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Self-Injury

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.
  

related books
  Secret Scars: Uncovering and Understanding the Addiction of Self-injury
UK Support Groups
  Bristol Crisis Service for Women

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Helpline 0117 925 1119
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Page Updated
13th August 2003