Self Injury

1. Self Injury • Self-Injury is also termed self-mutilation, self-harm or self-abuse. The behavior is defined as the deliberate, repetitive, impulsive, non-lethal harming of one’s self.

2. Self-injury includes: 1) cutting, 2) scratching, 3) picking scabs or interfering with wound healing, 4) burning, 5) punching self or objects,

3. 6) infecting oneself, 7) inserting objects in body openings, 8) bruising or breaking bones, 9) some forms of hair-pulling, as well as other various forms of bodily harm.

4. These behaviors, which pose serious risks, may by symptoms of a mental health problem that can be treated.

5. When a subject recalls a painful event from the past, feelings of rejection, anger, shame, and low self-worth arise.

6. Previous efforts to communicate this pain have been kept secret due to embarrassment and the unspoken familial code of silence.

7. Pain becomes hard to communicate and victims use mutilation as a way to express overwhelming emotions. Cutting becomes a desperate ploy to obtain empowerment, control, and self healing.

8. Self Injury/Self Mutilation • Stone and Sias (2003) state that self-mutilation refers to a complex group of behaviors in which there is "deliberate destruction or alteration of body tissue without conscious suicidal intent" (p. 113).

9. Why???? • Self-mutilation is a ritual performed for different reasons than suicide and should not be compared or confused with the latter. The self-mutilator uses pain to mask emotional pain, but does not intend to destroy the entire body .

10. Who????? • More girls than boys do self injury • Begins around the onset of puberty • Have average to high intelligence • Little ability to share feelings • Treatment takes time

11. Self Injury • Levenkron (1998) states that "the current trend of piercing the skin on various parts of the face and body ... is not self-mutilation. This behavior, although repugnant is not considered self injury.

12. Self Injury Examples • Examples might include skin carving, scratching or scraping, needle piercing, and minor burns. • Razor blades, Exacto knives, lighters, pins, bathroom tissue dispensers

13. Mutilation is a way to alleviate stress, depression, rejection, hyperactivity, excessive physical activity of emotional or physiological origin, usually seen in young children; numbness, and feelings of alienation.

14. Origin • Relatively new • Trend began around 10 years ago • Has become a silent epidemic

15. Factors that Trigger Self Injury • Stress • Depression • Conflict with parents • Social Acceptance • Sexual Abuse

16. While self-mutilation can be a real release for the people who do it, it can also be quite scary for them. Once the act of cutting and the release of blood have revived them, they can be quite frightened by what they have done to themselves.

17. Those who cut for social reasons show off the cuts • Real cutters are secretive and hide the cutting or burns

18. Many people who self-mutilate do not feel any pain when they are hurting themselves. They can break their own bones, burn themselves with hot irons, or cut up their arms -- with no feeling of pain. 

19. Researchers have discovered that, for some people, the stress of traumatic memories or emotional pain causes the brain to release chemicals that act as a kind of pain reliever. These chemicals are so powerful that they block the physical pain of self-mutilation. 

20. Some researchers believe that cutting and other self-harming behaviors can become addictive as a person begins to crave that rush of pain relieving chemicals and the calming effect they have come to rely on. 

21. So, once someone starts cutting, it can be hard to stop, even if they know that it's not a healthy thing to do.

22. The following statement are not true about individuals that cut: • They are crazy. • They do it for attention. • All they have to do is stop doing it. • Cutting is just a weak suicide attempt. • If we ignore it, it will go away. • They will grow out of it.

23. Myths • Myth # 1 Self-mutilators use this behavior to manipulate other people. • Truth-This physical pain is inflicted in an attempt to replace emotional rage.

24. Myth # 2 Self-mutilation is synonymous with suicide. • Truth-It is performed for different reasons and cutters do not intend to end their life; he/she wants to stop the emotional pain.

25. Myth # 3 Self-mutilators are dangerous and will probably harm others. • Truth-Self-mutilation is usually secretive and is most often performed in isolation to alleviate emotional pain.

26. Myth # 4 Self-mutilators just want attention. • Truth-Most self-mutilators perform their ritual and symbolic acts in private. They are often humiliated  about their scars and keep them private and hidden from view.

27. What We Can DO • Educate teachers and other staff on the importance of listening and empathizing with students.

28. Step 1 • Understand that cutting is that person's way of coping with a difficult situation. Cutting provides physical pain that covers up emotional pain.

29. Step 1 Cont. • Endorphins are released by the brain when the body is cut. Those endorphins relieve the pain and provide a sense of well-being. Unfortunately, endorphins are addictive and when emotions run high, the brain craves their calming effect.

30. Step 2 • Notice the type of clothing he/she wears. People who cut themselves often choose clothes or accessories that cover their scars.

31. Step 3 • Listen to the way the student expresses herself. Most people who cut themselves don't have the emotional skills to express their strong feelings in a healthy way.

32. Step 4 • Recognize his mental illness. People who cut themselves often suffer from other mental illness such as eating disorders, obsessive-compulsive disorder, bipolar disorder and depression. Look at the cutting as a sign of emotional trouble that needs to be dealt with.

33. Step 5 • Make yourself available to the student. Do not criticize or be abrasive about the cutting habit. Explain that he/she can have a healthier and happier life and that you are there to help her.

34. Step 6 • Know when he/she is cutting / burning etc. for attention. There are those who cut themselves to get attention or to feel like they are part of the crowd.

35. These "social cutters" make their actions known to others. They show off their scars or mention the habit in social settings. Reinforce that it is not a cool behavior.

36. Step 7 • Outside professional counseling is necessary and may result in temporary inpatient counseling. • The sooner she/he addresses the underlying issues of her habit, the sooner she/he begins dealing with emotions in a healthy way using newly learned coping skills.

37. Sometimes, if people are depressed, it can be hard for them to explain to others how they feel, and they may not even have the energy to try. That isolation can lead them to take their pain and anger out on themselves. 

38. They may use a brief episode of self-mutilation as a way to express how they feel. They may scratch up their arms or legs once or twice and then leave it at that. For others, though, it can turn into an addiction.

39. Behaviors can be short term • Can last 5-10 years or much longer without treatment • What caused this did not happen over night, thus cannot be cured overnight.

40. School Prevention/Care Checklist • FRESH WOUNDS OR INFECTIONS REQUIRE IMMEDIATE ATTENTION FROM THE NURSE • REFER TO COUNSELOR • PARENT NOTIFIED • PROFFESIONAL HELP WILL BE SOUGHT

41. Just as depression can be described as anguish turned inward, self-mutilation can be described as psychic pain turned inward in the most physical way. Girls who are in pain deal with that by harming themselves." -- Mary Pipher, Reviving Ophelia

42. Cutting becomes a desperate ploy to obtain empowerment, control, and self healing.

43. Student Talk Line • 1-800-273-TALK (1-800-273-8255

44. www.selfinjury.org • www.thefreelibrary.com • www.guidancechannel.com