Self-injury is
the act of deliberate, repetitive, impulsive, non-lethal harming of
one's body. Many people who self-harm do not even know they are doing
it. For example, some people pinch themselves until they create a
scar or pick at their fingernails until they bleed. The adoption of
self-injury practices usually indicates an unhealthy coping response.
The actual act of self harm may include:
Cutting.
Scratching.
Picking scabs or interfering with wound healing.
Burning.
Punching self or objects.
Infecting oneself.
Inserting objects in body openings.
Bruising or breaking bones.
Some forms of hair pulling.
Excessive Body Piercing.
Also called self-inflicted
violence, self-injury, self-harm, parasuicide, delicate cutting, self-abuse
or self-mutilation. Main characteristic are:
The act of self-harm reduces psychological, physiological tension
and arousal to normal.
Self-injurers may perform their ritual in private, bandage their own
injuries and don’t discuss the issue with anyone.
Low self-esteem and feelings of hopelessness and worthlessness.
Type of self-injury is pathological, as opposed to culturally-sanctioned.
The acts are compulsive, episodic, and repetitive.
Experiencing a depressed mood with a high degree of irritability and
sensitivity to rejection and some underlying tension.
Self-mutilators often are unable to provide explanations for their
own self-mutilative behavior.
The disturbance is not due to the direct physiological effects of
a substance (e.g., a drug of abuse, a medication) or a general medical
condition.
Associated
Features:
Groups at risk
include persons with borderline personality disorder (especially females
16 to 25 years of age), persons in a psychotic state (frequently males
in young adulthood), emotionally disturbed and / or battered children,
mentally retarded and autistic children and persons with a history
of physical, emotional, or sexual abuse.
Physical or
Mental Abuse.
Unusual outbursts.
Withdrawal and Depression.
Inability to deal with emotions.
Sleeping more than normal.
Secluding themselves from family, and friends.
Emotionally distressed person who retreats for small period of time
and returns.calm or sedated.
Differential
Diagnosis:
Some disorders have similar symptoms. The clinician, therefore, in
his diagnostic attempt, has to differentiate against the following
disorders which need to be ruled out to establish a precise diagnosis.
Factitious
Disorder - Munchausen's Syndrome.
Depression.
Schizophrenia.
Masocistic
Personality Disorder.
Suicide
Attempt.
Borderline
Personality Disorder.
Bipolar Disorder.
Major Depression.
Anxiety Disorders.
Posttraumatic Stress
Disorder.
Cause:
Those who have
difficulty talking about their feelings may show their emotional tension,
physical discomfort, pain and low self-esteem with self-injurious
behaviors. Other factors identified include:
Relief from
psychological / Emotional pain.
Release of tension.
Inability to handle feelings, good or bad.
Expressing anger.
Treatment:
The effective treatment of self-injury
is most often a combination of medication, Cognitive Behavioral Therapy,
and/or Interpersonal Therapy, supplemented by other treatment services
as needed.
Counseling
and Psychotherapy [ See
Therapy Section ]:
Cognitive Behavioral
Therapy that incorporates contracts, journals, and behavioral logs
are useful tools for regaining self-control. Interpersonal therapy
assist individuals in gaining insight and skills for the development
and maintenance of relationships, and helps individuals understand
their destructive thoughts and behaviors.
Pharmacotherapy
[ See Psychopharmacology
Section ] :
Medications that
stabilize mood, ease depression, and calm anxiety is being done; some
of these drugs may help reduce the urge to self-harm.
