Girl, 2, a victim of Forty Fort murder-suicide

FORTY FORT - Police said Nicholas Shultz shot his 2-year-old daughter and then turned the gun on himself, in what the Luzerne County Coroner's Office has ruled a murder-suicide.
Officers from Forty Fort and surrounding towns were dispatched to 52 Wesley St. at 11 a.m. Sunday on the report of a man with a gun threatening to kill himself and his daughter.
When police entered the house, they found a young girl, Camryn Lee Shultz, dead on the couch with one gunshot wound to the head, police said. Her father, Nicholas, 34, was found on the floor, also with one gunshot wound to the head, and was then transported to Geisinger Medical Center in Plains Township before eventually dying at the hospital, according to police.
Luzerne County District Attorney Stefanie Salavantis said the next step is an investigation to determine the cause of the shooting, as they have no official motive yet.
Tom Hess, Camryn's grandfather, told WBRE-TV that his daughter, Jessie, and the child had been staying with him for the past week ever since Jessie and Nicholas split up.
Hess told the station that his daughter received a chilling call from Nicholas on Sunday, in which he told her, "Say goodbye to your daughter."
Salavantis said she did not believe that Shultz had a past riddled with domestic nor criminal violence. A search through the Unified Judicial System of Pennsylvania Web Portal backed up her notion, as Shultz appears to have no criminal history in Luzerne County.
When asked if "senseless" was the correct word to describe this murder-suicide, Salavantis said, "That's the perfect word for this tragic day."
By Sunday's end, the yellow police tape that had surrounded the residence was taken down, replaced with a small assortment of stuffed animals and flowers outside the house.

Bullying is not on the rise and it does not lead to suicide

by Kelly McBride Published Oct. 25, 2013 8:00 am Updated Oct. 28, 2013 6:27 pm

 

Every other month or so a story about a child bullied until he or she commits suicide rises into our national consciousness.
This month it’s Rebecca Sedwick from Lakeland, Fla.
Before that it was Gabrielle Molina of Queens. And before that it Asher Brown.
All suicides are tragic and complicated. And teen suicides are particularly devastating because as adults we recognize all that lost potential.
Yet, in perpetuating these stories, which are often little more than emotional linkbait, journalists are complicit in a gross oversimplification of a complicated phenomenon. In short, we’re getting the facts wrong.
The common narrative goes like this: Mean kids, usually the most popular and powerful, single out and relentlessly bully a socially weaker classmate in a systemic and calculated way, which then drives the victim into a darkness where he or she sees no alternative other than committing suicide.
And yet experts – those who study suicide, teen behavior and the dynamics of cyber interactions of teens – all say that the facts are rarely that simple. And by repeating this inaccurate story over and over, journalists are harming the public’s ability to understand the dynamics of both bullying and suicide.
People commit suicide because of mental illness. It is a treatable problem and preventable outcome. Bullying is defined as an ongoing pattern of intimidation by a child or teenager over others who have less power.
Yet when journalists (and law enforcement, talking heads and politicians) imply that teenage suicides are directly caused by bullying, we reinforce a false narrative that has no scientific support. In doing so, we miss opportunities to educate the public about the things we could be doing to reduce both bullying and suicide.
There is no scientific evidence that bullying causes suicide. None at all. Lots of teenagers get bullied (between 1 in 4 and 1 in 3 teenagers report being bullied in real life, fewer report being bullied online). Very few commit suicide. Among the people who commit suicide, researchers have no good data on how many of them have been bullied.
It is journalistically irresponsible to claim that bullying leads to suicide. Even in specific cases where a teenager or child was bullied and subsequently commits suicide, it’s not accurate to imply the bullying was the direct and sole cause behind the suicide.
Reporters are often reacting to other misinformed authorities.  For example, Polk County Sheriff Grady Judd explained to reporters that he arrested two girls (one 12, the other 14) in Sedwick’s death, after seeing a callous social media post from one of the girls, “We can’t leave her out there, who else is she going to torment? Who else is she going to harass? Who is the next person she verbally and mentally abuses and attacks?” While it’s a great quote, it implies that this girl has the ability, through random meanness, to inspire others to commit suicide.
“Everything we know about unsafe reporting is being done here – describing the method(s), the simplistic explanation (bullying = suicide), the narrative that bullies are the villains and the girl that died, the victim,” Wylie Tene, the public relations manager for the American Foundation for Suicide Prevention, wrote in an email to me. “She (the victim) is almost portrayed as a hero. Her smiling pictures are now juxtaposed with the two girls’ mug shots. Her parents are portrayed as doing everything right, and the other girls parents did everything wrong and are part of the problem. This may be all true, and it also may be more complicated.”
Sheriff Judd has a record of grandstanding for the media. Yet, journalists are running with his narrative, despite the fact that experts on bullying and on suicide are suggesting that there has to be more to the story.
What’s a journalist to do? Challenge the sheriff. Add more information to place his quotes in the appropriate context.
“Clearly allowing police to make statements about whether a bullying incident was the cause of the suicide is contrary to suicide reporting recommendations. He has no training to make this judgment,” said Dan Romer,  director of the Adolescent Communication Institute at the Annenberg Public Policy Center at the University of Pennsylvania. “It would have been good if those quotes had been put into context if they felt the need to include them.  At this point, the stories are a lot of hearsay.  So, it’s a shame that the girls are being identified.  But this sheriff is clearly on the warpath about this and he can get all the media attention he wants.”
Remember the story of Phoebe Prince, a young Irish immigrant attending South Hadley High School near Boston? After she committed suicide in 2009, several of her classmates were charged with a variety of crimes. Slate writer Emily Bazelon went back and documented exactly what happened to Prince in the months leading up to her death.
Bazelon described how several of the students were active or complicit in acts of meanness, including veiled references to Prince on Facebook and yelling at Prince from a car. But those acts hardly amounted to the relentless campaign that authorities described when they announced the investigation and charges. Instead, Bazelon’s story reveals a girl who was already experiencing mental illness when she arrived at South Hadley and stepped into an intricate and nuanced social reality that includes bad behavior as well as acts of compassion, sometimes by the same kids.
Bazelon has offered a cautionary approach to Sedwig’s story as well.
When faced with a story about bullying, especially one that involves teenage suicide, reporters can find resources designed to encourage reporting that informs and educates the public. StopBullying.gov recently published media guidelines designed to help journalists include research and resources in their stories that will add important context and avoid common pitfalls. (In 2012, I facilitated several meetings with a group of researchers and experts who advised the government on the creation of these guidelines.)
There are also helpful resources for journalists covering suicide.
While there are myriad mistakes that journalists make on these two issues, here are some of the most common ones:

