Self-Injury

*this blog is not to be taken as medical advice. If you or someone you love are showing signs of self harm contact your family doctor or call Self-Injury Hotline SAFE (Self Abuse Finally Ends) Alternatives Program  www.selfinjury.com 1-800-DONT CUT (1-800-366-8288)  for a full list of hotline visit People to call*

Self-Injury just saying it is enough for people to step back and go what?  It is also something many families have experience with.  We do as well. I myself have burnt myself with a lighter in my past.  I know others who have cut or battled a eating disorder.  It typically is a sign that something is going on.  Those who do it also know how to hide it well. Sometimes it is a impulsive and unconscious behavior to release frustration.

The Mayo Clinic defines self-injury as :

"Self-injury, also called self-harm, is the act of deliberately harming your own body, such as cutting or burning yourself. It's typically not meant as a suicide attempt. Rather, self-injury is an unhealthy way to cope with emotional pain, intense anger and frustration.

While self-injury may bring a momentary sense of calm and a release of tension, it's usually followed by guilt and shame and the return of painful emotions. And with self-injury comes the possibility of more serious and even fatal self-aggressive actions.

Because self-injury is often done impulsively, it can be considered an impulse-control behavior problem. Self-injury may be linked to a variety of mental disorders, such as depression, eating disorders and borderline personality disorder." (http://www.mayoclinic.com/health/self-injury/DS00775)

So why am I bring this up.  I'm bringing it up because it is something that we need to be on the look out for.  There have been very few studies on Self injury and autism but the few that have been done do not show a increase in the rate of self injury between autism vs other disorders such as schizophernia.  One study did state that "Of interest, children with autism and developmental disability seem to be more prone to SIB than children with only developmental disability." (http://www.oadd.org/publications/journal/issues/vol9no2/v9n2download/art12Weiss.pdf)  

What dose Self-injury look like. That depends on the person. Self Injury can take on many forms, some more noticeable than others. Some examples are:

• "Burning (with lit matches, cigarettes or hot sharp objects like knives)
• Carving words or symbols on the skin
• Breaking bones
• Hitting or punching
• Piercing the skin with sharp objects
• Head banging
• Biting
• Pulling out hair
• Persistently picking at or interfering with wound healing

Most frequently, the arms, legs and front of the torso are the targets of self-injury because these areas can be easily reached and easily hidden under clothing. But any area of the body may be used for self-injury. People who self-injure may use more than one method to harm themselves." (http://www.mayoclinic.com/health/self-injury/DS00775/DSECTION=symptoms)

There are many myths about self harm some include:

• It is for attention: Self Injury is not about attention, it serves to relieve stress, emotional pain, or frustration.
• Self Injury is a filed suicide attempt: While yes self injury can progress to suicide in some people it is not a failed attempt. Rather it is a coping skill to deal with their surroundings.
• "People who self-injure are crazy and should be locked up. Tracy Alderman, Ph.D., author of The Scarred Soul, addressed this:

“Fear can lead to dangerous overreactions. In dealing with clients who hurt themselves, you will probably feel fear. . . . Hospitalizing clients for self-inflicted violence is one such form of overreaction. Many therapists, because they do not possess an adequate understanding of SIV, will use extreme measures to assure (they think) their clients’ best interests. However, few people who self-injure need to be hospitalized or institutionalized. The vast majority of self-inflicted wounds are neither life threatening nor require medical treatment. Hospitalizing a client involuntarily for these issues can be damaging in several ways. Because SIV is closely related to feelings of lack of control and overwhelming emotional states, placing someone in a setting that by its nature evokes these feelings is very likely to make matters worse, and may lead to an incident of SIV. In addition, involuntary hospitalization often affects the therapeutic relationship in negative ways, eroding trust, communication, rapport, and honesty. Caution should be used when assessing a client’s level of threat to self or others. In most cases, SIV is not life threatening. . . . Because SIV is so misunderstood, clinicians often overreact and provide treatment that is contraindicated." (http://drkathleenyoung.wordpress.com/2010/02/28/common-myths-about-self-injury/)

• Self Injury is a form of manipulation   During the period of self injury is not the time to judge.  People who self injury typically hide it or have little to any control over what they are doing. 
• That only females self harm: This is false males and females both self injure but females tend to be more likely to.
• Self Injury is a purposeful act: While yes in some cases the self injurer knows what they are doing and are purposely doing it to relieve stress, pain or frustration for many the act of self injury is a impulse which they have little to no control over.

So what do you do? How can you stop it? The answer depends on age, mental capacity, and the reasons behind the self injury.  There is no set protocol for treatment. Number one you have to find out the cause. Is it pain? stress? frustration? We went through a time where whenever asked to write in school Roger would try to stab himself with his pencil.  Once the teacher took notice and realized what was the cause she removed the cause. Now rather than handwriting papers he can type. By removing the stress we removed the behavior. Now it is not always so easy. Sometimes there is no apparent reason and you have to dig a bit.  Are you listening to the other person? No really are you listening? Sometimes we get so busy we don't stop for just a minute and listen not only to spoken words but the unspoken. Are they holding their ear and headbanging? Maybe a ear infection. If the room you are in chaotic? Maybe they are overstimulated and are trying to communicate the need to leave. It may just be way to get frustration out.  The thing is if we don't stop pay attention and listen the frustration is only going to grow not get better.

The number one thing is if you or someone you know is showing signs of self injury please don't search the internet for a cure pick up a phone and call for help.  Your family doctor is a great resource to send you in the right direction.