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Self-Mutilation, Self-Injury and Eating Disorders

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Self-mutilation and Eating Disorders

A study by Favazza and Conterio (1989) states that episodic and repetitive self-mutilation are frequently seen in conjunction with, or as a replacement for, eating disorders. In a study of 290 self-mutilating women, they found that 22% of the subjects suffered from only bulimia nervosa, 15% from anorexia nervosa and 13% from both disorders, for a total of 50%.
Among these subjects, the average age when the eating disorder first became evident was 16 years. Adolescence is also when superficial self-mutilation is usually first displayed.

One woman in Jennifer Harris's 2000 study was quoted as saying, "When I started to emerge from my anorexia, I needed some other way of dealing with the pain and hurt, so I started cutting instead. It is a way of gaining temporary relief. As the blood flows down the sink, so does the anger and the anguish." Some women use purging as a form of self-mutilation. Their purging is a literal form of self-mutilation from the inside out, as it lacerates organs and causes internal injuries and bleeding. They attack their bodies internally to find the same relief that cutters or burners do in attacking their bodies externally.

The link between superficial self-mutilation and eating disorders can create serious complication in treatment. According to Steven Levenkron, author of Cutting: Understanding and Overcoming Self-Mutilation, self-mutilating behavior is frequently "at the top of the pyramid of psychological problems that an individual may suffer from, the tip of the iceberg." This means that self-mutilation may develop from another problem, frequently anorexia or bulimia. In this case, as the patient in therapy begins to limit or stop their self-mutilating behavior, they will begin to lose weight or resume previously halted use of laxatives or drugs. According to Levenkron, treating such a patient, requires a uniquely strong therapist-patient relationship. Complete trust of the therapist is intrinsic to ensuring that the patient does not resume self-mutilating behaviors when they are again consumed by other destructive behaviors that neither they, nor the therapist can predict. Such psychotherapy is "no less than an undertaking to change one's mental and emotional personality organization."

Self-Injury and Eating Disorders

Many people with eating disorders also engage in the act of self-injury. Just like the eating disorders are used to help the individual cope, the act of injuring oneself is also used to help cope with, block out, and release built up feelings and emotions. Self-injury is probably the most widely misunderstood forms of self harm and there are many myths associated with it, which can make it difficult for people to reach out and ask for help.

Self-injury (self-harm, self-mutilation) can be defined as the attempt to deliberately cause harm to one's own body and the injury is usually severe enough to cause tissue damage. This is not a conscious attempt at suicide, though some people may see it that way.

It has been reported that many people who self-injure have a history of sexual or physical abuse, but that is not always the case. Some may come from broken homes, alcoholic homes, have emotionally absent parents, etc. There are many factors that could cause someone to self-injure as a way to cope.

There are three types of self-injury. The rarest and most extreme form is Major self-mutilation. This form usually results in permanent disfigurement, i.e. castration or limb amputation. Another form is Stereo typic self-mutilation which usually consists of head banging, eyeball pressing and biting. The third and most common form is Superficial self-mutilation which usually involves cutting, burning, hair-pulling, bone breaking, hitting, interference with wound healing and basically any method used to harm oneself.

Most people who self-injure tend to be perfectionists, are unable to handle intense feelings, are unable to express their emotions verbally, have dislike for themselves and their bodies, and can experience severe mood swings. They may turn to self-injury as a way to express their feelings and emotions, or as a way to punish themselves.

You may be wondering why someone would intentionally harm themselves. Self-injury can help someone relieve intense feelings such as anger, sadness, loneliness, shame, guilt and emotional pain. Many people who cut themselves, do this in an attempt to try and release all the emotions they are feeling internally. Others may feel so numb, that seeing their own blood when they cut themselves, helps them to feel alive because they usually feel so dead inside. Some people find that dealing with physical pain is easier than dealing with emotional pain. Self-injury is also used as a way to punish oneself. If they were abused, they may feel ashamed, guilty and blame themselves for the abuse, which in turn causes them to feel the need to punish themselves by inflicting pain to their bodies. Some people have such hatred for themselves and their bodies that they will carve demeaning names on their bodies as a way to remind themselves of how terrible they are. Whatever form of self-injury is used, the person is usually left with a peaceful and calm feeling afterwards. Since those feelings are only temporary, the person will probably continue to self-injure until they deal with the underlying issues and finds healthier ways to cope.

If you feel the urge to injure yourself, below is a list of suggestions that might help you to overcome that urge.  Please be advised that not all of these suggestions will be helpful to everyone.  What is helpful to one person, may not be helpful to someone else.  These suggestions have been provided by individuals who self injured and what they found helpful to them.  If you feel that a certain suggestion may in fact cause you to want to self injure even more, do NOT use that suggestion.  Find ones that are helpful for you.  Again, these are only suggestions and may not be helpful to everyone.

