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.
