Tag Archives: Self Mutilation

Non Suicidal Self Injury, Self Mutilation, Self Injury and Cutting – Part 2

Posted on April 20, 2012 by Michael

This week’s guest blog is posted by Naghma Khan, a Clinical & Addictions Psychologist in India, she writes the blog:  http://unwrappingminds.wordpress.com/

 

The million dollar question you might ask is “Who am I & what am I doing writing this blog?” I am a clinical psychologist with a purpose. When I decided to study psychology, it was also due to the fact that my country has only two respected professions, Medicine or Engineering. In a way, my folks were disappointed by my choice. At that young age I didn’t care much about the opinions of others, I had a fire inside me and I believed I could change the world. I started studying psychology with zeal and had an amazing time learning the science of behavior. I completed my Masters in Clinical Psychology and then attained a certification from Rehabilitation Council of India for practicing Psychology. I finally became a psychologist but thought nobody was taking me seriously. I started with a special school where I was supposed to just “take care” of the clients. The frustrations started building up; I had to do something else. I found a job in a renowned hospital as a consulting psychologist. This was the job where I learned the basics of counseling. I then joined an addiction center and bingo; I found the field I have a passion for.

 

Lorraine emphasizes, “I work with young people (11-19) who self harm and I hear that young people say self harming helps alleviate the internal pressure that builds up around issues they struggle to deal with. My experience here in England is that young people do talk to peers but issues relating to family, peers or educational expectations can far exceed their ability to cope. Unfortunately this can and has led to suicide. Generally though self harming is used as a coping mechanism, I find that once we establish a non-judgmental, caring, safe and therapeutic environment young people can move forward.”

 

Some people develop NSSI through observational learning; they learn it from somebody else or through the media. The chances of most people actually seeing another person self-injure are very slim, but in places such as psychiatric hospitals and prisons the odds are much higher. Since self-injury has become a part of the vernacular, part of society’s everyday knowledge, the incidence of NSSI, especially amongst teens, has exploded. Once a self-injurer may have been alone in their social group, it is now common for teenagers to have friends who actively self-injure or have self-injured in the past.

 

Diane Sue, PhD. shares, “I have found that many of those who persistently self-injure have underlying conditions, especially depression, anxiety and sometimes PTSD. Often there are few adults in their lives they can turn to for support.”

 

My research and experience has made me realize one thing that NSSI is not limited to any age group or gender. The experience of NSSI varies in different individuals. Chris White, Ed.D. says, “Interestingly, I have observed a major change in who is engaging in this behavior over the past few years. For most of the 27 years I have been practicing, cutters were almost always women who had experienced fairly severe physical or sexual abuse as children and had begun cutting in their 20′s or 30′s. Now, I am seeing much younger girls, as well as some boys/young men, begin cutting in their early teens or even pre-adolescence, who do not have histories of trauma! Some even talk of having “cutter clubs” in their high schools where kids trade “tips” around this behavior.”

 

Basically the purpose is not killing or hurting oneself but it is due to lack of healthy strategies to deal with your pain. I researched and asked a lot of professionals from this field for help. From the studies and contributions from people working in this field I have compiled some strategies for people involved with NSSI:

