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Treatment of Nonsuicidal Self-Injury in Adolescents
10 CEUs Physical Pain Stops my Pain - Treating Teen Self Mutilation

Section 25
Self-Mutilation and Prison

Question 25 | Test | Table of Contents | Self-Mutilation CEU Courses
Social Worker CEU, Psychologist CE, Counselor CEU, MFT CEU

Regardless of the source of stress, the inmate may resort to self-mutilation partly to gain the benefits of hospitalization. By qualifying as a "sick" person, the self-mutilation gains advantages.

First, by treating the "illness" as a physical condition, the physician legitimatizes the "sick" person's qualification for exemption from normal role responsibilities. For one thing, the resident prisoner is temporarily exempt from being handled as a rebel.

Second, the "sick" person is viewed as the victim of a condition to be changed rather than a possessor of defective attitudes. To the extent that his physical effects of his self-mutilation is the center of medical attention, the prisoner gains relief from the pressures of previous personality-oriented relationships with prison officials when his "defective attitudes" were the focus of concern.

Third, qualification for the "sick role" provides a number of secondary gains, such as removal from an undesirable locale to the hospital or physical removal from threatening inmates.

Individuals differ in the quality and quantity of stress they experience because of two classes of factors. They differ in their level of stress tolerance because of their personality qualities and the degree to which their previous experience prepares them for the world behind bars. This factor is emphasized among those self-mutilators who demonstrate either dependent personalities or a high degree of mental turmoil.

However, inmates also differ in the status positions they occupy within the social structure of the prison. The dependent personalities, inmates who fear other prisoners, and victims of mental turmoil are more likely to mutilate themselves than most prisoners because they have low status as prisoners and low status among prisoners. Their low tolerance of stress is aggravated because of their failure to gain access to inmate social structure which provides the protection and the subterranean means of gaining privileges and gratification barred by official rules.

Usually, inmates skilled in manipulation or prone to aggressive hostility against official restrictions would not engage in self-injuries. Their acceptance within the inmate social system usually provides them with means of gaining their purposes without such drastic and risky measures. But, on occasion, these inmates are in situations where their usual strategies are not effective or where the circumstances require emergency responses. Then their status in the inmate social system no longer provides benefits and innovative measures are required. Self-mutilation is one form of innovation.

To anticipate discussion to follow, we find two sociological types (Rebels and Manipulators), are most prone to be committed to the values of the inmate system and to utilize self-injury for purposes consistent with those values. The Rebels are less skillful usually than the Manipulators in perverting the official prison system to serve their personal goals. The former is more likely to employ self-injuries in a rather blatant and aggressive fashion, The other four sociological types operate essentially outside the bounds of the inmate social system. They have relatively low status in the inmate social system in addition to the low position in the official system which they share with all prisoners. Because of their low status in the inmate social system, their self-mutilations are less likely to represent art innovative strategy used by Rebels and Manipulators to supplement less drastic manipulative devices usually effective in achieving secondary gain.
- Johnson, Elmer, Correlates of Felon Self-Mutilations, Heckman Bindery: Manchester, 1997.

Personal Reflection Exercise #11
The preceding section contained information about self-mutilation and prison. Write three case study examples regarding how you might use the content of this section in your practice.

Peer-Reviewed Journal Article References:
Griffiths, L., Bailey, D., & Slade, K. (2020). Exploring the listener scheme in a women’s prison: The importance of a gendered approach to peer support for women who self-harm in custody. The Journal of Mental Health Training, Education and Practice, 15(6), 347–360.

Nielsen, E., & Townsend, E. (2018). Public perceptions of self-harm—A test of an attribution model of public discrimination. Stigma and Health, 3(3), 204–218.

Sansone, R. A., Sellbom, M., & Songer, D. A. (2018). Borderline personality disorder and mental health care utilization: The role of self-harm. Personality Disorders: Theory, Research, and Treatment, 9(2), 188–191.

Siddaway, A. P., Wood, A. M., O'Carroll, R. E., & O'Connor, R. C. (2019). Characterizing self-injurious cognitions: Development and validation of the Suicide Attempt Beliefs Scale (SABS) and the Nonsuicidal Self-Injury Beliefs Scale (NSIBS). Psychological Assessment, 31(5), 592–608.

Walker, T., Shaw, J., Gibb, J., Turpin, C., Reid, C., Gutridge, K., & Abel, K. (2021). Lessons learnt from the narratives of women who self-harm in prison. Crisis: The Journal of Crisis Intervention and Suicide Prevention, 42(4), 255–262.

What two sociological types are most prone to be committed to the values of the inmate system and to utilize self-injury for purposes consistent with their values? Record the letter of the correct answer the Test.

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