Post by Mel on Jan 15, 2006 20:32:46 GMT -5
Self-injury on rise
The growing phenomenon of harming the body to ease the mind
By Angela Kennedy
Senior Staff Writer
Some use razors, broken glass or their fingernails to break the skin. Others bang their heads, swallow metal objects or burn themselves just to know if they are alive. They are young, old, male, female and from different cultures all over the world. But the most tragic thing about self-injurers isn't how they do it, but the simple fact that more people are turning to this type of coping mechanism.
Self-mutilation, or self-injuring, is the deliberate, direct destruction or alteration of body tissue without conscience suicidal intent. Self-injuring is not a condition but one of the symptoms of Borderline Personality Disorder.
Joan Kimball, a therapist at Western Washington University counseling center, first started researching self-injurious behavior seven years ago, and she is currently writing her dissertation on the subject. In her years of study, she has spoken to hundreds of adolescents and adults about self-injury - trying to find the truth, the common denominator, the answer to "why."
"I think there is quite a bit of diversity among those who self-injure in any way. It used to be that a typical self-mutilator was female, white, middle to upper class and intelligent. But, subsequent research has found that in at least some studies, males tend to self-injure as often as females - maybe for slightly different reasons. It is not limited to any racial, ethnic or social economic group," Kimball said. "What you will find, are similarities in trauma. Some kind of event in their lives that has been very difficult for them to process and it has left emotional scars. Children of sexual abuse are highly represented among those who self-injure. In one study, it was as much as 75-90 percent." She added that what she finds most disturbing is the age the behavior begins - as early as seven according to recent research. "But, the thing that intrigued me was that 25 percent of self-injurers said that they started self-injuring in sixth grade or younger; 60 percent said they started in seventh or eighth grade and 12 percent in ninth grade."
She noted that self-injuring often is an experimental or transitional behavior that many young individuals will out- grow, but not everyone does. "In my research, eight percent of the college students surveyed acknowledged self-injuring. Although, this is lower than the percentage reported among adolescents, eight percent is still significant, and disturbing."
Kimball said there are many questions that remain to be answered regarding self-injury. "We still don't have it really nailed down as to why people choose self-injury as opposed to other ways to regulate themselves," Kimball said, noting that gender differences, treatment models and multicultural comparisons are areas that need to be further explored. "There are not many, if any, cross cultural studies. There are some researchers who are looking at different ethnic groups within the U.S., and there has been some research done in Britain, Australia, Japan and other countries. But looking cross-culturally to see what factors might be present in two cultures, or how they might be different - none of that has been done," she said.
Wendy Lader, clinical director of the Self-Abuse Finally Ends (S.A.F.E.) Alternatives program and co-author of "Bodily Harm: The Breakthrough Healing Program for Self-Injurers" said, based on her clinical observations and other professional studies, that 1,400 out of every 100,000 people in the general population have engaged in some form of self-injury.
"It's a growing phenomenon, and I do think we are seeing this increase as a coping strategy," she said. Although the behavior is being brought into the spotlight and more people are getting help, many people still do not understand what moves someone to self-harm.
"The public used to see this as a very crazy behavior and that self-injurers must be psychotic and hospitalized. Now, they see is as a cry for attention, but I think that it is often getting minimized."
She said the pendulum has swung in the other direction. "I hear from so many parents and professions, 'she is only a self- injurer.' It's like it is no big deal. I think that they feel that since the behavior isn't suicidal, it's just for attention."
Feeling nothing, nothing but feelings
In the book, "Cutting: Understanding and Overcoming Self Mutilation," psychotherapist Steven Levonkron said the overwhelming feelings of the self-injurer go beyond frustration. "Self-mutilating behavior means the mind has slipped away from its ordinary context or perspective, losing sight of the impracticality of pain and danger in order to commit an act that will bring an immediate solution (however unrealistic or temporary in nature) to emotional pain."
There are two types of self- injurers: those who want to escape their feeling and those who want to feel something - anything.
"I think that when people first start self-injuring they are overloaded and feeling too much - too much anger, stress, sadness, frustration - so they cut. And, it does help them to mute those feelings. However, when it becomes habitual, and they have learned to get rid of all their feelings; then, they get very numb. They have stuffed those feelings away, and now they are left wanting to feel something," said Lader.
