problems in a healthy way. Teenage Cutting: A Trend on the Rise
Wendy Lader, PhD, clinical director of S.A.F.E Alternatives and co-author of Bodily Harm, says self-harm is more prevalent than most people think. “Studies on adolescents in community samples report a lifetime prevalence between 15 and 20 percent,” she says. So, why would kids purposefully cut themselves? The most common reason is control of emotions, according to Lader. “For kids experiencing intense emotions, it can be used to deaden the intensity. For those feeling a sense of numbness, it serves the opposite effect, helping them feel something,” Lader says. Experts say for some adolescents, self-injury indicates other mental health concerns, such as depression. Others use is as a way to fit in with peers. And this behavior can become addictive, according to Susan Bowman, licensed counselor and author of See My Pain: Creative Strategies and Activities for Helping Young People Who Self-Injure. “When kids cut themselves, it releases endorphins and they get a high from it,” she says. “It becomes a control issue: This is the way I release the pressure.” There are clues that parents can watch for when it comes to self-injury. In addition to unexplained cuts and bruises, a change in communication, eating or sleeping patterns can be red flags. Though parents are understandably appalled at the thought of their child self-injuring, Bowman says this is exactly the reaction to avoid. “If you are shocked by a cut on their wrist, they may not trust you to accept and deal with what’s really bothering them,” she says. “They need caring and nurturing.” So, how should you react? Here's some advice from the experts: •Communication is key. “Listen. Speak calmly, without judging, while expressing your love and concern,” Lader says. “Don’t try to offer your opinion or fix the problem. The goal is to foster open communication,” •Ask the right questions. Bowman says parents should use “what” and “how” questions, like “What makes you want to hurt yourself?” • Positive attention is a valuable part of the healing process. “Kids need attention when they are using positive coping skills and talking about their problems,” Bowman says. • Consider therapy. “A therapist can help determine if the child is experiencing some underlying issue that they don’t know how to identify or talk about,” says Lader. If you aren't sure how to choose a therapist, the school counselor might be a good place to start. Bowman also advises looking for someone experienced in adolescent issues, and specifically self-injury. “A combination of therapy techniques, such as cognitive, behavioral and creative arts therapy usually works best,” Bowman says. Self-injury is a cry for help. Kids engaging in these
behaviors desperately need parents to provide understanding
and a willingness to listen. Cutting
and Self-Harm: Warning Signs and Treatment
Cutting. It's a practice that is foreign, frightening, to parents. It is not a suicide attempt, though it may look and seem that way. Cutting is a form of self-injury -- the person is literally making small cuts on his or her body, usually the arms and legs. It's difficult for many people to understand. But for kids, cutting helps them control their emotional pain, psychologists say. This practice has long existed in secrecy. Cuts can be easily hidden under long sleeves. But in recent years, movies and TV shows have drawn attention to it -- prompting greater numbers of teens and tweens (ages 9 to 14) to try it. It's clear that estrogen is closely linked with women's emotional well-being. Depression and anxiety affect women in their estrogen-producing years more often than men or postmenopausal women. Estrogen is also linked to mood disruptions that occur only in women -- premenstrual syndrome, premenstrual dysphoric disorder, and postpartum depression. Exactly how estrogen affects emotion is much less straightforward. Is it too much estrogen? Not enough? It turns out estrogen's emotional effects... "We can go to any school and ask, 'Do you know anyone who cuts?' Yeah, everybody knows someone," says Karen Conterio, author of the book, Bodily Harm. Twenty years ago, Conterio founded a treatment program for self-injurers called SAFE (Self Abuse Finally Ends) Alternatives at Linden Oak Hospital in Naperville, Ill., outside of Chicago. Picture of an Unhappy Kid Her patients are getting younger and younger, Conterio tells WebMD. "Self-harm typically starts at about age 14. But in recent years we've been seeing kids as young as 11 or 12. As more and more kids become aware of it, more kids are trying it." She's also treated plenty of 30-year-olds, Conterio adds. "People keep doing it for years and years, and don't really know how to quit." The problem is particularly common among girls. But boys do it, too. It is an accepted part of the "Goth" culture, says Wendy Lader, PhD, clinical director for SAFE Alternatives. Being part of Goth culture may not necessarily mean a kid is unhappy. Lader says "I think kids in the Goth movement are looking for something, some acceptance in an alternative culture. And self-injury is definitely a coping strategy for unhappy