- We live in a violent, “no pain, no gain” culture.
- Self-harm is often culturally acceptable (e.g. body art, medically unnecessary cosmetic surgery, violent sports, high-risk behaviors).
- Religious convictions sometimes reinforce/contribute to self harm (penance, “finishing out the sufferings of Christ”, “mortification of the flesh”, self-loathing, body hostility)
Myths About Self-Harm
- People who self-harm are just trying to get attention.
- Self-inflicted violence is just an attempt to manipulate others.
- People who self-injure are crazy.
- If the wounds aren’t “bad enough,” self-harm isn’t serious.
- Only teen-aged girls self-injure.
Common characteristics of adolescent self-harm
- Repetitive, non-suicidal injury not associated with delusions, hallucinations or mental retardation.
- Common Forms: superficial cutting, scratching, hitting, burning, hair pulling
- Typical age of onset: 13-14
- Co-occuring disorders: anxiety disorders, substance abuse, eating disorders, depression
- Complicated Issues:
- Link to sexual abuse?
- Suicide risk or anti-suicidal behavior?
- Addictive aspects of self-harm?
What’s the motivation?
- Pain as evidence I exist. (I can still feel!)
- Affect modulation (distraction from unwanted affect, a preference for intelligible pain.)
- Self-punishment (This is what I deserve. Purification?)
- Expression of things that can’t be put into words (returning to the scene of the crime?)
- The visualization of unexperienced experiences (body memories?)
- Maintaining control (a pain I can control, reenactment of abuse in a way that allows me to be in a more powerful role?)
How to Be Helpful
|Hurtful Things||Helpful Things|
|Panic/Shock/Call 911/Allow their anxiety to trigger my anxiety||Stay calm. Get appropriate help to manage my own anxiety.|
|Respond/argue about ideas or attempt to control behavior(rewards or punishments).||Respond to emotional pain and make room for expression of that pain.|
|Telling them they shouldn’t do that. Telling them God doesn’t want them to do that.||Listen|
|Tell them to try harder, pray harder etc.||Tell them you care about and respect them|
|Hope for the best. Refer and disengage.||Stay engaged, encourage them to seek professional help and to find multiple safe places to talk about their issues|
- Katherine Ryan, Melissa Allen Heath, Lane Fischer and Ellie L. Young, Superficial Self-Harm: Perceptions of Young Women Who Hurt Themselves. Journal of Mental Health Counseling Volume 30/Number 3/July 2008/Pages 237–254 [Full text available online at EBSCOhost. Accession Number: 2008-09842-005]
- Jacqueline Mangnall and Eleanor Yurkovich, A Literature Review of Deliberate Self-Harm, Perspectives in Psychiatric Care, Vol 44(3), Jul 2008. pp. 175-184. [Full text available online at EBSCOhost. Accession Number: 2008-09619-005]
- E. David Klonsky and Jennifer Muehlenkamp, Self-injury: A research review for the practitioner, Journal of Clinical Psychology, Vol 63(11), Nov 2007. pp. 1045-1056. [ [Full text available online at EBSCOhost. Accession Number: 2007-16760-002]
- Self Multilators Anonymous
- S.A.F.E. Alternatives: a treatment program
- Lysamena Project on Self-Injury
- Cornell Research Program on Self-Injurious Behavior
- Conterio, K. & Lader, W. (1998). Bodily harm: The breakthrough treatment program for self-injurers.(Hyperion)
- Favazza, A. R. (1996). Bodies under siege: Self-mutilation and body modification in culture and psychiatry (2nd ed.). (Johns Hopkins University Press)
- Miller, D. (2005)Women Who Hurt Themselves: A book of hope and understanding. (Basic Books)
- Clarke, A. (1999). Coping with self-mutilation: A helping book for teens who hurt themselves. (Hazeldon)
- Alderman, T. (1997). The scarred soul: Understanding and ending self-inflicted violence. Oakland, CA: New Harbinger.