• Perpetuating falsehoods through hyperbole or by confusing anecdotes with facts, such as stating that cyber-bullying is on the rise or is an epidemic.
• Implying that suicide is caused by a single factor, like a romantic breakup, a bad test score or being bullied.
• Suggesting, or allowing others to suggest, that bullying is criminal behavior.
• Allowing sources to reach beyond their anecdotal experience. Parents, teachers and school administrators are rarely qualified to describe research or trends.
• Equating all teenage aggression as bullying, when in fact there is a specific definition that involves sustained behavior and a power imbalance.
• Describing an act of suicide in vivid detail so that it creates a contagion effect among vulnerable populations.
• Glorifying a suicide victim in saintly or heroic terms, which could also contribute to the spread of suicides.
• Forgetting to link to local and national resources about suicide and bullying, including warning signs and strategies for intervention.

One reason these stories gain such traction is they are easy to sensationalize and they tap into a common narrative that children today are spinning out of control as a result of technology and popular culture. “It’s every parent’s worst nightmare,” the news stories and opinion pieces tell us.
By contrast, this Christian Science Monitor story seeks out experts and arms readers with research, facts and resources.
Reporters looking for more motivation to steer clear of the popular, yet erroneous narrative need only look at the way this story echoes through history. Whether it’s the proliferation of cars, rock n’ roll music on the radio, video games, cell phones, or social media, we find ways to demonize technology’s impact on the young people who embrace it with such enthusiasm. Over time, we look back and marvel at our own hysteria.
Bullying and suicide are serious problems. Journalists owe the public more than they are delivering. We owe the public the science and research. We owe the public the knowable facts. We owe the public the nuanced context of individual cases.
Anything less contributes to a misinformed society, which robs communities of the ability to bring about meaningful change.

Pain and deliberate self-harm

Pain and deliberate self-harm

Michaela Swales

 

Deliberate self-harm is a troubling aspect of adolescence (and possibly even adulthood) that appears to be on the increase. Its relationship with pain is uncertain, but for many self-harm is not so much about the inflicting of physical pain as the cessation of emotional pain.

For many people the idea of deliberately harming oneself is difficult to conceptualize. Many of us may spend our time attempting to avoid harm to ourselves either in the short-term (wearing a seat-belt) or in the long-term (exercising regularly, eating a healthy diet). Many of us would flinch from the idea of wilfully inflicting acute damage to our own bodies. How then can we understand individuals for whom harming the self is not something that they avoid or find aversive but is something that they seek out?
Deliberate self-harm is a term that covers a wide range of behaviours some of which are directly related to suicide and some that are not. This is a relatively common behaviour that is little understood.
What is deliberate self-harm?
Deliberate self-harm is a term that covers a variety of behaviours, with a multitude of different functions and a wide range of intentions. Perhaps the most useful definition is from Professor Keith Hawton and colleagues at the Centre for Suicide Research in Oxford (Hawton et al, 2002):
An act with a non-fatal outcome in which an individual deliberately did one or more of the following:

• initiated a behaviour (e.g. self-cutting, jumping from a height) which they intended to cause harm to the self);
• ingested a substance in excess of the prescribed or generally recognized therapeutic dose;
• ingested a recreational or illicit drug (which they intended to cause harm to the self);
• ingested a non-ingestible substance or object (e.g. batteries, razor blades).
  