Most self-injurers say they feel empty or have no feeling of pain at all when they are injuring. "After the act is complete, the pain can indeed be excruciating, but it also feels oddly calming, soothing - alive. On the other hand, some self-injurers say they do feel pain during the act of injuring, but that it doesn't stop them from proceeding. Seeing with their own eyes the wound they are producing is the object of the exercise, the pain is a small obstacle," she said noting that either way the person is dissociating himself or herself from reality.
Kimball noted that there has been some research into the relationship between dissociative episodes and self-injury. It seems that a number of people self-injure either to end a dissociative episode, or to induce one. "In my own clinical experience, I've found that people usually do it to end an episode. Often there is trauma in that person's background, usually of a sexual nature. In these cases, dissociation has been 'triggered' by something in their environment, or by their own internal experiences. These people dissociate and use self-injury to bring themselves back to reality - to ground themselves. This may explain why they do not feel pain at the time of the self-injury."
Almost anything can trigger a self-injurer into an episode. Some of the more common triggers are:
Intimacy
Sights
Smells
Memories of trauma
Social rejections
Interpersonal inadequacy
Kimball and Lader agree that self-injury has addictive qualities, but it is not an addiction. Kimball said she often hears self-injurers say they are compelled to harm themselves and they can't stop.
"It is addictive like, but we don't look at it as a life-long entity. With other kinds of addictions, like certain drugs or alcohol, most people have the same response to it, for the most part. Everybody gets inebriated if they drink too much alcohol, but not everyone who cuts feels the same," Lader said, adding that she doesn't believe that "once a self-injurer always a self-injurer," and therefore doesn't suggest 12-step programs as successful interventions for self-injury.
"First, is the sense of giving oneself up to a higher power - religion is fine, but we do not feel that a person is powerless. We think that self-injury is a choice and they can learn to make better choices," she said. " They have people identify themselves with their addiction. We don't want people to identify themselves as self-injurers - we see self-injury as a behavior, not who they are."
Lader noted that nothing takes the place of self-injury and substitutive methods dance around the real problems within the injurer. "Some people believe in snapping rubber bands on your wrists or putting your hand in ice water - to me that is the 'less is better' mode of therapy. It's like saying, instead of heroine why don't you just smoke grass. It's not quite as bad; it's not quite as addictive. But, that isn't dealing with the real issue. I think that it is really important that people recognize that because they are having a feeling you don't have to do anything. They have to challenge their irrational thoughts."
That task isn't an easy one. Locking up the knives and hiding sharp objects will not deter a self-injurer.
"People can be fairly ingenious when it comes to new ways to harm themselves. It's pretty tough to disarm someone who really wants to injure him- or herself. Self-injurers can pull out their hair or hit themselves it is not limited to cutting and burning. Taking away the implements does not solve the underlying problems," said Kimball.
S.A.F.E. haven
The main ingredients for success with self-injurers are stability, consistency, reliability and the formation of a positive therapeutic bond, Lader said, noting that pinpointing the emotions associated with before, during and after an episode, and processing the hidden trauma will help self-injurers define new, healthy coping strategies.
The S.A.F.E. Alternatives program is an eclectic, brief analytical therapy that focuses specifically on the hidden pain within the self-injurer. In 1985, it was the first inpatient treatment program for self-injury and has since helped hundreds of patients to overcome the urge to harm themselves.
The 30-day treatment program is for ages 13 and up, however, younger individuals must be screened before admittance due to the intensity of the curriculum. The 12-bed unit in Linden Oaks Hospital in Edward, Illinois, is considered a long-term program for insurance purposes, but once a patient is considered "stable," he or she is transferred to partial-day hospital services. A typical day at S.A.F.E. consists of five to seven group therapy sessions with individual therapy three times a week. In addition, there are group activities, art therapy and trauma therapy.
In conjunction with counseling sessions, Lader said, patients are given a "toolbox" that will be beneficial to both the self-injurer and the therapist. The kit consists of four key implements that are used simultaneously during treatment. They are:
No Harm Contract
The agreement should clearly spell out the expectations and responsibilities of both the client and counselor in regard to the therapeutic process. Lader noted that in an outpatient relationship, the contract will help the client stay focused on the goal of not self-injuring. She said it's important to collaborate with the client on the wording of the contract. "The therapist cannot be perceived as an adversary. We see it as a democratic process taking place between two responsible parties."
