Some behaviors found in other populations have been mistaken for self-mutilation. Individuals who have tattoos or piercing's are often falsely accused of being self-mutilators. Although these practices have varying degrees of social acceptability, the behavior is not typical of self-mutilation. The majority of these persons tolerate pain for the purpose of attaining a finished product like a piercing or tattoo. This differs from the individual who self-mutilates for whom pain experienced from cutting or damaging the skin is sought as an escape from intolerable affect (Levenkron, 1998).

Suicide

Stanley et al., (2001) report that approximately 55%-85% of self-mutilators have made at least one attempt at suicide. Although suicide and self-mutilation appear to possess the same intended goal of pain relief, the respective desired outcomes of each of these behaviors is not entirely similar.

Those who cut or injure themselves seek to escape from intense affect or achieve some level of focus. For most members of this population, the sight of blood and intensity of pain from a superficial wound accomplish the desired effect, dissociation or management of affect. Following the act of cutting, these individuals usually report feeling better (Levenkron, 1998).

Motivation for committing suicide is not usually characterized in this manner. Feelings of hopelessness, despair, and depression predominate. For these individuals, death is the intent. Consequently, though the two behaviors possess similarities, suicidal ideation and self-mutilation may be considered distinctly different in intent.

Attention-seeking behavior

Levenkron (1998) reports that individuals who self-mutilate are often accused of "trying to gain attention." Although self-mutilation may be considered a means of communicating feelings, cutting and other self-harming behavior tends to be committed in privacy. In addition, self-harming individuals will often conceal their wounds. Revealing self-inflicted injuries will often encourage other individuals to attempt to stop the behavior. Since cutting serves to dissociate the individual from feelings, drawing attention to wounds is not typically desired. Those individuals who commit self-harm with the intent of gaining attention are conceptualized differently from those who self-mutilate.

Dangerousness to others

Another reported misconception is that those individuals who commit self-harm are a danger to others. Although self-mutilation has been identified as a characteristic of individuals suffering from a variety of diagnosed pathology, most of these individuals are functional and pose no threat to the safety of other persons.

TREATMENT OF THE INDIVIDUAL WHO SELF-MUTILATES

Methods employed to treat those persons who self-mutilate range on a continuum from successful to ineffective. Those treatment methods that have shown effectiveness in working with this population include: art therapy, activity therapy, individual counseling, and support groups. An important skill of the professional working with a self-harming individual is the ability to look at wounds without grimacing or passing judgment (Levenkron, 1998). A setting that promotes the healthy expression of emotions, and counselor patience and willingness to examine wounds is the common bond among these progressive interventions (Levenkron, 1998; Zila & Kiselica, 2001).

Source: ERIC/CASS Digest

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