Recently the doctors and therapists at the BGCenter became
involved with treatment of a number of self-cutting cases in the adoptive
families - a disruptive and scary experience for the parents and school
personnel searching for the explanation and the right approach to solving
We collected some data below with the initial overview and directions
for parents and teachers who are usually the first responders in such
Types of self-harm (Fiona
Gardner from Community Care)
- Cutting, ripping or tearing the skin or pinching the
skin to cause bleeding or a mark. Cutting is the commonest form of
self-harm used by more than two-thirds of those who harm themselves.
The cutting can make superficial, delicate and designed incisions
that can heal to leave no visible scar, or can cause deeper cuts which
leave permanent scars and lumpy flesh.
- Banging or punching parts of the body (usually the
head or knuckles).
- Branding - burning self with a hot object: iron, matches,
cigarettes, cigarette lighters, hot water or cooker hot plates.
- Friction burn - rubbing a pencil eraser on your skin.
- Carving signs or words onto the skin (usually arms,
thighs, or stomach).
- Pulling out large clumps of hair.
- Re-opening wounds.
- Deliberate overdosing on over-the-counter drugs when
this is not consciously intended as suicide.
Who harms themselves and why?
Epidemiological findings show that self-harming
behavior usually begins in children over the age of 11 and increases
in frequency in adolescence. An Oxford study in 2000 found that approximately
300 out of 100,000 males aged between 15 and 24 years, and 700 out of
100,000 females of the same age, were admitted to hospital following
an episode of self-harm during that year.
The following are the principal factors associated
with increased risk of self-harm among children and adolescents: mental
health or behavioral issues, such as depression, severe anxiety and
impulsivity; a history of self-harm; experience of an abusive home life;
poor communication with parents; living in care or secure institutions.
Those who harm themselves usually see it as a way
of dealing with an immediate anxiety. Some see it as a way of feeling
in control. They may also believe that the wounds, which are now physical
evidence, prove their emotional pain is real.
explains: Many self-injurers
report feeling very little to no pain while self-harming. They face
the contradictory reality of harming themselves while at the same time
obtaining relief from this act. For some self-injurers this relief is
primarily psychological while for others this feeling of relief comes
from the beta endorphins released in the brain (the same chemicals that
are thought to be responsible for the "runner's high"). Endorphins
are endogenous opioids that are released in response to physical injury,
act as natural painkillers, and induce pleasant feelings and would act
to reduce tension and emotional distress. In individuals with developmental
disabilities, occurrence of self-injury is often related to its effects
on the environment, such as obtaining attention or desired materials
or escaping demands. As developmentally disabled individuals often have
communication or social skills deficits, self-injury may be their way
of obtaining these things which they are otherwise unable to obtain
in a socially appropriate way (such as by asking).
depicts a psychological mechanism of self-injurious behavior.
In general, the attention of a mental health professional
is needed in every case, but a lot can be done by parents and school
- Self-harm serves a function for
the person who does it, so observing the child and finding the real
cause for this occurrence is essential.
- Self-harmers lack the necessary skills to express strong
emotions in a healthy way; thus behavior therapy that teaches socially
appropriate ways to express feelings is helpful.
- Self-harming behavior is an attempt to maintain a certain
amount of control, which in and of itself is a way of self-soothing;
teach the child to control things through detailed planning, writing
down things to do and checking them out as they are accomplished,
and other techniques.
- Self-harming may be caused by excessively strict and
"cold" treatment in the family: let the child know that
you care about them and are available to listen.
- Encourage expressions of emotions including anger via
socially acceptable channels.
- Involve the child in activities that can enhance their
sense of worth and control.