Intro to Self Injury Essential Question: How can we identify teenagers with mental disorders and what strategies can we use to help them?

Intro to Self InjuryIntro to Self Injury

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

Intro to Self InjuryIntro to Self Injury

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

What is Self InjuryWhat is Self Injury

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

Types of Self InjuryTypes of Self Injury

Cutting Cutting Burning (or Burning (or

"branding" with hot "branding" with hot objects) objects)

Picking at skin or re-Picking at skin or re-opening wounds opening wounds

Hair-pulling Hair-pulling Head-banging Head-banging Hitting (with objects) Hitting (with objects) Bone-breaking Bone-breaking

Why Do Teenagers Self Why Do Teenagers Self Injure Themselves???Injure Themselves???

Teenagers who self-Teenagers who self-injure often report injure often report that there is no adult that there is no adult they could talk to they could talk to who accepts them who accepts them for who they are.for who they are.

Could be an effort to Could be an effort to make others care or make others care or feel guilty or to drive feel guilty or to drive them away. them away.

Self-injury can be set Self-injury can be set off by certain events.off by certain events.


To try to get a To try to get a reaction from reaction from someone," "to get someone," "to get control of a control of a situation," and "to situation," and "to stop bad feelings."stop bad feelings."

Way to self-regulate Way to self-regulate feelings and help feelings and help people cope with people cope with overwhelming overwhelming negative emotions. negative emotions.


Children don’t know Children don’t know how to express and how to express and deal with anger and deal with anger and sadness, instead sadness, instead turning emotional turning emotional pain on themselves. pain on themselves.

Depression, for Depression, for example, is often example, is often described as anger described as anger turned inwardturned inward


Self-injury makes Self-injury makes some people feel some people feel part of a group.part of a group.

Support from Support from internet community.internet community.

When they don't When they don't want to self-injure want to self-injure anymore, it means anymore, it means they have to leave they have to leave a community.“a community.“

Facebook and Facebook and myspace groupsmyspace groups


Celebrities, too, have Celebrities, too, have contributed self-injury. contributed self-injury.

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

How Often DO Teenagers How Often DO Teenagers Self Injure Self Injure

Themselves???Themselves??? 46% of the high 46% of the high

school students school students reported some form reported some form of self-injury within of self-injury within the previous year.the previous year.

17 percent of 17 percent of college students college students have self-injured have self-injured

15 percent of the 15 percent of the general general adolescent populatiadolescent population.on.

Symptoms of Self Symptoms of Self InjuryInjury

Frequent cuts and Frequent cuts and burns that cannot burns that cannot be explained be explained

Self-punching or Self-punching or scratching scratching

Needle sticking Needle sticking Head banging Head banging Eye pressing Eye pressing Finger or arm biting Finger or arm biting Pulling out one's Pulling out one's

hair hair Picking at one's skin Picking at one's skin

Signs of Self InjurySigns of Self InjuryOthers notice the following:Others notice the following:

Unexplained and Unexplained and frequent injuriesfrequent injuries

Unexplained blood Unexplained blood stains on clothing, stains on clothing, beddingbedding

Individual has tools Individual has tools (i.e., knife, lighter) (i.e., knife, lighter) in possession in possession without explanationwithout explanation

Individual wears Individual wears long sleeves and long sleeves and pants in warm pants in warm weatherweather

Signs of Self InjurySigns of Self Injury Individual has difficulty with the following:Individual has difficulty with the following:

Self-esteemSelf-esteem Handling and/or Handling and/or

expressing expressing strong feelingsstrong feelings

Interpersonal Interpersonal relationshipsrelationships

Functioning at Functioning at work, school, work, school, and/or homeand/or home

Signs of Self InjurySigns of Self InjuryIndividual does the following:Individual does the following:

Makes excuses for Makes excuses for injuriesinjuries

His/her own laundry His/her own laundry (won’t let others (won’t let others help)help)

Isolates Isolates himself/herself for himself/herself for long periods of timelong periods of time

Becomes defensive Becomes defensive when asked when asked questionsquestions

Self Injury-QuotesSelf Injury-Quotes

"I feel relieved and "I feel relieved and less anxious after I less anxious after I cut. The emotional cut. The emotional pain slowly slips pain slowly slips away into the away into the physical pain."physical pain."

"It's a way to have "It's a way to have control over my control over my body because I can't body because I can't control anything control anything else in my life.“else in my life.“

---Alicia Moore---Alicia MooreCutting Story: CBS

Self Injury-QuotesSelf Injury-Quotes

"It expresses "It expresses emotional pain or emotional pain or feelings that I'm feelings that I'm unable to put unable to put into words."into words."

"I usually feel like I "I usually feel like I have a black hole in have a black hole in the pit of my the pit of my stomach. At least if I stomach. At least if I feel pain it's better feel pain it's better than nothing."than nothing."

Intervention and Intervention and TreatmentTreatment Find ways to soothe Find ways to soothe

or focus yourself or focus yourself when you feel like when you feel like self-injuring. self-injuring.

Make a list of non-Make a list of non-harmful things that harmful things that help you feel help you feel relaxed and real. relaxed and real.

Keep this list where Keep this list where you can see it so you can see it so when you feel like when you feel like hurting yourself.hurting yourself.

Intervention and Intervention and TreatmentTreatment

How do I stop hurting myself in the moment?How do I stop hurting myself in the moment?

Here are some ways to use up nervous Here are some ways to use up nervous energy:energy:

go for a long walk go for a long walk dance to loud music dance to loud music shoot hoops or kick soccer goals shoot hoops or kick soccer goals go jogging go jogging clean your room clean your room

Here are some ways to relax and de-stress:Here are some ways to relax and de-stress: take a bath or a hot shower take a bath or a hot shower listen to music listen to music write in a journal write in a journal talk to a friend talk to a friend read a good book read a good book


How can I help a friend who self injures?How can I help a friend who self injures?

Suggest to your friend that they talk to an Suggest to your friend that they talk to an

adult they trust,, like a parent, school adult they trust,, like a parent, school counselor, or their health care provider. counselor, or their health care provider.

Second, support your friend by listening to Second, support your friend by listening to them, and letting them know you care about them, and letting them know you care about them. them.

Lastly, print out this guide, or some other Lastly, print out this guide, or some other information on self-injury, and give it to information on self-injury, and give it to them. They can read it when they feel ready.them. They can read it when they feel ready.


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

Find a trusted adult who knows your friend, Find a trusted adult who knows your friend, and talk to that person. and talk to that person.

Tell an adult even if your friend asked you to Tell an adult even if your friend asked you to keep their self-injury a secret!keep their self-injury a secret!

Remember your friends safety is of the most Remember your friends safety is of the most importance.importance.

Cutting-Nathalie's Cutting-Nathalie's StoryStory

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

Cutting-Nathalie’s Cutting-Nathalie’s StoryStory

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


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


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


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

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Intro to Self Injury Essential Question: How can we identify teenagers with mental disorders and what strategies can we use to help them?