Making realistic goals with the client is also a crucial element in the contract. She suggests that clients start out with refraining from self-injury on the days of their sessions. "If the client arrives for treatment already having calmed her anxiety, it could be hard to find that anxiety to work on during the session."
Impulse Control Log
Many self-injurers may say that the impulse to harm "comes out of nowhere," and all they know is that they feel overwhelmed and their emotions are uncontrollable. Lader said she tells clients that these feelings are driven by some deep feeling, thought or memory that is perhaps submerged in their psyche. To create an awareness of what may be triggering their harmful behavior, clients are asked to keep a log of all thoughts or feelings associated with the urge to self-harm.
Alternatives
he alternative list is a collection of comforting or distracting activities that a client can do instead of injuring. Suggestions are: calling a friend or family member, writing, drawing, reading, knitting, taking a walk or playing with a pet. They should be things that can be done at anytime or anyplace, said Lader.
Writing Assignments
The SAFE program uses 15 writing assignments in a specific order. The first assignment required the client to write his or her autobiography. The following prompts focus on self-awareness, family/relationships, gender or body issues and are usually two to three pages in length.
"These tools help mobilize thoughts and words, which are a person's best ammunition in the battle for self-control," she said.
For counselors
"We wrote 'Bodily Harm" to try to get people to use this model because it does work. We want to teach people and encourage them to branch out and use this method in an outpatient setting," said Lader. "The most important thing is to realize this behavior is a coping mechanism and once a person gets to the underlying issues and deals with them, they can truly get better.
Lader noted that not all counselors are suited to deal with this type of client. "Treating self-injurers takes a certain type of fortitude and tolerance. It also takes great technical finesse since self-injurers tend to be good at making other people feel responsible for their behavior," she said. "They may draw the well-meaning therapist into a dance of distraction in which self-injury keeps the atmosphere charged with tension and worry. It's a delicate balancing act to keep professional boundaries, avoid the rescue trap and simultaneously offer comfort and solace."
She recommended that counselors examine adjunct supports, like medication or group therapy for additional support.
Ending the pain
Two former S.A.F.E. patients share their stories of rehabilitation and recovery.
"Laura, 38"
She was only seven the first time she deliberately hurt herself. Her father returned from Vietnam and the family had just moved again. On a warm summer day, Laura found some broken glass and piled it neatly at the foot of a tree. She climbed the tree and then jumped upon the glass shards with her bare feet. She continued to harm herself for the next 21 years.
By the time she reached early adulthood, her self-injuring became very intense. She burned her stomach and chest with oven cleaner, swallowed nails, glass and razors and cut herself with anything she found. She would even reopen old wounds and try to infect them by inserting pieces of rusty, metal scrubbing pads into the gashes.
At 28, her therapist convinced her to check into the S.A.F.E. program. Although Laura completed the program and stayed injury-free for almost ten years, she relapsed. Last fall, she went back to S.A.F.E. and gave it another try.
"That time I got real with myself and I did a lot of hard work. I learned who I am," she said. "I now carry hope that people can overcome this. There is help out here that works."
Laura helps spread the word about S.A.F.E. through an internet discussion group she moderates. "I started it because there were a lot of places online you could go, but everything was so triggering and graphic. I didn't find that environment healing. So, I just started my own - with a 'no trigger' policy that I learned from S.A.F.E."
Lader was actually the first member to register with the group and participates in some of the discussions. The message board promotes healthy coping skills and the techniques used in the S.A.F.E. program.
"Cheri, 34"
At a young age, Cheri began scratching and biting herself. The self-injuring behavior started when she was being sexual abused by a step-relative.
"It was a comfort to me that took me to a place where the emotional pain wasn't. I would hurt myself before, during and after the abuse," she said.
