Slide 6+7+8 Self-mutilation has become an increasing problem among adolescents since the 1990s.

Professional thinking about self-mutilation has e ol ed o er the past !0 "ears. #efore the 1990s$ self-mutilation %as often identified as a failed suicide attempt. &his concept is no longer accepted. 's of !00( self-mutilation %as not a specific diagnosis recogni)ed b" the 'merican Ps"chiatric 'ssociation. *nstead$ it is recogni)ed as a feature of other ps"chiatric disorders. Some researchers dispute this designation and feel self-mutilation should be a separate diagnosis. 'lcohol is the most common ariable in ol ed in self-harm beha iors$ linked to o er half of all cases. &he person ma" be %ithdra%ing from alcohol or deepl" into+icated %hen acting out in the self-in,urious beha iors. -rugs and alcohol o erall are commonl" associated %ith self-in,urious acts. #en)odia)epine dependence and %ithdra%al can

attribute to self-in,urious beha ior particularl" in teens and "oung adults. Slide 9+10+11+1! Self-harm is listed in the -S.-*/-&0 as a s"mptom of borderline personalit" disorder. 1o%e er patients %ith other diagnoses ma" also self-harm$ including those %ith depression$ an+iet" disorders$ substance abuse$ eating disorders$ post-traumatic stress disorder$ schi)ophrenia$ and se eral personalit" disorders. 2arl .enninger in 1938 suggested that self -mutilation might be an effort to heal oneself. 1e %rote$ 45ocal selfdestruction is a form of partial suicide to a ert total suicide.4 .enninger also classified the beha ior into four categories6 neurotic$ ps"chotic$ organic$ and religious. neurotic 7 nail-biters$ pickers$ e+treme hair remo al and unnecessar" cosmetic surger". religious 7 self-flagellants and others. ps"chotic 7 e"e or ear remo al$ genital self-mutilation and e+treme amputation organic brain diseases 7 %hich allo% repetiti e headbanging$ hand-biting$ finger-fracturing or e"e remo al. -eliberate Self-1arm is an umbrella term that encompasses an" non-accidental acti it" that a person engages in that$ %ell$ harms that person ph"sicall". 8utting one9s skin %ith ra)ors or kni es is the most common pattern of self-mutilation. :ther forms of selfharm include biting$ hitting$ or bruising oneself; picking or

pulling at skin or hair; burning oneself %ith cigarettes$ or amputating parts of the bod". Self-mutilation can be episodic <infre=uent> or repetiti e. ?pisodic self-harm can progress to repetiti e self-harm after as fe% as fi e or as man" as !0 episodes. Slide 13+1(+1@+16+17 Self-mutilation should not be confused with current fads for tattoos and body piercing . In some cases, however, it may be difficult to distinguish between an interest in these fads and the first indications of a disorder. It is estimated that one in every 100 individuals in the United States, are self-mutilators. Girls are four times more li ely to engage in self-harm than boys, with girls between the ages of 1! and "# at highest ris , although many girls begin cutting in middle school $ages 1" or 1%&. 't ris individuals also include those who have underlying psychiatric disorders. Up to half of individuals who are selfmutilators were se(ually abused as children. 'n estimated " million 'mericans practice some form of self-in)ury, and there is a common misperception that * li e anore(ia * the problem afflicts mostly young women. +ut self-mutilation isn,t e(clusively a modern adolescent issue. -he disorder is an ancient one, and it is best understood as an attempt to relieve rather than inflict pain. 's a group$ man" in ol ed in self-mutilation are girls$

although bo"s do it too. Aend" 5ader <President and 8linical -irector of the S'B? '5&?0C'&*/?S>$ a selfin,ur" treatment program$ sa"s self-mutilation is an accepted part of the 4Doth4 culture. Eust because a child is in ol ed in the Doth culture though$ it doesn9t necessaril" mean the" self-in,ure. 1o%e er$ -r. 5ader notes kids in ol ed in the Doth mo ement are looking for acceptance in an alternati e culture. 'nd$ she adds that self-in,ur" is definitel" a coping strateg" for unhapp" kid. %hether the relation bet%een the self abusi e beha iour and Doth identification %as predominantl" due to modelling mechanisms <emulation of normati e beha iours of icons or peers %ithin the subculture group>$ or to selection <indi iduals %ith a predisposition of self abusi e beha iours being attracted to the subculture group>$ but suggested a combination of both processes. Slide 18+19 Ae all are taught to ,udge a book b" its co er$ so can a person sho% their feelings or lack of them on the bod"$ depending on the case. People %ho self-in,ure carefull" hide their %ounds and scars. .ost times the" cause damage in places that can be easil" hidden under clothing$ so that friends and famil" do not kno% that person selfharm in particular. -e often d"sfunctional self-in,ur" is a %a" of e+pressing emotions deep$ painful and unpleasant. People %ho self-harm do not find the abilit" to e+press emotions in an appropriate %a" and resort to this beha ior de iated looking for a %a" to release some er" strong feelings. Self-harm is ultimatel" a %a" of coping %ith pain$

