It is “Self-Injury Awareness” month so I wanted to take the opportunity to focus on what defines self-injury and how to recognize it in friends and family. 

There are myths and stigmas attached to self-harming that I would like to address. Contrary to popular belief, people that self-harm are not doing so to get attention. In fact, most of those who cut or harm themselves do not want others to know. They carry a sense of shame and guilt not a sense of pride. When they show their scars or marks to others it is a plea for help not a cry for attention.  Another false belief is that people who harm themselves are dangerous and should be avoided. In reality, people who self-harm are merely using this as a means to cope with emotional distress.  They typically have no intention of harming those around them. Another common mistake believed is that if the wounds or marks from self-harming are not severe, then the problem is also not severe. Do not equate the depth of a gash with the depth of pain the self-injurious individual feels. These two aspects have little to do with each other. 

It is important to be aware of the signs and symptoms of self-harming:

• Isolation for long periods of time- The person will need time alone to act out on the urge.
• Irritability and mood swings- A buildup of emotions will occur prior to a self-harming episode, which will then be followed by a state of calm.
• Wearing covering clothing- A person may wear long sleeves or pants to cover up the marks. This behavior is more apparent during the warmer seasons of the year.
• Unexplained blood marks- These can be found on the clothes of the individual, as well as, on towels, sheets, and tissues.
• Continuously being in possession of sharp objects- These objects include but are not limited to knives, lighters, nails, paper clips, and razors.
• Claiming to be “clumsy”- A self-harming individual will use clumsiness as an excuse to cover up the behavior when questioned about marks or scars.
• Unexplained marks or scars- Marks that cannot be explained or reasoned away are a tell-tale sign of self-injurious behavior. However, it is not uncommon for a person to be occasionally unaware of being cut, scraped, or bruised. If this becomes a pattern then it is typically a red flag. 

If someone you love appears to be portraying the warning signs for self-injurious behavior, it is pertinent that this person receives the help he/she needs.

1. This is a matter that must be treated delicately.  Being aware of how to approach the person is of the utmost importance. 
2. Remember to first get your own emotions in check before beginning a discussion with your loved one about your concern. Process your feelings with someone else or seek guidance from a professional.
3. Do research on what causes self-injurious behaviors.
4. Once you are prepared to approach the person, refrain from using attacking language, such as “you messages.” Instead, use “I statements” such as “I am deeply concerned. I am here for you and will help in any way that I can.”   
5. Voice your concerns in a loving manner. Be careful to make the discussion about him/her and not about you.
6. Encourage your loved one to feel free to talk openly and honestly. As stated earlier there is a sense of shame and guilt that comes along with this behavior so your loved one may not be ready to have an open discussion right away.
7. Keep the lines of communication open for when he/she is ready to talk.  Empathize with the difficulty of dealing with the day-in-and-day-out activities of life.  Be compassionate and understanding. 
8. Steer clear of judgmental statements or comments. 
9. Be supportive and encouraging if your loved one makes the choice to seek out a professional.  Having a counselor’s information to pass along may be helpful in this situation. 

As I counsel clients in this painful situation, my role is to direct each one in processing the internal pain that is driving the self-injurious behavior. But, I am also able to give them hope. I commend them for coming into counseling because reaching out is a good first step in healing. Although it is a long process, a client can learn how to feel the pain instead of injuring to deal with it. My main objective is letting them know they are not alone and healing is possible.

http://www.helpguide.org/mental/self_injury.htm is a website that offers facts and coping techniques about Self-Injury.

~Robin