Cutting and Self Harm

To learn more about self harm, LoveToKnow Teens editor, Charlotte Gerber, interviewed Dr. Alvera Milberg, a clinical and school psychologist with experience in treating this disorder.

Interview with Dr. Milberg

Who is most likely to self harm?

The people who are most likely to harm themselves are suffering from depression, guilt, depersonalization, and dysfunctional families. This is due to:

• A traumatic experience
• Neglect
• Rejection
• Physical, emotional or sexual abuse by family members

These causes lead to low self-esteem, especially if they do not have any one to turn to for emotional support.

Are there any warning signs of this type of behavior?

Warning signs include the following:

• Self-isolation
• An unwillingness to talk about how they are feeling
• Loss of feeling empowered
• Suppressed anger and anger directed at themselves
• Impulsive behavior
• Lack of plan for the future
• Feelings of hopelessness
• Overeating or under eating
• Low self-esteem
• Low energy
• A lack of good coping skills
• Avoidant

What are the types of self-harming?

You have to look at self harm behavior in regards to:

• Directness
• Lethality
• Repetition

We break it down to two categories: there is compulsive self-harm and impulsive self harm. The behaviors include:

• Hair pulling,
• Nail biting
• Skin picking
• Cutting
• Burning
• Bone breaking
• Hitting
• Abusing drugs and alcohol
• Starvation or anorexia
• Self-mutilation

Why do people resort to cutting and self harming?

They feel rejected; have self-hatred and a fear of abandonment. This anxiety makes them emotionally numb and cutting helps them to feel something, even if it is pain.

Are there any triggers that will make someone keep doing this?

The trigger appears to be a threat of separation, rejection, or disappointment. There are feelings of overwhelming tension and isolation caused by a fear of abandonment and self-hatred. They will have apprehension that they will be unable to control their own aggression.

Can this type of behavior escalate to suicide?

Usually the behavior does not escalate to suicide and major self-mutilation (including such things as castration, amputation of limbs, enucleation of eyes). Major self-mutilation is rare and is usually associated with psychotic states.

Is there anything that friends and family can do to help?

• Provide a supportive, nurturing and loving family environment where parents have an appropriate parenting style and spend time having meals and interacting positively with their children.
• Get a good behaviorist psychologist who can come up with a contract with the patient. The psychologist is needed for both the parents' own support and for their teen.
• Educate themselves and their teen about this disorder.
• Get them a buddy or support group who they can call whenever they are feeling rejected.

What should a teen do if they suspect this type of behavior in a friend?

They should notify a trusted adult like their teacher and the school psychologist or the parents if possible.

Where can teens go to get help for this problem?

To a trusted adult or therapist.

What kind of treatment is available for people subjecting themselves to cutting and self harm?

Safe Alternatives is a world-renowned program for teens that self harm at 1-800-DONT-CUT (1-800-366-8288). Many therapists also specialize in this area.

About Dr. Alvera Vayzer Milberg

Dr. Alvera Vayzer Milberg has a PhD in Clinical and School Psychology from Hofstra University. She has 12 years experience in the evaluation and treatment of various disorders. Dr. Milberg is also a yoga instructor and life coach. She has been cited as an expert in numerous magazines and is a contributor to NewLife Magazine. Dr. Milberg holds workshops on personalized yoga therapy that combines Rational Emotive Behavior Therapy and Specific Yoga postures to treat specific issues such as weight loss, anxiety, mild mood disturbances as well as others.

Dr. Milberg is also the creator of a 10-week life-balance coaching program available via teleseminars that balance people in the eight areas of life (spirituality/religion, career, finances, family, community, personal development, social/fun and health). The program can also continue for up to a year for individuals that need to make real changes in a particular area of their life. She is also in the process of developing a 2-hour course for One Minute University and CDs for personalized yoga. Dr. Milberg also hosts a radio show on Blog Talk Radio