  1. You need to find a healthy vent for your pain & problems. It is fine to find strength from within you, but it’s destructive to accumulate the pain you are going through internally. There is a critical difference here, which we need to understand; being a person who is not talkative is amazing if you are happy with it, but if you are going through a phase where you need help, you need to gather the courage to seek it.
  2. Young people need to understand the difference between positive & negative peer pressure. Just because someone we consider as our style icon is doing a certain thing, it is not necessary that we should follow them blindly. Sometimes it starts as a cool thing but stays with you forever, mutilating yourself becomes a habit which moves beyond your control. The origin of self-injury is often difficult to determine or understand. Many people are unable to remember where they first got the idea of hurting themselves, when they actually began to self-injure.
  3. If you know someone or are a caretaker of a person going through this syndrome, you need to establish a non judgmental & caring atmosphere.  You need to be very vigilant for the early signs of injury. Ask questions and seek answers. People who self-injure usually begin by cutting themselves with a knife, razor blade, or other sharp object. From there the person tries other forms of self-injury, such as burning, hitting, etc., until they find their preferred method. Bring in a person, a counselor, doctor or therapist that can help. The best way you can help a person going through NSSI is connecting him to a therapist. You need an expert here because often there is a lot of underlying reason behind the NSSI behavior.
  4. Allow and teach the expression of emotions in a healthy way. Don’t bottle emotions up inside. Often it is fear or the disturbing emotions around expressing the fear which leads to the self damaging path. Sometimes you also learn unhealthy ways of showing your emotions, through drugs, alcohol, sexually acting out, kleptomania, or anorexia. Seek proper care if you are involved in any addiction, by joining a support group.
  5. Don’t be scared of changes in your life. Change is growth, though it is feared by most, as it is“the unknown”. Most cases of NSSI are reported or observed in people aged 11-25. It could be due the fact that in this phase of your life you go through a lot of changes.The best way to deal with it to be aware and ready for the new.
  6. Feel the pain: Running away from your pain is never the solution.  NSSI is a short lived relief. You need to live your feelings. There is a therapeutic catchphrase on pain: Feel the pain, live the pain and relieve the pain.Repeating this mantra could help you with this step.

 

Do accept that there is no shame in what you are doing. It is quite understandable that until now NSSI was the only coping skill you had, but now you realize that it is not a healthy one. Deal with your feeling of shame and seek help.

For a primary self check, examine your thoughts by asking yourself direct questions like:

 

“What did you intend to accomplish through ___________?”

“What was the point to __________?”

“How did you expect people to react?”

“What did you expect to happen if you didn’t do it?”.

I would like to compare NSSI to an addiction to a depressant. You start with a feeling of euphoria, which fades away leaving you more depressed. You chase the “first time high”, sadly that is unattainable.

 

In the end I want to say that there are more ways of coping, you just need to look for it!

Related articles:

    Feel the Pain (unwrappingminds.wordpress.com)

    Pain: Your Take (unwrappingminds.wordpress.com)

    March 1st is International Self Injury Awareness Day (drdeborahserani.blogspot.com)

Written by Naghma Khan, a Clinical & Addictions Psychologist in India, she owns and writes the blog:  http://unwrappingminds.wordpress.com/

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“Why would anyone harm themselves?” – Non Suicidal Self Injury, Self Mutilation or Cutting – Part 1

Posted on April 13, 2012 by Michael

This week’s guest blog is posted by Naghma Khan, a Clinical & Addictions Psychologist in India, she writes the blog:  http://unwrappingminds.wordpress.com/

The million dollar question you might ask is “Who am I & what am I doing writing this blog?” I am a clinical psychologist with a purpose. When I decided to study psychology, it was also due to the fact that my country has only two respected professions, Medicine or Engineering. In a way, my folks were disappointed by my choice. At that young age I didn’t care much about the opinions of others, I had a fire inside me and I believed I could change the world. I started studying psychology with zeal and had an amazing time learning the science of behavior. I completed my Masters in Clinical Psychology and then attained a certification from Rehabilitation Council of India for practicing Psychology. I finally became a psychologist but thought nobody was taking me seriously. I started with a special school where I was supposed to just “take care” of the clients. The frustrations started building up; I had to do something else. I found a job in a renowned hospital as a consulting psychologist. This was the job where I learned the basics of counseling. I then joined an addiction center and bingo; I found the field I have a passion for.

Tina had a friend who used to show up with different kinds of marks on her hands or feet. This friend used to really cover her body well, which Tina presumed was because of religious reasons or parental pressure. Sometimes, they resembled burn marks, while most of the time they were cut marks. Tina used to think her friend was accident prone but after a few years she started connecting the dots. She understood that there was something ‘not right’ with her friend. Tina started researching and she discovered Non Suicidal Self Injury or ‘NSSI’.

