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wellcome to my painful reality.
WHO self-injures? Psychological characteristics common in self-injurers The overall picture seems to be of people who: - strongly dislike/invalidate themselves - are hypersensitive to rejection - are chronically angry, usually at themselves - tend to suppress their anger - have high levels of aggressive feelings, which they disapprove of strongly and often suppress or direct inward - are more impulsive and more lacking in impulse control - tend to act in accordance with their mood of the moment - tend not to plan for the future - are depressed and suicidal/self-destructive - suffer chronic anxiety - tend toward irritability - do not see themselves as skilled at coping - do not have a flexible repertoire of coping skills - do not think they have much control over how/whether they cope with life - tend to be avoidant - do not see themselves as empowered Demographics Conterio and Favazza estimate that 750 per 100,000 population exhibit self-injurious behavior (more recent estimates are that 1000 per 100,000, or 1%, of Americans self-injure). In their 1986 survey, they found that 97% of respondents were female, and they compiled a "portrait" of the TYPICAL SELF-INJURER: She is female, in her mid-20s to early 30s, and has been hurting herself since her teens. She tends to be middle- or upper-middle-class, intelligent, well-educated, and from a background of physical and/or sexual abuse or from a home with at least one alcoholic parent. Eating disorders were often reported. TYPES of self-injurious behavior reported were as follows: - Cutting: 72 percent - Burning: 35 percent - Self-hitting: 30 percent - Interference w/wound healing: 22 percent - Hair pulling: 10 percent - Bone breaking: 8 percent - Multiple methods: 78 percent (included in above) On average, respondents admitted to 50 acts of self-mutilation; two-thirds admitted to having performed an act within the past month. It''s worth noting that 57 percent had taken a drug overdose, half of those had overdosed at least four times, and a full third of the complete sample expected to be dead within five years. Half the sample had been hospitalized for the problem (the median number of days was 105 and the mean 240). Only 14% said the hospitalization had helped a lot (44 percent said it helped a little and 42 percent not at all). Outpatient therapy (75 sessions was the median, 60 the mean) had been tried by 64 percent of the sample, with 29 percent of those saying it helped a lot, 47 percent a little, and 24 percent not at all. Thirty-eight percent had been to a hospital emergency room for treatment of self-inflicted injuries (the median number of visits was 3, the mean 9.5). Psychological motivations: What self-injurers say SI does for them - Escape from emptiness, depression, and feelings of unreality. - Easing tension. - Providing relief: when intense feelings build, self-injurers are overwhelmed and unable to cope. By causing pain, they reduce the level of emotional and physiological arousal to a bearable one. - Relieving anger: many self-injurers have enormous amounts of rage within. Afraid to express it outwardly, they injure themselves as a way of venting these feelings. - Escaping numbness: many of those who self-injure say they do it in order to feel something, to know that they''re still alive. - Grounding in reality, as a way of dealing with feelings of depersonalization and dissociation - Maintaining a sense of security or feeling of uniqueness - Obtaining a feeling of euphoria - Preventing suicide - Expressing emotional pain they feel they cannot bear - Obtaining or maintaining influence over the behavior of others - Communicating to others the extent of their inner turmoil - Communicating a need for support - Expressing or repressing sexuality - Expressing or coping with feelings of alienation - Validating their emotional pain -- the wounds can serve as evidence that those feelings are real - Continuing abusive patterns: self-injurers tend to have been abused as children. - Punishing oneself for being "bad" - Obtaining biochemical relief: there is some thought that adults who were repeatedly traumatized as children have a hard time returning to a "normal" baseline level of arousal and are, in some sense, addicted to crisis behavior. Self-harm can perpetuate this kind of crisis state - Diverting attention (inner or outer) from issues that are too painful to examine - Exerting a sense of control over one''s body - Preventing something worse from happening CONDITIONS in which self-injurious behavior is seen - Borderline Personality Disorder - Mood Disorders - Eating Disorders - Obsessive-Compulsive Disorder - Post-Traumatic Stress Disorder - Dissociative Disorders - Anxiety and/or Panic - Impulse-control Disorder Not Otherwise Specified - Self-injury as itself a diagnosis So what do I DO INSTEAD? -----------angry, frustrated, restless - Try something physical and violent, something not directed at a living thing: - Slash an empty plastic soda bottle or a piece of heavy cardboard or an old shirt or sock. - Make a soft cloth doll to represent the things you are angry at. Cut and tear it instead of yourself. - Flatten aluminum cans for recycling, seeing how fast you can go. - Hit a punching bag. - Use a pillow to hit a wall, pillow-fight style. - Rip up an old newspaper or phone book. - On a sketch or photo of yourself, mark in red ink what you want to do. Cut and tear the picture. - Make Play-Doh or Sculpey or other clay models and cut or smash them. - Throw ice into the bathtub or against a brick wall hard enough to shatter it. - Break sticks. *I''ve found that these things work even better if I rant at the thing I am cutting/tearing/hitting. I start out slowly, explaining why I am hurt and angry, but sometimes end up swearing and crying and yelling. It helps a lot to vent like that. - Crank up the music and dance. - Clean your