Self-Harm Specifics – ADD girls at greater risk


Remember – links on this site are dark grey to reduce distraction potential
while you’re reading. They turn
red on mouseover.

In the What Kind of World do YOU Want? series
Part III of an article on Self-Injury & CUTTING
Intenational Self-harm Awareness Day – March 1

OrangeRibbonSelfHarmThere are NO graphic photos or descriptions, BUT if you self-injure, make SURE you are emotionally protected so that reading this article will not precipitate an episode. Have a list of substitute strategies available to self-soothe in healthier ways – you are stronger than you think, nobody’s perfect and I’m on your side!

The Cycle of Self-Harm

by Madelyn Griffith-Haynie, CTP, CMC, ACT, MCC, SCAC
CLICK HERE for Part II:  SI/Anxiety link

self-harm-cycleHow Pervasive
is the Problem?

Self-harm, or Self-Injury [SI] can be found with greater frequency in certain disorder-populations than its incidence in the population as a whole.

It has been listed in the American Psychological Association’s Diagnostic and Statistical Manual of Mental Disorders [DSM-IV-TR] as a symptom of borderline personality disorder.

However, according to a 2007 journal-published study it is also found in otherwise high-functioning individuals who have no underlying clinical diagnosis.

(Klonsky, E.D.,”Non-Suicidal Self-Injury: An Introduction” – Journal of Clinical Psychology &
“The functions of deliberate self-injury: A review of the evidence” – Clinical Psychology Review)

Self-harm behaviour [SI] can occur at any age, including in the elderly population. The risk of serious injury and suicide is reportedly higher in older people who self-harm.

Acording to Klonsky, patient populations with other diagnoses who are more likely to be drawn to self-harm as a coping strategy include individuals with the following disorders:

There is disagreement between experts as to whether SI is part of the symptom profile included in these diagnoses, or whether it is actually a separate diagnosis that is comorbid with a number of other diagnoses.

Self-harming behaviors are not confined to the human population either.  Animals under significant stress (and sometimes as a side-effect of certain medications) will also self-injure. For example, birds will pull out feathers as far as their beaks will reach, dogs lick or bite themselves raw, and monkeys exhibit many of the human forms of self-injury, with the exception of cutting, etc.

MORE than cutting

In addition to the subtance-related addictions, a list of other self-harming behaviors found on the LifeSIGNS website includes, among many others, the following activities as self-injury:

  • Burning and Branding
  • Scalding
  • Pulling out hair
  • Head & body banging / intentional bruising, including bone breaking
  • Pricking and scratching (raw)
  • Biting
  • Ingesting, including chronic self-medicating, overdosing (chronic or acute),
    self-poisoning, swallowing objects intended to cause harm

Lies, damned lies and statistics

An article written by Wedge (real name), an SI sufferer and advocate from
the LifeSigns website (linked HERE) might encourage you to take statistics
with enough grains of salt to empty the salt bins in a pretzel factory.

Gerald_G_House_sitting_on_a_pile_of_moneyHis article aptly underscores what I have frequently said about ADD statistics: they are helpful to guestimate the size of the forest, but don’t depend on the tree-count to build your abode!

Statistics rarely indicate anything so much as the fact that an issue has come to public awareness to a significant enough degree that somebody was able to secure funding for a study or a survey.

Since SI researchers have used different definitions, metrics and population samples for data collection, it is especially difficult to know exactly what the composite numbers represent. There are some areas of agreement about trend, if not metrics (i.e., that SI in children seems to have been increasing since the 1980s), and one statistic that is relatively encouraging:

It has been estimated, extrapolating from an average of studies of non-clinical,
adolescent populations, that we can expect to see a lifetime prevalence of
between 15-20% (higher in clinical populations).

So it is possible to become an ex-cutter eventually, and at least 80-85% get there.

For what it’s worth, however, below are a few other statistics I’ve found sprinkled around the web, attempting to quantify the extent to which self-harm as a coping strategy is prevalent, along with a few other metrics attempting to make sense of the phenomenon:

•  England: 3 teens self-harm per hour
•  Australia: 24,087 teens were hospitalized for self harm in 2003-2004
•  United States: 3,000,000 Americans self-harm
•  Cutting is reported most often in girls/women between the ages of 13 and 30
(Wikipedia reports 12-24, other studies estimate that 1 in 200 girls have cut themselves, and one source reports that cutting usually begins between the ages of 10 and 16)

•  90% of SI sufferers begin self-harming behaviors in their teen years or younger
(almost 50% began at the age of 14 and continue into their 20’s and beyond;
13% of 15 to 16-year-olds have deliberately harmed themselves. )

•  Almost 50% of SI sufferers have reported being sexually abused

According to Wikipedia, “Self-harm is often associated with a history of trauma and abuse, including emotional and sexual abuse.[14][15]

Starting to Stop – repeatedly

No matter how badly the individual who self-harms wants to stop, SI is a condition in which stop-start relapses are common – it’s part of the pathway toward wellness that anyone who wants to offer help and support MUST accept without censure if you want to avoid becoming part of the problem.

