Breaking_the_Myths_About_Self-Mutilation

Breaking the Myths about Self-mutilation With over 2 million Americans and almost one percent of the total population admitting to having consistent problems with self-injury, it is hard to believe that this problem is not taken as seriously as it should (Williams xv). This is a severe problem because those who hurt themselves in any way usually do not know any other ways of coping with bad situations. Self-mutilation, also known as self-injury, deliberate self-harm, self inflicted violence or cutting, is defined as the purposeful injury of one’s body that causes physical damage. This damage leaves a scar and is done by someone in order to deal with overwhelming situations (Williams 14, 19). It is not always obvious to outside observers, but self-injury is doing something very important for those with the problem. Cutters and other self-injurers find that the process works as a coping mechanism for uncomfortable or overwhelming feelings of inner pain and this method can be extraordinarily effective (Strong xvii). Some of the most common forms of self-injury are: cutting, burning, head banging, hitting oneself, and tearing out large amounts of hair in an attempt to ease pain. Approximately 75 percent of those with self-mutilation issues use more than on method to inflict harm (Conteria, Lader & Bloom 17). This can cause serious long term effects because the person continues with a life of instability unless they can get help for the syndrome. The main problem with those who hurt themselves is figuring out what mental problem they have, if any, that has triggered their self-injurious behavior, and what mental need self-injury serves for them. Something that has hindered the progress of providing help is the myth about self-injury. In order to help those who have problems with self-mutilation society must break away from the stereotypes in order to see others in need of care. This syndrome has been hidden and misdiagnosed for so many years that people have lost sight of how significant of a problem self-injury really is. With 1,400 out of every 100,000 people in the general population and 12 percent of college students admitting to some sort of persistent self-injury, it is time to take action (Conteria, Lader & Bloom 21). Self-mutilation was also known as “the addiction of the 90s” with its sudden spring in popularity (Strong 57). Even though self-injury has been a concept present since biblical times, Christian beliefs used this as a form of atonement for disobeying God; it has exploded in popularity in the past few decades (Conteria, Lader & Bloom 5). In the past, those with self-mutilating tendencies were often diagnosed as psychotics, psychopaths, or hysterics, which hindered the evolution of realistic and helpful treatments (Strong 59). In the nineteenth century the public began to view self-injury as a result of mental illness and were only believed to be extreme and failed cases of attempted suicide (Plante 7). In the last two decades, cutting has been the most public form of self-injury or self-mutilation. There has been an up rise in movies and celebrities embracing the topic. One of the most publicized celebrities who had admitted to the problem was the late Princess Diana. In 1995, she came forth telling the public that she had been a cutter as well as struggled with eating disorders. She admitted to cutting her arms and legs during her childhood as well as during her famous marriage to Prince Charles (Strong 19). This widely publicized case has lead to a media fascination with self-injury and therefore a popularization of the problem. Films have had an impact of the popularity of cutting in both positive and negative ways. Popular films such as Thirteen, the Virgin Suicides, and Girl Interrupted have brought the problem to the public’s attention but have also caused people to create a stereotype of the self-injuring person. Movies such as these often show self-injurers with serious mental disorders, abusive families, and substance abuse problems. Although some self-injurers may have these problems, this is not always the case. Having these stereotypes in the public’s mind can cause people to be blind to those who do not “fit the mold” which hinders the ability for them to receive the help they need. Due to the popularity of the problem, self-mutilation is considered to be less of a serious problem. Those in the general public see self-injury as a need for attention and completely purposeless. This causes those who hurt themselves to feel as if they have nowhere to turn because they are not taken seriously (Conteria, Lader & Bloom 19). One of the largest problems with the public’s view of self-mutilations is the unawareness of why people hurt themselves. Self-harm can have very powerful emotional results for those looking to soothe themselves. The purpose of self-harm can usually fall under two generalized categories: Analgesic or palliative aims or communicative aims. Those who harm themselves for analgesic aims are searching for the physical calm from the connection of body and mind. These people use self-harm to feel more in control in there possibly hectic lives as well as a way to feel cleansed of their emotion problems in order to move on with their lives. Those people who harm themselves for communicative aims are searching for a way to express their inner mind set. This form is most common in people who harm in order to punish themselves or those who are crying for help (Conteria, Lader & Bloom 61). All of these reasons can be either hidden or blatant depending on the individual person. For some patients, cutting