The ISMAG Gazette
Welcome to the International Self-Mutilation Awareness Group!
Thanks for visiting the International Self-Mutilation Awareness Group website. We plan to use this site as a tool to inform cutters, their families, and their doctors about the ways to understand, approach, and treat self-mutilation.
As many of you know, this organization was founded by me, Brian Larsen, in early 2003 as a way to help self-mutilators and those around them to better understand (and thus treat) their condition.
We hope to bring you exclusive interviews with doctors who've treated patients for self-mutilation, and some of the ways that they've helped their patients get through the debilitating illness.
Welcome to the International Self-Mutilation Awareness Group. We hope that, if you are a cutter, this resource will help you gather the resolve you need to conquer your problems with self-mutilation, and that if you are a doctor or family member of a cutter, that you will better understand and thus will be better to interpret their condition from our resources. Thanks in advance for your support.
The International Self-Mutilation Awareness Group
Helping Doctors Understand Self-Mutilation
by Brian Larsen
As a doctor, it can be hard to overcome the stigma that comes with having a patient who mutilates himself or herself. This can be especially true for someone such as a family doctor, who has little to no experience with psychiatric disorders. The above still applies, however, to a psychologist who may not often see patients who have illnesses with such "blatant" effects. It can, at times, be hard for a psychologist to get past the aforementioned stigma of seeing a patient with gory scars running alongside their arms. Although dismissed by many in the psychiatric field as being a "fad" used by teens to gain attention, there is an ever-growing number of doctors who are beginning to have genuine empathy for their self-mutilating patients' condition. A patient who goes to see a psychiatrist showing all visible symptoms of moderate-scizophrenia with acute schizophrenic episodes will most likely be prescribed one of the new atypical antipsychotics (including medications such as Zyprexa, Abilify, and Risperdal). What, however, can a doctor do for a patient who mutilates themselves? There is not a single medication approved by the FDA for the indication of self-mutilation, nor is there a drug used without the FDA's approval for the treatment of cutting (just as doctors often use the anti-seizure medications Neurontin and Klonopin to control psychosis and panic disorder, respectively). What, then, can a doctor do?
First of all, a patient who has been mutilating themselves should be seen as soon as possible by a psychologist. The most effective means of treating self-mutilation is by intense psychotherapy sessions. A self-mutilating patient who sees a psychologist for psychotherapy to treat their disorder is far more likely to achieve remission of the desire to cut than a patient who is seen by a family doctor and pushed aside as having depression.
It is important to mention, however, that psychiatry (including clinical psychiatry) can play an extremely important role in controlling the symptoms and desires toward self-mutilation. Usually, patients who mutilate-themselves are experiencing symptoms of depression, bipolar (manic-depressive) disorder, or mild-to-moderate psychosis. Patients can be effectively treated via medications and regular checkups from a psychiatrist, but due to the relatively short time slot granted to a patient from a psychiatrist ("medication checkups" are mandated by insurance companies in nearly every state to last "no more than fifteen minutes"), a remission of symptoms can only occur when that patient is also being seen by a psychologist who will help the patient better understand his or her symptoms.
This is an excellent time for psychology, psychiatry, and psychopharmacology. More and more doctors, clinical workers, nurses, and social workers are beginning to understand the symptoms of "atypical" psychiatric disorders such as self-mutilation, and as this continues to occur, more and more patients will find themselves receiving the treatment that they so badly need.
Table of Contents
Introduction and Welcome From Brian Larsen
"Methods for Cutters to Avoid the Act of Self Mutilation", an informative list
"Helping Doctors Understand Self-Mutilation," an essay
Methods for Cutters To Avoid Cutting
affirmations (I am worth it. I don't need to cut)
call a friend, your therapist or a crisis line
try not be be alone (visit a friend, go shopping, etc.)
take a hot bath
listen to music
go for a walk
write in a journal
wear an elastic around wrist and snap it when you have the urge to harm yourself
draw red lines on yourself with washable markers instead of cutting
hold ice cubes in your hands - the cold causes pain in your hands, but it is not dangerous or harmful (some people find it relieves the urge to harm themselves for that moment)
punching a bed or a pillow (when nothing but a physical outlet for your anger and frustration will work).
scratch draw a picture on a thick piece of wood or use a screw driver and stab at the piece of wood. (can be another physical way to release your emotions without harming yourself.)
avoid temptation (i.e. avoiding the area in a store where the razor blades are kept, etc.)
try to find your own creative ways as outlets for emotions.
learn to confront others/making your own feelings known instead of keeping them inside
go outside and scream and yell
take up a sport (a form of exercise can help you release tension, etc.)
work with paint, clay, play-dough, etc.
draw a picture of what or who is making you angry
instead of harming yourself, try massaging the area you want to harm with massage oils or creams, reminding yourself that you are special and you deserve to treat yourself and your body with love and respect
go to church or your place of worship
wear a pipe cleaner or something that will fit on the places that you injure. One person did this as a way to remind herself that she could call someone instead of hurting herself and that she had other ways to cope.
break the object that you use to self-injure as a way to show that you have control over it.
write a letter to the person(s) that have hurt you and express how they made you feel. These letters do not have to be in perfect form and you do not have to please anyone but yourself. You do not have to give these letters to the people, but it is a great way to release the feelings that you are carrying within. After you write the letters, you can decide then what to do with them. Some people find destroying the letters help (i.e. tear them up, throw them in a lake, etc.)
do some household chores (i.e. cleaning)
do some cooking
try some sewing, crossstitch, etc.
recite a poem, prayer or anything else familiar the comforts you multiple times (similar to an affirmation)
write down all your positive points and why you do not deserve to be hurt
write in your journal why you want to hurt yourself and if you have hurt yourself, write down what caused it to happen so in the future you can prevent it from happenings - or find out what your triggers were
Play some kind of musical instrument. Even if you don't really know how to play, picking out tunes is a way to concentrate and help get rid of the urge to harm yourself.
allow yourself to cry. Getting the tears out can make you feel better. It allows the inside to release, as opposed to self abuse. Picture your "ickies" pouring out as you cry.
Take a shower
write down a word best associated with what you are feeling (i.e. horrible, sad, lonely, angry) and continue to write it down, over and over. Sometimes when you do that, the words looks silly etc., and it puts humor or a smile in your life.
sing a song on what you are feeling. It's another way to get it outside. Shout if you are made, etc. Let the words just come to you.
Scribble on paper. Clutch the pen in your fist. It's a way to diffuse it on to paper. (Get a few sheets so they don't tear.)
Take item you are self injurying with and use it against something else. For example, if you are using a razor blade, rip it across a towel. Sometimes seeing what "can" be done to an object can make a person think twice about using it on themselves. Can also give the feeling of "doing it"...the tangible aspect.
Make a list of reasons why you are going to stop cutting. Every time you get the urge, read the list to remind yourself why you shouldn't. Also remember to put on that list that you do not deserve to hurt yourself. You are important and special and you do not deserve to be hurt.