Treatment for Self-Injury

David: For those in the audience who are self-injurers, I'd be interested in knowing what you did or said to let someone know about your self-injury behavior.

What about the use of medications to treat self-injury, Dr. Lader? Are there any that are used in the treatment of self-injury?

Dr Lader: Our clients come in on many different medications and we do believe that medications can help clients deal with the acute and intense anxiety that many clients experience. It has been our experience that low dose of neuroleptics help with this acute anxiety, and the hope is that clients only need to be on them for limited amounts of time. Other medications that some people find helpful are anti-depressants and mood stabilizers.

David: Here are some of the audience responses to how do you let someone else know about your self injury? Hopefully by sharing these, we'll be able to help each other:

wonder: I only let people know about my self-harm if they ask. I am very scared that they will interpret it as attention seeking if I tell them without their asking.

Liz Nichols: The first person I told was my mom. I didn't know what to tell her, so instead I just showed her the cuts/scars and started crying. She thought they were suicide attempts but later on she started to understand what it was.

kayla_17: The first time that someone found out, he was shocked, and he didn't really know what to do. He asked me about it and wanted to know why I've done it. But I really was trying to let him see it because I needed someone to know

Lela: When someone asked me about my scars, I said that I deliberately cut myself. I added that it was the dumbest thing I'd ever done and that I don't recommend it for anyone.

Chickie96: One of my friends brought up her problem, and it turned out that another two people present (myself included) in this group of four were doing it too. We use each other for support, and we talk to each other about our problems too.

Trainer: How my husband found out? I had been very withdrawn. I couldn't bring it up verbally so I purposely left drops of blood on the floor by the toilet. He then confronted me on it.

BPDlady23: I tell people that ask about my scars that I self injure. I go on to explain that I cut myself, but am not a danger to others. This usually leads to more questions, which I am glad to answer.

David: What is it like to get treatment for self-injury, Dr. Lader? You mentioned the possibility of needing anti-anxiety medications. For instance, alcoholics need to "dry out" first and go through the "shakes". Do people who self-injure have similar withdrawal experiences?

Dr Lader: People have all kinds of fears about what will happen if they don't self injure such as, "I'll go crazy,"I'll explode," "I'll start crying and never stop," or "I'll die." But in all of the fifteen years that we've been doing this, I've never seen any of these happen.

David: Some more audience responses to how you shared the news with others that you self-injure:

darknesschild: When people say "what happened?" I just say "razor blade." Then they don't ask anything else.

Cathryn: I've only told a few close friends. No one in my family knows, not my husband nor my daughters.

ang2 A: The first person that asked me, saw wrists bandaged and motioned a question so in private simply told him whole story. The second one found me out one night and asked how I was. When I said "I've been better," he questioned me what's wrong. So told him what was bothering me and the whole thing.

wendles: I never tell anyone unless they ask. Sometimes I tell them my dog scratched me. I finally confessed to my mom and my best friend.

bluegirl: I told a friend that I had tried to hurt myself. I didn't really say self-injury or suicide attempt or anything. And I told her that I had been at the hospital getting stitches and they had tried to admit me involuntarily. She was the first non-therapist-type person I told.

Rabbit399: What is the draw that a person may have that moment right before they self injure for the first time? Have you any information on the reasons why a person may pick up that object and hurt himself or herself without ever doing so before? Also, is it more common for people to just be self-injurers, or is it something they become because they first saw it and wanted to try to see if it worked?

Dr Lader: Most people don't know why they picked up the first object to hurt themselves. It's becoming more common, however, for people to have heard about it from other people and then try it.

David: For those of you who are wondering if it's possible to recover from self-injury, here's a comment from one of our audience members tonight:

mazey: I have been in treatment 2 times with Dr. Lader being my psychologist. I have been injury-free, I'm honestly not sure, maybe going on 2 years now. I didn't think that I would ever stop, but I did. Not easily, though. It's been a lot of hard work and tears.

I attended treatment. I have impulse logs in my car, by the computer, in my binder so when I'm in class, I surrender. I barrel right on through the emotions. I take it head on because I have the tools to not injure. I try to just say it, and I cry and cry and don't try to stop the feelings. The thoughts of injuring lessoned until I realized I was thinking about it all the time

Lela: I've been a self-injurer for 2 years and recently decided to quit. But I keep occasionally going back to it. How can I stop completely?

Dr Lader: It's to recognize that the self injury itself is not the problem. Many people have been able to go for months and sometimes even years between episodes, but unless they deal in more direct ways with their feelings, the symptom is likely to persist.

David: For those who asked for it, here's the link to the HealthyPlace.com Self-Injury Community. You can click on this link and sign up for the mail list at the top of the page so you can keep up with events like this.

Now, to follow-up on that comment, what you are saying is, even after attending a treatment program like yours, it's important to receive follow-up therapy on a regular basis?

Dr Lader: Absolutely.