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Forum Name: Psychiatric Topics

Question: Can someone help me understand self mutilation

nursie3205 - Sat Sep 10, 2005 1:27 am

I just learned that my 15 year old niece is a self mutilator. She is seeing a psychaiatrist but will not open up. She says that it stems from the divorce of her parents, and not having a relationship with her father. I love her very much and we have a good relationship, but I feel so helpless. Can someone please help me understand this disease, and have any suggestions on how to cope.

Shana Johnson, CNA - Sat Sep 10, 2005 10:47 am

Self injury or "cutting" usually starts because a teen feels they have lost control of their lives, and they begin cutting as a way to feel control in a situation, and as a sort of "release" of the pain they feel. They may also be cutting as a way to punish themselves, because they feel they deserve it and are worthless. It is a good thing she is seeing a psychiatrist, and in time she will begin to open up and heal. You need to be as nonjudgemental and supportive as possible, letting her know you are there if she needs to talk, but never pushing her to open up. Love her unconditionally, be supportive and in time, she will work through her feelings and begin to heal. If the cutting escalates, you may want to look into an in patient program for awhile. Good luck, Gracie

nursie3205 - Sat Sep 10, 2005 3:59 pm

Thank you Gracie for your reply. I am very supportive of her, as supportive as I can be. But I love her so much. It is so shocking to me She says that she is not going to talk to her psychiatrist, and I am so heartbroken. I just keep praying that she will open up and work through this. What kind of meds will help this disorder?? Any alternative therapies that we can try?? Sorry to bother, but I am a geriatric nurse and don't really know a lot about psych nursing. Any advise appreciated. Thanks nursie3205

nursie3205 - Sat Sep 10, 2005 4:02 pm

also Gracie, please see my post in Dermatology issues, I am also having that problem and was hoping to get the advise of some other nurses and doctors. The post is MD and health care professionals please read. thanks again

Shana Johnson, CNA - Sat Sep 10, 2005 10:09 pm

The effective treatment of self-injury is most often a combination of medication, Cognitive/behavioral therapy, and interpersonal therapy, supplemented by other treatment services as needed. Medication is often useful in the management of Depression, Anxiety, obsessive-compulsive behaviors, and the racing thoughts that may accompany self-injury. Cognitive/behavioral therapy that incorporate contracts, journals, and behavioral logs are useful tools for regaining self-control. Self-injury treatment options include outpatient therapy, partial (6-12 hours a day) and inpatient hospitalization. When the behaviors interfere with daily living, such as employment, school and relationships, and or are health or life-threatening, a specialized self injury hospital program with experienced staff is recommended. You can call 1-800-dontcut(1800-366-8288) abotu referrals for in and outpatient programs designed just for people who cut themselves The most important part of recovery is the patient understanding she has a problem, and wanting the recieve help and begin to heal and stop cutting. As hard as it may be, you just need to be there for her until she wants to help herself.

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