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The Collegian

The Student News Site of Tarrant County College

The Collegian

The Student News Site of Tarrant County College

The Collegian

Nurse reports causes of self-injuries

By Charles Swanigon/reporter

An estimated 4 percent of the general adult population admits to at least occasional self-injury, a registered nurse from Cook Children’s Medical Center told a group on NE Campus last week.

The District closed early March 6 because of inclement weather, but not before Mollie Kuchta delivered Self-Injurious Behavior.

With the behavior related to aggression, Kuchta said more than two-thirds of the self-injurers report no control over the act; 18-45 percent report anger toward themselves while 10-32 percent report anger toward others.

During her 18 years in medicine, Kuchta has also worked at John Peter Smith Hospital and with organizations like Child Protective Services and Court Appointed Special Advocates to protect kids from harm, and in this case from harming themselves.

Kuchta said self-injury has gone by many names over the years. In 1935, Karl Menninger, American psychiatrist, referred to it as “partial suicide.” E. B. Simpson called it “anti-suicide” in 1976. Also referred to as self-mutilation, Kuchta said, the preferred name is self-injurious behavior. She provided a definition from Self-Injurious Behaviors: Assessment and Treatment by Simeon and Favassa.

“[Self-injurious behavior is] the deliberate infliction of direct physical harm to one’s own body without intent to die as a consequence of the behavior,” the authors said.

Kuchta said such behavior can be unique to certain populations such as prisons and state hospitals.

“Tattoos and piercings are not self-injuring behavior,” she said.

Closed studies conducted by Whitlock in 2006 showed that of the 2,875 students evaluated, 17 percent showed lifetime prevalence. 

Skin is a very large bulletin board, Kuchta said. Self-injurers find a sense of belonging, a canvas to express their feelings. She said it is also a sign of individuality. Eating disorders and body hatred go hand and hand with self-injury.

One study in 2002 of 376 inpatient women being treated for eating disorders found that 34.4 percent had self-injured at one time or another.

Both those with eating disorders and body hatred believed they were tough enough to control their illness and could rid themselves of toxic feelings, and for both, the body became the object of displaced hate.

Self-injurers strongly hate their bodies, Kuchta said. In cases involving women, they hate their periods and injure themselves in an effort to stop them. They hate pelvic exams and believe life would be better without a vagina.

When children self-injure, Kuchta said caretakers should ask these questions: “What brought this on? What was the feeling? Why did you choose destructive behavior?”

Kuchta said doctors should start treatment and provide a structure for problem solving. What a parent can do to help during treatment is document this behavior.

“Don’t engage in power struggles,” she said. “Follow a safety plan, don’t minimize, and don’t try to rescue the child.”

Treatment also dispels any belief that these impulses come from nowhere, Kuchta said. While going through treatment, self-injurers replace that behavior with a more reasonable behavior such as snapping rubber bands. Less reasonable behavior was described in a study by Marsha Linehan.

“[Self-injurers were] putting their hands in cold water, drawing on their bodies with a red marker to simulate wounds, breaking an egg over the skin to simulate blood,” she reported.

Self-injuring behavior is diverse and bewildering, Kuchta said and then quoted Wendy Lader, who described it as “once an obscure psychiatric symptom, now an alarming problem.”

Stereotypical self-injuring behavior, Kuchta said, includes head-banging, self-hitting, hand and lip chewing, self-biting, skin picking and hair pulling.

Behaviors can be highly repetitive, monotonous, fixed, often rhythmic and seemingly highly driven. As a result, patients can suffer from mild tissue damage, which may be life threatening. Examples of major self-injurious behavior are castration, eye enucleation (removal) and limb amputation, Kuchta said. Mental Retardation may or may not be present.

Self-injury and suicide are totally different. Self-injurers desire to make improvements to their body while suicide is an attempt to terminate life, Kuchta said. Self-injurers are temporarily relieved through self-injury whereas such relief can only come in death for those who are suicidal. Typically when a self-injurer dies as a result of their injuries, Kuchta said, it is an accident.

“The No. 1 for self-injury is seeking some time in treatment,” she said.

Kuchta said approximately 55-85 percent of self-injurers have made at least one suicide attempt.

“Twenty-eight-41 percent of individuals who engage themselves in self-injurious behavior report suicide ideation during the episode,” she said.

Kuchta said Landers reported that “researchers point to cultural changes since 1960 to the rise in self-injuring. Many believe in the collapse of the extended family.” Kuchta added rampant divorce, loss of mentoring and the taking of prayer out of school to the list.

“Traditions and family rituals are no longer sacred,” she said. “Strangers baby-sit our children.”

Self-injury is usually one of many problems with an individual, Kuchta said. Treatment is essential to success and many of them believe they have gotten away with something and need help.

For any further questions, contact Kuchta at molliek@cookchildrens.org.

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