Two elements are crucial: there is acute damage to the self (this excludes, therefore, behaviours such as smoking or eating an unhealthy diet); and damage is intentional (therefore, excluding accidents or behaviours such as starving where the motive is to lose weight as in anorexia nervosa).
Some clinicians and researchers draw distinctions between forms of deliberate self-harm where there is or is not an intention to die, distinguishing attempted suicide from self-harm or self-mutilation. There is some validity to this distinction. For some people, deliberate self-harm is more about finding a way of coping with life rather than ending it.
Nevertheless, regardless of the method or motive, harming the self seems to put people at risk of more severe forms of self-harm over time. In addition, even for people who primarily think of self-harm (e.g. cutting) as a way of coping, they may at other times harm themselves in other ways where they do have the intention to die. The potential lethality of a method adopted by an individual is not always an accurate indicator of his or her intent. Very few people who harm themselves have sufficient knowledge about how the body works to judge the impact of their actions.
How common is deliberate self-harm?
This is a difficult question to answer accurately. Some methods of measuring the behaviour (e.g. counting everyone who attends an Accident and Emergency department after harming themselves) underestimate the milder forms of self-harm (e.g. self-cutting), much of which is carried out in secret. In a recent UK study with a community sample (Hawton, Rodham, Evans and Weatherall, 2002), 6.9 per cent of a school population of 15 and 16 year olds had engaged in an act of deliberate self-harm in the previous year. Only 12.6 per cent of these episodes had led to a hospital visit. These figures are similar to those from a US sample (Centers for Disease Control. Attempted Suicide among High School Students – United States 1990).
While deliberate self-harm is particularly common among adolescents and has been on the rise in recent years, it continues into adulthood. Its incidence and prevalence in adulthood is also difficult to estimate accurately, and figures based on hospital attendance again probably underestimate its impact. One review (Favazza and Rosenthal, 1993) reported prevalence estimates of between 400 and 1400 per 100 000 of population per year.
While there is an increasing awareness of the risk of suicide in older adults, less is known about deliberate self-harm in the older population. It has often been assumed that the behaviour declines as people age. It may be, however, that the behaviour is even more taboo in older adults than in the young.
Who is at risk?
There are a number of risk factors for the development of deliberate self-harm. Females are more likely to engage in the behaviour than males, although rates in males have been rising recently. Also, males in particular are at more risk of suicide. Some of the other main risk factors are:
Childhood experiences

• Sexual abuse
• Neglect
• Emotional abuse
• Physical abuse
• Loss or separation
• Parental mental health problems
• Parental substance misuse.

Current experiences:

• Rape/sexual abuse
• Domestic violence
• Psychiatric diagnoses
• Substance misuse (both alcohol and drugs).
  

Not everyone that experiences these events goes on to self-harm. So what are the links between these experiences and the development of deliberate self-harm?
There are a number of different theories but two common themes are apparent. The first is the experience of intense and distressing emotions. These may be related to particular experiences, such as sexual or physical abuse.
The second factor is the absence of the right kind of emotional support. In other words, the child (or in some cases the adult) is not provided with the assistance to recognize and understand their responses to the events they are experiencing. In some cases, for example sexual abuse in childhood, the fact that the experience occurred at all may be denied. The absence of recognition and support in the context of extreme and distressing events leads to a sense of powerlessness, and an incapacity to understand and manage painful feelings. Linehan (1993) refers to these environments as 'invalidating' because the individual's experience of reality and their responses to it go unrecognized and unsupported.
Why do people deliberately self-harm?
In the context of intense and distressing emotions and the absence of emotional support, deliberate self-harm can come to fulfil a number of different functions (Babiker and Arnold, 1997; Gratz, 2003; Williams, 2001):

• Deliberate self-harm as a coping mechanism. Deliberate self-harm can help in the short-term management of problematic emotions (harming the self seems to decrease the intensity of some emotions) and can therefore be experienced as stress-relieving. For some, the desire to terminate unpleasant emotional states is so strong that they want to interrupt consciousness either temporarily by sleep or permanently by death.
  
  However, the emotion-reducing effects rarely last for long (minutes to a few hours), and self-harm in the longer term can be a source of stress in itself. People may feel ashamed of the behaviour, or distressed by the scars that are left. In addition the disapproval or worry of others around them may lead to interpersonal conflict. Also, the short-term nature of the relief can lead to a sense of not really being successful in solving the problem.
  
  As well as helping in the regulation of emotions, deliberate self-harm can also help some people regulate unpleasant self-states, for example dissociation (feeling disconnected from reality) or depersonalization (feeling unreal or in some extreme cases as if you are dead). These self-states, relatively common after trauma, are extremely distressing and unsettling. Harming the self can bring an abrupt return to the reality of the moment or to an increased sense of being 'alive'.
  
  The short-term effectiveness of deliberate self-harm in reducing emotions, or in effecting a 'return to reality', can provide an increased sense of mastery and control, which may be important for individuals who feel out of control and powerless to change their circumstances or experiences.
  
