Impulsive Sib Behaviors example essay topic

Understanding Teens Who Self Injure Imagine being sixteen years old and taking a razor to your arm because you feel so much pain inside that cutting is the only way to escape it. For a lot of people this idea seems strange and incomprehensible, but for many teenagers this is their reality. In a society with so much abuse, neglect and crime children are facing things that they never had to face in the past. Adolescents who are lacking more positive coping skills are turning to self-injurious behaviors to ease their pain and frustration. In recent years the issue of self-injurious behaviors or SIB (White Kress, 2003) has increased in popularity. The general public is starting to take a special interest in the issue as more and more people are doing it.

The issue of self-mutilation can be found in movies, television and popular literature today. With increasing media attention people want to understand what these behaviors include, who does it and why. Although researchers agree that more research is needed on the topic, much is already known about these behaviors. About 1% of the general population and 4% of the mental health population suffer from a form of SIB (Shoemaker, 2004).

Often times people who suffer from SIB have preexisting mental health disorders such as major depression, Dysthymia, dissociate identity disorder, OCD, substance abuse disorders, adjustment disorders, schizophrenia, personality disorders, and eating disorders (Brittle bank et al. as quoted in White Kress, 2003). Although there is many different definitions of what SIB is, most researchers would agree that? SIB is defined as a volitional act to harm one's body without any intention to die as a result of the behavior? (White Kress, 2003). There are also a lot of different terms out there for these behaviors, they include self-inflicted violence, self-injury, self-harm, para suicide, cutting, self-abuse, and self-mutilation (Martinson, 2001). Without any intention to die as a result is a very important piece of information when understanding SIB.

While many people who self injure do have suicidal ideation, most are not in fact suicidal.? Menninger described self-mutilation as the focusing of suicidal impulse on part of the body instead of the whole body to avoid actual suicide? (Zila & Kiselica, 2001). Someone who is suicidal wants to end his or her life, however someone who is self-injurious uses the behavior as a means of escape.

SIB is often triggered by stress and intense emotions (Shoemaker, 2004).? The object wasn? t to make myself bleed to death, just to let go of the ugly feelings holding me hostage -- feelings that would leave me at the sight of blood? (Pederson, as quoted in Zila & Kiselica, 2001). SIB includes a wide range of behaviors including head banging, hair pulling, skin cutting, self-hitting, and skin burning. SIB is typically found in early adolescence but can become a chronic behavior that carries on into adulthood.

Most research focuses on females who self injure because it is found that, while males do self injure many more females do it. We also need to take into consideration that females tend to be more help seeking than males; so many more males may be self-injuring than we know. Zila and Kiselica define the typical self-mutilator as female, adolescent or young adult, single, usually from upper- middle class family and intelligent. It is found that one in four teenage girls cut (Barnard, 2004).

SIB can be classified into four categories: Stereotypic SIB, Major SIB, Compulsive SIB and Impulsive SIB (White Kress, 2003). Each of the four categories corresponds with and tends to be more prevalent with various DSM-IV mental disorders. The following will describe each of the four categories in detail. Stereotypic SIB The kind of behaviors that can be classified under Stereotypic SIB include head banging, self-hitting and slapping, self biting, and hair pulling. These kind of behaviors are most commonly found in individuals with mental retardation, developmental delays, Tourette's, syndrome, L esch-Ny han syndrome, autism, temporal lobe epilepsy, and Cornelia de Lange.

In this category SIB is seen as organically based, biologically driven behaviors. Stereotypic behaviors tend to be highly repetitive and at times may cause mild to serve tissue damage (White Kress, 2003). Major SIB Major SIB is a more serious form of SIB compared to Stereotypic. It can be potentially life threatening and includes such behaviors as castration, eye enucleation and limb amputation (White Kress, 2003). These types of behaviors are not common and usually occur when someone is suffering from severe psychosis, intoxication or character disorder. The person is in such as distorted state that they do not realize that their behavior is harmful and irrational.

Many people suffering from Major SIB self injure in response to hallucinations or delusions (White Kress, 2003). People suffering from Major SIB often express that they feel no pain and may experience calmness before, after and during the injury. Compulsive SIB Compulsive SIB is a more repetitive form of SIB that includes such behaviors as hair pulling, skin picking, and nail biting. These behaviors range from mild to moderate in severity. Many people suffering from Compulsive SIB feel they need to carry out their impulses to self injure but would rather resist it. People suffering from SIB often have heightened states of anxiety, exhibit obsessive compulsive behaviors and may suffer from trichotillomania and stereotypic movement disorder.

These people report that they have no control over their behaviors and they occur automatically. (Simeon & Favazza as quoted in White Kress, 2003). Impulsive SIB Impulsive SIB the more commonly known of the four types of SIB. It includes such behaviors as cutting, skin burning, and self-hitting.

The behaviors range from mild to moderate and can be isolated or habitual (White Kress, 2003). There are two sub-categories of Impulsive SIB: episodic and repetitive. Episodic Impulsive SIB occurs only a small amount of times in a person's life. Repetitive Impulsive SIB is more of a reoccurring form of SIB. Repetitive Impulsive SIB can have an addictive like quality to it and can be classified under Impulse Control Disorders in the DSM (White Kress, 2003). Impulsive SIB behaviors tend to be externally triggered and sporadic.

