Learning Objective #1: Describe the statistics and importance of identifying self-mutilation in youth

Learning Objective #2: Describe therapeutic interventions in nursing to help stop self-injurious behavior

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For most people it is hard to conceive that 3 million Americans use some form of self-injury. This self-injury is a deliberate act that includes burning, bruising, head banging, or cutting. IT IS NOT DONE WITH INTENT TO COMMITT SUICIDE nor attention seeking behavior. 90% of the self-injurers begin cutting as teenagers, usually at age 14 and continue until late 20's or early 30's. It is more prevalent in females, but up to 40% are men. Self-injury is found in ALL races and economic backgrounds. Most clients report that they were victims of abuse or neglect as a child. For many cutters, it is a desperate attempt at self-help. The most common type of self-mutilation is cutting of the skin. This behavior is characterized by repetitive, low-lethal behavior. Episodes of deliberate self-harm may result from feeling of anger, sadness, rejection, anxiety, shame, helplessness, abandonment, fear, failure, loss, or boredom. Personality traits that many cutters share are dislike for their body, inability to cope, feeling that perfection is needed, inability to express emotions to others, frequent mood swings, feeling unreal at times. Many self-mutilators are diagnosed with borderline personality disorder, histrionic personality disorder, antisocial personality disorder, psychosis, bipolar disorder, or schizophrenia. Many clients state that cutting themselves temporarily reduces the feelings of anxiety, guilt, or hallucinations, like command voices. Clients have stated that cutting themselves is like picking a pimple or breaking a balloon. The feeling following the cut or burn is a rapid relief that brings on both positive and negative effects. The positive effects are thought to be from endorphins released, with anxiety and negative feelings rapidly decreased. The negative effects are guilt, shame, and depression after the act. These feelings triggers a cyclical reaction and the person may build up anxiety and tension and start the act again.