Under the Surface. Understanding Self-Injury July 10, 2008 Carolyn O. Lee, MSW, LCSW. What is Self-Injury?. Deliberate destruction or alteration of body tissue that occurs in the absence of conscious suicidal intent (Yates, 2006)
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Under the Surface
July 10, 2008
Carolyn O. Lee, MSW, LCSW
Aztec Sacrifices Inca Empire
Each of the young men presented himself to a medicine-man, who took between his thumb and forefinger a fold of the loose skin of the breast—and then ran a very narrow-bladed knife through the skin. This was tied to a long rope fastened to the top of the sun-pole. To liberate himself he must tear the skewers through the skin.
Other cultures, groups
b) & c), impulsive (Favazza, 1986, 1996)
Definition: Having no words for feelings
Self-injurers have difficulty verbalizing emotions (Dean, 2007)
Theorized due to early maternal depravation (Farber, 2002)
Bleeding: body’s weeping
Most SIB is not suicidal in nature, but actually intended to preserve & restore psychic functioning ( Favazza, 2000; Walsh & Rosen, 2005)
*Suicidal behavior--clear intention to die
*Primary objective in 85% of SIB is tension relief opposed to suicide (Canver, 2006)
Someone else performs in a social context
Designed to beautify (Alderman, 1997)
At risk of SIB if diagnosed with:
50-61% of self-injurers have, or at one time had, an ED (Dean, 2007)
Derealization & depersonalization, before & after (Farber, 1995, 2002)
When the patient has nobody to whom he can turn for soothing, it feels as if he has no body. So to attack his own body means that there is a body there, that there is somebody for him. To be somebody without having to attack the body means using words with somebody who can listen, so that meaning can be created. It is a way of making real a life that had seemed unreal and was lived in an unreal or dissociated way. The patient becomes real in the relationship with the therapist in the same way that a toy becomes real to a child.
Sharon Klayman Farber, Ph.D
(In My Room- Cutting Story; mettaproductions)
(Scenes from the movie Thirteen)
(Britney Spears, Every Time video)
(ED & SIB in movies, TV, music videos)
Farber, S. (2002). When the Body Is the Target: Self-Harm, Pain, & Traumatic Attachments. Northvale: Jason Aronson Inc.
Favazza, A. R. (1996). Bodies Under Siege: Self Mutilation & Body Modification in Culture and Psychiatry. 2nd Edition. Baltimore: Johns Hopkins University Press.
Hassrick, R. (1964). The Sioux. Norman, Oklahoma: University of Oklahoma Press.
Levenkron, S. (1998). Cutting: Understanding & Overcoming Self-Mutilation. New York: W.W. Norton & Co.
McCormick, P. (2000). Cut. New York: Push/Scholastics, Inc.
McVey-Noble, M., Khemlani-Patel, S. & Neziroglu, F. (2006). When Your Child Is Cutting- A Parent’s Guide to Helping Children Overcome Self-Injury. Oakland: New Harbinger.
Miller, D. (1994). Women Who Hurt Themselves: A Book of Hope & Understanding. New York: Basic Books.
Self-Injury: A Struggle (section that has self-injurers display their artwork and poetry)
American Academy of Child & Adolescent Psychiatry- Facts for Families #73
American Self-Harm Information Clearinghouse
National Mental Health Association Fact Sheet
Psyke: Self-Injury Information and Support
Self-Injury: A Struggle
Sirius Project: Self-Help for Self-Harm
Self-Help for Self-Injury
The National Self Harm Network
Creative Destruction: Art-Based Applications with Eating Disordered Clients Who Self-Injure. Presented by: Michelle Dean, MA, ATR-BC, LPC, CGP. October, 2007 in Cary, NC.
When The Body Speaks: Psychotherapy with People who Self-Injure. Presented by: Judy Byck, MSW, LCSW. November, 2007 in Chapel Hill, NC.