Perhaps counterintuitive to many of you reading, the “just say no” approach will increase,
not decrease, these self-injury behaviors – so JUST SAY NO to speaking that phrase anywhere within earshot of anyone who has come to you for understanding and support.

There are a number of different methods that can be used to help an SI sufferer gradually move to less dramatic and harmful ways to cope. The underlying reasons for the SI in the first place changes how you approach the trajectory toward wellness.

Also from Wikipedia:

“The motivations for self-harm vary and it may be used to fulfill a number of different functions.[12] 

These functions include self-harm being used as a coping mechanism which provides temporary relief of intense feelings such as anxiety, depression, stress, emotional numbness or a sense of failure or self-loathing and other mental traits including low self-esteem[13] or perfectionism.

That’s quite a large basket into which they’ve thrown a number of disparate “motivations.”

I want to make sure that you note the “emotional numbness” function cited above.

In the next part of this article, where we will look briefly at a few theories about WHY individuals cause intentional harm to themselves, we will distinguish between the different types of SI, and will take a look at SI as a strategy to manage depersonalization and derealization.

The link between ADD and SI

One possible risk factor bears mention NOW, illuminated in the recently reported results of the 10-year UC Berkeley study of 233 girls: those with ADD-Combined Type seem to be at significantly greater risk for both SI and Suicide

Subjects, which included both those with ADD and controls, were between 6 and 12 years old when the study began, now between the ages of 17 and 24, with a 95% study retention rate at the ten year mark. The results were published in the Journal of Consulting and Clinical Psychology in August, 2012.

Of the girls diagnosed with ADD-Combined Type, 51% reported self-harming, compared to 29% of girls with Inattentive ADD, and a significantly lower 19% of the control group.

Results regarding suicide were also surprisingly disproportionate: 22% of the girls diagnosed with ADD-Combined Type reported at least one suicide attempt within the past 10 years, compared with 8% in the Inattentive group and 6% of the controls.

So it would seem, from this ten year study, that over half of girls with ADD-Combined Type self-harm — which is over two and a half times the likelihood of a teen without ADD, and one and three-quarters times more likely than a teen with Inattentive ADD.

They are also almost four times more likely to attempt suicide than non-ADD teens and pre-teens, and three times more likely than girls with Inattentive ADD.

There were no significant differences regarding substance use, though young women in both ADD groups reported continuing ADD symptoms, greater incidences of other psychiatric problems, and a greater rate of use of psychiatric services.

Coming up in this article: I will continue to explain more about what’s going on, how ADD complicates the problem, what relatives and friends can do and say to make a positive difference, and what you might be tempted to do and say that will escalate the problem. I will also unpack what’s helpful and what’s not with The Butterfly Project.

Scroll down for “Regular” Related Content links, Self-Harm links immediately below
(Items **enclosed with stars** include visuals – if you self-harm, make SURE you are in an emotional place where viewing them will not precipitate an incident before you click)

Repeated Links

Help Wanted: If you are one of the relatively few individuals who is already dealing with this issue in a proactive fashion and want to add links to your articles on the topic in the comments section below, please DO. PLEASE link back, so that we can ALL help spread the word.

1st-person insights from cutters, recovering cutters and ex-cutters are welcome.

I will approve links to related content posted in the comments section as soon as I can verify that they are not link-spam (or shaming). If and when links reach a sufficient number to do so, I will compile and list in a separate “Self-Harm Related Content” post (similar to the one for sleep struggles and disorders).

