NUMBER 678ē 8 FEBRUARY ē SELF-INJURY
In recent years, many us who spend our days involved with the lives of children and youth have become increasingly alarmed by the number of young people resorting to repetitive forms of physical self-injury and mutilation. Iím not talking about the current culturally condoned practices of tattooing and body-piercing, although we might ask ourselves why these expressive forms have become so prevalent recently and why so many popular songs and movies contain references to self- injurious behavior Ė but thatís another matter. Nor am I referring to those forms of self-inflicted bodily injury that are ritualized in various cultures around the globe, although the same questions might be asked about why these practices were initiated in the first place. My concern here is with youngsters in our society who isolate themselves and engage in repeated acts of physical mutilation, even when those around them recoil in disbelief and revulsion. By definition, Iím referring to ďany deliberate, non life-threatening self-effective bodily harm or disfigurement of a socially unacceptable nature (Walsh & Rosen, 1998, p.10).
While we cannot calculate the actual numbers of children and youth that engage in this type behavior, there can be no question that it is on the increase and approaching epidemic proportions (Cosens, 2003). It might be possible to create sociological explanations for this, but in child and youth care, our concern is to understand why a particular individual would choose this particular form of self-harm.
As you might expect, there is no theoretical or professional consensus on the matter and, as Favazza (1992) has pointed out, the helping systems of North America are still struggling to develop a general and effective response.
Some psychiatrists and therapists choose to view physical self-harm as a form of manipulation and deal with the behavior accordingly. (Smith, Cox & Saradjian, 1999). Others consider the same behaviors to be an indicator of deep emotional turmoil (Levenkorn, 1998) and advocate various strategies of psychotherapy that are rarely available. In child and youth care, many of us have come to believe that young people express their troubles through their behavior and that these are best addressed through relationships. From this perspective, the child and youth care relationship is a vehicle through which young people who choose to self-injure can be supported and encouraged to discover alternative ways of coping with the pressures they experience from the outside and the turmoil they feel on the inside.
Shaw, K. (2003) A youth care approach to working with youngsters who self injure. Relational Child and Youth Care Practice, 16(2) pp.9-14
Cosens, P. (2003). Self mutilation: an examination of a growing phenomenon. Relational Child & Youth Care Practice. (16)2 p.5
Favazza, A. (1992). Bodies under siege : Self-mutilation in culture and psychiatry. London : Johns Hopkins University Press.
Levenkron, S. (1998). Cutting: Understanding and overcoming self-mutilation. New York: W.W. Norton.
Smith, G., Cox, D. & Saradjian, J. (1999). Women and self-harm: Understanding, coping, and healing from self-mutilation. New York : Routledge.
Walsh, B.W. & Rosen, P.M. (1988). Self - Mutilation: theory, research, and treatment. New York: Gilford Press.