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Self-Injury

What is Self-Injury? 

Self-Injury has been known by many terms: “cutting,” “self-mutilation,” “self-inflicted violence,” “self-injurious behavior,” or “non-suicidal self-injury (NSSI)”.  

It is the deliberate, self-inflicted destruction of body tissue without suicidal intent. It can include a variety of behaviors, but is commonly associated with scratching, cutting, carving the skin, banging oneself, punching objects into oneself, or biting oneself. Most common locations for these injuries are arms, wrists, hands, and thighs
Self-injury is a way of expressing and dealing with deep distress and emotional pain. As counterintuitive as it may sound to those on the outside, hurting yourself makes one feel better. In fact, one may feel like they have no choice. Injuring themselves is the only way they know how to cope with feelings like sadness, self-loathing, emptiness, guilt, and rage.
The problem is that the relief that comes from self-injury doesn’t last very long. It’s like slapping on a Band-Aid when what one really need are stitches. It may temporarily stop the bleeding, but it doesn’t fix the underlying injury.

Signs of Self-Injury
• Unexplained or clustered wounds or scars;
• Fresh cuts, bruises, burns, or other signs of bodily damage;
• Bandages worn frequently;
• Inappropriate clothing for the season (e.g., always wearing long pants or sleeves in the summer);
• Constant use of wristbands or other jewelry that covers the wrist(s) or lower arms;
• Unexplained cutting implements (e.g., razor blades or other equipment); and
• Heightened signs of depression, anxiety, or social withdrawal.

Risks  of Self-Injury
• Infection from injuries or sharing implements;
• Accidental severe injury such as life threatening blood loss or infection;
• Scars and disfigurement from healed injuries;
• Worsening shame, guilt, or other painful emotions; and
• An increased risk for suicide.

What You Can Do If You Suspect Self-Injury?

• Let him or her know you are concerned and would like to help. Be direct and honest about what you are seeing and why you are concerned.
• Respond calmly with what has been termed “respectful curiosity” (e.g., listening and asking questions in a way that demonstrates care and respect). Avoid displaying extreme reactions like shock, pity, or criticism because such reactions will likely limit the opportunity to talk, build trust, and assist in opening the door to recovery.
• Help him or her explore more positive strategies for coping with intense feelings and stress such as talking with a friend, exercising, or participating in therapy. 
• Actively help make connections with a professional therapist or counselor. It may be helpful to make an appointment, and accompany the person to the first visit. The S.A.F.E. Alternatives website provides a listing of therapists by state that are trained in self- injury treatment therapists. Contact the EAP at 1-800-322-5327 for more information.
• If you or a loved one is suicidal or in emotional distress, you can call the
National Suicide Prevention Lifeline 24-hour crisis line at 800-273-TALK (800-273-8255).

Healthy Ways to Cope with Stress
• Exercise – physical activity is one of the most important ways to lower stress and lift your mood;
• Eat well – eating regular healthy meals will help you have the energy you need to tackle your day;
• Get enough sleep – a good night’s sleep will help you recharge and think clearly;
• Laugh out loud – head off stress by watching a funny movie or cartoons or by reading a joke book;
• Have fun with friends – friends can help you work through your problems and see the brighter side of things;
• Talk to someone you trust about what’s bothering you;
• Take time to relax – do something you enjoy like: read a book, listen to your favorite music, practice relaxation techniques, write in a journal, or work on a relaxing project;
• Manage your time – feeling overwhelmed or unprepared can be stressful; planning ahead and organizing what you need to do can help;
• Help someone – get involved in an activity that helps others;
• Learn ways to better deal with anger – try to calm yourself down before doing or saying anything, tell the other person what the problem is and how it makes you feel, try to think of some solutions and what good and bad results might be; and
• Get help from a doctor, therapist, or support group.

Resources on Self-Injury 
S.A.F.E. Alternatives  - Self Abuse Finally Ends 
Understanding Self-Injury – Cornell University College of Human Ecology  
WebMD  -  Mental Health and Self-Injury

Resources on Self-Injury for Teens & Children
Kids Health for Teens  - Cutting
Focus on the Family - Conquering Cutting and Other Forms of Self-Injury
ASIF - The Adolescent Self Injury Foundation