Now, because of the lack of research in this field there are different terms or synonyms floating around for NSSI, cutting, self mutilation, self harm and self inflicted violence. Actually there very little difference between these terms, let’s try to understand the behavior in a better way:

• Self Injury is the act of physically hurting yourself on purpose without the intent of committing suicide. It is a method of coping during an emotionally difficult time that helps some people temporarily feel better because they have a way to physically express and release the tension and the pain they hold inside. In other people hurting themselves produces chemical changes, or endorphins, which are the same chemicals that cause a “runners high” in their bodies that make them, feel happier and more relaxed.

• Emotionally or verbally punishing yourself isn’t self-injury, instead it’s what a lot of people call negative self-talk.

• Unprotected sex, getting a piercing or a tattoo for the pain of the act or starving yourself all are self-destructive but they’re not necessarily self-injury.

• Emotional cutters are people who injure themselves on purpose by making scratches or cuts on their body with a sharp object.

• Self-harm includes self-injury (as described above) and self-poisoning is defined as the intentional, the direct injuring of body tissue most often done without suicidal intentions.

• The most common form of self-harm is skin-cutting but self-harm also covers a wide range of behaviors including, but not limited to, burning, scratching, banging or hitting body parts, interfering with wound healing, hair-pulling and the ingestion of toxic substances or objects.

I thought for this article I would use the term ‘Self Mutilation’ but then I found the correct term is ‘Non-Suicidal Self Injury’ (NSSI). Aaron D. McClelland points out, “The term self-mutilation is an antiquated and misapplied descriptor for NSSI that it speaks to intent, however, the vast majority of those who self-injure their intent is for affect regulation, not to cause disfigurement. Many in the self-injury support community consider the term “self-mutilation” to be derogatory, hurtful and only adds to the mythology of the disorder. Most prefer the term self-injury or self-harm.”

In this post I will use NSSI but the title also includes self mutilation and cutting because there are few people who understand and know the proper term is NSSI. If you are one of those who have not seen or heard about it the first question that will crop up in your mind is going to be: “Why anyone will do so, as in harm oneself?”

This is a story from a recovering NSSI person: “Because of my chronic abuse, I began to self injure myself. It was a way to forget about all the pain that was eating me alive. I first began doing this about the age of 8. I would beat my hands with a hammer or take a hot iron and iron my hands or stomach. That worked for a little while and the burns and bruises were easy to cover up. As time passed and the abuse kept on, ironing and beating myself didn’t give me enough pain anymore, so then I began cutting along with the burning and beating. To see the wounds made the pain inside not seem so real. You may say ‘didn’t it hurt?’ My answer would be no! I didn’t feel anything, because the pain inside was just too intense and I had to numb myself to all pain. I didn’t love anyone, not even myself!”

Studies conducted by Nock and Prinstein (in 2004 and 2005) suggest that there are four primary reasons for engaging in NSSI behaviors:

1) to reduce negative emotions,
2) to feel “something” besides numbness or emptiness,
3) to avoid certain social situations, and
4) to receive social support.

Although instances of all of these reasons for Non Suicidal Self Injury (NSSI) are apparent, a common misconception is that NSSI is primarily a form of social manipulation. In reality, a number of studies have found that the primary reason for NSSI is reason number one: to reduce negative emotion. This seems like such a bizarre reason! How is it that inflicting physical pain or injury could be used to deal with emotional pain? Despite how paradoxical this may seem, people most often report the following reasons for using NSSI: to stop bad feelings, to relieve feelings of loneliness, emptiness, or isolation, to distract from other problems, to decrease feelings of rage, to release tension, or to control racing thoughts.

Candance shares, “I’ve worked with adolescents in the foster care system in Orange County, California, for the past 17 years and most often teens who engage in self-mutilation or cutting are not trying to kill themselves. Instead they find superficial cutting relieves the internal emotional pain they are feeling. It’s like releasing a valve that is built up with pressure, as the emotional pain dissolves they feel better. The children who tend to engage in this behavior are often the ones who won’t talk to others about their pain or problems, but rather let it build up internally, which leads to the cutting. This behavior is also contagious, a child who witnesses a peer engaging in the behavior, may try it as well.”

Written by Naghma Khan, a Clinical & Addictions Psychologist in India, she writes the blog: http://unwrappingminds.wordpress.com/

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