kids." Very often, kids who self-harm have an eating disorder. "They may have a history of sexual, physical, or verbal abuse," Lader adds. "Many are sensitive, perfectionists, overachievers. The self-injury begins as a defense against what's going on in their family, in their lives. They have failed in one area of their lives, so this is a way to get control." Self-injury can also be a symptom for psychiatric problems like borderline personality disorder, anxiety disorder, bipolar disorder, schizophrenia, she says. Yet many kids who self-injure are simply "regular kids" going through the adolescent struggle for self-identity, Lader adds. They're experimenting. "I hate to call it a phase, because I don't want to minimize it. It's kind of like kids who start using drugs, doing dangerous things." Blunting Emotional Pain Psychiatrists believe that, for kids with emotional problems, self-injury has an effect similar to cocaine and other drugs that release endorphins to create a feel-good feeling. "Yet self-harm is different from taking drugs," Conterio explains. "Anybody can take drugs and feel good. With self-injury, if it works for you, that's an indication that an underlying issue needs be dealt with -- possibly significant psychiatric issues. If you're a healthy person, you might try it, but you won't continue." Self-harm may start with the breakup of a relationship, as an impulsive reaction. It may start simply out of curiosity. For many kids, it's the result of a repressive home environment, where negative emotions are swept under the carpet, where feelings aren't discussed. "A lot of families give the message that you don't express sadness," says Conterio. It's a myth that this behavior is simply an attention-getter, adds Lader. "There's a [painkiller] effect that these kids get from self-harm. When they are in emotional pain, they literally won't feel that pain as much when they do this to themselves." What It Looks Like David Rosen, MD, MPH, is professor of pediatrics at the University of Michigan and director of the Section for Teenage and Young Adult Health at the University of Michigan Health Systems in Ann Arbor. He offers parents tips on what to watch for: Small, linear cuts. "The most typical cuts are very linear, straight line, often parallel like railroad ties carved into forearm, the upper arm, sometimes the legs," Rosen tells WebMD. "Some people cut words into themselves. If they're having body image issues, they may cut the word 'fat.' If they're having trouble at school, it may be 'stupid,' 'loser,' 'failure,' or a big 'L.' Those are the things we see pretty regularly." Unexplained cuts and scratches, particularly when they appear regularly. "I wish I had a nickel for every time someone says, 'The cat did it,'" says Rosen. Mood changes like depression or anxiety, out-of-control behavior, changes in relationships, communication, and school performance. Kids who are unable to manage day-to-day stresses of life are vulnerable to cutting, says Rosen. Over time, the cutting typically escalates -- occurring more often, with more and more cuts each time, Rosen tells WebMD. "It takes less provocation for them to cut. It takes more cutting to get the same relief -- much like drug addiction. And, for reasons I can't explain but have heard often enough, the more blood the better. Most of the cutting I see is quite superficial, and looks more like scratches than cuts. It's the sort that when you put pressure on it, it stops the bleeding." What Parents Should Do When parents suspect a problem, "they are at a loss of how to approach their child," Conterio says. "We tell parents it's better to err on the side of open communication. The kids may talk when they're ready. It's better to open up the door, let them know you're aware of this, and if they don't come to you, go to someone else ... that you're not going to punish them, that you're just concerned." Be direct with your child, adds Lader. "Don't act out of anger or let yourself become hysterical -- 'I'm going to watch you every second, you can't go anywhere.' Be direct, express concern. Say, 'We're going to get help for you.'" Parents often mistake cutting for suicidal behavior. "That's usually when they have finally seen the cuts, and they don't know how to interpret it," explains Rosen. "So the kid gets dragged into the ER. But ER doctors aren't always used to seeing this, and find it difficult to understand whether it's suicidal or self-injurious behavior. Many kids who are not suicidal at all are being evaluated and even hospitalized as suicidal." Unfortunately, "the attitude in hospital emergency rooms can be very cavalier and harsh about self-injurers," adds Lader. "There's a lot of dislike, because it's a self-made injury, so ER personnel can be very hostile. There are all kinds of stories of girls getting stitched without anesthetic. The thing is, after they've self-injured, the girls are calmer -- so when they're getting stitches, they feel the pain. Yet the doctor is angry, wants to get this over with." Psychotherapy should be the first step in treatment, Lader adds. The SAFE web site has a list of doctors who have been to