Self-mutilation – Klerksdorp – FAMSA

SELF-MUTILATION/CUTTING

Klerksdorp – 25 July 2019

“Scars are stories, history written on the body.” Kathryn Harrison.

The challenge for every counselor: to get the detail of this story written on the body

Prof Daniel Siegel said: “Behaviour is communication”

We could therefore say that in most cases cutting is a desperate cry for help

Self-mutilation is a frightening barrier that keeps us from seeing a person who is lost, in pain, and in desperate need of help” (Clark & Henslin, 2007:48)

This is indeed a very relevant topic and in my own conversations with young people over the past few years this has been a theme that repeatedly came to the fore

First three slides

We could further say that where the major emphasis was on aspects such as anorexia and bulimia about 30 years ago, it has now shifted to this area of cutting to a large extent

Like one psychiatrist, Joshua Weiner, involved in the treatment of adolescent self-cutters in the city of Washington, states:

“Self-injury is the anorexia and bulimia of the new millennium.”

It seems that the average young person today is aware of at least one or two others involved in self-mutilation. School counselors, athletic coaches, youth workers, social workers and anyone working with young people confirms that it has become a common phenomenon (Penner 2008: 18; Gregston 2006: 9).

Research by Shamos (2007: 255) among South African teenagers indicates a figure of 10-15%, but she emphasizes the fact that due to the stigma and shame associated with self-cutting, the actual figure is probably much higher.

According to another researcher (Whitlock, 2010), 12-24% of young people in the age group 14 to 25 practices self-mutilation.

According to two other researchers (Gratz & Roemer, 2008:14), this rises among students to between 17-41%. It is also indicated (Sim et al., 2009:76) that more than 60% of adolescents hospitalized in psychiatric units were involved in deliberate self-mutilation.

In one to one conversations with young people where you as a counsellor have built a strong relationship, they are usually prepared to acknowledge these facts.

Slides 4 & 5

  • The importance of a holistic approach

There is a close unity among body, spirit and emotions – a problem within any one of these three dimensions has a direct influence on the other two. This aspect is clearly defined with regard to cutters by Clark and Henslin (2007:16,97):

“Self-inflicted violence is all at once a psychological, physical, and spiritual battle… Self-injurers are living proof that when the body is ravaged, the soul cries out. And when the soul is trampled upon, the body bleeds.”

Furthermore, it has become more evident to me after several visits to counseling centres in the USA (and especially where the focus is on young people) that it is only a multi-disciplinary approach which is the real solution.

I have seen in all these clinics that the emphasis is on the physical, emotional and spiritual dimensions > phenomenal results

What is also important: none of these clinics nowadays accept a young person into their institution for treatment without a contract signed by the parents or guardians that they will be part of the treatment program.

This principle of a multidisciplinary approach is illustrated very practically by Dr Daniel Amen who wrote the foreword to the book, Inside a cutter’s mind, by Clark and Henslin (2007). Amen is psychiatrist who specialises in brain scanning.

In this foreword he refers to a patient who was treated by him and who’s case illustrates the complexity of the problem of self-harming as well as the necessity of a

holistic and multidisciplinary approach. She was a twenty-three-year-old woman who came to him for help with bulimia and depression. Through a combination of medication and psychotherapy, she showed significant improvement. After two years she ended treatment in a much healthier state than when she started.

However, eight years later, after a very stressful period at work, she started cutting on herself, at first lightly and then much more intensely. Initially she appeared to be having blackouts when the cutting occurred. She would have times she didn’t remember. Through treatment they discovered that she had been sexually molested by a neighbour when she was five years old – prior abuse is common in cutters.

Dr Amen worked with her using various forms of treat­ment to deal with her past traumas. These techniques were very helpful for her. Additionally, he prescribed Naltrexone for her on the premise that cutting raises levels of endorphins, morphinelike substances that bring pleasure to the brain and thereby contribute to the addictive, repetitive behaviour of cutting. Naltrexone blocks the effects of endorphins, so rather than causing relief from emotional pain, the cutting causes acute pain, as it would for any of us. Over time, this patient was able to stop her self-destructive behaviour.

