self-harm

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Understanding the “Voice” of Self-Injury

August 25, 2009 in Self Injury by Evelyn Wenzel

Self-injurious behavior has a voice and it speaks of the underlying pain that is buried deep inside. It communicates the emotional pain that can only be represented by physical marks. Sometimes self-harm speaks such loud internal critical self-talk that punishment must ensue and the self-injurer cuts. Perhaps self-injury functions the most frequently as a way to regulate moods. The anxiety and confusion that has built up like an internal combustion engine must be qualmed and the self-injury harms him/herself to bring relief, relaxation, and a sense of calm.

 

There are several other functions that self-injury serves. When the person feels deadened to the world around him/her and emotionally numb, self-harm helps him/her feel alive. The blood seems to bring peace and a certainty of aliveness. It seems to ground the person back to reality. Oddly enough, self-injury can be a way people self-soothe. Once they have burned or cut themselves, they use great care to tend to their injury. It may be the only instance where they pay attention to their needs.  Self-injury can also be used to dissociate, transporting the person to a place where they no longer feel the intense emotions that seem daunting.

 

Sometimes their may be one or more of these functions that self-injury plays. Knowing the function self-injury has in the life of the self-injurer is important for treatment considerations. Understanding the importance of this coping method in the self-injurers life is vital to designing an individual treatment program unique to that person. Developing a voice to communicate without self-injury is always one important aspect of therapy.

 

To learn more about self-injurious behavior, contact Evelyn Wenzel, MSW, LCSW, CAP.

 

 

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The Great Disconnect: Adolescent Self-Injurious Behavior

March 31, 2009 in Self Injury by admin

Self-injurious behavior is no longer seen as novel or unusual behavior. When I asked a college student what she thought about such behavior, she replied that she thought it was stupid, but it certainly was common. People are inundated with this behavior. Real World San Diego had a “cutter” on its show. Several popular television shows have characters who cope with stress by cutting themselves. Christina Ricci has expressed her fling with self-mutilation in Rolling Stones magazine. Internet message boards are out there for those who want to learn more about how to cut or receive support not to cut.

Dr. Janis Whitlock at Cornell University recently published an article in Pediatrics indicating that she found that 20% of women and 14% of males on 2 major college campuses engage in self-injurious behavior at least once in their lifetime. 

With all the hype on television, internet and video, one would think that younger teenagers would be drawn to such behavior. However, Dr. Nancy Heard found that about 14% of adolescents try self-injurious behavior. I have found many teens try self-injurious behavior just to see what it feels like. This usually is the only time they do it. It hurts and doesn’t achieve any desired effect, such as tension release. Some, however, find that this is the way they want to express their anger, fears and loneliness. It becomes the way to avoid communication and a way to cope with overwhelming emotions. Regardless of who cuts/burns more, the number of self-injurious adolescents and young adults is not likely to abate.

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Self-Harm: Should Self-Mutilarion Be considered Suicidal Behavior

March 31, 2009 in Self Injury by admin

Although all behavior that causes tissues damage should be assessed for lethality, the intent of self-mutilating behavior is one of reaffirming life. So no, it is not a suicidal act and the person should not be treated as if they had attempted to end their life. Adolescents and adults who self-injure generally do not have the words to express the emotions that underlie the behavior. “Cutting” is an active way for them to express their emotions visually. Cutting also, by its very nature communicates a very profound anger. It may also convey self-hatred, but the self-mutilation does not equate with permanent self-destruction.Self-mutilation generally is scratching, cutting, hitting oneself, or burning. The locations where adolescents self-mutilate are: wrists, forearms, legs, etc. Most of the tissue damage is not severe enough to cause much bleeding. The problem, however, is that many adolescents are unaware of the location of arteries or of the depth of cuts that might create problems. Research supports the tendency for a self-mutilator to use a different method to commit suicide than the one they use to self-harm. They might use poison to try to kill themselves, where they used a razor blade as a means to draw blood.Scars and open wounds normally are covered or hidden. When open wounds are visibly apparent, the self-harmer may be attention seeking, may be trying to manipulate another, or may even by crying for help. However here the likelihood of a suicide attempt is exponentially increased as this is much more of a dramatic show staged with the intent of letting others know their pain. The term for this type of behavior is more appropriately deemed “para-suicidal”.Oftentimes friends and family of those who know “cutters” try to force them to stop their acting out. Usually self-mutilation is a result of their discomfort. Until the self-injurer has an increased emotional vocabulary and has developed new coping methods of their own, trying to force them to give up cutting is counterproductive. Be supportive by listening and trying to truly understand what they have to say. Suggest therapy if they are not going to counseling. Finally work through your own emotions that the “cutter” has brought up and seek counseling yourself if necessary.Evelyn Wenzel LCSW, CAP may  be contacted at (407)375-1214.

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