—————————————————————————————————————————————
As always, if you want notification of new articles – in this Series, or any new posts on this blog – give your name and email to the nice form on the top of the skinny column to the right.  (You only have to do this once, so if you’ve already asked for notification about a prior series, you’re covered for this one too) STRICT No Spam Policy

If you’d like some one-on-one (or group) coaching help with anything that came up while you were reading this article (either for your own life, that of a loved one, or as coaching skills development), click the E-me link  <—here (or on the menubar at the top of every page) and I’ll get back to you ASAP (accent on the “P”ossible!)
—————————————————————————————————————————————

What Kind of World Articles & Related Inspiration:

Related articles around the ‘net

About Madelyn Griffith-Haynie, MCC, SCAC
Award-winning ADD Coach Training Field founder; ADD Coaching field co-founder; [life] Coaching pioneer -- Neurodiversity Advocate, Coach, Mentor & Poster Girl -- Multi-Certified -- 25 years working with EFD [Executive Functioning disorders] and struggles in hundreds of people from all walks of life. I developed and delivered the world's first ADD-specific coach training curriculum: multi-year, brain-based, and ICF Certification tracked. In addition to my expertise in ADD/EF Systems Development Coaching, I am known for training and mentoring globally well-informed ADD Coach LEADERS with the vision to innovate, many of the most visible, knowledgeable and successful ADD Coaches in the field today (several of whom now deliver highly visible ADD coach trainings themselves). For almost a decade, I personally sponsored and facilitated seven monthly, virtual and global, no-charge support and information groups The ADD Hours™ - including The ADD Expert Speakers Series, hosting well-known ADD Professionals who were generous with their information and expertise, joining me in my belief that "It takes a village to educate a world." I am committed to being a thorn in the side of ADD-ignorance in service of changing the way neurodiversity is thought about and treated - seeing "a world that works for everyone" in my lifetime. Get in touch when you're ready to have a life that works BECAUSE of who you are, building on strengths to step off that frustrating treadmill "when 'wanting to' just doesn't get it DONE!"

11 Responses to Self-Harm Specifics – ADD girls at greater risk

  1. Pingback: ABOUT ADD Comorbidities | ADD . . . and-so-much-more

  2. kindle fire hd review says:

    Hi there would you mind letting
    me know which web host you’re using? I’ve
    loaded your blog in 3 completely different internet browsers and I must say this blog
    loads a lot faster then most.

    Can you recommend a good internet
    hosting provider at a honest
    price? Thanks, I
    appreciate it!

    Like

    • ADDandSoMuchMore.com is hosted on the free WordPress.com platform. There are limitations, but there is also much to recommend it.

      It’s nice to hear that it’s working for you.

      I used the WordPress services to purchase my own domain name, otherwise they append “/wordpress.com” to your site name, and also popped for a CSS upgrade to be able to make a few site-specific tweaks to my theme to make it more ADD-friendly.

      WordPress.com has fairly comprehensive support information, if you will be flying solo.

      Good luck with setting up your own situation.
      xx,
      mgh

      Like

  3. Julia says:

    I am a former cutter – decades since I’ve done it, did it for decades before. Remember, like with anything mind-based, be careful how much attention you give the symptom. I can tell you this – both from personal experience and from others I have personally known who cut.

    The problem is not the cutting.

    Don’t over-emphasize the Cutting!@!! as if IT has some power of its own.

    If this is your child or your friend, try to help them find good help to work out their identity problems, their alternations between self-hatred and self-idealization (usually as a Goal, but still, holding onto the wishful fantasy to be Perfect).

    Often cutting has a sexual component…might be the result of abuse or prior incest, might be the result of fantasies that sprang from goodness-knows-what but that now feel out of control. Often cutting is the result of an extreme physical self-loathing, almost taking a kind of cruel pleasure is cutting up a hated body (and these are usually people who are only kind and gentle to others physically).

    The problem is not the cutting. It’s one way the problem is showing.

    I would shut down every website about cutting. Cutters mimic. As do many eating disorder sufferers. Helpers help best by not reacting too dramatically to the scarves and smoke in the magician’s act (the bloody scars). Keep your eyes on the magician, i.e., the mind that is in pain and unsure how to talk about itself.

    Words are the cure for cutting. But not others’ words – the cutter has to learn how to use her own voice.

    How did I stop finally?
    I lost interest.
    Not grand will power. Not “I conquered it!” or “I was cured!”
    I got to other issues, the stuff behind the cutting….and the urge to cut just left like yesterday’s ghost.
    Been there.
    Done it.
    It’s no life sentence.

    Just find someone good to talk with. And do some talking. Try not to cut. If you do, you do. Mostly, don’t make your day about cutting or not cutting. There are other things to work on – like Yourself.
    Best,
    Former Slice Girl

    Like

    • Thank you so much for your comments – well said, and a much appreciated point of view. You have obviously done some nice work on yourself – and underscoring “getting good help” from a “been there/done that Former Slice Girl” will go a lot farther than anything I could say.

      This is a follow-on to The Butterfly Project – which is going viral among the teens. The parenting sites are beginning to be quite concerned.

