 |
Conservative use of drug therapy
-----------------------------
A psychological approach that emphasizes the present and future of the patient, rather than the past.
-----------------------------
Emphasis on nutrition and physical exercise
-----------------------------
Family participation, if appropriate
-----------------------------
Psychoeducation for patients and relatives
-----------------------------
|
|
|
THE FACTS ABOUT SELF-INJURY
What is Self-Mutilation?
Self-mutilation is repetitive behavior that results in minor to moderate physical injury. Individuals that self-mutilate may cut or burn their skin, bang parts of their bodies, pick at wounds or engage in others behaviors that cause damage to their bodies. Self-mutilation may be a symptom that is part of an underlying psychiatric disorder such as depression, obsessive-compulsive disorder, Gilles de la Tourette syndrome, psychosis, borderline personality disorder, trichotillomania, eating disorder, or body dysmorphic disorder. Most commonly used instruments are knives, scissors, razor blades, broken glass, pins, belts, fists, and walls. To cause burns individuals may use cigarette butts, lighted matches, or cotton imbedded in alcohol, etc, are common means.
Self-mutilation generally occurs in response to a triggering event. Individuals that self-mutilate often report the following experiences:
- Strong urges to commit the act.
- An increase in tension that they try to resist.
- A sense of relief following the act.
- High threshold of pain.
- A feeling of realness after the act.
Who Self-Mutilates?
The prevalence rate of self-mutilation in the general population of the United States is estimated to be about 1 to 2%. Research indicates higher prevalence rates among college students, institutionalized individuals, and survivors of childhood
Biological, social, and psychological theories have been suggested as reasons for self-mutilation. Self-mutilation may be learned through family modeling of abuse linking pain to caring or control. An event is usually present which triggers emotional reactions of anxiety, anger and/or fear. The individual may then isolate him or herself and engage in self-mutilation.
Reason for self-mutilation may be to stop racing thoughts, to feel relaxed, to feel less depressed, to feel less lonely, and to feel real. The acts may function as self-punishment or as a way to allow a person to feel in control.
What Treatments are Available?
Behavior therapy involves teaching self-monitoring methods to increase awareness and identify triggers and consequences of self-mutilation. Cognitive-behavioral programs such as Dialectical Behavior Therapy (DBT) have been shown to be effective in reducing self-mutilation and maintaining long-term effects in follow-up studies. DBT combines standard cognitive-behavioral techniques with Eastern theories of acceptance and validation. Individuals learn to view behaviors as learned coping skills and are taught more adaptive strategies that enable them to be more effective in stressful situations.
Research involving medication as a treatment for self-mutilation indicates that they are partially effective by reducing episodes of self-mutilation. However, these results are usually not maintained following discontinuation of medication. Medications used are dependent upon the severity of injuries, frequency of self-mutilation and presence of a psychiatric disorder
|
|
|
|
Consultations