I had a friend who used to cut herself, but I don’t know what method she used. I’d gasp at the site of her self-inflicted wounds and could almost feel the pain just by looking at the gashes and scabs. To this day I regret not talking her about it and I feel guilty about not helping to protect her. I was too polite to ask her why she hurt herself or how on earth she wanted to make herself bleed.
Later in life, this beautiful and talented friend of mine became obsessed with getting tattoos and piercings and I couldn’t help wondering if there was any correlation between the two. But I thought about the connection. At some point she must have decided cutting wasn’t appropriate anymore, yet the pain was still somehow necessary. I can understand how the appeal of colorful designs displayed on her skin could serve the dual-purpose of drawing attention to herself (she definitely had star quality) and creating the opportunity for physical pain as a way to numb her emotional pain.
WebMD talks about the various forms of self-injury, which is often a behavior associated with Borderline Personality Disorder (BPD) and serves as a relief or distraction from depression, anxiety, and a variety of emotions, such as anger, loneliness, confusion, or hopelessness. Self-injury can also be accompanied by an eating disorder, alcoholism, or drug abuse. I’m sad to say my friend dabbled in all of them. Signs of self-injury include visible cuts or scars on the arms or legs, an effort to hide scars by wearing clothing that covers even in the warm weather, and making up excuses about how injuries occurred.
Many years before earning a PhD and becoming a Professor of Psychology at the University of Washington, a courageous girl named Marsha Linehan was someone who harmed herself. At 17, she was hospitalized for more than two years for mental illness. She was diagnosed with BPD. But this courageous girl-turned-woman would eventually use her own experiences to develop Dialectical Behavior Therapy (DBT), now recognized by the Cochrane Review as the treatment of choice for characteristics associated with BPD including self-harm, impulsivity and suicidal tendencies, among others. She also founded The Linehan Institute of Behavioral Technology at the University of Washington.
People who self-harm or self-mutilate, according to Mental Health America.net, typically feel empty, either over- or under-stimulated, incapable of self-expression, lonely, misunderstood and afraid of responsibilities and relationships. The interesting fact is that self-harming is not often meant as a suicide attempt. “But relief is temporary, and a self-destructive cycle often develops without proper treatment,” says the Mental Health America.net website. “Self-injurers often become desperate about their lack of self-control and the addictive-like nature of their acts, which may lead them to true suicide attempts. The self-injury behaviors may also cause more harm than intended, which could result in medical complications or death.”
DBT has been shown to cut suicide attempts in half and reduce psychiatric hospitalization. It has also been found effective at treating BPD, substance dependence, depression, PTSD, and eating disorders. There are many people who owe their mental health to Dr. Linehan, who has dedicated her life to working with people who risk their lives attempting to numb their pain. DBT combines the technology of change based on behavioral science, “technology of acceptance,” derived from both eastern and western practices, such as mindfulness, willingness and radical acceptance.
I wish I had known about Dr. Linehan and DBT way back when my friend was suffering, as well as Brookhaven Retreat ® LLC, the residential treatment facility for women, which uses DBT as part of The Lily Program ®, a 90-day program for women offered exclusively at the facility in Seymour, TN. She most certainly would have benefitting from the program and perhaps her life would have gone differently. From what I can tell, she’s made peace with the pain of her past and I’m grateful for that. But I still wonder what might have been if she had gotten help as a younger person.