      Since this site is written for coaches and other helping professionals, as well as ADDers, EFDers, TBIers – and those who live with them – and since the late 2012 publication of the ADD and Girls longevity study found a bump-up in a particular habit that isn’t well known by most of the populace, I decided to do some research and share what I’ve discovered.

      Thanks for YOUR contribution. And congrats for being in a good place.

      xx,
      mgh

      PS.I added some spacing to make it easer for those who struggle with reading to be able to jump “from rock to rock” — I also added to your own emphasis with some bolding so it is more likely they will be seen and integrated (you can’t do that – it’s a back-stage thing.) Your WORDS remain.

      Like

  4. Mark Church says:

    Interesting article to read. As I was reading through, what came into my mind was ‘I wonder if the Fear Paralysis reflex and or the Moro reflex are still active in people who self harm?’

    MGH UPDATE 2/12/13: Click his name to go check out his content on these reflexes – VERY interesting & quite possibly highly useful!

    If you haven’t heard of the infant reflexes please do look them up as they are all part of our physical, emotional and cognitive development. The reflexes each have a role to play in developing areas of the brain neurologically and can sometimes not do their job sufficiently. The result is an immature neurological system especially to the Limbic system and prefrontal cortex where reasoning and rationalisation take place.

    I would check the FPR and Moro reflex as the FPR relates to withdrawal and overwhelm in stressful situations and the Moro is a reaction to being over excited, anxious, nervous, panicky, fearful, living on your nerves. I wonder if working to integrate these reflexes, if still active in these people’s system, would be of enormous help to their coping strategies that they would self harm a lot less to the point of not needing too.

    I am a Rhythmic Movement Training instructor and specialise in all types of stress in the UK. Hope this is of interest and helps.

    Like

    • VERY helpful, Mark. Sounds highly likely to me.

      I will take the time to look at both of those terms – thank you so much. I’d love to hear more about what you do – and I”ll bet my readers would too (I’ll scoot over to your site and look too — the internet has made the world a marble!)

      UPDATE 2/12/13: go check out his content – VERY interesting & quite possibly highly useful!

      MANY years ago (grad school in theatre) I did a secondary concentration in movement (Feldenkrais, Alexander, etc.) – and have read some of the more recent cerebellar theories that, IMHO, need more play with the public.

      I am also big on neuroscientists who work with embodied consciousness, but I’ll bet you have a depth of info I’d LOVE to know. Wanna’ guest post – this series or any? I’m especially interested in any articles you have written about reintegration (sleep disorder info too, btw.)- I’ll link them here to any posts that relate (in my “spare time” :|).

      Thanks for stopping by (& commenting). I’ll go read what you have posted on your site tonight — once I handle the daytime to-dos. Can’t wait!

      xx,
      mgh

      Like

  5. Very enlightening! Thanks, I’m just gonna click my way through lol xx

    Like

    • Glad to see you made it over to read this particular section of the “Butterfly (<–link)” article! Thanks for letting me know you were here.

      OTHER READERS – this comment is from a former SI sufferer who only recently posted an article about her experience on her blog, hoping to shed some light so that others could find their way – direct link to that article can be found above in the SI section under “Repeated Links.” (you can also click on her name above and search for “Mirror”)

      WELL worth your time to read!

      xx,
      mgh

      Like

      • It’ll be in small portions though lol, some articles are really long!! Love the new info on glia cells though, that’s pretty earth shattering.

        Like

        • SOME??? I am the champ of words ::vbg:: I tell people, “If you want long, you can have it quickly — give me a LOT longer if you need it brief.”

          I try to make the info worth it, but I know it can LOOK daunting (especially for some of the brain-based stuff with unfamiliar words)

          Good for you for jumping into the glial cell (<–link) stuff (and thanks for bringing it up because there is a link between that info and SI that I might have forgotten about but for you).

          Reading in chunks is a super strategy – tiny bites. MOST ADDers read “rock to rock” – which is why my paragraphs are sometimes only a sentence long) – read it aloud. I write like I talk (and I’m chatty!), so it will make sense that way, if only because it adds modalities for tracking focus.

          I WISH I had the bucks to read them all aloud and post the tape — but I’d have to win the lottery (or charge for content), so I write.

          Thanks again for your interest.
          xx,
          mgh

          PS – If you are talking about the linked content – some of those are VERY long. Pay attention to how much more difficult they are to read when they “run on” (meaning, no white space for your eyes to land on before they go again).

          Like

And what do YOU think? I'm interested.

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

%d bloggers like this: