Self-Injury Behavior (Cutting)Self-injury is best defined as the deliberate mutilation of the body or a body part, done not with the intent to commit suicide, but as a way of managing emotions that seem too painful for words to express. It can include cutting or burning the skin or bruising oneself through a premeditated accident. It can mean scratching the skin until it bleeds or interfering with the healing of wounds.
History of Self-Injury Though the media and the medical community appear to have just discovered self-injury, the phenomenon was documented as early as biblical times. Mark 5:5 refers to a demon-possessed man who “always, night and day, was crying and cutting himself with stones.”
In the middle Ages a religious sect known as the “flagellants” wandered through Europe, lashing themselves with cat-o’-nine-tails, attempting to atone for society’s sins and to lift the great plague ravaging the continent. Manifestations of self-injury — as ritual, rite of passage or to appease angry gods —have existed in virtually every culture and every era.
Self-injury is the act of attempting to alter a mood state by inflicting physical harm serious enough to cause tissue damage to your body. This can include cutting (with knives, razors, glass, pins, any sharp object), burning, hitting your body with an object or your fists, hitting a heavy object (like a wall), picking at skin until it bleeds, biting yourself, pulling your hair out, etc. The most commonly seen forms are cutting, burning, and head banging.
"Tissue damage" usually refers to damage that: tears, bruises, or burns the skin -- something that causes bleeding or marks that don't go away in a few minutes. A mood state can be positive or negative, or even neither; some people self-injure to end a dissociated or unreal-feeling state, to ground themselves and come back to reality.
Cutters deliberately hurt themselves to feel better, to get rapid respite from distressing thoughts and emotions, and to regain sense of control.
What is Cutting?Someone who cuts uses a sharp object to make marks, cuts, or scratches on the body on purpose — deep enough to break the skin and cause bleeding. People typically cut themselves on their wrists, forearms, thighs, or belly. They might use a razorblade, knife, scissors, a metal tab from a soda can, the end of a paper clip, a nail file, or a pen. Some people burn their skin with the end of a cigarette or lighted match.
Cutting often begins as an impulse. But many teens discover that once they start to cut, they do it more and more, and can have trouble stopping. Many teens who self-injure, report that cutting provides a sense of relief from deep painful emotions. For this very reason, cutting is a behavior that tends to reinforce itself. Cutting can become a teen's habitual way to respond to pressures and unbearable feelings. Many say they feel "addicted" to the behavior. Some would like to stop but don't know how or feel they can't. Other teens don't want to stop cutting.
What Kinds of People Self-Injure?
Self-injurers come from all walks of life and all economic brackets. People who harm themselves can be male or female; gay, straight, or bi; Ph.D.s or high-school dropouts (or high-school students); rich or poor; from any country in the world. Some people who SI manage to function effectively in demanding jobs; they are teachers, therapists, medical professionals, lawyers, professors, engineers. Some are on disability.
Their ages range from early teens to early 60s. In fact, the occurrence of self-injury is about the same as that of eating disorders, but because it's so highly stigmatized, most people hide their scars, burns, and bruises carefully. They also have excuses ready when someone asks about the scars (there are a lot of really vicious cats around).
Educational Issues Regarding Self-Injurious Behavior Questions that define what it is:
1) Does the self-injurer deliberately cause physical harm to his or her self to the extent of causing severe tissue damage (leaving marks that last for more than an hour)?
2) Does the self-injurer cause this harm to his or her self as a way of dealing with unpleasant or overwhelming emotions, thoughts, or situations?
3) If the self-harm is not compulsive, does the self-injurer often think about SIB even when he or she is relatively calm and not doing it at the moment?
If the individual answers #1 and #2 yes, then they are a self-injurer. If the individual answers #3 yes, they are most likely a repetitive self-injurer.”
What it is not: it is not suicidal!! Often it is done to prevent or ward off suicide.
Is the client’s body being used as a bulletin board?
Statistics and Traits • Female – 70%
• Males are more frequently hospitalized
• Middle to upper socioeconomic status
• Average to above average intelligence
• Correlation between childhood abuse and SIB – 80%
• Linemann hypothesizes that people who engage in SIB grow up in “invalidating environments”; invalidating environment is one in which communication of private experiences are met by erratic, inappropriate or extreme responses.
• Traits sometimes connected with SIB: sensitive to rejection, chronic anger & depression, suppress anger & feelings, feelings of anxiety & powerlessness, impulsivity, tend to be avoidant, view things as static & non-changing
• Studies have suggested that when people who self-injure get emotionally overwhelmed, an act of self-harm brings their levels of psychological and physiological tension and arousal back to a bearable baseline level almost immediately. They may still feel bad (or not), but they don't have that panicky jittery trapped feeling; it's a calm bad feeling.”
SIB and Irrational Thoughts
• Self injury does not hurt anyone.
• I don’t understand why it upsets others.
• It my body and I can do what I want with it.
• It’s not my fault. It just happens.
• I’m stronger than others. I can take the pain.
• If I don’t self injure I will kill myself.
• It’s the best way for others to see my pain.
• Nobody knows that I injure myself anyway.
• It’s the only way to know if people care about me.
• I need to be punished. I am bad.
This person’s thoughts display poor reality testing. There is probably infrequent social contact & when it occurs the other person may also be dysfunctional.
Three Therapists
- First therapist said she would ask the client if she was ready to try something new. “What you’re doing now isn’t working, is it?” “You have advanced into another stage in your life. The old way of doing things is the old way.”
- Second therapist disagreed with first therapist. “The other therapist was being judgmental. A parent might have said what the other therapist said. The message is you are screwing up!! The client may say ‘Yeah, I’ll stop’ in order to comply but keep on cutting. The client may stop seeing therapists. The client has not been shown any other way to channel emotions by parents or the other therapist.”
“I would try to get the client back in touch with her body, her senses. Let her play with clay while we are talking. Engage her in expressive art therapy, e.g. Sand Tray therapy which works with unconscious content, is non-threatening, sensory & can be non-verbal. No contracts, no weekly goals. First get physical sensations back on track & then work on emotional sensations.” - Third therapist: “Some therapists focus on stopping the SIB ASAP because they themselves are not comfortable with it -- it repulses them, it makes them feel ineffective, frightens them. An ideal approach would be one in which SIB is tolerated but has specific consequences. For example, a client might be invited to contact the therapist when an urge to self-harm occurs, but restricted from contact for 24 hours after an actual self-injurious act”
There is no right or wrong way. See what fits the client & therapist and then get going.
All of the Following are Motivators for Self-Injurious Behavior:
• Limited or primitive communication
• Punishment of self/others
• Control over affect states
• Avoidance of separation/loss
• Control over relationships
• Self-preservation prevention
Source:
Secret Shame
Self-Injury Awareness
Self-Injurious Behavior
Welcome to our blog. This blog is intended to increase education and awareness on Self Injurious Behavior (SIB) specifically centered towards cutting and burning. Our intended audience is social work students and professionals who may be in need of more information about SIB.