her lectures, who want to work with self-injurers. With other therapists, ask if they have any expertise in working with self-injurers. "Some therapists have a fear reaction to it. The therapist needs to be comfortable with it," she advises. However, the girl or boy must be ready for treatment, says Rosen. "The ultimate lynch pin is -- the child has to decide they're not going to do this anymore," he tells WebMD. "Any ultimatum, bribery, or putting them in a hospital is not going to do it. They need a good support system. They need treatment for underlying disorders like depression. They need to learn better coping mechanisms." When An Inpatient Program Is Necessary When kids just can't break the cycle through therapy, an inpatient program like SAFE Alternatives can help. In their 30-day program, Lader and Conterio only treat patients who voluntarily request admission. "Anybody who can't perceive that they have a problem will be hard to treat," says Conterio. Those who come to us have recognized that they have a problem, that they need to stop. We tell them in the acceptance letter we send them, 'This is your first step toward empowering yourself.'" When admitted to SAFE, patients sign a contract that they won't self-injure during that time. "We want to teach them to operate in the real world," says Lader. "That means making choices in response to emotional conflict -- healthier choices, rather than just self-injuring to feel better. We want them to understand why they are angry, show them how to handle their anger." Although self-harm is not allowed, "we don't take away razors," Conterio adds. "They can shave. We don't take belts or shoe laces. The message we're sending is, 'We believe you're capable of making better choices.'" Turning Inward to Heal Many kids haven't thought about it at all -- exactly why they self-injure, says Lader. "It's like any addiction, if I can take a pill or self-medicate in some way, why deal with the problem? We teach people that cutting only works in the short term, and that it will only get worse and worse." When kids learn to face their problems, they will quit self-harming, she adds. "Our goal is to get them to communicate what's wrong. Babies don't have the capacity for language, so they use behavior. These adolescents regress to that preverbal state when they self-harm." Individual and group therapy are the hubs of this treatment program. If there is underlying depression or anxiety, antidepressants may be prescribed. The patients also write regularly in their journals -- to learn to explore and express their feelings. Helping them gain self-respect and self-esteem is a critical treatment goal, Conterio tells WebMD. "Many kids have difficulty dealing with situations and people that make them angry," Lader adds. "They don't have great role models for that. Saying no, standing up to people -- they don't really believe they're allowed to do that, especially girls. But if you can't do that, it's very difficult to maneuver the world, survive in the world without someone stronger, more capable than you to fight your battles." Circular negative thinking keeps kids from developing self-esteem. "We help them empower themselves, take risks in confrontation, change how they view themselves," says Conterio. "If you can't set limits on someone else's behavior, stand up to them -- you can't like yourself. Once these girls learn to take care of themselves, stand up for what they want, they will like themselves better." "We want them to get to the point where they believe, 'I am somebody, I do have a voice, I can make changes, instead of, 'I'm nobody,'" she says. Staying Safe One study of the SAFE program showed that, two years after participating, 75% of patients had a decrease in symptoms of self-injury. An ongoing study is indicating a decrease in hospitalizations and emergency room visits. "I've been doing this for 20 years, and the success rate is far greater than the failure rate," says Conterio. "We truly believe that if people can continue to make healthy choices, they won't go back to self-harm. We get emails that are a blast from the past. Some patients do extremely well. Others regress. Others have finally decided to do the work they learned here. When they apply it, they do well. It all goes back to choice." The bottom line: "When kids decide they don't want to cut any more - and they get stressed again -- they have to be able to manage stress as it arises," Rosen says. "They can't succumb to cutting. People who can figure out some alternative way to manage stress will eventually quit it." Parents can help by providing emotional support, helping identify early warning signs, helping kids distract themselves, lowering the child's stress level, and providing supervision at critical times, Rosen says. "But a parent can't do it for them. It takes a certain level of resource to be able to stop cutting, and many kids don't have those resources. They need to stay in therapy until they get to that point." Self-harm is not a problem that kids simply outgrow,
Rosen adds. "Kids who develop this behavior have fewer
resources for dealing with stress, fewer coping mechanisms.
