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the last track, we discussed the reasons teens are so susceptible to self-injuring:
a drive for perfection; triggers from childhood; and the construction of identity.
Body Image & Self-Mutilation
Nineteen year old Lori is one such case of self hate. Lori stated, "I'm not comfortable in my fat body. When I'm at my normal weight, I wear a 36C bra, but that's still too big for my comfort. I don't appreciate guys staring at my chest or me thinking that the only reason they want to be with me is to have sex." Lori dealt with her negative self-image by gorging on foods to make herself unattractive. She, like other women, feel that this makes her less vulnerable to a sexual attack when in fact low self-esteem and bad health made her even more at risk for attack.
Preoccuptaion with Food
"My want to be perfect and my strong belief that I wasn't made me want to punish myself by depriving myself of food." Because food can have a nurturing connotation about it, Tony felt that he had to deny himself of any pleasure. He saw his needs as dangerous and destructive. Interestingly enough, his self-injurious actions are more detrimental than his perceived dangers. What do you think of this paradox?
Technique: "Self-Esteem Log"
Lori wrote down in her Self-esteem Log:
At the end of the week, I asked her to review her log and recall those positive moments. By emphasizing the positive and not the negative aspects of herself, Lori could start to open the door to improving her self-concept. Are you treating a Lori whose self-mutilation has also materialized through overeating? Would a Self-Esteem Log be beneficial? .
Difference between Female and Male Self-injurers
Tony was beaten regularly by his mother's
various boyfriends. In addition to his anorexia, to escape this, he emerged himself
in alcohol, drugs, and self-mutilation. One interesting aspect of Tony's case
is his incapacity to place the blame on his mother.
Here is a summary of his responses; Tony related that his parents divorced when he was very young. After the separation, his mother became involved with a second cousin who jumped bail after being jailed for drug sale. Because of these legal problems, Tony, his mother, and his mother's boyfriend went as he put it "underground." Though they never married, the couple had a son and later the boyfriend had a nervous breakdown. Then, Tony's mother got a boyfriend who routinely beat Tony.
Through the use of the Autobiographical Sketch it became apparent to Tony that his initial statements that his mother "possesses an almost impeccable sense of morality" strongly contradicted reality and that the saintly image of his mother he had previously maintained was his idealized version of her. Being able to consciously remember these negative memories helped Tony to recognize the harm that resulted from his mother's behavior. The Autobiographical Sketch helped to start to resolve the conflict between Tony's reality and idealization of his mother.
On this track, we discussed how loathing one's body and a preoccupation with food can lead to self-mutilation. Also we discussed the differences between male and female self-injurers regarding the way in which they vent their emotions. Would it be beneficial for you to replay this track to review the techniques of the Self-Esteem Log and the Autobiographical Sketch?
On the next track, we will discuss the various ways a family can be affected by self-injury: shock and guilt; anger and resentfulness; and stronger bonds.
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