can be a form of personal treatment for releasing tension, providing punishment, or ending long periods of feeling “dead” or “numb” (Strong 33). The behavior causing self-injury can be characterized into four major forms: impulsive, compulsive, major and stereotypic. Major and stereotypic self-harm is very rare and seen among those with severe mental disorders. Compulsive injury is often less severe and is associated most commonly with obsessive compulsive disorder. Impulsive injury is more serious than compulsive and can be associated with the common disorders (Williams 15). It is important to remember that a mental disorder does not have to be associated with self-injury. Impulsive injury also includes the more popularized methods such as cutting and burning. One of the main reasons that people self-injure is because it causes “dissociation”. Dissociation is a psychological term referring to an unconscious separation between a person’s body and mind. This process can make the person feel as if they are in a dreamlike state and distant from reality. When in this state the bodies needs become second to the person’s emotional needs (Conteria, Lader & Bloom 55). Dissociation in the most serious cases can be used as a way to completely shut out traumatic memories and emotional distress from one’s mind. This is one of the reasons why self-injury it is so prevalent among people with abusive pasts (Strong 38). Dissociation allows those who harm themselves to step back from reality and feel as if their problems and overwhelming feelings do not belong to them, which is one reason why this is not an affective coping mechanism. This allows people to put their problems aside rather than face the issues that are causing their behavior. One problem with self-mutilation is that there are many myths that have made it harder to diagnose or notice those with the problem. When people imagine self-injurers they mainly think of teenagers, who are obviously depressed, withdrawn from their peers, and with a broken family. This is an extreme case of the stereotype but, none the less, an example of the idea that causes some people to be over looked. Though some myths and stereotypes are true in some cases, there are still a large amount of sufferers who do not fit the norm and are therefore not noticed by those around them. If they are unnoticed they have the choice of either reaching out for help, which is uncommon with self-injury because people are often ashamed of their actions, or they have to deal with it on their own, which is rarely successful. One of the most common myths about self-mutilation is that those with the problem have some sort of mental disorder (http://www.selfinjury.org). Self-injurers whose behavior gets so bad they need medical attention are often diagnosed with either borderline personality disorder, major depression, bipolar disorder, or multiple personality disorder. The problem with this is that it causes the public to believe that all those who self-injure have a mental disorder which is often untrue (Conteria, Lader & Bloom 18). The most common diagnosis for those who self-injure is borderline personality disorder. According to the American Psychiatric Association, “the essential feature of the borderline personality disorder is a pervasive pattern of instability of interpersonal relationships, self image and affects, and marked impulsivity that begins by early adulthood and is present in a variety of contexts”. Though one of the main characteristics of borderline personality disorder is suicidal or self-mutilating behavior that does not mean all people with this disorder are self-harming or those who self-harm must have this disorder (qtd. in Dobbert 65). What is misunderstood is that that this problem is usually unrelated to a serious mental disorder, such as borderline personality disorder, but merely an inability to cope with overwhelming emotions. With only approximately 48% of self-injurers testing positive for borderline personality disorder it causes the public and medical professionals to look over those self-injurers without a mental disorder and think that they are emotionally stable (Conteria, Lader & Bloom 22). Another myth surrounding self-injury is that some believe that if it is not causing pain to the individual why should they take action to help' Even though self-injurers often say they feel no pain when in the act, that is not always the case. The amount of pain a person feels can often be determined by the level of control a person has over the pain. Some people feel that when they are in control the pain does not exist. Some self-injurers say they feel no pain. During the process of cutting or burning people say they feel numb or empty unable to connect with the pain until afterwards (Conteria, Lader & Bloom 55, 57). These are often the most serious cases because those who feel no pain believe that they are not doing anything wrong because it makes them feel numb to the problems causing their need for self-injury. Even when in severe pain after harming themselves those people say it feels “oddly calming, soothing - alive”. In contrast, those who say they do feel pain during the act say that it is a small obstacle in order to achieve the desired result. This coincides with the category of self-injurers who do it as a form of self punishment. In this case the pain is what they need to feel as if they are getting what they deserve for their actions or emotions. The pain can even be considered “a confirmation of their feelings of sinfulness” (Conteria, Lader & Bloom 55). This myth causes people to not receive help because if the public believes that