Intro to Self Injury

1
Intro to Self Injury

• Essential Question How can we identify
  teenagers with mental disorders and what
  strategies can we use to help them?

2
Intro to Self Injury

• Learning Objective The students will have an
  understanding of how to recognize warning signs
  and understand how to proceed with
  interventions.

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What is Self Injury

• When you hurt your body on purpose it is called
  "self-injury." Other names for self-injury are
  "cutting", "self-harm", or "self-mutilation."

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Types of Self Injury

• Cutting
• Burning (or "branding" with hot objects)
• Picking at skin or re-opening wounds
• Hair-pulling
• Head-banging
• Hitting (with objects)
• Bone-breaking
•  

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Why Do Teenagers Self Injure Themselves???

• Teenagers who self-injure often report that there
  is no adult they could talk to who accepts them
  for who they are.
• Could be an effort to make others care or feel
  guilty or to drive them away.
• Self-injury can be set off by certain events.

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Why Do Teenagers Self Injure Themselves???

• To try to get a reaction from someone," "to get
  control of a situation," and "to stop bad
  feelings."
• Way to self-regulate feelings and help people
  cope with overwhelming negative emotions.

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Why Do Teenagers Self Injure Themselves???

• Children dont know how to express and deal with
  anger and sadness, instead turning emotional pain
  on themselves.
• Depression, for example, is often described as
  anger turned inward

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Why Do Teenagers Self Injure Themselves???

• Self-injury makes some people feel part of a
  group.
• Support from internet community.
• When they don't want to self-injure anymore, it
  means they have to leave a community.
• Facebook and myspace groups

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Why Do Teenagers Self Injure Themselves???

• Celebrities, too, have contributed self-injury.
• Confessions of self-injury include the late
  Princess Diana, Johnny Depp, Angelina Jolie,
  Nicole Richie, Richie Edwards, Courtney Love and
  the lead singer on the Garbage band album "Bleed
  Like Me."

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How Often DO Teenagers Self Injure Themselves???

• 46 of the high school students reported some
  form of self-injury within the previous year.
• 17 percent of college students have self-injured
• 15 percent of the general adolescent population.

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Symptoms of Self Injury

• Frequent cuts and burns that cannot be explained
• Self-punching or scratching
• Needle sticking
• Head banging
• Eye pressing
• Finger or arm biting
• Pulling out one's hair
• Picking at one's skin

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Signs of Self InjuryOthers notice the following

• Unexplained and frequent injuries
• Unexplained blood stains on clothing, bedding
• Individual has tools (i.e., knife, lighter) in
  possession without explanation
• Individual wears long sleeves and pants in warm
  weather

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Signs of Self Injury Individual has difficulty
with the following

• Self-esteem
• Handling and/or expressing strong feelings
• Interpersonal relationships
• Functioning at work, school, and/or home

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Signs of Self InjuryIndividual does the
following

• Makes excuses for injuries
• His/her own laundry (wont let others help)
• Isolates himself/herself for long periods of time
• Becomes defensive when asked questions

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Self Injury-Quotes

• "I feel relieved and less anxious after I cut.
  The emotional pain slowly slips away into the
  physical pain."
• "It's a way to have control over my body because
  I can't control anything else in my life.
• Cutting Story CBS

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Self Injury-Quotes

• "It expresses emotional pain or feelings that I'm
  unable to put into words."
• "I usually feel like I have a black hole in the
  pit of my stomach. At least if I feel pain it's
  better than nothing."

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Intervention and Treatment

• Find ways to soothe or focus yourself when you
  feel like self-injuring.
• Make a list of non-harmful things that help you
  feel relaxed and real.
• Keep this list where you can see it so when you
  feel like hurting yourself.

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Intervention and TreatmentHow do I stop hurting
myself in the moment?

• Here are some ways to use up nervous energy
• go for a long walk
• dance to loud music
• shoot hoops or kick soccer goals
• go jogging
• clean your room
• Here are some ways to relax and de-stress
• take a bath or a hot shower
• listen to music
• write in a journal
• talk to a friend
• read a good book

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Intervention and TreatmentHow can I help a
friend who self injures?

•  
• Suggest to your friend that they talk to an adult
  they trust,, like a parent, school counselor, or
  their health care provider.
• Second, support your friend by listening to them,
  and letting them know you care about them.
• Lastly, print out this guide, or some other
  information on self-injury, and give it to them.
  They can read it when they feel ready.
•  

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Intervention and TreatmentWhat should I do if my
friend won't talk to an adult, and refuses help?

• Find a trusted adult who knows your friend, and
  talk to that person.
• Tell an adult even if your friend asked you to
  keep their self-injury a secret!
• Remember your friends safety is of the most
  importance.

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Cutting-Nathalie's Story

• I Cut When The Pain Gets To Be Too Much Nathalie
  calls her self a "cutter." She is 15 years old.
  She doesn't have many friends in real life. Her
  best friends are from the Internet. On the
  Internet she can be totally honest. She can talk
  about why she cuts herself and why she doesn't
  eat. She has never had a boyfriend and she can
  not remember the last time anyone hugged her or
  told her they loved her. She lives with her
  grandparents because her step-father and mother
  didn't want her to live with them anymore.

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Cutting-Nathalies Story

• She gets one hour three times a week on the
  Internet. If she goes one minute over, she loses
  it for two weeks. She said she can't talk to her
  grandparents. She said they come from another
  era. Nathalie told me she cuts when the pain gets
  to be too much. She has 23 scars. When she was 10
  she would sit in the class and stare out the
  window. When the teacher would call out her name
  and tell her to stop looking out the window and
  pay attention it would frighten and embarrass
  her. She said the other children in the class
  would laugh at her. They called her the Nathalie
  the daydreamer.

23
Cutting-Nathalies Story

• Sometimes she would get punished for not knowing
  the answers to the teacher's questions. She said
  once she had to write "I will not stare out the
  window" 500 times. I asked her what she would
  think about when she was staring out the window.
  She said she was usually trying to figure out why
  she was such a horrible person. I asked her why
  she thought of herself as a horrible person. She
  said, "I thought I must be horrible if my mother
  doesn't want me to live with her and my father
  never wanted to see me." I asked her if her
  mother had hit her. She said, "Yes. Sometimes." I
  asked her if she thought that her mother was
  abusive. She said, "No, I wouldn't say that.

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Cutting-Nathalies Story

• She only hit me when I made her angry. So I guess
  I deserved it. Then I asked her why she thought
  her father never wanted to see her. She said, "I
  really don't know. Isn't it normal for a father
  to want to see his own daughter? What could I
  have done to make him hate me so much?" She said
  he moved away when she was 6. She said she has
  written him letters but he has never written
  back. She said she lays awake at night wondering
  if he ever reads the letters or if he even gets
  them. She said he must get them because they
  never get returned to me by the post office.

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Cutting-Nathalies Story

• I asked her if she ever told anyone that her
  mother was hitting her. She said once she did but
  then they talked to her mother and the mother
  said Nathalie was a "compulsive liar." They
  believed her mother over Nathalie, so Nathalie
  was afraid to ever tell anyone else again. When
  we talked about her feelings she always said she
  learned that people didn't want to hear her true
  feelings. So she kept to herself. When they got
  too much for her, she would reach for her razor