"Old" notes. . . . .

<font color="blue">I found some "old" former graduate work notes and stuff about self injury... and hope they can help someone here. I'll add a little as I go, unless y'all tell me to stop, ok?

Self injury is the deliberate damaging of body tissue without conscious intent to commit suicide. It has been described as "self-mutilation", "self-harm," "auto aggression," "deliberate self-harm," "delicate self-cutting," and a number of other terms.

A wide variety of people self-injure. The "typical" repetitive self-injurer begins this behavior during late childhood and early adolescence. For some it becomes chronic, for many, the disorder ends within 10-15 years. Those who engage in this behavior often have, or may develop, eating disorders. (A smaller group may suffer from substance abuse, and/or kleptomania.) Female self-injurers more often enter treatment, but the syndrome appears to be equally experienced by both sexes.

Common items in backgrounds of those who self-injure repetitively include childhood physical or sexual abuse, violence at home, inhibition of verbal expression of anger, broken homes, hypercritical fathers, history of hospitalization during early childhood (procedures or illness), parental alcoholism and/or depression, residential institution confinement.

<font color="#000088">Thanks for the notes I can relate to loads of what you said![/colour]

Inhibition of verbal expression of anger jumps out at me.

If they were teaching this when you were in graduate school, then I wonder why the first T that I told about cutting so totally failed to recognize or understand - that was like 15 years ago - and he thought I was lying to him. I didn't know what SI was then - I thought it was a weak attempt at suicide.

Thanks for sharing your notes, and for making the effort to understand.

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_Sky said:
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Common items in backgrounds of those who self-injure repetitively include childhood physical or sexual abuse, violence at home, inhibition of verbal expression of anger, broken homes, hypercritical fathers, history of hospitalization during early childhood (procedures or illness), parental alcoholism and/or depression, residential institution confinement.

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ARGH!!!!! I'm not mad at you for saying this...just at my T. I spent almost an entire session trying to convince her that I wasn't abused, because she knew none of these other reasons were true. Does anyone else have the same problem. That they don't fit the USUAL critiria.

Since we're talking about a heterogeneous group of people some may not fully match any of these! I don't think that really matters. What does is beginning to understand, and control self-injurious behavior.

I do have some updated stuff from psychiatrists Favazza & Rosenthal, 1993. Some of the studies were of Kahan & Pattison who in 1984 when they proposed for a distinctive diagnosis: The Deliberate Self-Harm Syndrome.

<font color="blue"> Feelings that activate feelings of need for self injury can include:
rejection, loss, abandonment, confinement, failure, anger, guilt

People who SI tend to have certain personality traits such as:
perfectionism, rapid mood swings, poor response to intense feelings, poor self body image, inability to express needs

SI'ing can be connected to other disorders such as:
Depersonalization, depression, eating disorders, MPD, substance abuse (info added later also includes: ptsd, Addisons's, inner-cranial hypertension, borderline personality, antisocial and of course MPD is now DID... maybe they are 2 different things, but that's another thread!)
The personality traits tend to be absent when the injury syndrome is resolved.[color]

<font color="green">(I won't list the then diagnostic criteria proposed,as I'm sure it's been dignified differently now. I'm trying to update some of this with current ideas as I go along...) <font color="blue">Self injurious behavior is an outward display of rage with which the person is unable to cope. The act of self injury (which shows in forms of self mutilation such as cutting, eating disorders, cosmetic surgery, piercing, and substance abuse) is not the disorder. Self injury is the symptom of a problem. Therapy needs to focus on understanding and easing the originating problem for the self abuse to abate. The behavior can become addicting, just as any addiction which changes the emotional state.

I know I said I wouldn't read this forum anymore, but I checked it one last time for responses to my post and I saw your post, Sky. I always enjoy reading your posts and considering I knew you didn't SI yourself, I thought this would be safe.

Not only safe, but very informative! I love these little tidbits you're throwing at us. Keep it up, cause you got atleast one person interested.

tyvm yes.. um here! I will do my best to give more information... if I'm to believe my T, what he says might work for all of us: I have inside what I need to heal... maybe our "inner" self needs nudges to know how smart we really are?!

<font color="dark green">How to help yourself: Suggestions of things to do. <font color="purple">
1) Change your environment, if necessary. Evaluate where you are. If you are still in an "unsafe" environment, either physically or emotionally, then you might not be able to heal while there. You will continue to react to it and not feel safe.