they are not in pain and suffering then there is no incentive to help. It is important to notice that even if some sufferers do not feel the physical pain they are struggling with mental and emotional pain that is causing them to harm themselves in the first place. Another misconception about self-mutilation is that the wounds are not bad enough to cause serious action (http://www.selfinjury.org). Even in the case of cutting, the most common form of self-injury, the problem can have many different levels of intensity. People usually start with smaller superficial nicks that can lead to deep gouges or large circle punctures in their flesh. They also usually start cutting in hidden places and lead to more visible cuts or even in extreme cases words carved into arms and openly visible body parts. Those who cut are not restricted to razors and can be extremely resourceful. Those with this problem will find and use any object they can in order to get the “high” they believe they need. Self-injury can become so prevalent in a person’s life that they will resort to hiding razors, knives and other implements in school lockers, cars, wallets, and anywhere that makes the release readily available (Conteria, Lader & Bloom 17-19). This shows that even if the wounds are small it does not dictate how much self-injury can take over a person’s life. The size of the wound has nothing to do with the amount of emotional distress that the person is experiencing to cause them to self-harm. If medical professionals and the general public only consider it a problem when the wounds are life threatening than it is often too late for those suffers. This also makes those in the early stages not able to receive help because they are not taken seriously until it is too late. The most common and most impacting myth about self-mutilation is that it is usually a failed suicide attempt (http://www.selfinjury.org). Self-injury was not viewed correctly in its relation to suicide until the popular book Man Against Himself by Karl Menninger (Plante 7). Karl Menninger is a Harvard trained physician, cofounder of the Menninger Clinic, author of many respected books, and one of the most credible voices on the topic of self-injury and self image. In his book he shows how self-injurers are not suicidal but rather in search for something to help them get rid of negativity. He shows how they are constantly searching for something to self-preserve and self-heal in order to sustain their own lives (Strong 31). Menninger wrote about self-injury stating, “In this sense it represents a victory, even through sometimes a costly one, of the life instinct over the death instinct”. This explains how those with this problem are not trying to commit suicide but rather to find a way to stay alive the best way they can (qtd. in Strong 32). Statistically speaking, the amount of people who self-injure is 30 times larger than those who attempt suicide and 140 times larger than successful suicides (Strong 25). With there being such small amount of people who self-injure wanting to commit suicide it is unrelated in most cases. This is also not counting the amount of attempted suicides that were merely self-injury gone wrong and not actually intended as a way to end one’s life. The main problem with this myth is that self-injury is very different than suicide because they achieve two entirely opposite goals. Suicide provides an ultimate irreversible escape while self-injury actually promotes life to those who harm themselves (Strong 33). Self-injury is an important problem and affects not only the sufferers but those that care about them. Those who self-injure have no ability to deal with emotional pain, even if they have a high tolerance for self inflicted physical pain (Conteria, Lader & Bloom 57). This can cause many problems later in life even after they stop harming themselves. Those who can only deal with self inflicted pain often cannot handle normal pains, such as headaches, which can hinder their ability to live a normal life. Self-injury can also cause problems with forming long lasting personal relationships due to the fact that those self-injurers do not know how to deal with their own emotional problems that it becomes harder to communicate with others. Society needs to be more understanding that this is a serious condition and without early help, sufferers can be scarred for the rest of their lives. After noticing the flaws in some of the most common myths we can start to notice those who harm themselves and get them the help they desire. Once we stop looking for what is considered to be stereotypical we can see the silent sufferers that account for many self-injurers and are constantly overlooked. There are some characteristics to look for in people, which can be more reliable that myths, yet are not always fully true. Some things to look for are if the person has an extreme fear of change or they do not take good care of their physical bodies. Self-injurers can also have low self esteem or more commonly a constant need for acceptance and companionship. Another characteristic that is very common, but not necessary, is childhood trauma that has caused the person to have an inability to cope with overwhelming situations in a healthy manner (Conteria, Lader & Bloom 138-139). It is important to remember that these characteristics and myths can be true for some self-injurers but they should not be focused on. If society focuses on the myths and certain characteristics then they are blinded by tunnel vision, to those who do not fit the normal stereotypes or are not as open with their problem as others. Since the 1980s, when