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When a Loved One Engages in Self Injury
If you have a loved one who engages in self injury,
you may be shocked, dismayed and scared. You might not know what to do. Learning more about self injury can help you understand
why it occurs and help you develop a compassionate but firm approach.
If your loved one is an adult, gently encourage him
or her to seek medical treatment. If it's your child, you can start by consulting your pediatrician or family doctor, who
can provide an initial evaluation or a referral to a mental health specialist.
Parents are encouraged to talk with their children about
respecting and valuing their bodies. Parents should also serve as role models for their teenagers by not engaging in acts
of self injury.
Some helpful ways for people to avoid hurting themselves
include learning to:
accept reality and find ways to make the present moment
more tolerable
identify feelings and talk them out rather than acting
on them
distract themselves from feelings of self injury (for
example, counting to ten, waiting 15 minutes, saying "NO!" or "STOP!," practicing breathing exercises, journaling, drawing,
thinking about positive images, using ice and rubber bands, etc.)
stop, think, and evaluate the pros and cons of self
injury
soothe themselves in a positive, non-injurious, way
practice positive stress management
develop better social skills
Evaluation by a mental health professional may assist
in identifying and treating the underlying causes of self injury. Feelings of wanting to die or kill themselves are reasons
for adolescents to seek professional care emergently. A child and adolescent psychiatrist can also diagnose and treat the
serious psychiatric disorders that may accompany self injurious behavior.
Prevention
Preventing self injury involves identifying people who
are most at risk and then offering help. For instance, those at risk can be taught healthy coping skills that they can then
draw upon during periods of intense distress. But identifying those at risk isn't always easy.
If you have a loved one who seems to have signs or symptoms
of depression or who seems overwhelmed by events in his or her life, early intervention, such as psychotherapy, may prevent
a worsening of problems that can lead to self injury.
Some adolescents learn about cutting and other forms
of self injury from their peers or from media accounts. You may be able to help prevent your child from trying out self injury
if you openly talk about the issue and discuss what emotional challenges they face.
If you're contemplating self injury for the first time,
turn instead to a trusted friend or loved one, or a medical professional. They can help you find better options — options
that won't leave you permanently scarred.
When To Seek Medical Help
People who deliberately injure themselves typically
feel overwhelmed by a mix of emotions, ranging from anger and rage to depression and hopelessness. They may be embarrassed
and ashamed about their self injury and try to hide it from others. Some who engage in self injury may secretly enjoy it since
it soothes emotional pain, albeit temporarily. Some may even flaunt it, especially if self injury is used as a way to upset
parents or other authority figures.
In any case, self injury contributes to a life of distress
and chaos. It also poses the risk of serious, debilitating injury, disfigurement or even death. If you have injured yourself
severely or believe it may be life-threatening, call 911 or your local emergency services provider. If a loved one has injured
himself or herself severely, take them to the hospital or call for emergency help.
When you or a loved one engages in self injury
The relief found in self injury is almost always short lived.
You may feel better for a little while, only to find that distressing emotions have quickly returned and you're once again
reaching for a razor to cut your arm or a match to burn your stomach, even if you vowed to stop injuring yourself. Self injury
can become almost habitual — you may automatically turn to self injury without stopping to consider other, safer alternatives
to handling distress.
Self injury may be more dangerous than you think. You
risk hurting yourself more seriously than you intended — for instance, severing an artery that can lead to life-threatening
blood loss. If you injure yourself while you're under the influence of illicit drugs or alcohol, you increase your risk of
inflicting serious injury or even death.
It's very difficult to overcome self injury on your
own. Getting treatment from a mental health professional with experience in self injury issues can help you learn healthier
ways to cope — ways that won't leave your body permanently scarred. Try to work up the courage to confide in someone
you trust, whether it's a friend or loved one, a health care professional or a school or university employee. They can help
you take the first steps to successful treatment.
Complications
of Self Injury
Self injury causes a variety of complications.
Engaging in self injury can contribute to or worsen
feelings of shame, guilt and low self esteem.
Even if they don't mean to hurt themselves seriously,
self injury can lead to life-threatening problems, such as blood loss if major blood vessels or arteries are cut.
Self injury can lead to accidental or deliberate suicide.
One may unintentionally injure themselves fatally, especially if engaging in self injury while under the influence of alcohol
or illicit drugs. People who engage in self injury are also at higher risk of deliberately taking their own lives.
Self injury can cause permanent scars. One may not worry
about that while in the midst of hurting themselves or if thinking the future is bleak, but scarring may create shame or embarrassment
years down the road.
Cuts can become infected if a person uses non-sterile
or dirty cutting instruments - razors, scissors, pins, or even the sharp edge of the tab on a can of soda.
Cutting can be habit forming. It can become a compulsive
behavior - meaning the more a person does it, the more he or she feels the need to do it. The brain starts to connect the
false sense of relief from bad feelings to the act of cutting, and it craves this relief the next time tension builds. When
cutting becomes a compulsive behavior, it can seem impossible to stop. So cutting can seem almost like an addiction. A behavior
that starts as an attempt to feel more in control can end up controlling you.
Treatments
Treating self injury usually requires therapy and medications,
with emergency or psychiatric hospitalization sometimes necessary. Whether you engage in self injury or have a loved one who
does, know that there are ways to overcome it and healthier options to cope with emotional distress.
Treating self injury takes time and hard work. Treatment
focuses on addressing the underlying reasons for hurting yourself. Because self injury can become so entrenched and it's often
accompanied by serious mental disorders, treatment with a mental health professional well versed in self injury issues may
be necessary.
Treatments include:
Dialectical Behavioral Therapy:
Also called DBT. This is done in a group and
with a therapist that knows DBT. It is a combination of Cognitive Behavioral Therapy (CBT) and Zen. DBT is frequently used
for self injury. Its main objective is to teach behavioral skills to help one tolerate stress, regulate their emotions and
improve ones relationships with others. DBT can be extremely effective.
Therapy: Also known as talk therapy or counseling, psychotherapy can help
one identify underlying issues that trigger self injury. A therapist may ask one to create a safety plan that includes steps
to take to prevent an episode of self injury. In addition to individual therapy, family therapy or group therapy may also
be recommended.
Medications: There are no medications that specifically treat self injury.
However, a doctor may recommend treatment with antidepressants or other psychiatric medications that can help improve depression,
anxiety or other mental disorders. An improvement in those symptoms may help one feel less compelled to hurt themselves.
Psychiatric Hospitalization:
If one injures themselves severely or repeatedly,
their doctor may recommend psychiatric hospitalization. Hospitalization can provide a safe environment and more intensive
treatment until they get through a crisis.
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