Self-Injurious Behavior

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The American Mental Health Counselor conducted a national survey in 2007 reporting that mental health counselors are seeing an average of 12 clients per month engaging in self-injurious behavior (Trepal & Wester, 2007). Evidence suggests that these surveys represent only the minority; epidemiological studies confirm that the majority of young people do not seek professional help (Gollust, 2008; Michelmore & Hindley, 2012). This poses a big concern for me and I intend to open up a discussion on what hinders this population to seek help and what is our role as mental health counselors. Self-injurious behavior [SIB] is the intentional destruction of body tissue such as cutting, banging or hitting, burning and hair pulling without suicidal intent (Klonsky & Muehlenkamp, 2007). SIB functions as an emotional coping mechanism such as affect regulation, self-punishment, interpersonal influence, antidissociation, and sensation seeking; however, these coping strategies are maladaptive and potentially harmful (Mikolajczak et al, 2009).

Childhood trauma such as emotional or physical neglect, loss of a parent or significant other, and abuse has been the prevailing underlying stressor (Lesniak, 2010). Traumatized children believe that they lost their power to make changes or exert control over situations leaving them helpless in the face of overwhelming emotions (Perry, 2006); therefore, SIB serves to be their way of gaining control back. Young people perceive mental health services such as mandated medications, involuntary hospitalizations, and attempts of directly stopping these behaviors to be coercive and re-traumatizing (Fitzgerald et al, 2012). This apparently could be a reason for not seeking help because of fear of the reenactment of their loss of power and control (Michelmore & Hindley, 2012). I believe that mental health professionals should not focus on stopping self-injury behavior, but instead understanding behavior from the client’s perspective. It is...
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