self-harming behavior

Introduction
Cause
Examine
Diagnosis

Introduction

Introduction Self-mutilation is a deliberate act of destroying one's own body tissue, but in essence, it is not like suicide, to let yourself die. It is estimated that 4% of the general population has experience of self-harm and 1% has reached severity. In the self-restraint group of psychiatric patients, 70% cut their skin, which may be palms, wrists, arms or thighs, etc. Other common methods include bumping, pickpocketing, cigarette hot, hunger strike and so on.

Cause

Cause

According to the international psychiatric community, self-harm behavior is roughly summarized into seven motives:

First, adjust the mood:

This is one of the most common effects that self-harmers want to achieve. When an individual has too many negative emotions, including anger towards the outside world, strong anxiety or frustration, self-harm can be used as a way to cope with stress. In particular, adolescents and children who are studying for school have not matured because of their ability to express and deal with their emotions. They often use self-harming behaviors to alleviate negative emotions. Parents and teachers should pay more attention.

Second, self-punishment:

People who are less confident in themselves or who are more likely to blame themselves will use self-harm to express their anger against themselves and to punish themselves. If parents give their children excessive demands and criticism, they may plant an excessively harsh child's mind, make the child feel inferior, and when they encounter setbacks or performances that are not up to the parents' requirements, they can easily punish themselves with self-harm.

Third, affecting people:

There are many family members, friends, or teachers around the self-mutilated person, but the self-mutilated person often makes the concerned person feel tired, frustrated, and even makes people ignore it, because he is used to self-mutilation to manipulate others or attract concern, and even control important things around him. people.

Fourth, advertised independence:

When the other party wants to do things that he or she does not want to do, for example, the intimate partner asks to break up and the boss wants to fire his own squid. The self-mutilation behavior at this time is to express independence, showing that only one can control himself, and the other party cannot control him.

V. Resistance to dissociation:

Dissociation is when people face a lot of psychological pressure, they will become numb, hoping to ignore the pain. But numbness also makes people feel lost. Therefore, by self-harm, they feel pain and regain the feeling of being alive.

Sixth, resist suicide:

This feature is also reasonable. When negative emotions accumulate to a certain extent, self-harm may consider suicide; before attempting suicide, if self-harm is used to alleviate some negative emotions, it may be far from suicide. Therefore, self-mutilation may be a protective factor for suicide, reminding yourself or others that there is indeed psychological distress and must be actively addressed and dealt with.

Seven, the pursuit of stimulation:

When the human body is injured, the brain secretes "endorphin" at the same time, which gives people a feeling of euphoria and expels pain. Sometimes, self-mutilation can also trigger the thrill of sitting on a roller coaster or jumping at high altitude. Adolescents collectively open their wrists, often using this self-harming behavior, together to pursue pleasure, and to establish peer recognition.

Injury to the body can be painful, but self-injury often thinks: "The wound is not painful at all, and the heart is more painful." The "heart" here may be one of the seven psychological reasons mentioned above.

In the face of self-harm, their families and relatives should shift their eyes from painless wounds to painful hearts, find opportunities to listen to self-harming people to describe the dilemmas they face, support their emotions and ideas, and accompany them in positive direction. Way to solve the problem. Many self-injured people also suffer from depression, anxiety, or schizophrenia. If the self-injured or caring person encounters difficulties, they should seek assistance from someone.

Examine

an examination

Related inspection

Brain ultrasound examination of brain CT

Common forms include: hitting the head, biting the hand, over-friction and scratching the body.

First, in order to describe the patient's self-harm behavior in detail and explore the potential causal relationship between behavior and physiology and social environment, relevant physiological functions analysis is needed (Wacker, Northup & Lambert, 1997). It includes the following items: observation of the crowd; specific performance before, after and during the self-harm; time and place of the behavior. The relevant information obtained is expected to explain the reasons for self-harm.

Before data collection, it is important to determine the specific behavior of the survey analysis. The focus of the analysis should be on a specific behavior (eg, biting the wrist) rather than a type of behavior (eg, self-harm). If several specific self-harm actions are grouped into one large category, it will be difficult to analyze the different causes of each behavior. For example, a child's self-harm behavior includes biting the wrist and over-scratching the body, both of which are caused by different causes (Edelson, Taubman and Lovaas, 1980). The former may be a frustrating reaction, and the latter may be a means of self-motivation.

During the data collection process, the salient features of self-harm behavior should be recorded, such as frequency of occurrence, duration, and severity. The objective and social environment of the patient should also be recorded. Objective environmental projects include: background (classroom, canteen, playground); light (natural light, incandescent light); sound (grass, other children's screams). Also record the names or codes of other people in the environment, such as teachers, parents, staff, visitors, and other students/patients. Other elements of the record include the specific time of day and the specific time of each week.

Diagnosis

Differential diagnosis

Suicidal behaviors include suicide gestures, suicide attempts and established suicides. Suicide plans and actions that are clearly impossible to achieve are often referred to as suicidal gestures; they are mainly about expressing will. However, the suicidal gestures should not be taken lightly; they are a strong call for help, they must be thoroughly examined, managed, relieved, and prevented from attempting the next suicide attempt. In particular, it should be noted that 20% of attempted suicides will be within 1 year. Try suicide again, and 10% of them eventually commit suicide and have a life. Suicide attempts are an unsuccessful suicide attempt because of the lighter willingness of the actor to self-destruct, the ambiguity, hesitation, or the lethal ability of the action.

Most suicide attempters have ambivalence in the search for death. Suicide attempts may be praying for help, and a strong desire to survive defeats suicide attempts. Suicide has ended in death. The difference between a successful suicide and a suicide attempt is not absolute. Because suicide attempts also include those who decide to seek short but are not killed because they are discovered or rescued in time, and there are also suicide attempters who have lost their hands and caused fatal committed suicide.

Self-destructive behavior is direct (usually including suicidal ideation, suicide attempt and established suicide) and indirect (characteristics are that although there is no short-sighted intention, but engage in life-threatening risk-taking behaviors, often unconsciously repeated, and may eventually self-destruct). Indirect self-destructive behaviors include excessive drinking, drug abuse, heavy smoking, excessive diet, neglect of health, self-injury, multiple operations, hunger strikes, criminal behavior, and reckless driving.