“the wounding embrace” self-injurious...
TRANSCRIPT
“THE WOUNDING EMBRACE”Self-Injurious Behavior
June Allder, Ph.D., LCSWPsychological Health- Roanoke
DefinitionSelf-injury is the act of attempting
to alter a perceived intolerable moodstate by inflicting physical harmserious enough to cause tissuedamage to the body. (Lavender, 2005)
It is a clinical disorder that affects1%-3% of the population.
Self- InjurySometimes it is called the
“Wounding Embrace” becausepeople use it to harm andcomfort themselves at thesame time.
Why People Self-Injure
“How will you know I’m hurtingIf you cannot see my pain?
To wear it on my bodyTells what words cannot explain.”
-C. Blount
Why People Self-Injure
Escape from emptiness, depression, andfeelings of unreality.
Easing tension. Providing relief: when intense feelings build,
self-injurers are overwhelmed and unableto cope.
Relieving anger: many self-injurers haveenormous amounts of rage within. Afraidto express it outwardly, they injurethemselves as a way of venting thesefeelings.
Why People Self-Injure
Escaping numbness: many of those whoself-injure say they do it in order to feelsomething, to know that they’re still alive.
Grounding in reality, as a way of dealingwith feelings of depersonalization anddissociation.
Obtaining a feeling of euphoria. Expressing emotional pain they feel they
cannot bear. Communicating to others the extent of
their inner turmoil.
Why People Self-Injure
Communicating a need for support. Expressing or repressing sexuality. Expressing or coping with feelings of
alienation. Validating their emotional pain- the
wounds can serve as evidence that thosefeelings are real.
Continuing abusive patterns: self-injurerstend to have been abused as children.
Why People Self-Injure
Punishing oneself for being“bad”.
Diverting attention (inner orouter) from issues that aretoo painful to examine.
Exerting a sense of controlover one’s body.
Preventing something worsefrom happening.
Alexithymia
Being unable to pinpoint any particularfeeling(s) that is present prior to SI.
Rather than use words to expressfeelings, an alexithymic’scommunication is an act aimed atmaking others feel the same feelings.
(Zotnick, et.al., 1996)
“An Act of Self-Help”
“The razor pierces the skin,and the blood flows out,carrying with it all thepoison, rage, and self-loathing that I feel inside.I feel “whole” again,grounded in reality.”
Conterio and Lader, 1998
Forms of Self-Injury
Cutting (the most common form of SI) Using scissors, sharpened screwdrivers,
razor blades, glass, knives. May range from superficial nicks to deep
gouges. Arms and legs are the most common
targets. May carve words in the skin, ie.. fat, ugly,
bad.
Forms of Self-Injury
Burning- cigarettes, lighters, stove burners,light bulbs, hot water, chemicals, etc…
Hitting oneself Head banging Scratching excessively Biting oneself Picking at wounds and not allowing them to
heal
Forms of Self-Injury
Breaking bonesChewing the lips, tongue, fingersAmputation of limbs, breasts, digits,
or genitals Ingesting sharp or toxic objectsFacial/body scraping, i.e. using
sandpaper, pot scrubbers, pencilerasers
Hair pulling
More Extreme Forms of SI
Inserting a knife in her vagina “toprevent a rape”
Injecting herself with the HIVvirus
Soaking clothes with gasoline andsitting fire to herself
Self-Injury
The goal is to end theemotional pain and sufferingeven if the body bears thebrunt of the injury.
CharacteristicsSelf-Injurers and Their Families
“I get bogged down inall my family’s problems and
wonder why I have such ascrewed-up life.”
Characteristics1. Neglect or abuse- physical, emotional, sexual.2. Traumatic losses, illnesses, or instability in
family life, i.e. frequent moves.3. Family life characterized by rigid, dogmatic
code of values or religious beliefs which areapplied in a hypocritical or inconsistentmanner.
4. Breakdown in the structure of family roles inways that made children take on adultresponsibilities prematurely andinappropriately.
Conterio and Lader, 1998
Helping Those Who Hurt Themselves
“For me, cutting says so much.I AM SORRY it brings painto others, but sometimes it isthe only way I can say how
much I am hurting.”
Helping Those Who Hurt Themselves
Half the battle in treatment is toget the self-injurer to realize thathurting herself is not a solitary actbut one that affects other peopleprofoundly.
Family and friends often feel angry,sad, confused, hopeless, helpless,frustrated, repulsed.
Helping Those Who Hurt Themselves
1. Don’t take it personally. The person whoself-injures is usually not trying to makeothers feel guilty and, most often, are notbeing manipulative.
2. Acknowledge the SI’s pain- It doesn’tmake the pain go away but it can make itmore bearable. Be willing to talk abouther self-abuse, and to listen if/when shewill talk. This helps remove the secrecyand reduces the shame attached to self-injury.
Helping Those…….
3. Offer support without reinforcing thebehavior- Let the SI know that she isloved and that others can separate whoshe is from what she does.
4. Education is very important. Get as muchinformation as you can about self-injury.Find books in which self-injurers talkabout what they do and why- It letsothers “inside the mind” of people who areSI.
Helping Those…
5. Get support from others. Find someonewho is a good listener and talk about whatis happening.
6. Take care of yourself- Take breaks fromthe SI when you need to so that you can“recharge”.
7. Ultimatums DO NOT work. You cannotforce another person to stop self-abusing.Getting into a power struggle will oftenmake him/her resentful and resistant.Accept your limitations.