Self-Cutting Behaviors in Adolescents
Self-Injury: Addiction? Parasuicide? A Call for Help?
Self-Injury: Myths and Misconceptions 1
Self-Injury: Myths and Misconceptions 2
While watching Manic, I couldn't help but wonder why a few of them had injured themselves. The one girl had an 'Anarchy' symbol on her thigh, and Lyle had burned himself. Self-Injurious behavior has increased over the last several decades and is probably seen as an American problem, but it has been around for a long time throughout cultures. Cases involving emergency visits occur at a rate of 225 per 100,000 people aged 7-24. While causality is unclear, my Abnormal Psychology textbook cites a recent study that found that of the adolescents that engage in self-injurious behavior, 50% have a depressive or anxiety disorder, 60% have a substance used disorder, 60% have a disruptive behavior disorder, and more than 50% have a personality disorder (most often borderline, avoidant, or paranoid personality disorder). Obviously, those numbers add up to more than 100%, so the comorbidity of mental disorders associated with this behavior makes intervention and treatment that much more difficult and complex.
Self-injury is typically thought of as a suicide attempt, but that is not necessarily true. It can be used as a coping mechanism (albeit a short-lived and poor one) for dealing with emotional stress. Some people actually run into cutting by accident (like the girl in Manic) when they accidentally cut themselves shaving or something and instead of pain they feel relief. As described in the 'myths and misconceptions 2' link, this lack of pain experience might be explained by being in a dissociative state ( or zoned out). What causes the dissociative state is less clear. The relief (negative reinforcement) is actually the result of endorphins flooding the brain which is the result of the response to pain and can have actual euphoric-like effects (positive reinforcement). With the co-occurrence of both of these effects, it is easy to see why self-injurious behavior can become a powerful coping mechanism.
Self-Injury: Addiction? Parasuicide? A Call for Help?
Self-Injury: Myths and Misconceptions 1
Self-Injury: Myths and Misconceptions 2
While watching Manic, I couldn't help but wonder why a few of them had injured themselves. The one girl had an 'Anarchy' symbol on her thigh, and Lyle had burned himself. Self-Injurious behavior has increased over the last several decades and is probably seen as an American problem, but it has been around for a long time throughout cultures. Cases involving emergency visits occur at a rate of 225 per 100,000 people aged 7-24. While causality is unclear, my Abnormal Psychology textbook cites a recent study that found that of the adolescents that engage in self-injurious behavior, 50% have a depressive or anxiety disorder, 60% have a substance used disorder, 60% have a disruptive behavior disorder, and more than 50% have a personality disorder (most often borderline, avoidant, or paranoid personality disorder). Obviously, those numbers add up to more than 100%, so the comorbidity of mental disorders associated with this behavior makes intervention and treatment that much more difficult and complex.
Self-injury is typically thought of as a suicide attempt, but that is not necessarily true. It can be used as a coping mechanism (albeit a short-lived and poor one) for dealing with emotional stress. Some people actually run into cutting by accident (like the girl in Manic) when they accidentally cut themselves shaving or something and instead of pain they feel relief. As described in the 'myths and misconceptions 2' link, this lack of pain experience might be explained by being in a dissociative state ( or zoned out). What causes the dissociative state is less clear. The relief (negative reinforcement) is actually the result of endorphins flooding the brain which is the result of the response to pain and can have actual euphoric-like effects (positive reinforcement). With the co-occurrence of both of these effects, it is easy to see why self-injurious behavior can become a powerful coping mechanism.
One article brings up the notion that self-injurious behavior might actually be not that bad compared to drug and alcohol abuse. It is typically not life threatening, and can even be less costly than potential medical costs (if the injury is not too severe, infected, etc). What do you guys think? Is this actually a coping mechanism along the lines of drug and alcohol use (ok in small amounts but possibly addictive?), or is there something about it that is worse?
While watching Manic I too noticed that a lot of the teens had a high rate of self-injury. In regards to self-injury being better than drugs I can definitely understand where they are coming from. Self-injury is not addicting like many drugs, so it doesn't usually become a long term behavior. As long as the self-injury is not very severe, that is. Although it may be better than drugs in some instances, there is definitely ways to completely eliminate all destructive behaviors in a positive manner.
One thing that I have often heard, that you did not mention, is that self-injury is used to take control over some aspect in one's life. In the movie, none of the teens had control over their own life, and as a result they resorted to self-injury to cope, in addition to the release of endorphins. I found this website that gives a very good overview, explanation, and specific examples of people that self-injure.
http://www.aboutourkids.org/files/articles/nov_dec_3.pdf
One very interesting thing the article talks about is that self-injury is a way to externalize negative feelings. When someone has strong negative emotions they may not know how to tell others, or they may have nobody to talk to. When marks and scars begin to appear on an individual who injures themselves, they not only gain attention that they may have never had, but it can also be a way to express how they feel. Some people even scar themselves each time a traumatic event occurs to help tell a story that could otherwise not be verbally expressed.
The article discusses that group psychotherapy is a very positive way to deal with self-injury in that it creates a positive environment where people may share many commonalities. They are often places that relationships and comforting friendships can be created in order to successfully express true feelings.