|
RESOURCES- Articles
Self Injury in Adolescents - Q&A
How common is self injury in
adolescents?
Self injury or "cutting" is increasingly prevalent
in the 14 to 17 year old age group with about 80 percent
being female. Most people who self injure
themselves are depressed. However, cutting is not usually meant to be an attempt
at suicide. It is often assumed that people who cut are trying to kill themselves,
though frequently this is not the case.
Self injury is defined as deliberately cutting, scratching,
puncturing, abrading, or burning the skin. This is usually
done on the arms or hands as a reaction to powerful or intolerable
emotions. Some people try to hide their cutting by wearing
long sleeves even in the summer, or cutting on the legs,
stomach or chest. Other people who cut will wear very short
sleeves or tank tops as if to make sure others see their
cutting.
What causes kids to cut themselves?
Motivation for cutting is usually rooted in feelings that may include self-hatred,
punishing self or parents. These injuries are often inadvertently reinforced
by friends family or a teacher who has a very strong emotional reaction when
they see the cuts.
Cutting is seen by mental health professional
as a sign of distress and a faulty coping mechanism. Some
of my 15
and 16 year old clients have given these reasons for cutting: "I
cut because it's the only way my parents know how bad I feel." "I
cut because the physical pain is much easier to deal with
than the emotional pain I'm going through." "I
deserve the pain because I'm no good and I just cause my
family stress." "I cut because it makes me feel
better." "It stops the bad feelings."
What kinds of problems are associated with cutting?
Often there is scarring, infection and the possibility of
nerve damage. Each episode of cutting needs to be investigated
on an individual basis to determine
the motivation of the client and assess for suicidality.
The second problem with cutting is its addicting quality.
Repeated cutting becomes a habit and clients begin to rely
on this as a way to deal with painful feelings. There are
some schools of thought in psychiatry that feel endorphins
are released by self injury and can act as self-medication.
Once the pattern is in place it is often very difficult to
break.
How can you stop the cycle of self-injury?
Another problem associated with cutting is that painful feelings, though reduced,
often do not get resolved and the cycle of self-injury can go on, be more habituating,
and often gets in the way of learning productive coping skills that may be
a healthier way to deal with the stress.
Do kids cut themselves because it is dramatic?
Yes. The sight of blood or cuts tends to incite high emotions and drama. If
a student cuts in school it often draws a lot of attention and some panicked
reactions from teachers and staff. At times a student will scratch a word into
their skin, such as "I want to die" or "death." People
tend to overreact to cutting. This can be very reinforcing to the cutter.
What are the treatment options for cutting?
The most effective treatment modalities for cutting appears to be a combination
of cognitive behavioral therapy and medication. Medication is often an antidepressant
that is prescribed by a psychiatrist or a family doctor. The therapeutic approach
of cognitive behavioral therapy begins by learning to think in more logical
and functional ways and to challenge irrational thinking. New behaviors to
cope with feelings are explored. One intervention is to have the client and
therapist work on a list of coping mechanisms that the client can use when
he or she begin to feel like they're going to cut. It is important that teachers
and others often interact with adolescents be kept up to date on cutting behavior
and possible ways to intervene when this happens in the school setting. Also
involved in the therapeutic process is learning to be less afraid of painful
feelings and being able to open up and process them as opposed to keeping them
locked away as a self-torture device
Click here to read an article on self injury that appeared
in the Doylestown Intelligence
Foundations Behavioral Health
|