  
• Deliberate self-harm as a form of self-punishment: For many individuals, the behaviour acts as a re-enactment of past experiences where they have been traumatized and abused. Following a history of abuse or neglect it is not uncommon for people to believe that they are evil or bad (they may have been told this directly by the person who harmed them or they may believe this was why they were being harmed) and deserve to be punished. Harming the self is a way of delivering the punishment that they feel they deserve for being 'bad' and to blame.
  
  
• Deliberate self-harm as a means of validating the self: As described earlier, for many individuals who have been traumatized or abused or neglected there was no recognition of their experiences and the events that so damaged them may have been actively denied. For such individuals, deliberate self-harm is a way of testifying to the enormity of their experience and a way of remembering events that others may have forgotten or denied. For some it is a way of confirming or authenticating that what they suffered really was as traumatic as they remember.
  
  
• Deliberate self-harm as a means of influencing others: In some circumstances harming the self can be a way of communicating distress that is not heeded when communicated in words. At other times self-harm can be a means to influence others, either to care for the person who has harmed or to keep others at a distance.
  
  Often, more than one function may be relevant. For example, cutting the self may serve both to regulate anxiety and to validate the severity of current emotional pain. It is very important not to make assumptions about the function of a particular episode of self-harm without understanding both the behaviour itself and the person who has harmed.
  
  Often professionals and family members make the mistake of assuming that all episodes of self-harm are about influencing them or other key people in the environment, because the other aspects (reduction of emotional pain, self-validation) are hidden to the outside observer. Because they are experiencing a response to the self-harm, they make the (often mistaken) assumption that the person who has self-harmed intended to make them feel this way. This is not always the case.
  
  

Deliberate self-harm and pain
The above suggests that the experience of physical pain may only be relevant in some forms of deliberate self-harm, for example, cutting. Other actions (e.g. taking an overdose) do not involve any immediate physical pain. Also, the experience of pain will vary from person to person and from episode to episode. Some individuals feel little or no pain at the time of the injury but do so later. Others experience pain at the time, and it is the experience of physical pain that is essential in the relief of the emotional pain. For many, handling physical pain (in the short run) is described as 'easier' than dealing with the enormity of their emotional pain.
The biological bases of the relationship between self-harm and pain is, as yet, unclear. Some theorists have argued that early experience of trauma damages certain neuroanatomical pathways in the brain related to the release of endorphins, which are implicated in the regulation of emotional states. In individuals whose neural pathways are affected in this way, it is suggested that deliberate self-harm may offer a means of releasing endorphins. Others have noted changes in the brain systems utilizing the neurotransmitter serotonin in both suicide and deliberate self-harm. The role of these systems in both the development and maintenance of deliberate self-harm behaviours remains to be fully elucidated.
Treatment interventions
The National Institute of Clinical Excellence (NICE) is in the process of producing a guideline on the management of deliberate self-harm. For this guideline a thorough review of available treatments was conducted. The evidence base was found to be very small and consequently it was difficult to make firm recommendations about effective treatments at this stage. The draft guideline can be located on the NICE website.
There is some debate among therapists and people who self-harm about whether deliberate self-harm should form a primary focus of treatment. Some therapists advocate addressing the underlying problems in the past (and also in the present) that lead to the behaviour, rather than focusing on the behaviour itself. They argue that when these problems are resolved the behaviour will cease.
Other therapeutic schools suggest that the deliberate self-harm should be a primary focus for treatment, particularly when the behaviour is especially frequent or particularly severe, or associated with significant mental health disorders, as failure to do so places the person at risk. Which is the effective option for any one individual is likely to depend on a number of factors, such as the severity of the self-harm, whether the individual is highly suicidal or not, their capacity to function generally, their own preference for therapeutic approach and a thorough understanding of how the deliberate self-harm relates to other aspects of the person's life.
For individuals who harm themselves who also present with very severe and complex mental health problems that would fit the diagnostic criteria known as borderline personality disorder, there is relatively good evidence for the effectiveness of dialectical behaviour therapy (Linehan, 1993). This therapy recognizes the importance of both managing problematic emotions and situations when they arise, by using a wide range of techniques derived from cognitive behaviour therapy, as well as understanding why it is that deliberate self-harm and other behaviours that may also be considered impulsive are effective for people with very traumatic pasts.

Mental Health & Self Injury

How Is Self-Injury Diagnosed?

If an individual shows signs of self-injury, a mental health professional with self-injury expertise should be consulted. That person will be able to make an evaluation and recommend a course of treatment. Self-injury can be a symptom of psychiatric illness including:

• Personality disorders (particularly borderline personality disorder)
• Bipolar disorder
• Major depression
• Anxiety disorders (particularly obsessive-compulsive disorder)
• Schizophrenia

How Is Self-Injury Treated?

Treatment for self-injury may include:

• Psychotherapy:  Counseling can be used to help a person stop engaging in self-injury.
• Dialectical Behavior Therapy (DBT): DBT is a group- and individually-based treatment program that helps people gain greater mastery over self-destructive impulses (such as self-injury), learn ways to better tolerate distress, and acquire new coping skills through techniques such as mindfulness.
• Post-traumatic stress therapies: These may be helpful for self-injurers who have a history of abuse or incest.
• Group therapy: Talking about your condition in a group setting to people who have similar problems may be helpful in decreasing the shame associated with self-harm, and in supporting healthy expression of emotions.
• Family therapy: This type of therapy addresses any history of family stress related to the behavior and can help family members learn to communicate more directly and openly with each other.
• Hypnosis and other self-relaxation techniques: These approaches are helpful in reducing the stress and tension that often precede incidents of self-injury.
• Medications: Antidepressants or anti-anxiety medication may be used to reduce the initial impulsive response to stress.