By the time she entered her twenties, Cheri's self-injuring became more life threatening. It was then she confided in her immediate family about the abuse. Soon after that, she married an emotional and physically abusive man who only fueled her feeling self-hate. During the marriage, she cut herself with knives and razors in secret. The marriage quickly ended and she started counseling, but she continued to harm herself and was too ashamed to tell anyone about her behavior. Finally, after 14 years of counseling and bouncing from one doctor to the next, she found a therapist with whom she felt comfortable enough to share her secret.
"In the beginning of this year, my injuring had become a daily occurrence. It was more excessive and harmful. I was working with a therapist on an out-patient basis, and my injuring was jeopardizing that relationship and that process," she said.
By June, Cheri and her therapist knew that she was in a life- or-death situation. He contacted S.A.F.E. and she entered the program in July.
"If I would have continued without getting help, I wouldn't be here today. I was suicidal, but more than anything I just wanted the pain to stop. I was to the point where I couldn't handle the emotional pain and flashbacks anymore, and I need that distraction constantly. I was cutting deeper and more often, and it was becoming very risky. I really didn't know if I could stop."
Once in the program, Cheri had her doubts but she said she was determined to getting better.
"At first I thought 'what have I done.' I was so scared that I made a commitment to stop doing the one thing that was getting me through life," she said. " In the first couple of weeks I didn't think I could live without injuring. But, I started to believe that I could survive, could cope, and could use other strategies to deal with this pain. I didn't have to abuse myself."
Cheri said she learned that her self-abuse was actually a way of re-living and re-enacting the abuse she suffered as a child. "At the end of the program, I had a new outlook on life. I had hope for the first time in my life. I believe I can protect myself and love myself, and I did not have to perpetuate the abuse. I don't have to harm myself in order to get through a problem," she said. "I spent a lot of time wanting someone to rescue me. What I realized at the end of the 30 days was that I could take care of me - I could rescue me from the pain that I suffered the majority of my life."
Cheri said that she still has bad days every now and then, but she hasn't injured. She nurtures herself, eats well, socializes with friends and focuses on a healthy lifestyle.
"S.A.F.E. helped me see that I was important enough to take care of. It was definitely a life saving, life altering experience for me. I'm not proud that I injured, but I'm proud that I survived."
For more information about the S.A.F.E treatment program call 1.800.DON'TCUT or visit www.selfinjury.com .
Self-injury
The growing phenomenon of harming the body to ease the mind
By Angela Kennedy
Senior Staff Writer
Some use razors, broken glass or their fingernails to break the skin. Others bang their heads, swallow metal objects or burn themselves just to know if they are alive. They are young, old, male, female and from different cultures all over the world. But the most tragic thing about self-injurers isn't how they do it, but the simple fact that more people are turning to this type of coping mechanism.
Self-mutilation, or self-injuring, is the deliberate, direct destruction or alteration of body tissue without conscience suicidal intent. Self-injuring is not a condition but one of the symptoms of Borderline Personality Disorder.
Joan Kimball, a therapist at Western Washington University counseling center, first started researching self-injurious behavior seven years ago, and she is currently writing her dissertation on the subject. In her years of study, she has spoken to hundreds of adolescents and adults about self-injury - trying to find the truth, the common denominator, the answer to "why."
"I think there is quite a bit of diversity among those who self-injure in any way. It used to be that a typical self-mutilator was female, white, middle to upper class and intelligent. But, subsequent research has found that in at least some studies, males tend to self-injure as often as females - maybe for slightly different reasons. It is not limited to any racial, ethnic or social economic group," Kimball said. "What you will find, are similarities in trauma. Some kind of event in their lives that has been very difficult for them to process and it has left emotional scars. Children of sexual abuse are highly represented among those who self-injure. In one study, it was as much as 75-90 percent." She added that what she finds most disturbing is the age the behavior begins - as early as seven according to recent research. "But, the thing that intrigued me was that 25 percent of self-injurers said that they started self-injuring in sixth grade or younger; 60 percent said they started in seventh or eighth grade and 12 percent in ninth grade."
She noted that self-injuring often is an experimental or transitional behavior that many young individuals will out- grow, but not everyone does. "In my research, eight percent of the college students surveyed acknowledged self-injuring. Although, this is lower than the percentage reported among adolescents, eight percent is still significant, and disturbing."
