June 19, 2013 - This is the first part of a three part series about negative coping skills like self-injury, and how positive coping skills can be developed. In the first part of this series, The Clarkston News talks to Abigail about her experience with self-injury.
Abigail has a secret.
The Clarkston resident is the 37-year-old mom with scars all over her body. Scars she got from cutting herself on purpose - a condition known as self-injury-or self-harm.
Abigail has been cutting herself since she was 15. Her troubles began after she had surgery and was raped at just 14. Highly educated, Abigail has been diagnosed with bipolar disorder and has been seeing psychologist Dr. Donald Deering for the past three years. He serves as a clinician in the Department of Behavior Medicine at St. Joseph Mercy Oakland, Professor in the Department of Counseling at Oakland University and also works out of Oakland Psychiatric Associates in Clarkston.
Self-injury can come in many forms including cutting, pinching, burning and pulling out hair. Individuals who self-injure can be any age or sex, but it's most often seen in females under 18.
Dr. Tim O'Neill of Clarkston Medical Group said the most common area people self-injure is on the arms, thighs and stomach.
O'Neill added he sees quite a few patients each month that self-injure.
"They say they feel nothing and self-injury is a way to feel something," he said.
Self-injury can lead to permanent scarring, lowered self-esteem and can be unintentionally fatal. According to O'Neill he often sees self-inflicted wounds so deep they will never fade.
"The scars will last a lifetime," he explained.
"People will inflict physical pain on themselves to override the emotional pain they are feeling," said Deering. "Self-injuring allows the person to escape the emotional pain by instead feeling physical pain."
The behavior can also be addictive, due to endorphins released by the body, when people injure themselves.
O'Neill and Deering said self-injury is often found in individuals suffering from mental illness like depression or anxiety.
"It is often a sign of an underlying condition," O'Neill said. "It's a sign that the person needs help."
Abigail admits she has also struggled with other issues like substance abuse, developing close relationships and eating disorders.
According to Deering, someone who self-injures is not dealing with underlying issues.
"Conditions like anxiety or depression or obsessive compulsive disorder left untreated can lead someone to practice self-injury," he explained.
He added patients who self-injure can suffer from identity disorders and low self-esteem.
Growing up her home life was not terrible, but she said her mother was emotionally distant and may have had bipolar disorder, too. Abigail said she never felt like she could confide in her parents.
"We just didn't have that kind of relationship," she said.
O'Neill said he sees several patients each month with self-injury wounds.
"It seems to increasing in frequency, but awareness is also increasing," he said, adding he most often sees self injury in young people, but he also sees it in adults like Abigail.
O'Neill said he first treats the wound, assesses the situation and then provides resources for psychological help.
Deering added a common treatment for self-injury is Cognitive Behavior Therapy.
"We look at cognitive thoughts and how certain thoughts can transform to behaviors," he said. "If a person is really suffering we can add medication."
Those who self-injure often engage in the behavior to cope with negative emotions and feelings. It is also a form of expression, a way to relieve emotional pain and feel in control.They have trouble expressing emotions in a healthy way, and difficulty controlling impulses. A person who self-injures often feels guilty and can experience shame and guilt.
The series continues next week.