What Is the Outlook for People Who Engage in Self-Injury?

The prognosis for self-injurious behavior varies depending upon a person's emotional or psychological state. It is important to determine the factors that lead to an individual's self-injuring behaviors, and to identify and treat any pre-existing personality disorders.

Mental Health and Self-Injury

Mental Health and Self-Injury

Share this:

Font size:

AAA

Self injury, also called self-harm, self-mutilation, or simply cutting, is defined as any intentional injury to one's own body. Usually, self-injury leaves marks or causes tissue damage. Self-injury can involve any of the following behaviors:

• Cutting
• Burning (or "branding" with hot objects)
• Excessive body piercing or tattooing
• Picking at skin or re-opening wounds
• Hair-pulling (trichotillomania)
• Head-banging
• Hitting (with hammer or other object)
• Bone-breaking

Most who engage in self-injury act alone rather than in groups. They also attempt to hide their behavior.

Recommended Related to Mental Health

Dysthymia

Important It is possible that the main title of the report Dysthymia is not the name you expected. Please check the synonyms listing to find the alternate name(s) and disorder subdivision(s) covered by this report.

Read the Dysthymia article > >

Who Is More Likely to Engage in Self-Injury?

Self-injury occurs across the spectrum; the behavior is not limited by education, age, race, sexual orientation, socioeconomic status, or religion. However, self-injury occurs more often among:

• Adolescent females
• People who have a history of physical, emotional, or sexual abuse
• People who have co-existing problems of substance abuse, obsessive-compulsive disorder, or eating disorders
• Individuals who were often raised in families that discouraged expression of anger
• Individuals who lack skills to express their emotions and lack a good social support network

What Leads to Self-Injury?

Self-injury usually occurs when people face what seem like overwhelming or distressing feelings. It can also be an act of rebellion and/or rejection of parents' values and a way of individualizing oneself. Sufferers may feel that self-injury is a way of:

• Temporarily relieving intense feelings, pressure, or anxiety.
• Being a means to control and manage pain - unlike the pain experienced through physical or sexual abuse or trauma.
• Providing a way to break through emotional numbness (the self-anesthesia that allows someone to cut without feeling pain).
• Asking for help in an indirect way or drawing attention to the need for help.
• Attempting to affect others by manipulating them, trying to make them care, trying to make them feel guilty, or trying to make them go away.

Self-injury also may be a reflection of a person's self-hatred. Some self-injurers are punishing themselves for having strong feelings that they were usually not allowed to express as children. They also may be punishing themselves for somehow being bad and undeserving. These feelings are an outgrowth of abuse and a belief that the abuse was deserved.

Although self-inflicted injury may result in life-threatening damage, it is not considered to be suicidal behavior.

What Are the Symptoms of Self-Injury?

The symptoms of self-injury include:

• Frequent cuts and burns that cannot be explained
• Self-punching or scratching
• Needle sticking
• Head banging
• Eye pressing
• Finger or arm biting
• Pulling out one's hair
• Picking at one's skin

Warning Signs of Self-Injury

Signs that an individual may be engaging in self-injury include:

• Wearing of pants and long sleeves in warm weather.
• The appearance of lighters, razors, or sharp objects that one would not expect among a person's belongings.
• Low self-esteem.
• Difficulty handling feelings.
• Relationship problems.
• Poor functioning at work, school, or home.

Cutting & Self-Harm

Self-Injury Help, Support, and Treatment

Share:

Self-harm can be a way of coping with problems. It may help you express feelings you can’t put into words, distract you from your life, or release emotional pain. Afterwards, you probably feel better—at least for a little while. But then the painful feelings return, and you feel the urge to hurt yourself again. If you want to stop but don’t know how, remember this: you deserve to feel better, and you can get there without hurting yourself.

In This Article:

• Understanding cutting and self-harm
• Signs and symptoms
• How does self-harm help?
• Confide in someone
• Figure out why you cut
• Find new coping techniques
• Professional treatment
• Helping a friend or family member

Understanding cutting and self-harm

Self-harm is a way of expressing and dealing with deep distress and emotional pain. As counterintuitive as it may sound to those on the outside, hurting yourself makes you feel better. In fact, you may feel like you have no choice. Injuring yourself is the only way you know how to cope with feelings like sadness, self-loathing, emptiness, guilt, and rage.
The problem is that the relief that comes from self-harming doesn’t last very long. It’s like slapping on a Band-Aid when what you really need are stitches. It may temporarily stop the bleeding, but it doesn’t fix the underlying injury. And it also creates its own problems.
If you’re like most people who self-injure, you try to keep what you’re doing secret. Maybe you feel ashamed or maybe you just think that no one would understand. But hiding who you are and what you feel is a heavy burden. Ultimately, the secrecy and guilt affects your relationships with your friends and family members and the way you feel about yourself. It can make you feel even more lonely, worthless, and trapped.