2) Make the decision to stop self-harm. If you haven't made this decision, or wish to continue no matter what, you can't go much farther on this. If you do wish to stop, if not now but in the future, making your own self aware of this is important.

3) Identify those events or thoughts that either provoke or encourage your self-harming behavior. Writing these down helps, imo.

4) When you feel like you need to self-harm:

a) Don't be alone. Move to a room or place where there are other ppl. If someone is around who can hold or hug you while you're in crisis, ask!
b) Stay away from the instruments you use to self-harm
c) Distract yourself, delay the act.
d) Say NO! or STOP! to your thoughts and actions.
e) Remind yourself of the results of self-harm : social rejection, guilt, scars, clothing considerations
f) if you cannot do the above, try using an alternative non-harmful symbolic act

<font color="blue">There are plenty of longer term actions you can take to help curb self-harm. Being honest with an understanding therapist can be quite supportive of ending this behavior as well as teach you better communication of your feelings, learning to deal with your anger, so that you don't take it out on yourself, even taking a self defense course to build self esteem, self discipline, and a sense of safety can help!

It's also important to not feed the behavior (by discussing your actions of self-harm in a positive, desirable way.)

I almost feel as if that post was directed towards me...and I liked it, even if it wasn't.

Great post, Sky. Sharing knowledge is something everyone can benefit from.

<font color="darkgreen"> I had a few more old notes for this thread, but right as I was going to post, someone in this forum had a situation and I didn't want it to look like I was speaking to them. Any of this stuff is for your use only, not putting anyone down or anything. Information, to me, has always been a neutral thing, what you can use for yourself, that is good.

This section is about IF you must harm yourself

-Try to substitute more socially accepted methods such as getting your hair cut, changing your haircolor, or piercing your ears.

-Don't beat yourself up about it. This only makes matters worse, but it is a habit that is very hard to break. Focus on finding better ways to communicate and express your feelings. Try to find ways to increase your control over your self harming behavior. Don't focus on the fact that you've hurt yourself again!

-BE AS SAFE AS YOU CAN BE. NEVER share instruments with another! Sharing razors and such has been identified as a potential route for HIV transmission. This is where your non-lethal act can accidently turn into a lethal one. Remember, many people who self harm also abuse drugs and other substances, not being in total control of actions etc., and are at a higher risk for carrying HIV.

PLEASE ...the following can be very triggering to anyone on the "edge" of self harm. But I post it so that you can be as safe as possible in this.

Before you do any self harm, think. I know you are doing a lot of trying not to, trying either to not feel or to feel, depending up your mood. But think about just WHAT you think you need to do, WHERE on your body and then? Clean the area. Use soap and water, alcohol wipes whatever. Make sure your instruments are also clean. Try and do as little damage as you can hold yourself to, take it slowly so you can see how little might make you feel better. When you stop, make sure you be also clean the area, and the item. If you need to, place a sterile bandage such as bandaids (they do come large, you know?) to protect the area and keep infection out. Use an antibiotic type cream also, if you can. If you don't want the pain, find one that also has a pain killer in it. Be as "safe" as you can be with this.

<font color="blue"> All I have left in my notes are words for family or friends of self injurers. Let me know if you wish me to post that in the future, or not, ok?

_Sky

I'd like to see them, if you don't mind and/or are not too busy.

We get a lot of questions here about how to explain this to friends and family members and other concerned parties. If you would like to share that information also, I think that would be great!

Thanks for the information that you have already shared. Thanks also for using the trigger icon on that last one. You're right - it's triggery - you did a good job warning us though, and it is important.

Sky, I like your notes. I have to say though that the last thing I wanted when I self injured was to not feel the pain. You are so good to point out infection risks etc. I just wondered did others need to feel the pain?

I just wondered did others need to feel the pain

Yes. That's what it was all about. Feeling.

((((WW))))

Petunia

I need to feel it too. When I cut and am too dissociated to feel it, that's really disappointing, like there's no point to it.

oh if only it was that easy

Isn't the wide variety of uses for self-injury amazing? Most are polar opposite. Some do it to feel, some do it to stop feeling. Some do it because they are too anxious, some because they are numb. Some people to keep themselves freaking, some to calm themselves from the freaking. It just amazes me sometimes.

I know this is slightly off topic but I just wanted to add that.