Cutting and Other SelfInjurious Behaviors

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Cutting and Other Self-Injurious Behaviors

• Allison S. Kress, Psy.D.
• Specialist in the Treatment of Cutting and Other
  Self-Injurious Behaviors
• [phone] ext. 4
• Laguna Niguel (Orange County), CA

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What is Cutting/Self Injury?

• The intentional cutting of ones skin as a way to
  cope.
• It is also called self-injury, self-abuse,
  self-mutilation, self-harm, and self-destructive
  behavior.

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What is Cutting/Self-injury?(cont.)

• Other forms of self-injury can include but are
  not limited to
• burning, carving, extracting hair to excess,
  scratching to excess, biting, interfering with
  the healing of wounds, chewing the lips, tongue,
  or fingers, head banging.

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Diagnostic Criteria

• Currently, the fourth edition of the Diagnostic
  and Statistical Manuel of Mental Disorders does
  not recognize self-injury as a distinct disorder.
• It is often coded as Impulse Control Disorder
  NOS.

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Is Cutting a Suicide Attempt?

• Cutting is usually not a suicide attempt.
• Cutting and suicide attempts are usually two
  different mental states.

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Prevalence

• Considered by experts to be a growing problem.
• Some believe that cutting is the most critical
  mental health problem facing adolescent girls.

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Why People Cut or Self-Injure

• People self-injure because they are trying to
  cope.
• Often it is to get relief from intense emotions.

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Why People Cut or Self-Injure(cont.)

• Personal story- 15 year old girl.

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Personal Story Consequences

• Female, age 18, HS graduate.

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Personal Story Consequences(cont.)

• Male, age 24, hs graduate

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Personal Story Consequences(cont.)

• Female, age 24, B.A.

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Personal Story Consequences

• Female, age 29, university student

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Warning Signs

• Can include unexplained frequent injury
  including cuts and burns, wearing long
  pants/sleeves in warm weather, low self-esteem,
  difficulty handling feelings, relationship
  problems, poor functioning at work, school, home,
  a history of emotional problems, abuse,
  drug/alcohol abuse, anxiety, and impulsive
  behavior

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Treatment for Cutting/Self-Injury

• People seek treatment because they are in
  emotional pain.
• The goal is to help them identify what they are
  feeling, where it is coming from, and how to
  resolve it.

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Treatment - Alternative Coping Strategies

• Writing in a journal
• Listening to music
• Deep-breathing exercises/progressive relaxation
• Challenging distorted thinking
• Ask for help
• Talking and listening to a trusted person
• Take a shower or bath
• Take a walk
• Make a collage
• Write a letter to the person or problem
• Plan regular activities for your most difficult
  time of the day

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Prognosis

• Self-injury is treatable and 100 recovery is
  possible.
• The persons motivation and determination to stop
  their behavior is the most important factor.

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Preventative Strategies

• EXPRESS
• YOURSELF!!

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Preventative Strategies - Realistic Self-Talk

• Be honest and true to myself.
• It is okay to let myself be distressed for
  awhile.
• I am not helpless. I can and will take the steps
  needed to get through this crisis.
• One step at a time.
• I know I will be okay no matter what happens.
• In the long run, who will remember, or care?
• Other peoples opinions of me are just their
  opinions.
• My past does not control my future.
• I am willing to do whatever is necessary to make
  tomorrow better.
• Source Skill Building Resources for Increasing
  Social Competency

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Resources To Get Help/Information

• S.A.F.E. Alternatives
• www.selfinjury.com
• National Mental Health Association
• www.nmha.org/infoctr/factsheets/ selfinjury.cfm
• SIARI Self-Injury Related Issues
• www.siari.co.uk