Myths and facts about cutting and self-harm

Because cutting and other means of self-harm tend to be taboo subjects, the people around you—and possibly even you—may harbor serious misconceptions about your motivations and state of mind. Don’t let these myths get in the way of getting help or helping someone you care about.
Myth: People who cut and self-injure are trying to get attention.
Fact: The painful truth is that people who self-harm generally do so in secret. They aren’t trying to manipulate others or draw attention to themselves. In fact, shame and fear can make it very difficult to come forward and ask for help.
Myth: People who self-injure are crazy and/or dangerous.
Fact: It is true that many people who self-harm suffer from anxiety, depression, or a previous trauma—just like millions of others in the general population. Self-injury is how they cope. Slapping them with a “crazy” or “dangerous” label isn’t accurate or helpful.
Myth: People who self-injure want to die.
Fact: Self-injurers usually do not want to die. When they self-harm, they are not trying to kill themselves—they are trying to cope with their pain. In fact, self-injury may be a way of helping themselves go on living. However, in the long-term, people who self-injure have a much higher risk of suicide, which is why it’s so important to seek help.
Myth: If the wounds aren’t bad, it’s not that serious.
Fact: The severity of a person’s wounds has very little to do with how much he or she may be suffering. Don’t assume that because the wounds or injuries are minor, there’s nothing to worry about.

Signs and symptoms of cutting and self-harm

Self-harm includes anything you do to intentionally injure yourself. Some of the more common ways include:

• cutting or severely scratching your skin
• burning or scalding yourself
• hitting yourself or banging your head
• punching things or throwing your body against walls and hard objects
• sticking objects into your skin
• intentionally preventing wounds from healing
• swallowing poisonous substances or inappropriate objects

Self-harm can also include less obvious ways of hurting yourself or putting yourself in danger, such as driving recklessly, binge drinking, taking too many drugs, and having unsafe sex.

Warning signs that a family member or friend is cutting or self-injuring

Because clothing can hide physical injuries, and inner turmoil can be covered up by a seemingly calm disposition, self-injury can be hard to detect. However, there are red flags you can look for (but remember—you don’t have to be sure that you know what’s going on in order to reach out to someone you’re worried about):

• Unexplained wounds or scars from cuts, bruises, or burns, usually on the wrists, arms, thighs, or chest.
• Blood stains on clothing, towels, or bedding; blood-soaked tissues.
• Sharp objects or cutting instruments, such as razors, knives, needles, glass shards, or bottle caps, in the person’s belongings.
• Frequent “accidents.” Someone who self-harms may claim to be clumsy or have many mishaps, in order to explain away injuries.
• Covering up. A person who self-injures may insist on wearing long sleeves or long pants, even in hot weather.
• Needing to be alone for long periods of time, especially in the bedroom or bathroom.
• Isolation and irritability. 

How does cutting and self-harm help?

In your own words

• “It expresses emotional pain or feelings that I’m unable to put into words. It puts a punctuation mark on what I’m feeling on the inside!”
• “It’s a way to have control over my body because I can’t control anything else in my life.”
• “I usually feel like I have a black hole in the pit of my stomach, at least if I feel pain it’s better than feeling nothing.”
• “I feel relieved and less anxious after I cut. The emotional pain slowly slips away into the physical pain.”

It’s important to acknowledge that self-harm helps you—otherwise you wouldn’t do it. Some of the ways cutting and self-harming can help include:

• Expressing feelings you can’t put into words
• Releasing the pain and tension you feel inside
• Helping you feel in control
• Distracting you from overwhelming emotions or difficult life circumstances
• Relieving guilt and punishing yourself
• Making you feel alive, or simply feel something, instead of feeling numb

Once you better understand why you self-harm, you can learn ways to stop self-harming, and find resources that can support you through this struggle.

If self-harm helps, why stop?

• Although self-harm and cutting can give you temporary relief, it comes at a cost. In the long term, it causes far more problems than it solves.
• The relief is short lived, and is quickly followed by other feelings like shame and guilt. Meanwhile, it keeps you from learning more effective strategies for feeling better.
• Keeping the secret from friends and family members is difficult and lonely.
• You can hurt yourself badly, even if you don’t mean to. It’s easy to misjudge the depth of a cut or end up with an infected wound.
• If you don’t learn other ways to deal with emotional pain, it puts you at risk for bigger problems down the line, including major depression, drug and alcohol addiction, and suicide.
• Self-harm can become addictive. It may start off as an impulse or something you do to feel more in control, but soon it feels like the cutting or self-harming is controlling you. It often turns into a compulsive behavior that seems impossible to stop.

The bottom line: self-harm and cutting don’t help you with the issues that made you want to hurt yourself in the first place.

Help for cutting and self-harm step 1: Confide in someone

Need help for self-harm?

