Self Mutilation

[GardenDove]

I started posting on a teacher's website and it looks like I'm already considered the nurse in residence there.

Anyways, I was invited to comment on a thread where a highschool girl confided to her teacher that she used to engage in self mutilation, but has totally quit and is resolved not to. Apparently, they have some sort of mandatory reporting rule there if the student might be a danger to themselves or others. The girl is an otherwise high functioning straight A student. The teacher is worried that if she reports it it will break the bond of trust she has built with the girl.

Isn't this a form of OCD? What meds are used to control it? I would think it's highly likely that the girl will eventually relapse into this behavior, especially if she isn't on medication.

Any imput would be welcome as far as this condition.

[NPinWCH]

My two cents...take it for what it's worth.

As a previous cutter, I would feel betrayed if the teacher went forward, but this student is looking for help, she's crying out for it.

As a nurse and a parent, I would want to know my child was hurting and needed help.

I cut for release...to feel, to stop feeling. I was depressed, and at one point considered suicide, though in all honesty, the cutting is what kept me from it.

Getting this student help is what is needed, how you get there is a different story. The real issue is: Why is this student cutting. Cutting doesn't happen in isolation. The cutting is the symptom, not the problem and this student needs help. How to help is the problem...if the teacher isn't qualified to handle this (i.e. doesn't have a counseling/psych backround) she's gonna need help and it doesn't seem she does as she seems more concerned with the actual mutilation than with the reason behind it.

These are lyrics from a song by Plumb called Cut. I couldn't express it any better than this...

I do not want to be afraid

I do not want to die inside just to breathe in

I'm tired of feeling so numb

Relief exists I find it when

I am cut

I may seem crazy

Or painfully shy

And these scars wouldn't be so hidden

If you would just look me in the eye

I feel alone here and cold here

Though I don't want to die

But the only anesthetic that makes me feel anything kills inside

[KellNY, RN]

SH (self harm) can often be seen as similar to binge/purge and drug abuse, other addictive behaviors.

For many people, it is something that will be an issue (at least off and on) their entire life. I've never been a drug addict, but I've heard lots of stories where during a stressful time, or when confronted with a trigger

Point being-even if she stated that she resolved to quit, you are right. Relapse rates are very high.

I'm not sure it's likened to OCD, unless she habitually cut herself only before/after an exam or something like that. I think it's more like a self medication, as the PP mentioned. Pain really does release endorphins (think of childbirth!) and really does physiologically numb emotional pain.

I have heard of/seen Zoloft and Paxil (though not together) being used to treat SH, as well as an anti-anxiety med (Xanax, ativan, etc) for acute episodes.

NOW-Before talking to the girl's parents, what about encouraging the girl to talk with her mother in the teacher's presence? Or refering her to the school guidance counselor who can decide if this is still an issue.

As far as teh legalities....I'm not sure.

Hope this young woman gets some help, either way.

[Ophelia78]

The school guidance counselor or social worker should be informed. Yes, the girl may seem betrayed, but her safety is most important. I used to cut myself as a 12 to 13-year old. I really wanted someone to notice. Several teachers suspected for months but no one did anything. When that ploy didn't work I took it up a notch to attempt suicide by ODing. Thankfully I did it in front of my sisters. The mutilating isn't about OCD, it's a release of a great emotional pain. Something is causing that child's emotional pain. Is the child being abused? Has she suffered a loss? The cutting behavior will not go away until the underlying problem and her coping skills are addressed.