Kimball said there are many questions that remain to be answered regarding self-injury. "We still don't have it really nailed down as to why people choose self-injury as opposed to other ways to regulate themselves," Kimball said, noting that gender differences, treatment models and multicultural comparisons are areas that need to be further explored. "There are not many, if any, cross cultural studies. There are some researchers who are looking at different ethnic groups within the U.S., and there has been some research done in Britain, Australia, Japan and other countries. But looking cross-culturally to see what factors might be present in two cultures, or how they might be different - none of that has been done," she said.
Wendy Lader, clinical director of the Self-Abuse Finally Ends (S.A.F.E.) Alternatives program and co-author of "Bodily Harm: The Breakthrough Healing Program for Self-Injurers" said, based on her clinical observations and other professional studies, that 1,400 out of every 100,000 people in the general population have engaged in some form of self-injury.
"It's a growing phenomenon, and I do think we are seeing this increase as a coping strategy," she said. Although the behavior is being brought into the spotlight and more people are getting help, many people still do not understand what moves someone to self-harm.
"The public used to see this as a very crazy behavior and that self-injurers must be psychotic and hospitalized. Now, they see is as a cry for attention, but I think that it is often getting minimized."
She said the pendulum has swung in the other direction. "I hear from so many parents and professions, 'she is only a self- injurer.' It's like it is no big deal. I think that they feel that since the behavior isn't suicidal, it's just for attention."
Feeling nothing, nothing but feelings
In the book, "Cutting: Understanding and Overcoming Self Mutilation," psychotherapist Steven Levonkron said the overwhelming feelings of the self-injurer go beyond frustration. "Self-mutilating behavior means the mind has slipped away from its ordinary context or perspective, losing sight of the impracticality of pain and danger in order to commit an act that will bring an immediate solution (however unrealistic or temporary in nature) to emotional pain."
There are two types of self- injurers: those who want to escape their feeling and those who want to feel something - anything.
"I think that when people first start self-injuring they are overloaded and feeling too much - too much anger, stress, sadness, frustration - so they cut. And, it does help them to mute those feelings. However, when it becomes habitual, and they have learned to get rid of all their feelings; then, they get very numb. They have stuffed those feelings away, and now they are left wanting to feel something," said Lader.
Most self-injurers say they feel empty or have no feeling of pain at all when they are injuring. "After the act is complete, the pain can indeed be excruciating, but it also feels oddly calming, soothing - alive. On the other hand, some self-injurers say they do feel pain during the act of injuring, but that it doesn't stop them from proceeding. Seeing with their own eyes the wound they are producing is the object of the exercise, the pain is a small obstacle," she said noting that either way the person is dissociating himself or herself from reality.
Kimball noted that there has been some research into the relationship between dissociative episodes and self-injury. It seems that a number of people self-injure either to end a dissociative episode, or to induce one. "In my own clinical experience, I've found that people usually do it to end an episode. Often there is trauma in that person's background, usually of a sexual nature. In these cases, dissociation has been 'triggered' by something in their environment, or by their own internal experiences. These people dissociate and use self-injury to bring themselves back to reality - to ground themselves. This may explain why they do not feel pain at the time of the self-injury."
Almost anything can trigger a self-injurer into an episode. Some of the more common triggers are:
Intimacy
Sights
Smells
Memories of trauma
Social rejections
Interpersonal inadequacy
Kimball and Lader agree that self-injury has addictive qualities, but it is not an addiction. Kimball said she often hears self-injurers say they are compelled to harm themselves and they can't stop.
"It is addictive like, but we don't look at it as a life-long entity. With other kinds of addictions, like certain drugs or alcohol, most people have the same response to it, for the most part. Everybody gets inebriated if they drink too much alcohol, but not everyone who cuts feels the same," Lader said, adding that she doesn't believe that "once a self-injurer always a self-injurer," and therefore doesn't suggest 12-step programs as successful interventions for self-injury.
"First, is the sense of giving oneself up to a higher power - religion is fine, but we do not feel that a person is powerless. We think that self-injury is a choice and they can learn to make better choices," she said. " They have people identify themselves with their addiction. We don't want people to identify themselves as self-injurers - we see self-injury as a behavior, not who they are."
