Treatment for Self-Harm

What is Self-Harm ?

Self-harm (SH) or deliberate self-harm (DSH) includes self-injury (SI) and self-poisoning and is defined as the intentional, direct injuring of body tissue most often done without suicidalintentions. These terms are used in the more recent literature in an attempt to reach a more neutral terminology. The older literature, especially that which predates the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), almost exclusively refers to self-mutilation. The term is synonymous with "self-injury".


Write Self-harm behaviour

a) burning,
b)scratching,
c)banging or
d)hitting body parts,
e)interfering with wound healing,
f)hair-pulling (trichotillomania) and the
g)ingestion of toxic substances or objects.

Cutting types:
Small, linear cuts. "The most typical cuts are very linear, straight line, often parallel like railroad ties carved into forearm, the upper arm, sometimes the legs," Rosen tells WebMD. "Some people cut words into themselves. If they're having body image issues, they may cut the word 'fat.' If they're having trouble at school, it may be 'stupid,' 'loser,' 'failure,' or a big 'L.' Those are the things we see pretty regularly."

Write names of psychiatric disorders where in self-harm behaviour is noted.

Self-harm is listed in the DSM-IV-TR as a symptom of borderline personality disorder. However patients with other diagnoses may also self-harm, including those with depression, anxiety disorders, substance abuse, eating disorders, post-traumatic stress disorder, schizophrenia, and several personality disorders.

Causes
Mood changes like depression or anxiety, out-of-control behavior, changes in relationships, communication, and school performance. Kids who are unable to manage day-to-day stresses of life are vulnerable to cutting,

Abuse during childhood is accepted as a primary social factor increasing the incidence of self-harm,

Treatment

PsychotherapyKnown as talk therapy or counseling, psychotherapy can help you identify and manage underlying issues that trigger self-injuring behavior. Therapy can also help you learn skills to better manage distress, help regulate your impulsiveness and other emotions, boost your self-image, better your relationships, and improve your problem-solving skills.

Several types of individual psychotherapy may be helpful, such as:

• Cognitive behavioral therapy, which helps you identify unhealthy, negative beliefs and behaviors and replace them with healthy, positive ones.
• Dialectical behavior therapy, a type of cognitive behavioral therapy that teaches behavioral skills to help you tolerate distress, manage or regulate your emotions, and improve your relationships with others.
• Psychodynamic psychotherapy, which focuses on identifying past experiences, hidden memories or interpersonal issues at the root of your emotional difficulties through self-examination guided by a therapist.
• Mindfulness-based therapies, which help you live in the present, appropriately perceive the thoughts and actions of those around you to reduce your anxiety and depression, and improve your general well-being.

In addition to individual therapy sessions, family therapy or group therapy also may be recommended.

MedicationsThere are no medications that specifically treat self-injuring behavior. However, your doctor may recommend treatment with antidepressants or other psychiatric medications to help treat depression, anxiety or other mental disorders commonly associated with self-injury. Treatment for these disorders may help you feel less compelled to hurt yourself.

Psychiatric hospitalizationIf you injure yourself severely or repeatedly, your doctor may recommend that you be admitted to a hospital for psychiatric care. Hospitalization, often short term, can provide a safe environment and more intensive treatment until you get through a crisis. Day treatment programs also may be an option.

Avoidance techniques
Generating alternative behaviours that the sufferer can engage in instead of self-harm is one successful behavioural method that is employed to avoid self-harm.Techniques, aimed at keeping busy, may include journaling, taking a walk, participating in sports or exercise or being around friends when the sufferer has the urge to harm themselves. The removal of objects used for self-harm from easy reach is also helpful for resisting self-harming urges.[16] The provision of a card that allows sufferers to make emergency contact with counselling services should the urge to self-harm arise may also help prevent the act of self-harm. Alternative and safer methods of self-harm that do not lead to permanent damage, for example the snapping of a rubber band on the wrist, may also help calm the urge to self-harm.Using biofeedback may help raise self-awareness in the sufferer of certain pre-occupations or particular mental state or mood that precede bouts of self-harming behaviour,and help the sufferer identify techniques to avoid those pre-occupations before they lead to self-harm. Any avoidance or coping strategy must be appropriate to the individual's motivation and reason for harming.

Ref: http://en.wikipedia.org/wiki/Self-harm



Aetiology