As they develop better ways of coping, as they get better at
self-monitoring, it's easier to eventually give up this
behavior. But it's much more complicated than something they
will outgrow." Wound Locations
Quick Facts on
Self-Injury
A brief overview of the signs of self-injury and how it's treated in children and adolescents. Self-injury is characterized by deliberately injuring oneself to alleviate some kind of emotional distress. The most common form of self-injury is cutting or scratching the skin, but people also self-injure by burning themselves, picking at skin and wounds, or hitting themselves. Self-injury is more common in girls than boys, and onset is often around puberty. Signs Your Child May Be Self-Harming:
How to Help If you discover that a child has been hurting herself it's important to have her evaluated by an experienced mental health professional to find out why she is self-injuring and what emotional difficulties she's experiencing. Therapy:
Medication: Often, if there is another disorder
involved, a doctor will prescribe medication to treat that
condition. The combination of medication and psychotherapy
is very successful at treating kids who self-harm. Cutting/Self Harm
Self-harm (SH) or deliberate self-harm (DSH) includes
self-injury (SI) and self-poisoning and is defined as the
intentional, direct injuring of body tissue without suicidal
intent. These terms are used in the more recent literature
in an attempt to reach a more neutral terminology. The older
literature, especially that which predates the DSM-IV-TR,
almost exclusively refers to self-mutilation. The term is
synonymous with
"self-injury."[1][2][3] The most
common form of self-harm is skin-cutting but self-harm also
covers a wide range of behaviours including, but not limited
to, burning, scratching, banging or hitting body parts,
interfering with wound healing, hair-pulling (trichotillomania
Self-harm in childhood is relatively rare but the rate
has been increasing since the 1980s.[12] Self-harm
is listed in the Diagnostic
and Statistical Manual of Mental Disorders
Self-harm is most common in adolescence and young
adulthood, usually first appearing between the ages of 12
and
24.[1][5][6][17][18]
However, self-harm can occur at any age,[13]
including in the elderly population.[19] The risk of
serious injury and suicide is higher in older people who
self-harm.[18] Self-harm is not limited to humans.
Captive non-human animals are also known to participate in
self-mutilation, such as captive birds and
monkeys.[20][21] Gender differences
Does Cutting Mean That Someone Is
Suicidal? Question: My teenage daughter has been cutting herself. Does this mean she is suicidal? Why does she want to hurt herself like this? Answer: While it might seem like she is hurting herself because she wants to commit suicide—after all, cutting the wrists is one method that people use to kill themselves—this isn't necessarily what her intentions are. People who injure themselves by cutting, scratching, burning and other methods of self-harm are often doing it as a way to relieve their emotional suffering. While it might seem counterintuitive that causing oneself physical pain could help emotional pain, many cutters report that this is exactly what happens. Cutting causes the release of chemicals called endorphins. Endorphins are the body's own natural painkillers and they help it to cope with the stress and pain associated with injury. They can also help dampen emotional pain. Other reasons that self-injurers often give for cutting and self-harm are: releasing anger, slowing down racing thoughts and coping with dissociation or flashbacks. When dissociation or flashbacks occur, the physical sensations of pain are a way for the person to ground themselves back in reality. While I can't say for certain whether your daughter is experiencing any thoughts of suicide, one thing I do feel fairly certain of is that she is going through quite a bit of emotional turmoil and needs your help and support. You will need to do what you can to ensure that she gets professional treatment with both medications (to help quell the feelings that are driving her urges to hurt herself) and therapy (to help teach her better ways to deal with her feelings). Please be aware that this is not just a passing phase that she is going through or a cry for attention. You should take this quite seriously. Cutting can be very addictive and hard to stop without assistance. There is also the risk that she may accidentally hurt herself more seriously than she intends to. Sources: Alderman, Tracy. "Myths and Misconceptions of Self-Injury: Part II." Psychology Today. Sussex Publishers, LLC. Published: Ocobert 22, 2009. Accessed: June 28, 2015. Ferrales, Diana and Sonja Koukel. "Teens and Self-Cutting (Self-Harm): Information for Parents: Guide I-104." New Mexico State University. New Mexico State University Board of Regents. Accessed: June 28, 2015. Lohmann, Raychelle Cassada. "Understanding Suicide and Self-Harm." Psychology Today. Sussex Publishers, LLC. Published: October 28, 2012. Accessed: June 28, 2015. It concerns me that you are, probably
unintentionally, aiding the concept that girls are the only
ones that self-harm. While you do use the word "people" at
times, I have yet to find a comment from you that says that
boys self-harm a about the same rate as girls, though their
self harm is more around burning and scratching. With
heading like "Does someone who cuts herself want to die?