is a defense mechanism but it9s also a mechanism that ,ust destro"s the de ice$ %hich makes this topic so contro ersial among speciali)ed research. Slide !0+!1+!!+!3 Ahether %e talk about se+ual abuse$ ph"sical$ emotional$ lo% self-esteem and self-hatred$ neglect$ isolation or separation of a person reference$ feelings of guilt$ an+iet"$ grief$ anger$ numbness or emptiness$ all these feelings are sometimes too much for some people. &he moment a person turns to self-mutilation$ %hether or not the" %ish$ famil" needs to guide them to speciali)ed help. Patients are no% the responsibilit" of a ps"chologist. *n the future the" ma" be our responsibilit"$ and so 6 %e as ps"chologists must practice compassion that comes %hen %e kno% that %e are all made of dark and light$ po%er and struggle. Ae must learn to help a person to feel accepted. &he man %ho feels accepted starts to feel lo ed and healing begins %ith self-lo e and respect that sometimes needs an e+ternal stimulus in order to ignite the flame. *f our method fails$ it %ill fail for others too$ the obstacles that %e still ha e %ill be the obstacles of those %ho need us. 1o% are %e going to help an"one o ercome their demonsF Slide !(+!@ Specialists from Section ps"chological and social acti it" of the -epartment of Penitentiar" *nstitutions during !01! %ere monitored processes and self harm self-mutilation among inmates in prisons across the countr".

*n this conte+t$ the -epartment of Penitentiar" *nstitutions$ in :ctober !01! %as de eloped comprehensi e program to reduce the incidence of self-harm$ %hich pro ides a range of comple+ measures in ol ing multidisciplinar" ser ices penitentiar" s"stem. *n se eral papers and monographs is demonstrated ps"chological profile of prisoners %ho self-harm - mainl" to conduct demonstration and blackmail to get some goals. &hus$ self-harm beha ior in prison is often used as a %a" to impress$ intimidate prison staff and a oid disciplinar" action and intimidate other inmates. &he studies describe that e+cess attention to prisoners %ho self-harm it strengthens him in his intention to self harm <-. 5aster$ #5 -anto$ 4Suicide behind bars4>. ?+perts recommend in situations of self-mutilation$ as contact %ith the inmate$ prison staff member to be %ithout a high status$ not strengthen his manipulati e beha ior. Slide !6+!7 'utism and self in,ur" has er" little research. 1o%e er$ in a stud" on challenging beha iors in indi iduals %ith intellectual disabilities$ self in,ur" has been found to be connected to both recepti e and e+pressi e communication. 'mong indi iduals %ith autism$ self in,urious beha ior incidence estimates a range from !0G to 71G depending$ relati el"$ on the *H and age range of the child. 'utism Self *n,ur" and 'ggression 8an :ccur Huickl" Aith Co ?+ternal Pro ocation Self in,ur" found in autism is also often referred to as self mutilation$ self destructi e$ or masochistic beha iors

<gratification gained from ph"sical pain>. Self in,urious beha iors are often placed on a categor" of repetiti e stereot"pes$ and ha e been proposed to onl" differ in se erit" at the moment of in,ur". *n fact$ recent re ie%s of repetiti e beha iors in autism place self in,urious beha ior %ithin a %ide range. Self in,urious beha iors can range from se ere$ life threatening in,uries to less directl" damaging cases. Slide !8+!9+30 &he cogniti e beha ior therap" it is used b" the ps"chologist to e+plore the feelings %itch the pacient feels before he hurts himself and also tr"es to make the pacient to e+press his feelings in other %a"s.&he usual length of an cogniti e beha ior therap" must ha e bet%een 10 or !0 sessions .Ahen the session is short it is ital to be educati e and uses the optimal time. 8utting and other forms of self-harm ma" be e+tremel" difficult to stop. Aithout help$ it is often too much to handle. &he first step to%ards stopping the destructi e beha ior is to confide in somebod" "ou trust. 'lthough this is possibl" the hardest step$ it is absolutel" crucial. Parents$ friends$ counselors$ and ps"chologists are good people to tell %ho ma" help guide "ou in the right direction. Bor the least$ the" gi e "ou the relief of e+pressing "our pain rather than keeping it in an" longer. Ps"chotherap" is often re=uired to help pre ent the indi idual from cutting again. 's the method of escape from emotional pain is taken a%a" from the person$ the" must learn to deal %ith their emotions and

e+press them in safer %a"s. *f "ou or someone "ou kno% is suffering from self-harming tendencies$ it is important to seek help. &he" ma" accidentall" kill themsel es or seriousl" harm themsel es$ and the" ma" go on for "ears %ithout trul" dealing %ith their emotions. &he first step is to talk about it$ and talking %ill %ork %onders. Slide 31 #efore finding emotional health$ the" struggled %ith selfin,ur". Singer$ Biona 'pple; 8omedian$ 0ussell #rand; 'ctress$ -re% #arr"more; 'ctor$ Eohnn" -epp; 'ctor$ 8olin Barrell; 'ctress$ .egan Bo+; 'ctress$ 'ngelina Eolie; Singer$ -emi 5o ato and Princess -iana &he former Puss"cat -oll secretl" struggled %ith self-in,ur" %hile she %as in the group. 4* ,ust hated m"self. * %as in a group but * ne er felt so alone in m" life...* ne er did drugs$ but hurting m"self %as m" addiction$4 'nother current X-Factor ,udge$ .emi /ovato$ has also been open about her struggles to a oid cuttingIshe %ent to rehab in !010 to treat her issues %ith self-harm$ substance abuse and bulimia.