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Although McDonald (2006) referred to this phenomenon as self-mutilation, most authors use the term "self-injury" (i.e., American Self- Harm Information Clearinghouse, 2005;Van Sell, et al., 2005). Others use the terms "self-harm"(Ayton, Rasool, & Cottrell, 2003; Harris, 2000), "self-wounding" (Sharkey, 2003), or "self-inflicted violence" (SIV) (Alderman, 1997). Because the term "self-mutilation" evokes grotesque images and implies permanent damage or alteration to one’s body (Alderman, 1997), it is particularly annoying to those who self-injure (Hoyle, 2003; Levander, 2005; Sutton, 2005). In contrast, SIB usually is temporary and often unnoticeable or hidden.
Common Self-Injuring Behaviors
The tools most often used are razors, knives, lighters, broken glass, matches, sewing needles, pencils (sharpened lead and erasers), and sandpaper. Cerdorian (2005) asserted that SIB often is inflicted repeatedly on the same part of the body. Contradicting the notion that persons who self-injure are seeking attention, most self-injuring adolescents wear clothing that covers their scars and wounds (Cerdorian, 2005;Hoyle, 2003; Shannon, 2005).
Four Types of SIB
WHO IS SELF-INJURING?
The Eight C’s
Adolescents who self-injure claim the behavior affords them a sense of desired control. Some describe a feeling of relief when experiencing the pain of SIB because it is then that they know they are truly alive. Others claim it produces a state of numbness or dissociation. Such chastisement is self-punishment for imagined or real mistakes or shortcomings, in which the self-inflicted wound is a conduit for the voice that the adolescent lacks (Sutton, 2005).
THE CYCLE OF SELF-INJURY
They felt stigmatized and experienced increasing feelings of abandonment as their friends and family members did not understand their self-injury. These negative feelings led them back to the desire for temporary relief. As one participant stated, "I just cut myself and thought about the pain, and I cried and then it was over. I felt better until the next time problems came, whether they were the same problems or different ones, and I did the same thing. It was just something that got me through it." (Lesniak, 2007b).
In essence, the inability to cope with intolerable feelings leads to alternate ways of expressing those feelings. Self-injurers may experience relief from SIB. However, the shame resulting from the act of harming oneself leads in a patterned manner back to emotions that are unacceptable. Other researchers describe the cycle of self-injury in adolescents using six points: mental anguish (escalating emotions), emotional engulfment (fright, anxiety), panic stations (loss of control, detachment), action stations (act of self-injury), better/different feeling (relief, control regained), and the grief reaction (shame, guilt) (Sutton, 2005,p. 114).
Adolescents at risk for self-injury behavior are searching for a way to give voice to their pain. When approached with a caring attitude that reflects the love of Christ, when listened to with intentionality, and when nurtured by an authentic presence, self-injurers are relieved to externalize their difficult emotions through verbal means rather than to record their pain with visible stories on their skin. For even when the wounds heal, the scars remain a visible reminder of the hurt hiding within. In essence, the history of the self-injurer is recorded on their skin.
- Lesniak, R. Self-injury behavior: How can Nurses Help. JCN Oct 2008; 25, 4 (186-193)
Personal Reflection Exercise #3
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