makes it look like victomology and does not address the real
issue that it's not just a girl's issue by any means. How
different would that article and others you write, to
acknowledge the surprising statistic that self-harm is about
equally practiced by girls and boys. Wouldn't your readers
be shocked by that information? Changing the title of
that article to "Does someone who cuts themselves want to
die?" would give you a chance to talk about the issue
of equality and differenecs and bring this hidden fact to
light. depression.about.com/od/selfinjury/
How do I knows if my friend is
self-injuring? Sometimes it’s hard to know if a friend is self-injuring. For many people, self-injury is secretive. It is hard to talk about – even with a close friend. This secrecy itself may be a signal that something is wrong – especially if this is out of the ordinary for your friend (e.g., you notice your friend doesn’t want to hang out with anyone any more). Another important sign to look for is a significant change in your friend’s mood or behavior. If you notice that your friend is withdrawing from you or others and feeling down for a prolonged period of time, there may be something going on. As a friend, checking in to see what might be going on for your friend and expressing your concern is okay (we provide a few steps on how to bring up self-injury with your friend, below). Often, when people self-injure, they experience more negative moods (e.g., sadness, stress, anxiety, frustration); they may also become more distant. Here are a few other possible signs of non-suicidal self-injury that are important to be aware of: 1. Unexplained cuts, burns or bruises; these typically occur on the arms, legs and stomach. These signs do not mean that your friend is definitely
self-injuring, just that he/she might be. You should talk
with your friend if you suspect self-injury, as something
else besides self-injury could be going on. How do I talk to my friend
about self-injury? 1. Choose a good time to speak with your friend. It is best to talk privately in a place where you can both be comfortable and calm. If your friend does not want to talk about it,
that’s okay. It can be difficult at first. Continue to
let your friend know that he/she is not alone and that you
are there to support him/her. Let your friend know that you
are concerned and that you will be there to listen when they
are ready. Six types:
2. religious – self-flagellants and others. 3. puberty rites – hymen removal, circumcision or clitoral alteration. 4 .psychotic – eye or ear removal, genital self-mutilation and extreme amputation 5. organic brain diseases – which allow repetitive head-banging, hand-biting, finger-fracturing or eye removal. 6. conventional – nail-clipping, trimming of hair and shaving beards.[84]
Why Go to Therapy? Many of us have been to therapy, whether by choice or by force. We’ve sat in a chair week after week talking—or not talking—about our problems. However, we often don’t really understand the purpose of therapy. We’ve come up with our own definitions for our therapists: “That crazy lady who asks all the questions,” or, “That man who’s always in my business.” At Represent, many of us writers wanted to know how therapy is supposed to work and how a relationship with a therapist can be healing. So last year a group of us interviewed therapist Carrie King, director of the Children’s Psychotherapy Project in Brooklyn, NY, to sort out all of the ideas we have about therapy. Working Out the Past King was short and slim, empathetic but with a sharp tongue. She told us that most kids in care have been through traumatic experiences and that spending time in a safe place thinking about what has happened to you is important, because traumas can have a lasting impact. Even if years have passed, your mind and body may still be working out an understanding of a traumatic event that happened to you when you were much younger. Your feelings might come out through harmful behaviors like self-mutilation (hurting yourself) or eating disorders (bulimia, anorexia or binge eating). These are all signs that your mind and body are trying to work out what happened to you. If you were physically or sexually abused, you might never have fully allowed yourself to experience the feelings associated with what happened. Those feelings can come back in ways that may feel strange to you. For instance, some people develop panic attacks (a sudden feeling of intense anxiety, shortness of breath, sweating and trembling), or hypervigilance (an unusually high awareness of surroundings), or dissociation (a feeling of being separate from yourself and away from your body). “Kids who are molested grow up wondering if they’re good,” King told us. “They ask questions like: ‘Is who I am good enough? Am I good enough in relationships? Am I good enough as a friend?’” Her message was clear: although the abuse many of us endured