This type of SIB is typically formed in early adolescence and by adulthood without proper help can become chronic. Psychological disorders associated with Impulsive SIB include BPD, antisocial, dependent and histrionic personality disorders; eating disorders, post traumatic stress disorder and dissociative disorders (White Kress, 2003). For a person suffering from Impulsive SIB self-injury provides relief from an unpleasant experience and at times can prevent temporary psychotic episodes and suicidal acts. According to prior research in this form of SIB self injury often prevents the person from experiencing? depersonalization, severe anxiety, intense anger, depression, hallucinations, perceived external and internal flaws, racing thoughts and rapidly fluctuating emotions, boredom, and stimulus deprivation and feelings such as loneliness, emptiness, and insecurity?

(Favazza & Conterio as quoted in White Kress 2003). Besides suffering from a mental disorder there are certain types of life and childhood events that can trigger SIB in teens. Things like physical and sexual abuse, sexual identity issues, eating disorders, and childhood attachments, all play a role in SIB. In a study done by Graft and Mallin on SIB patients nearly all of clients reported sexual confusion.

Many times childhood sexual or physical abuse leaves teens with sexual identity issues and painful memories. In a means of trying to escape their feelings of shame and hurt they turn to hurting themselves as a relief. Simpson and Porter hypothesized hat sexual experienced in childhood such as abuse and rape somehow change normal physical and emotional responses to both sex and pain. For many that suffer from SIB control is a major issue, as it is in eating disorders. Simpson found a connection between self-mutilation and anorexia. In a study done by Favazza and Conterio 61% of their participants admitted to having an eating disorder by age 16.

Poor attachment in childhood is also a common factor found in many SIB patients. Favazza and Conterio found that more than half of their participants selected the adjective? miserable? to describe their childhood, and 62% noted childhood abuse (White Kress, 2003). For people who have poor childhood attachments they have difficulty later in life to form lasting relationships, so they learn to rely on themselves. Hurting oneself is a way to keep other at a distance so you don? t have to be disappointed by them. Interview I interviewed a 13-year-old female named Lisa who is currently a patient in a children's psychiatric hospital. Lisa is in the hospital for SIB, in particular cutting.

In my talks with Lisa she presented as a very intelligent 13-year-old girl who says she does very well in school. She comes from an upper-class family that moved to the United Stated from Syria when Lisa was 3 years old and she has one younger brother. She described her parents as very strict and controlling of her. Lisa has been cutting for the past 2 years, but more servari ty and regularly the past 6 months. Lisa says she cuts for two reasons, most times it is because she remember things about her past and she wants to forget them and other times she is ashamed of her past and wants to punish herself by dying. She explained to me about her past.

As a child Lisa's father physically abused her until she was 10 years old when he sought help. An old neighbor of hers sexually abused and tried to rape her over the course of several years. When she was 6 years old she told her uncle that he wouldn? t give him a hug because he was? gross? and a week later he was arrested on drug charges. The uncle was sent to prison and? supposedly? has since escaped.

Lisa blames herself for all of these events except for her father's abuse. Lisa explained that she didn? t think she deserved it and he was having problems and he is better now but it is still painful for her to think about. Lisa is very hung up on the incident with her neighbor. She can? t understand why he choose her, what she could of done. She thinks it is all her fault, even after being told that it's not. Lisa feels very responsible for her uncle's incarceration and escape.

She thinks that she made him so upset that she was responsible for his poor choices. Lisa is very fixated on these events and says she has? flashes? of them on a regular basis. Lisa's behavior is very labile, one moment she is happy with the other kids, and the next minuet she is stealing a fork and trying to cut herself. A lot of the research I have found does relate well to what Lisa talks about.

Lisa would fall under the category of Repetitive Impulsive SIB. One of the characteristics of this form of SIB is eating disorders. Lisa appears to have some type of bingeing and purging type of eating disorder but is not officially diagnosed. My research also stated that most teens that self injure are from upper-class families and are intelligent, Lisa is both. The research on attachment also comes into play. Because of the abuse Lisa received from her father, I doubt that a proper attachment was established.

The research also stated that many people who suffer from SIB could have suicidal ideation, which at times Lisa does, but I would not consider her suicidal. Overall, my information was very informative and well written. It gave me a clearer look into the world of SIB and a better understanding of Lisa and what she is dealing with. I definitely think more research needs to be done in the field. I would like to find more information on boys with SIB because that seems to be becoming more frequent and also more treatment suggestions.

Bibliography

Martinson, Deb. (2001).
Self Injury. Focus Adolescent Services. web Interview with Lisa at Kids Peace Children's Psychiatric Hospital Shoemaker, Carma Haley. (2004).
A Cut Above: The Practice of Self-Mutilation. Teenagers today. web Kress, Victoria. (2003).
Self Injurious Behaviors: Assessment and Diagnosis. J Journal of Counseling & Development, 81 (4), 490-497. Zila, Laurie MacA niff & Kiselica Mark. (2001).