Monday, March 17, 2014

Self-Injury in the News

It was disappointing and heart-wrenching to read this article from today's Austin-American Statesman:

As Austin schools tally nearly 1,000 cases, experts warn of prevalence of ‘self-injury’ among teens 
By Benjamin Wermund - American-Statesman Staff

When Lizzie was in seventh grade, she would use a mechanical pencil to cut her arms and ankles under her desk. Her teachers never noticed.

She would do it to make herself feel numb when she was anxious or when her emotions overwhelmed her. It became an addiction that Lizzie, now a high school student, is still fighting.

Health officials say self-injury — cutting, hitting, burning, bruising or otherwise hurting oneself to relieve stress or anxiety — frequently stems from underlying emotional or psychiatric problems, such as bipolar disorder or post-traumatic stress disorder.
It is an often misunderstood problem that is more widespread than parents might think.
The Austin school district last year began tracking when students tell counselors or teachers that they are cutting or hurting themselves, and it has tallied nearly 1,000 such reports so far.

“When I got those numbers, I was alarmed,” said Dianna Groves, a crisis counseling coordinator at the district who started the program. “For many years we’ve known it’s high, but the last two or three years we started paying more attention to it.”
Health officials say self-injury isn’t a fad: for decades, it has been something teenagers and preteens have seen their friends and classmates doing, and some try it, not realizing that it can become addictive or that it can be a precursor to suicide.

“Self-injury is a really powerful punch — this is a lot more than people are bargaining for when they start,” said Linda Spielman, a nationally known expert and counselor at Dialectical Behavior Therapy Associates of Austin, who has worked with Austin and other area districts to build awareness of self-injury in schools.

The body reacts to the cuts, burns and bruises by releasing serotonin, dopamine and endorphins. Self-injury can become addictive as the body builds tolerance.
There is relatively little research about it, however, so it’s difficult to say whether self-injury is becoming more or less prevalent. Spielman compared the growing awareness of self-injury to the way eating disorders became better known and understood throughout the 1970s and ’80s.

'You put a target on your back'
Lizzie, who was a straight-A student and a cheerleader in a Central Texas middle school, said she started cutting after finding herself in a “bad situation” with a boy. She became depressed and took one of the many razors in her parent’s garage that her father used for his business. Like many self-injuring teens and preteens, Lizzie was crafty. She would hide the razors in a small first-aid kit her parents gave her, and she would only cut parts of her body she could cover with clothes.

Her parents saw the cuts once or twice, but they didn’t think it was very serious at first. They talked to her about it and thought she was going to stop.

“It was almost like it was a fad and something to try,” Lizzie’s mother, Terri, said.
Eventually her friends at school noticed. Some tried to help. Once in the locker room, Lizzie was planning to cut, but dropped her razor. A girl who Lizzie said she didn’t know well took the razor and flushed it down the toilet. Others, though, weren’t as understanding. Lizzie said she was bullied a lot.

“When you start cutting, you put a target on your back,” Terri said.

Spielman, who has worked with Lizzie for the last few years, said that’s typical. She teaches her clients other coping mechanisms. Lizzie writes poems or makes scrapbooks. Now, after years of therapy, Lizzie says she still gets the urge to do it, but she knows the impulse will pass if she waits. She calls it “riding the wave.”

Unhealthy coping mechanism
Last year, at least 521 students told Austin school officials they were struggling with self-injury. An additional 460 students have reported injuring themselves so far this school year. Officials say that more students are likely in the same situation but have not reported it, and the tracking program is still new, so many schools are still not turning in complete figures.

Officials have also worked to prevent self-injury in schools.

Officials rewrote the district’s crisis handbook over the summer and added a protocol for dealing with self-injury. They did staff development at the beginning of the school year with counselors. They’re also creating a DVD aimed at middle schoolers to teach them what to do if they or their friends are hurting themselves.

The increased awareness and understanding is important for making sure students get the care they need, said Meagan Butler, a counselor at the Liberal Arts and Sciences Academy who helped develop the protocol this summer.

“Self-injury is one of those things a lot of people aren’t aware of,” Butler said. “What surprises me time and time again is how well the kids hide it. Our kids are really good at masking — their grades will look great and they’re still involved in clubs and look happy, but they are doing this.”

Once adults do find out, though, they need to be sure to treat it like it is: an unhealthy coping mechanism.

“There are a lot of things people do that are unhealthy, and this is just one of them,” Butler said. “It’s not like you’re crazy for cutting … you just learned a way to cope that’s not healthy.”

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