was not our fault, it often leaves us feeling tainted, unworthy, or like we’re bad inside. The Risk of Getting Hurt Again King told us that if you don’t come to an understanding of what happened to you in the past, you might put yourself at a greater risk of being abused again. Many times, people who have suffered a trauma seek out experiences that feel similar to those that led to the painful experience. Just as you may replay the trauma in your head, trying to understand what happened or why, you may unconsciously replay the trauma in your life. King researched factors that affect whether adult women who had been sexually abused in the past were sexually abused again. She found two things: First, because it feels so bad to be abused, some women got depressed and started drinking or doing drugs. “Anyone on drugs or drinking is at a higher risk of being sexually assaulted,” King said, because they are not always aware of their surroundings or what’s happening to them. Second, some women feel so badly about themselves because of their past abuse that their vision of who they are and what their body means to them changes. “They lose an attachment to or respect for their bodies,” King said. So when there were danger signs, these women didn’t take action to protect their bodies from harm. “A repetition of the trauma (being abused in a similar way as in the past) shows you there’s still something you need to understand about how you think about what happened, or what it means to you, and how you approach your body and your life as a result,” she said. Why We Build Walls. . . Because of betrayals we’ve experienced in past relationships, many of us feel unsure about getting into new relationships. To protect ourselves from harm, we may build boundaries and walls inside to shield ourselves from people or situations that we fear may hurt us. But those walls—like reacting to other people with distrust or hostility—can also make us feel isolated or misunderstood. We asked if it’s possible to loosen our boundaries so we can truly become close to others, and how we could go about doing that without making ourselves unsafe. “You built that boundary because you love yourself and you had the will to survive,” King said. “But when the danger is not there anymore, you have to let go of those boundaries.” King told us that you can take certain steps to help you rethink how you approach others. . . .And How to Take Them Down The first step is to acknowledge that you built those walls for a reason: you needed to protect yourself from danger. The second is asking yourself, “Why did I build this?” Looking back at what you didn’t have as a child (like protection or consistent love) and figuring out if you have it now or not is a lot of work. It means considering your past and seeing how many things in your life have changed, investigating your mind and environment consciously and seeing how safe you really are now. The third step is to begin to take the boundary down. That’s a huge thing to do because you’re making yourself vulnerable and leaving the familiar. Say one of your former foster parents abused you by constantly cutting you down. You might have become hostile and untrusting of people, fearing that they will do the same thing. But once you become aware of this pattern you decide to try to let go of your hostility and distrust and connect to positive, caring friends and adults. That’s a great goal, but scary. You are leaving the ways of acting that you are familiar with and trying out a new way of relating to people that you hope will be better. But acting more openly might lead to getting hurt again. When taking any risk, it’s best to have someone safe to return to for support and to reflect on the feelings that risk-taking raises inside of you. That’s where a therapist can be more helpful than a friend or even a mentor. “It’s very hard for a friend to help you feel safe enough to take such enormous risks. In most cases, it takes someone who is trained,” King said. Seeing the Big Picture King told us that therapists can often help their clients hear themselves. She gave us an example of a girl who says she wants to settle down, but is constantly going from guy to guy. “I would try to get her to figure out why she’s going from guy to guy if she wants to be connected to one person,” she said. A therapist can help you think about your experiences in new ways. “Sometimes you spend so much time in your own head, you lose the creativity of thinking about your problems in a different way. Telling someone else and hearing their ideas on your problems can be good,” she told us. Many of us believed that our therapists’ main job is to give advice on the day-to-day goings-on in our lives. But King told us that she is not there to give advice and solve problems; she’s there to observe and notice her clients’ behaviors and to pay attention to the larger themes in their