If you have any suggestions that have helped you in the past and feel might be helpful to someone else, please email and we will add it to the list.

It is very difficult for people to admit to someone that they harm themselves because there is usually so much shame and guilt that goes along with it. It's important to try and remind yourself that there is no shame in what you are doing and that it's okay to reach out and ask for help. In order to help yourself overcome this, you need to want to stop the behavior and you need to find a therapist that you like and trust to help you deal with the underlying issues causing you to do this to yourself. Sometimes treatment may also involve the use of medications such as Xanax and Klonopin. Hypnosis and relaxation techniques can also be helpful, and in extreme cases, hospitalization might be required for a short period of time. If there are support groups in your area, you may want to think about joining them for extra support.

Many people who self-injure keep it a secret because they feel like they are crazy, insane and evil. They fear if they tell anyone, they might be locked away forever. The truth is, people who intentionally harm themselves are in fact very normal and sane people, who are in a lot of emotional pain. They self-injure as a way to cope, because they were probably never taught how to deal with intense feelings and emotions in healthy ways. Unfortunately, when people hear about this form of self-harm, they do tend to place labels on these people as being psychotic and crazy, which is why so many people do not come forward and ask for help. Until society dispels all the myths surrounding self-injury and start to educate themselves on this subject, sufferers will continue to keep quiet and this form of abuse will continue to be a secret for a long time to come.
Taken from the Mirror-Mirror Eating Disorder Web Site

Self-Injury: Types, Causes and Treatment

Self-injury (SI) – also known as self-harm or self-mutilation – is defined as any intentional injury to one's own body. It usually either leaves marks or causes tissue damage. It is hard for most people to understand why someone would want to cut or burn himself/herself). The mere idea of intentionally inflicting wounds to oneself makes people cringe. Yet there are growing numbers of young people who do intentionally hurt themselves. Understanding the phenomenon is the first step in changing it.

Who engages in self-injury?

There is no simple portrait of a person who intentionally injures him/herself. This behavior is not limited by gender, race, education, age, sexual orientation, socio-economics, or religion. However, there are some commonly seen factors:

What are the types of self-injury?

The most common ways that people self-injure are:

Throughout history, various cultures have intentionally created marks on the body for cultural or religious purposes. Some adolescents, especially if they are with a group engaging in such practices, may see this as a ritual or rite of passage into the group. However, beyond a first experiment in such behavior, continued bodily harm is self-abusive. Most self-injuring adolescents act alone, not in groups, and hide their behavior. There are also some more extreme types of self-mutilation, such as castration or amputation, which are rare and are associated with psychosis.

How does self-injury become addictive?

A person who becomes a habitual self-injurer usually follows a common progression:

Why do people engage in self-injury?

Even though there is the possibility that a self-inflicted injury may result in life-threatening damage, self injury is not suicidal behavior. Although the person may not recognize the connection, SI usually occurs when facing what seems like overwhelming or distressing feelings. The reasons self-injurers give for this behavior vary:

What is the relationship between self-injury and suicide?

Self-injury is not suicidal behavior. In fact, it may be a way to reduce the tension that, left unattended, could result in an actual suicide attempt. Self-injury is the best way the individual knows to self-sooth. It may represent the best attempt the person has at creating the least damage. However, self-injury is highly linked to poor sense of self-worth, and over time, that depressed feeling can evolve into suicidal attempts. And sometimes self-harm may accidentally go farther than intended, and a life-threatening injury may result.

What can you do to help a friend or family member who is a self-injurer?

It is very hard to realize that someone you care about is physically harming herself or himself. Your concern may come out in frustration and even comments that can drive the person farther away. Some things that might be helpful are:

How can a self-injuring person stop this behavior?

Self-injury is a behavior that becomes compulsive and addictive. Like any other addiction, even though other people think the person should stop, most addicts have a hard time just saying no to their behavior – even while realizing it is unhealthy.

There are several things to do to help yourself:

How is self-injury treated?

One danger connected with self-injury is that it tends to become an addictive behavior, a habit that is difficult to break even when the individual wants to stop. As with other addictions, qualified professional help us almost always necessary. It is important to find a therapist who understands this behavior and is not upset or repulsed by it. Some of the online resources below offer links for referrals to therapists experienced with self-injury.

More Information on the Internet

Self-Abuse Finally Ends (SAFE) Alternatives

Self-Injury: You Are NOT the Only One

Kids Health - Cutting

A Healing Touch