self-injury became more public, there has been much more awareness of how those that harm themselves should be treated. There are still alarmingly small amounts of medical professionals who fully understand how to treat this problem (Conteria, Lader & Bloom 21). One of the biggest problems in treating self-injurious people is that it is hard to understand if self-injury is the main problem or the result of a much larger issue that the person must work through before the self-injury can be treated correctly. Therapists and researchers have begun to examine the complicated ways that self-injury sustains those people. There is a psychological and physiological relief that is achieved by self-injury and it helps those people to cope (Strong xvii, 43). This knowledge has helped the medical society to learn how to effectively treat patients. There are a small amount of people who self-injure that may simply grow out of it and stop without outside help. This can be positive and effective but it also produces negative affects because those who get better on their own often find other unhealthy habits to fill the void (Strong 161). Due to this, 56 percent of self-injurers have problems with alcohol abuse and 30 percent face addictions to street drugs later in life. The most astonishing fact is that 61 percent of self-injurers are reported to have some form of eating disorder (Conteria, Lader & Bloom 60). Those who self-injure constantly have trouble developing healthy ways to express their emotional or physical distress (http://www.selfinjury.org). Treatment for those with past traumas can be much harder to treat and it becomes a lifelong process. This is because the initial trauma caused them to learn unhealthy coping mechanisms and it is a longer process to reteach a person how to deal with emotions when they have lived their life doing it another way (Plante 84). As Alice Miller states, “an acknowledged trauma is like a wound that never heals over and may start to bleed again at anytime” (qtd. in Strong 85) One of the most successful forms of treatment is psychiatric treatment. Marcel Proust states in his work Remembrance of Things Past, “We are healed of suffering only by experiencing it in the full” (qtd. in Strong 158). In 1985, Karen Conteria and Wendy Lader created the first program devoted specifically to treating those with self-mutilating tendencies. The program S.A.F.E, Self Abuse Finally Ends, has been able to successfully treat many patients. Their program focuses on treating underlying inner conflicts that patients have and teaching them new healthy ways to cope with their emotions (Conteria, Lader & Bloom 3-11). Understanding what is true and what is exaggerated regarding the myths and stereotypes about self-injury can help those who suffer with this problem. We as a society need to keep our eyes open if we notice problems with people close to us. If the myths are broken than people can understand that this problem can exist in the happy, popular, smart, seemingly normal person as well as those who are more obviously troubled. This is a serious problem that affects more than one percent of the total population and can lead to many other serious conditions. It is very important that those who can act and try to help as best they can. Often merely being a person to listen or someone to notice can help in tremendous ways to those who self-injure. Epilogue: Achieving my dream Now after a full year of recovery, and counting, I am able to wear a bathing suit to the beach and feel confident yet still aware of what I have struggled with and the pride I can have in the fact that I am finally healthy. I still struggle every day with my own perception of myself. I still have days where I feel worthless, I feel like a failure, and I feel unwanted. But now I know that I can talk about it to the people who care about me, I can allow myself to be upset, and I can allow myself to actually feel. I was never able to do that while I was cutting, I was mentally shut off from everything around me. I am now able to look at my faint scars and say that “I made it through some things others have never had to deal with and I am a better friend, a better daughter, a better sister, and most importantly a better person because of it”. Not all stories end up happy like mine, I was lucky, others may not be and need more help. It took four years of struggling for me to get better, I did not want to go through that and I wish no other person has to struggle unnoticed and afraid. Sometimes it takes just one person, just one dream, just one tear to set someone free. I wish that there would have been someone like myself to intervene with my situation as I did with my friends. All that someone struggling with self-injury needs is one person to notice them, acknowledge that what they are doing in not alright, and show them how to get the help they need. Show them that they need to be healthy, they deserve it. Works Cited American Self-Harm Information Clearinghouse. 2007. ASHIC. 1 February 2010 . Conterio, Karen, Wendy Lader, and Jennifer Kingson. Bloom. Bodily Harm: the Breakthrough Treatment Program for Self-injurers. New York: Hyperion, 1998. Print. Dobbert, Duane L. Understanding Personality Disorders An Introduction. New York: Praeger, 2007. Print. Plante, Lori G. Bleeding to Ease the Pain Cutting, Self-Injury, and the Adolescent Search for Self (Abnormal Psychology). New York: Praeger, 2007. Print. Strong, Marilee. A Bright Red Scream: Self-Mutilation and the Language of Pain. New York, N.Y: Viking, 1998. Print. Williams, Mary. Self-mutilation (Opposing Viewpoints). New York: Greenhaven, 2007. Print.