lives, such as the main emotions they feel, experiences they seek out and patterns of their behavior. She said therapists are trained to see the big picture. “We try to look for what’s behind all the details of a story: the rage, or the fear of being left again, or the worry about what’s going to become of you. Those are the bigger things, the big umbrella sort of piece behind many of your stories,” she said. We thought therapists must become bored listening to their clients for hours, but King said even boredom can be useful. “When someone is telling a big long boring story, I use it to think, ‘What’s happening here? Why am I feeling bored’?” Sometimes people go on and on about something unimportant to avoid talking about something real or important. If the therapist points that out, they can at least talk about why the client is avoiding a more important conversation. Speaking with Dr. King made therapy seem less scary and
threatening. She helped us see that with the right person,
therapy is a place where you have the freedom and safety to
think and talk about painful experiences in your past, and
to get help changing harmful patterns of thinking or acting,
so you don’t get hurt again. The thing that comes to mind when I look at my friends is, "How much did you cut today?" It hurts my heart to know they do it. A couple of them do it on their legs. They wear pants in the summer so no one can see the nasty gashes and scars. My other friends do it on their arms and wear long-sleeved shirts or sweater-shirts in 80-degree weather. It's scary knowing some of your closest friends do this. I am only 14 and I am crying out for help. What can I say or do to make them stop? I feel like if I tell them, they'll feel bad and cut more and I really don't know what to do. I don't think they realize how much this hurts not just them, but me. Please print this soon. Frightened and Worried in Minnesota: Dear Frightened: You are right to be worried about your friends. They are in serious trouble. Strange as it may seem, people who cut themselves do it to distract themselves from their emotional pain. Cutting is usually a symptom of a serious emotional problem, and often cutters need professional intervention to stop their compulsion. One would think that a child's parents would recognize that something was wrong when the young person habitually wears clothing that is inappropriate for the season - but apparently your friends' parents are too focused on something else to notice. Your friends are sick, and they're not likely to listen to you at this point. That's why you must tell your parents what is going on, so they can tell the other adults that their children are in need of treatment - and the sooner the better. Editor's Note: Another option is to talk to your
school's counselor. Too often the emotional/physical/sexual
abuse that creates emotional pain comes from the parents of
the cutters. Even if this isn't so, it's not a bad idea to
guarantee outside sources are involved in the situation. Self-mutilation rampant at 2 Ivy League schools Survey: 17 percent at Cornell and Princeton purposely cut themselves Sarah Rodey, 20, a University of Illinois student began self-injuring by cutting herself, a disturbing phenomenon that counselors say is happening at colleges, high schools and middle schools nationwide. Nearly 1 in 5 students at two Ivy League schools say they have purposely injured themselves by cutting, burning or other methods, a disturbing phenomenon that psychologists say they are hearing about more often. For some young people, self-abuse is an extreme coping mechanism that seems to help relieve stress; for others it’s a way to make deep emotional wounds more visible. The results of the survey at Cornell and Princeton are similar to other estimates on this frightening behavior. Counselors say it’s happening at colleges, high schools and middle schools across the country. Separate research found more than 400 Web sites devoted to subject, including many that glorify self-injury. Some worry that many sites serve as an online subculture that fuels the behavior — although whether there has been an increase in the practice or just more awareness is unclear. Sarah Rodey, 20, a University of Illinois student who started cutting herself at age 16, said some online sites help socially isolated kids feel like they belong. One of her favorites includes graphic photographs that the site warns might be “triggering.” “I saw myself in some of those pictures, in the poems. And because I saw myself there, I wanted to connect to it better” by self-injuring, Rodey said. The Web sites, recent books and media coverage are pulling back the curtain on the secretive practice and helping researchers better understand why some as young as grade-schoolers do it. “You’re trying to get people to know that you’re hurting, and at the same time, it pushes them away” because the behavior is so distressing, said Rodey, who has been diagnosed with bipolar disorder. The latest prevalence estimate comes from an analysis of responses from 2,875 randomly selected male and female undergraduates and graduate students at Cornell and Princeton who completed an Internet-based mental health survey. Seventeen percent said they had purposely injured themselves; among those, 70 percent had done so multiple times. The estimate is comparable to previous reports on U.S. adolescents and young adults, but slightly higher than studies of high school students in Australia and the United Kingdom. 