Lader noted that nothing takes the place of self-injury and substitutive methods dance around the real problems within the injurer. "Some people believe in snapping rubber bands on your wrists or putting your hand in ice water - to me that is the 'less is better' mode of therapy. It's like saying, instead of heroine why don't you just smoke grass. It's not quite as bad; it's not quite as addictive. But, that isn't dealing with the real issue. I think that it is really important that people recognize that because they are having a feeling you don't have to do anything. They have to challenge their irrational thoughts."
That task isn't an easy one. Locking up the knives and hiding sharp objects will not deter a self-injurer.
"People can be fairly ingenious when it comes to new ways to harm themselves. It's pretty tough to disarm someone who really wants to injure him- or herself. Self-injurers can pull out their hair or hit themselves it is not limited to cutting and burning. Taking away the implements does not solve the underlying problems," said Kimball.
S.A.F.E. haven
The main ingredients for success with self-injurers are stability, consistency, reliability and the formation of a positive therapeutic bond, Lader said, noting that pinpointing the emotions associated with before, during and after an episode, and processing the hidden trauma will help self-injurers define new, healthy coping strategies.
The S.A.F.E. Alternatives program is an eclectic, brief analytical therapy that focuses specifically on the hidden pain within the self-injurer. In 1985, it was the first inpatient treatment program for self-injury and has since helped hundreds of patients to overcome the urge to harm themselves.
The 30-day treatment program is for ages 13 and up, however, younger individuals must be screened before admittance due to the intensity of the curriculum. The 12-bed unit in Linden Oaks Hospital in Edward, Illinois, is considered a long-term program for insurance purposes, but once a patient is considered "stable," he or she is transferred to partial-day hospital services. A typical day at S.A.F.E. consists of five to seven group therapy sessions with individual therapy three times a week. In addition, there are group activities, art therapy and trauma therapy.
In conjunction with counseling sessions, Lader said, patients are given a "toolbox" that will be beneficial to both the self-injurer and the therapist. The kit consists of four key implements that are used simultaneously during treatment. They are:
No Harm Contract
The agreement should clearly spell out the expectations and responsibilities of both the client and counselor in regard to the therapeutic process. Lader noted that in an outpatient relationship, the contract will help the client stay focused on the goal of not self-injuring. She said it's important to collaborate with the client on the wording of the contract. "The therapist cannot be perceived as an adversary. We see it as a democratic process taking place between two responsible parties."
Making realistic goals with the client is also a crucial element in the contract. She suggests that clients start out with refraining from self-injury on the days of their sessions. "If the client arrives for treatment already having calmed her anxiety, it could be hard to find that anxiety to work on during the session."
Impulse Control Log
Many self-injurers may say that the impulse to harm "comes out of nowhere," and all they know is that they feel overwhelmed and their emotions are uncontrollable. Lader said she tells clients that these feelings are driven by some deep feeling, thought or memory that is perhaps submerged in their psyche. To create an awareness of what may be triggering their harmful behavior, clients are asked to keep a log of all thoughts or feelings associated with the urge to self-harm.
Alternatives
he alternative list is a collection of comforting or distracting activities that a client can do instead of injuring. Suggestions are: calling a friend or family member, writing, drawing, reading, knitting, taking a walk or playing with a pet. They should be things that can be done at anytime or anyplace, said Lader.
Writing Assignments
The SAFE program uses 15 writing assignments in a specific order. The first assignment required the client to write his or her autobiography. The following prompts focus on self-awareness, family/relationships, gender or body issues and are usually two to three pages in length.
"These tools help mobilize thoughts and words, which are a person's best ammunition in the battle for self-control," she said.
For counselors
"We wrote 'Bodily Harm" to try to get people to use this model because it does work. We want to teach people and encourage them to branch out and use this method in an outpatient setting," said Lader. "The most important thing is to realize this behavior is a coping mechanism and once a person gets to the underlying issues and deals with them, they can truly get better.
Lader noted that not all counselors are suited to deal with this type of client. "Treating self-injurers takes a certain type of fortitude and tolerance. It also takes great technical finesse since self-injurers tend to be good at making other people feel responsible for their behavior," she said. "They may draw the well-meaning therapist into a dance of distraction in which self-injury keeps the atmosphere charged with tension and worry. It's a delicate balancing act to keep professional boundaries, avoid the rescue trap and simultaneously offer comfort and solace."