If you’re not sure where to turn, call the S.A.F.E. Alternatives information line in the U.S. at (800) 366-8288 for referrals and support for cutting and self-harm. For helplines in other countries, see Resources and References below.
In the middle of a crisis?
If you’re feeling suicidal and need help right now, call the National Suicide Prevention Lifeline in the U.S. at (800) 273-8255. For a suicide helpline outside the U.S., visit Befrienders Worldwide.

If you’re ready to get help for cutting or self-harm, the first step is to confide in another person. It can be scary to talk about the very thing you have worked so hard to hide, but it can also be a huge relief to finally let go of your secret and share what you’re going through.
Deciding whom you can trust with such personal information can be difficult. Choose someone who isn’t going to gossip or try to take control of your recovery. Ask yourself who in your life makes you feel accepted and supported. It could be a friend, teacher, religious leader, counselor, or relative. But you don’t necessarily have to choose someone you are close to.
Eventually, you’ll want to open up to your inner circle of friends and family members, but sometimes it’s easier to start by talking to an adult who you respect—such as a teacher, religious leader, or counselor - who has a little more distance from the situation and won’t find it as difficult to be objective.

Tips for talking about cutting and self-harm

• Focus on your feelings. Instead of sharing sensational details of your self-harm behavior—what specifically you do to hurt yourself—focus on the feelings or situations that lead to it. This can help the person you’re confiding in better understand where you’re coming from. It also helps to let the person know why you’re telling them. Do you want help or advice from them? Do you simply want another person to know so you can let go of the secret?
• Communicate in whatever way you feel most comfortable. If you’re too nervous to talk in person, consider starting off the conversation with an email or letter (although it’s important to eventually follow-up with a face-to-face conversation). Don’t feel pressured into sharing things you’re not ready to talk about. You don’t have to show the person your injuries or answer any questions you don’t feel comfortable answering.  
• Give the person time to process what you tell them. As difficult as it is for you to open up, it may also be difficult for the person you tell—especially if it’s a close friend or family member. Sometimes, you may not like the way the person reacts. Try to remember that reactions such as shock, anger, and fear come out of concern for you. It may help to print out this article for the people you choose to tell. The better they understand self-harm, the better able they’ll be to support you.

Talking about self-harm can be very stressful and bring up a lot of emotions. Don’t be discouraged if the situation feels worse for a short time right after sharing your secret. It’s uncomfortable to confront and change long-standing habits. But once you get past these initial challenges, you’ll start to feel better.

Help for cutting and self-harm step 2: Figure out why you cut

Learn to manage overwhelming stress and emotions

Learn to recognize & accept your emotions

Watch 3-min. video: Developing emotional awareness

Understanding why you cut or self-harm is a vital first step toward your recovery. If you can figure out what function your self-injury serves, you can learn other ways to get those needs met—which in turn can reduce your desire to hurt yourself.

Identify your self-harm triggers

Remember, self-harm is most often a way of dealing with emotional pain. What feelings make you want to cut or hurt yourself? Sadness? Anger? Shame? Loneliness? Guilt? Emptiness?
Once you learn to recognize the feelings that trigger your need to self-injure, you can start developing healthier alternatives.

Get in touch with your feelings

If you’re having a hard time pinpointing the feelings that trigger your urge to cut, you may need to work on your emotional awareness. Emotional awareness means knowing what you are feeling and why. It’s the ability to identify and express what you are feeling from moment to moment and to understand the connection between your feelings and your actions.
The idea of paying attention to your feelings—rather than numbing them or releasing them through self-harm—may sound frightening to you. You may be afraid that you’ll get overwhelmed or be stuck with the pain. But the truth is that emotions quickly come and go if you let them. If you don’t try to fight, judge, or beat yourself up over the feeling, you’ll find that it soon fades, replaced by another emotion. It’s only when you obsess over the feeling that it persists.

Help for cutting and self-harm step 3: Find new coping techniques

Self-harm is your way of dealing with feelings and difficult situations. So if you’re going to stop, you need to have alternative ways of coping in place so you can respond differently when you start to feel like cutting or hurting yourself.

If you cut to express pain and intense emotions

• Paint, draw, or scribble on a big piece of paper with red ink or paint
• Express your feelings in a journal
• Compose a poem or song to say what you feel
• Write down any negative feelings and then rip the paper up
• Listen to music that expresses what you’re feeling

If you cut to calm and soothe yourself

• Take a bath or hot shower
• Pet or cuddle with a dog or cat
• Wrap yourself in a warm blanket
• Massage your neck, hands, and feet
• Listen to calming music

If you cut because you feel disconnected and numb

• Call a friend (you don’t have to talk about self-harm)
• Take a cold shower
• Hold an ice cube in the crook of your arm or leg
• Chew something with a very strong taste, like chili peppers, peppermint, or a grapefruit peel.
• Go online to a self-help website, chat room, or message board

If you cut to release tension or vent anger

• Exercise vigorously—run, dance, jump rope, or hit a punching bag
• Punch a cushion or mattress or scream into your pillow
• Squeeze a stress ball or squish Play-Doh or clay
• Rip something up (sheets of paper, a magazine)
• Make some noise (play an instrument, bang on pots and pans)

