Michelle Seliner LCSW, Chief Operating Officer for S.A.F.E. Alternatives, discusses the treatment of self-injury, self-harm, including:

• how to determine whether one needs professional help or not when it comes to self-abuse.
• the difficulty in stopping repetitive self-injurious behavior.
• the recognized standard for treating self-injury.
• the S.A.F.E Alternatives (Self-Abuse Finally Ends) method of treatment.
• can self-injury really be stopped altogether or just really managed?

Self-Injury Chat Transcript

Natalie: is the HealthyPlace.com moderator.

The people in blue are audience members.

Natalie: Good evening. I'm Natalie, your moderator for tonight's “Treating Self-Injury chat conference. I want to welcome everyone to HealthyPlace.com.

Tonight's conference topic is "Treating Self-Injury."

We receive a dozen or more emails every month from people inquiring about self-injury / self-mutilation and when you get to the bottom line, they all have one question in common:

How do I quit hurting myself?

Our guest tonight is Michelle Seliner LCSW, Chief Operating Officer for S.A.F.E. Alternatives, the nationally recognized treatment approach for self-injurious behavior.

S.A.F.E. Alternatives' (Self-Abuse Finally Ends) approach is designed to help people end self-injurious behavior. The website for S.A.F.E is www.selfinjury.com. The phone number 1-800-DONTCUT (1-800-366-8288).

To be clear, self-injury is not a psychiatric disorder, but rather it's a symptom of a more serious psychiatric problem; a personality disorder, a mood disorder like bipolar or depression, or possibly OCD (obsessive-compulsive disorder).

Good evening, Michelle, and thank you for joining us tonight. How does one determine whether they need professional help or not when it comes to self-abuse?

Michelle Seliner: Thank you for inviting me.

It is our opinion at S.A.F.E. that anyone who is injuring could benefit from a professional evaluation. Research shows that even those who have injured only once have a higher level of emotional distress. A professional can help the client to identify the source of that stress and learn to cope in healthier ways. It is our belief that self-injury doesn't “work" for healthy people: That is, rather than providing a sense of relief, it merely hurts.

Natalie: How difficult is it for someone to stop repetitive self-injurious behavior? And why?

Michelle Seliner: Although people can and do get better on their own, many find it incredibly difficult to stop the behavior as it provides an immediate sense of relief. In addition, self-injury is not the actual problem, but rather an attempt to soothe uncomfortable emotional states that underlie the behavior.

Natalie: What is the recognized standard for treating self-injury?

Michelle Seliner: The standard treatment for self-injury involves focusing on emotional regulation through skills training. Clients are taught to pay attention to the irrational thoughts that might serve to fuel intensive feeling states. They are also taught to focus on the present rather than the past.

Natalie: So there's therapy. Are there medications that can help?

Michelle Seliner: Yes, there are medications used to treat the psychiatric diagnosis that accompany the symptoms of self injury.

Natalie: So for instance, if you suffer from bipolar or depression, you might be on an antipsychotic or antidepressant. Do these medications also relieve the self-injury behaviors or the urge to commit self-harm?

Michelle Seliner: No, there is no medication used to treat self-injury.

Natalie: Besides the recognized standard, are there any other alternative methods of treatment?

Michelle Seliner: Yes, for example, while the S.A.F.E. Alternatives model also focuses on irrational thinking, we do look at early childhood experiences as well as family systems and relational difficulties.