She recommended that counselors examine adjunct supports, like medication or group therapy for additional support.
Ending the pain
Two former S.A.F.E. patients share their stories of rehabilitation and recovery.
"Laura, 38"
She was only seven the first time she deliberately hurt herself. Her father returned from Vietnam and the family had just moved again. On a warm summer day, Laura found some broken glass and piled it neatly at the foot of a tree. She climbed the tree and then jumped upon the glass shards with her bare feet. She continued to harm herself for the next 21 years.
By the time she reached early adulthood, her self-injuring became very intense. She burned her stomach and chest with oven cleaner, swallowed nails, glass and razors and cut herself with anything she found. She would even reopen old wounds and try to infect them by inserting pieces of rusty, metal scrubbing pads into the gashes.
At 28, her therapist convinced her to check into the S.A.F.E. program. Although Laura completed the program and stayed injury-free for almost ten years, she relapsed. Last fall, she went back to S.A.F.E. and gave it another try.
"That time I got real with myself and I did a lot of hard work. I learned who I am," she said. "I now carry hope that people can overcome this. There is help out here that works."
Laura helps spread the word about S.A.F.E. through an internet discussion group she moderates. "I started it because there were a lot of places online you could go, but everything was so triggering and graphic. I didn't find that environment healing. So, I just started my own - with a 'no trigger' policy that I learned from S.A.F.E."
Lader was actually the first member to register with the group and participates in some of the discussions. The message board promotes healthy coping skills and the techniques used in the S.A.F.E. program.
"Cheri, 34"
At a young age, Cheri began scratching and biting herself. The self-injuring behavior started when she was being sexual abused by a step-relative.
"It was a comfort to me that took me to a place where the emotional pain wasn't. I would hurt myself before, during and after the abuse," she said.
By the time she entered her twenties, Cheri's self-injuring became more life threatening. It was then she confided in her immediate family about the abuse. Soon after that, she married an emotional and physically abusive man who only fueled her feeling self-hate. During the marriage, she cut herself with knives and razors in secret. The marriage quickly ended and she started counseling, but she continued to harm herself and was too ashamed to tell anyone about her behavior. Finally, after 14 years of counseling and bouncing from one doctor to the next, she found a therapist with whom she felt comfortable enough to share her secret.
"In the beginning of this year, my injuring had become a daily occurrence. It was more excessive and harmful. I was working with a therapist on an out-patient basis, and my injuring was jeopardizing that relationship and that process," she said.
By June, Cheri and her therapist knew that she was in a life- or-death situation. He contacted S.A.F.E. and she entered the program in July.
"If I would have continued without getting help, I wouldn't be here today. I was suicidal, but more than anything I just wanted the pain to stop. I was to the point where I couldn't handle the emotional pain and flashbacks anymore, and I need that distraction constantly. I was cutting deeper and more often, and it was becoming very risky. I really didn't know if I could stop."
Once in the program, Cheri had her doubts but she said she was determined to getting better.
"At first I thought 'what have I done.' I was so scared that I made a commitment to stop doing the one thing that was getting me through life," she said. " In the first couple of weeks I didn't think I could live without injuring. But, I started to believe that I could survive, could cope, and could use other strategies to deal with this pain. I didn't have to abuse myself."
Cheri said she learned that her self-abuse was actually a way of re-living and re-enacting the abuse she suffered as a child. "At the end of the program, I had a new outlook on life. I had hope for the first time in my life. I believe I can protect myself and love myself, and I did not have to perpetuate the abuse. I don't have to harm myself in order to get through a problem," she said. "I spent a lot of time wanting someone to rescue me. What I realized at the end of the 30 days was that I could take care of me - I could rescue me from the pain that I suffered the majority of my life."
Cheri said that she still has bad days every now and then, but she hasn't injured. She nurtures herself, eats well, socializes with friends and focuses on a healthy lifestyle.
"S.A.F.E. helped me see that I was important enough to take care of. It was definitely a life saving, life altering experience for me. I'm not proud that I injured, but I'm proud that I survived."
For more information about the S.A.F.E treatment program call 1.800.DON'TCUT or visit www.selfinjury.com .
Self-injury