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Self-harm should not be ignored

Aug. 23, 2013 @ 12:00 AM

Self-harm behaviors are deliberate actions that result in damage to body parts, most commonly the arms and legs, usually in a hidden and secretive way. These behaviors are also known as self-injury, self abuse, cutting or self mutilation. They are often the result of deeply rooted emotional pain and suffering. Cutting skin on the arms, legs or torso is the most common self injurious behavior even though self-harm can also include burning yourself, scratching to the point of bleeding, head banging, bruising body parts or hair pulling (hair pulling is also known as "trichotillomania").

It is difficult to find data on how common self-harm is among people. The National Institutes of Health estimates that 1 in 100 or 1 percent of people engage in self-harming behaviors, while a study in the United Kingdom of adolescents showed 33 percent had engaged in self-harming behavior (see www.nih.gov). The US Department of Veteran's Affairs estimates that somewhere between 2 and 6 percent of adults and somewhere between 13 and 25 percent of adolescents engage in self-injurious behaviors (see www.ptsd.va.gov). Since self-injury is a problem that is covered up and hidden and does not often require an emergency room visit, it might be under-reported.

Self-harm is more common in adolescents and young adults ages 11 to 25, although there are some adults and seniors who also deliberately harm themselves. Most people who harm themselves are not suicidal or trying to die. They could be suffering from a mental illness like depression, anxiety, post-traumatic stress disorder, eating disorders, addiction issue or personality disorder, especially borderline personality disorder. They might have an autism spectrum disorder or a developmental delay or an intellectual disability. Some people who harm themselves have no mental illness and no intellectual disability (according to www.nlm.nih.gov).

People use self-harm for a variety of reasons. Self-harm is used as a coping skill that provides temporary relief from intense feelings, including fear and worry, depression, anxiety, blunted emotions or emotional numbness, or stress. People who harm themselves may experience a sense of self-loathing or self-hatred. They often feel angry at themselves and their decisions or behaviors and carry a sense of low self-esteem. Problems at school, problems at home, divorcing parents, being isolated, being bullied, feeling different from others, having relationship issues with a peer or group of peers may drive a young person to harm themselves. Self-harm commonly occurs when there is a history of trauma and abuse, including emotional, physical and sexual abuse.

Many adolescents and adults who self-harm say that they do not feel pain while they are cutting themselves. Scientists believe that some natural endorphins or natural painkillers are released in the brain during cutting that numb the physical pain, and, in some cases, may actually create a euphoric feeling of well-being. For others, self-harm is a way to feel something as opposed to the numbness or emptiness they carry with them most of the time. For others, the physical pain acts as a distraction to the emotional pain. Physical pain can bring them back to reality if they are having trouble with day dreaming, feeling outside their own body or losing track of time. For some, self-harm shows a physical culmination of the pain and suffering that is occurring internally, similar to how a good crying spell can relieve stress or emotional pain.

Read more about self-harm at the National Institutes of Health's National Library of Medicine (see www.nlm.nih.gov) or the Veteran's Administration's National Center for PTSD (see www.ptsd.va.gov).

People may not get help because they are too embarrassed or ashamed of the self-harm and the scars left behind. They may also refuse medical treatment when necessary because of the embarrassment and shame. It could be difficult to stop the self-harming behaviors as they become more like habits than a single or few events and occur with more regularity.

Overcoming the urge to harm one's self is possible. Learning other ways to cope and find relief from intense emotions is part of treatment. Treatment may include cognitive behavioral therapy focused on self-harming behaviors. In cognitive behavioral therapy, a trained professional works to help identify the thoughts that generate the feelings or urges to do self-harm, and in turn, those feelings or urges that lead to the self-harming behaviors. The professional therapist or counselor will help re-frame or turn around those thoughts so they lead to different feelings and that results in behaving differently and not self-injury.

Another successful treatment teaches avoidance of the people, places and things that cause the urge to self-harm. This might include learning alternative coping skills like removing sharp objects from the home, staying busy, writing in a daily journal, taking a walk, participating in sports or exercise or contacting friends when the urge hits to self-harm. A red permanent marker may be substituted for the knives or razors used to self-harm. Medication can be helpful in treating anxious feelings or depression to make them more manageable. Any treatment should be appropriate and acceptable for that individual and their own needs and motivation.

Prestera Center offers professional therapy, counseling and psychiatry for adults, children and families experiencing behavioral health problems and self-harming behaviors. Individuals and families get better with the right kind of care. Prestera Center offers a variety of services that promote mental wellness and help people achieve their full potential.

Prestera Center offers Putnam County residents access to effective professional mental health and addictions treatment services in Winfield and Hurricane. Offices in Winfield are located at 3389 Winfield Road, Suite 8, on the grounds of the Courthouse Complex (304-586-0670). Offices in Hurricane are called "Hopewell" and are located at 3772 Teays Valley Road (304-757-8475). The Hopewell offices specialize in serving adults with insurance in need of addiction treatment and mental health problems like grief, depression and anxiety or more severe mental health problems. Both offices are accepting new clients and scheduling appointments. Walk-ins are also welcome Monday through Friday between 8 a.m. and 9 a.m. at the Winfield location.

Kim Miller is the director of Corporate Development at Prestera. She can be reached at kim.miller@prestera.org.