Part of the overall treatment was going back to the deep root of molestation and then also combining the general treatment with a pastoral approach.

  • An example of a high school girl who came for counseling:
  • Her younger sister was born when she was four and since then all the parents’ attention was focused on her sister > afterwards she experienced intense rejection and felt cut off from the family.
  • She felt specifically rejected by her Mom, while her Dad was absent most of the time because of his work.
  • Gr. 8: a romantic relationship broke up because of gossiping by a girlfriend > this resulted in depression.
  • Gr. 9: the next romantic relationship came to an end and then she started cutting herself – in this regard she told me: “Half of the girls in our class are doing it!”
  • Then at some stage a boy saw her while cutting herself at school > he spread the information by SMS to all his friends and then sent her a message, telling her that she actually needs a bigger knife > total rejection: felt that no one understood her pain.
  • She also experienced that God does not hear her and does not want to help her.
  • Then the father of one of her girlfriends molested her > that led her to a next step of addiction, namely drugs (trying to escape the overwhelming negative emotions) while the cutting process just became more intense.
  • During our counseling sessions the experience of rejection when she was four years old seemed to be the deepest root > finally she could speak to God again in prayer for the first time after a few years

Listen to the words of another girl:

“In our household we have to be brave. Crying is not allowed. My father has a very short temper and if you make noise that will annoy him like crying, he gets mad. I’m not incapable of crying, I just can’t. I do it (cutting) to stop thinking so that I have something else to occupy my mind in times of pain. I cry through the blood; my body cries for me(Penner, 2008:22).

  • The process of addiction

Slide 6

  • The last example: the story of Hanna Conradie

Slides 7 & 8

She struggled for 29 years

“My father was a professional soldier and he was never home.  He was a Reccie and later joined Koevoet. 

The thought of having me completely overwhelmed my mom.

From a very young age I carried a pain within myself that I did not understand.

At the age of 9 my father died in a motor vehicle accident.  I’ve started self-harming at the age of 12.

As the years went by, the self-harming got worse. I was on high dosages of psychiatric medication that completely numbed me. Several times I was admitted to

psychiatric hospitals with the hope that doctors could help. But nothing did.

The self-harming worsened to a point where I would scratch up to 16 hours a day.  I was slowly dying. However, in rehab seeds were planted in my life and God started watering those seeds. And although there wasn’t any change on the outside, God started preparing my heart for the road ahead.

Eventually my mom agreed to look after me.  My mom is very practical and she made me gloves with chains and locks so that I could not remove them. I continued this process for more than two months. My mom knew I was fighting this battle, I was

making the right choices and that I chose life and not death. I moved in with my mom in her room because I could not be alone.

God not only restored me, but He also restored my family. They are so grateful that I am free and part of the family again. Today I live a complete independent life. I got my driver’s license two and a half years back which was a miracle in itself. I’m still walking this road of recovery and it’s a battle that I need to fight every day.”

Slides 9 & 10

  • To summarize: Five action steps to help teens dealing with cutting:
  • Tell Someone – admitting to or talking about cutting is often the first and hardest step to helping someone stop cutting.
  • Identify the triggering problem – cutting is a way of reacting to emotional tension or pain. Try to help them determine what feelings or situations are causing them to cut.
  • Ask for help – many teens have no idea why they are cutting. Getting them into your office or the office of a colleague is the best way to help them begin their path toward healing.
  • Deal with the root issues – most teens who cut have deep emotional pain or distress and use cutting as a way to numb the hurt, rather than working through the process of emotional healing.
  • Follow a multi-disciplinary approach: medically, psychologically and pastoral.

There is a wonderful promise in Ps 34:18:

 “The Lord is close to the broken-hearted and saves those who are crushed”

  • In conclusion

It is not necessarily always the person with the highest qualification that will be able to help a victim

A schoolgirl wrote the following poem in this regard:

My razor doesn’t cut any more

My blood doesn’t flow any more

I can control myself

You can’t rule me any more

I have learnt to be in control without you With the help of my teacher

All my pain and all my hate is gone

With just a little bit of advice