1. Self-Mutilation

2.  Self-mutilation: Intentional, non-lethal, self-inflicted bodily harm that is socially unacceptable  Ex. Cutting, burning, punching, breaking bones, or preventing wounds from being healed  Many students will try to conceal the injuries under clothing or by making excuses for it (ex. “My dog scratched me.”)  This behavior usually occurs with other disorders, such as bipolar disorder, major depression, eating disorders, anxiety disorders, etc.  Usually begins in late childhood or early adolescent What is Self-Mutilation?

3.  1. Major self-mutilation: extreme acts that occur suddenly and cause a lot of damage  Associated with intoxication or being in a psychotic state  2. Stereotypic self-mutilation: repetitive, self-harm behaviors  Found in autistic or mentally disabled individuals  Usually not secretive  3. Moderate or superficial self-mutilation: type most likely to encounter  Compulsive: repetitive behavior, such as hair pulling or picking at scabs  Episodic: behaviors occur periodically, but do not pre-occupy the individual  Repetitive: behavior is a major preoccupation—almost an addiction (self- identified as “cutter” or “burner”) Categories of Self-Mutilation

4.  Coping mechanism-lack ability to control emotions  Acts as a release/relieves tension  Causes them to “feel” something-if they feel empty  Gives them a “high”  Can’t express feelings in words, so they express them through pain  Gives a sense of control over themselves  Punishment  Ritual/Symbolism Why do student self-mutilate?

5.  Show that you are interested in and care about the person behind the self-injury  Show concern about the injuries and offer compassion  Communicate that you are willing to talk about self-mutilation  Help student recognize and understand the functions of the behavior  Help student learn other ways of expressing their feelings and ask for support when needed  Encourage student to create support systems  Acknowledge small gains-small steps lead to bigger ones What Should We Do? Tips from one student’s perspective:

6.  Keeps one’s reactions from finding out about someone’s self- mutilation from interfering  Avoid open displays of revulsion on seeing the self-injuries  Don’t overreact and seek unnecessary medical attention  Empathy is helpful; sympathy is a barrier  Be aware of the signs  Recognize that this is difficult  Don’t directly or indirectly ever reinforce the behavior  Keep an eye on the student What Should We Do? Tips for Counselors & Teachers:

7.  Contact parents—you are liable if you do not report  Be aware—students feeling of alienation may worsen by the breach of confidentiality—student may not disclose anymore information  Encourage student to tell parents his or herself  Explain the importance of telling the parents  Let them know that you can be present as a support when telling them Ethical Concerns