'An increasing phenomenon' The study appears in this month’s issue of Pediatrics, released Monday. Cornell psychologist Janis Whitlock, the study’s main author, also led the Web site research, published in April in Developmental Psychology. Among the Ivy League students who harmed themselves, about half said they’d experienced sexual, emotional or physical abuse that researchers think can trigger self-abuse. Repeat self-abusers were more likely than non-injurers to be female and to have had eating disorders or suicidal tendencies, although self-injuring is usually not considered a suicide attempt. Greg Eels, director of counseling and psychological services at Cornell, said the study’s findings are not surprising. “We see it frequently and it seems to be an increasing phenomenon.” While Eels said the competitive, stressful college environment may be particularly intense at Ivy League schools, he thinks the results reflect a national problem. Dr. Daniel Silverman, a study co-author and Princeton’s director of health services, said the study has raised consciousness among his staff, who are now encouraged to routinely ask about self-abuse when faced with students “in acute distress.” “Unless we start talking about it and making it more acceptable for people to come forward, it will remain hidden,” Silverman said. Some self-injurers have no diagnosable illness but have not learned effective ways to cope with life stresses, said Victoria White Kress, an associate professor at Youngstown State University in Ohio. She consults with high schools and says demand for her services has risen in recent years. Psychologists who work with middle and high schools “are overwhelmed with referrals for these kids,” said psychologist Richard Lieberman, who coordinates a suicide prevention program for Los Angeles public schools. He said one school recently reported several fourth-graders with burns on their arms, and another seeking help for “15 hysterical seventh-grade girls in the office and they all have cuts on their arms.” In those situations, Lieberman said there’s usually one instigator whose behavior is copied by sympathetic but probably less troubled friends. Rodey, a college sophomore, said cutting became part of her daily high school routine. “It was part of waking up, getting dressed, the last look in the mirror and then the cut on the wrist. It got to be where I couldn’t have a perfect day without it,” Rodey said. “If I was apprehensive about going to school, or I wasn’t feeling great, I did that and I’d get a little rush,” she said. Whitlock is among researchers who believe that “rush” is feel-good hormones called endorphins produced in response to pain. But it is often followed by deep shame and the injuries sometimes require medical treatment. Vicki Duffy, 37, runs a Morris County, N.J., support group and said when she was in her 20s, she had skin graft surgery on her arms after burning herself with cigarettes and a fire-starter. After psychological and drug treatment, she stopped the behavior 10 years ago. Author of the 2004 book “No More Pain: Breaking the Silence of Self-Injury,” Duffy recalled being stopped on the street by a 70-year-old woman who saw her scarred arms and said, “’I used to do that.”’ Rodey said she stopped several months ago with the help of S.A.F.E. (Self-Abuse Finally Ends) Alternatives treatment program at a suburban Chicago hospital. Treatment includes behavior therapy and keeping a written log to track what triggers the behavior. Rodey said she feels “healed” but not cured
“because it’s something I will struggle with the
rest of my life. Whenever I get really stressed out,
that’s the first thing I think about.” Self-injury Awareness Day
(SIAD) An annual global awareness event/campaign on March 1, where on this day, and in the weeks leading up to it, some people choose to be more open about their own self-harm, and awareness organizations make special efforts to raise awareness about self-harm and self-injury. Some people wear an orange awareness ribbon, wristband, or beaded bracelet to encourage awareness of self-harm. eqi.org/nsiad.htm 
and en.wikipedia.org/wiki/Self_Injury_Awareness_Day
and confusinglife.tripod.com/id20.html
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(March 1)
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