Substitutes for the cutting sensation

• Use a red felt tip pen to mark where you might usually cut
• Rub ice across your skin where you might usually cut
• Put rubber bands on wrists, arms, or legs and snap them instead of cutting or hitting

Source: The Mental Health Foundation, UK

Professional treatment for cutting and self-harm

You may also need the help and support of a trained professional as you work to overcome the self-harm habit, so consider talking to a therapist. A therapist can help you develop new coping techniques and strategies to stop self-harming, while also helping you get to the root of why you cut or hurt yourself.
Remember, self-harm doesn’t occur in a vacuum. It’s an outward expression of inner pain—pain that often has its roots in early life. There is often a connection between self-harm and childhood trauma.
Self-harm may be your way of coping with feelings related to past abuse, flashbacks, negative feelings about your body, or other traumatic memories. This may be the case even if you’re not consciously aware of the connection.

Finding the right therapist

Finding the right therapist may take some time. It’s very important that the therapist you choose has experience treating both trauma and self-injury. But the quality of the relationship with your therapist is equally important. Trust your instincts. If you don’t feel safe, respected, or understood, find another therapist.
There should be a sense of trust and warmth between you and your therapist. This therapist should be someone who accepts self-harm without condoning it, and who is willing to help you work toward stopping it at your own pace. You should feel at ease with him or her, even while talking through your most personal issues.

Helping a friend or family member who cuts or self-harms

Perhaps you’ve noticed suspicious injuries on someone close to you, or that person has confided to you that he or she is cutting. Whatever the case may be, you may be feeling unsure of yourself. What should you say? How can you help?

• Deal with your own feelings. You may feel shocked, confused, or even disgusted by self-harming behaviors—and guilty about admitting these feelings. Acknowledging your feelings is an important first step toward helping your loved one.
• Learn about the problem. The best way to overcome any discomfort or distaste you feel about self-harm is by learning about it. Understanding why your friend or family member is self-injuring can help you see the world from his or her eyes.
• Don’t judge. Avoid judgmental comments and criticism—they’ll only make things worse. The first two tips will go a long way in helping you with this. Remember, the self-harming person already feels ashamed and alone.
• Offer support, not ultimatums. It’s only natural to want to help, but threats, punishments, and ultimatums are counterproductive. Express your concern and let the person know that you’re available whenever he or she wants to talk or needs support.
• Encourage communication. Encourage your loved one to express whatever he or she is feeling, even if it’s something you might be uncomfortable with. If the person hasn’t told you about the self-harm, bring up the subject in a caring, non-confrontational way: “I’ve noticed injuries on your body, and I want to understand what you’re going through.”

If the self-harmer is a family member, especially if it is your child, prepare yourself to address difficulties in the family. This is not about blame, but rather about learning ways of dealing with problems and communicating better that can help the whole family.

Sister shares story of brother's suicide after prescription drug addiction

Sister shares story of brother's suicide after prescription drug addiction

Posted: Oct 29, 2013 9:49 AM EST Updated: Oct 29, 2013 10:00 AM EST By Lisa Robbins, Reporter

Nearly four months after his death, Lora Vance fights back tears when she talks about her younger brother, David Lawhon.
David was only 41-years-old when he committed suicide after a difficult battle with prescription drugs.
"It's just really broken me and I'm a very strong person. This has really broken me. It's broken my whole family," she said.
Lora said her family had no idea David was addicted to pain pills until they read his suicide letter. In it, he said he was addicted to pain pills, and he was sorry. He said the pills took away his physical and mental pain. He also revealed he heard voices in his head in the days leading up to his death. Lora suspects he was broke and didn't have any money to feed his addiction. She thinks the hallucinations played a role in his suicide.
David was an accomplished construction worker, loving father and grandfather, and all around amazing man, she said.
She decided to share his story in the hopes it will help other families who are going through the same thing.
"My family has gone through a lot since my brother, and I just don't want to see another family go through what we've gone through," he said.
David hid his addiction well. However, when Lora looks back at his old pictures, she notices something isn't right.
"You could see in his face that he wasn't happy. You could see the pain in his eyes."
After his death, Lora uncovered shocking details about his addiction.
"You could see on his bank accounts that he was withdrawing $800 a day sometimes," she said.
She also suspects he was ordering pain pills online from Canadian pharmacies. She researched some of the websites in question and was shocked at how easy it is to do.
"I don't know that they are all easy to do like that, but the couple that I did, I got clear to putting my credit card information in. I didn't need a prescription, I didn't need anything," she said.
Lora said her faith in God is helping her heal, but she has a long road ahead of her to make sense of it all.
"I've really leaned on my church family. I don't know what I would have done without my church family through all of this," she said.
According to the American Foundation for Suicide Prevention, there are many warning signs to look for in suicidal people.  These signs include mental disorders, alcohol and drug abuse, changes in eating and sleeping habits, withdrawing from family and friends, and dramatic mood changes.
If you are in a crisis, call the National Suicide Prevention Lifeline at 1-800-273-8255.