room (or your whole house). - Go for a walk/jog/run. - Stomp around in heavy shoes. - Play handball or tennis. ------------sad, soft, melancholy, depressed, unhappy - Do something slow and soothing, like taking a hot bath with bath oil or bubbles, curling up under a comforter with hot cocoa and a good book, babying yourself somehow. Do whatever makes you feel taken care of and comforted. Light sweet-smelling incense. Listen to soothing music. Smooth nice body lotion into the parts or yourself you want to hurt. Call a friend and just talk about things that you like. Make a tray of special treats and tuck yourself into bed with it and watch TV or read. Visit a friend. ----craving sensation, feeling depersonalized, dissociating, feeling unreal - Do something that creates a sharp physical sensation: - Squeeze ice hard (this really hurts). (Note: putting ice on a spot you want to burn gives you a strong painful sensation and leaves a red mark afterward, kind of like burning would.) - Put a finger into a frozen food (like ice cream) for a minute. - Bite into a hot pepper or chew a piece of ginger root. - Rub liniment under your nose. - Slap a tabletop hard. - Snap your wrist with a rubber band. - Take a cold bath. - Stomp your feet on the ground. - Focus on how it feels to breathe. Notice the way your chest and stomach move with each breath. [NOTE: Some people report that being online while dissociating increases their sense of unreality; be cautious about logging on in a dissociative state until you know how it affects you.] ----------wanting focus--------------- - Do a task (a computer game like tetris or minesweeper, writing a computer program, needlework, etc) that is exacting and requires focus and concentration. - Eat a raisin mindfully. Pick it up, noticing how it feels in your hand. Look at it carefully; see the asymmetries and think about the changes the grape went through. Roll the raisin in your fingers and notice the texture; try to describe it. Bring the raisin up to your mouth, paying attention to how it feels to move your hand that way. Smell the raisin; what does it remind you of? How does a raisin smell? Notice that you''re beginning to salivate, and see how that feels. Open your mouth and put the raisin in, taking time to think about how the raisin feels to your tongue. Chew slowly, noticing how the texture and even the taste of the raisin change as you chew it. Are there little seeds or stems? How is the inside different from the outside? Finally, swallow. - Choose an object in the room. Examine it carefully and then write as detailed a description of it as you can. Include everything: size, weight, texture, shape, color, possible uses, feel, etc. - Choose a random object, like a paper clip, and try to list 30 different uses for it. - Pick a subject and research it on the web. - Try some of the games and distractions at digibeet''s page; she''s assembled a lot of distractions. ---------wanting to see blood-------------- - Draw on yourself with a red felt-tip pen. - Take a small bottle of liquid red food coloring and warm it slightly by dropping it into a cup of hot water for a few minutes. Uncap the bottle and press its tip against the place you want to cut. Draw the bottle in a cutting motion while squeezing it slightly to let the food color trickle out. - Draw on the areas you want to cut using ice that you''ve made by dropping six or seven drops of red food color into each of the ice-cube tray wells. - Paint yourself with red tempera paint. --------wanting to see scars or pick scabs------------- - Get a henna tattoo kit. You put the henna on as a paste and leave it overnight; the next day you can pick it off as you would a scab and it leaves an orange-red mark behind. - Another thing that helps sometimes is the fifteen-minute game. Tell yourself that if you still want to harm yourself in 15 minutes, you can. When the time is up, see if you can go another 15. I''ve been able to get through a whole night that way before. information taken from http://www.palace.net/~llama/psych/ *I tried all of that. I still want to hurt myself.* BEING A PATIENT Hello. My name is Natalie. I''m recovering from mental illness. Schizoaffective Disorder, actually. Kinda like schizophrenia and manic depression mixed together - the value multi-buy diagnosis of mental health. I am a patient.I have a choice - I can belong to the group of the patient or, if I can fake it enough, I can join the mentally ''normal''. As a patient I can talk easily to other patients about how crap the system is - my psychiatrist, the ward, the food. I can share (almost honestly) my feelings - admit how hard it is to face the day. I can even describe my visions, voices and bizarre experiences. As a ''normal'' I would stay silent. I know because I did. As a ''normal'' I would stay silent for fear of being different. I''d fear their pity, their shocked silence and their fear. Even if I chose to let them into my head (well, the reception area - nothing too deep) I''d be afraid that they''d freak out or wrap me up in fluffy cotton wool. As a patient among patients I am normal. As a patient I feel sane. As a patient it''s my role to be fixed - cured. My psychiatrist and his team know best. They see me as a complex mix of symptoms and behaviour. High? - reduce the antidepressants, Psychotic - raise the dose of Seroquel. Not sleeping? - Too high or possibly too low. Is it the voices? - check the Seroquel dose. Are you taking your medications? If the drugs don''t work I risk being labelled as resistant - maybe even personality disordered. Given up on because after years of their help I refuse to improve. When all I want is to feel ok - get my life back. I feel hopeless. I feel that this is my lot. That my illness has taken over my life. I feel I need someone to help me. I am a patient, yes, but where''s it written that patients can''t help themselves? And so now I''m also working on becoming my doctor. Natalie |
