Is Self-Injury A Mental Disorder, Or Just Part Of A Larger Problem?

Though it's estimated that 2 to 8 millions Americans self-injure, from cutting to the newly-reported practice of self-embedding, doctors still can't agree on whether self-injury itself is a disorder, or how to treat it.

Last month, Dr. William Shiels, the chief of radiology at Nationwide Children's Hospital in Columbus, Ohio, presented evidence of what he says is an increase in the number of self-injurers embedding sharp objects under their skin, showing x-rays of patients who had inserted objects such as paper clips, staples, glass, and even chunks of crayon. This led to media reports on the "new trend" of self-embedding, and now Shiels is lobbying to have "Self-Embedding Disorder" included in the next edition of the the American Psychiatric Association's Diagnostic and Statistical Manual (DSM), the bible of psychiatric disorders.

But this has raised several questions: Should self-embedding be classified as its own condition separate from cutting? And is self-injury itself a disorder, or is it always just a symptom of a larger mental problem? Though the media jumped on self-embedding as a new practice, doctors say that embedding is a known method of self-injury. There are accounts of self-injury and embedding in the earliest known medical literature, and yet doctors still say there isn't enough research on self-injury and there have been no studies on embedding. It may have something to do with the fact that self-injury has always been seen as something "silly girls" do. "The early writing on this was of the tone that this was just another lunatic, hysterical female behavior," Joan Jacobs Brumberg, social historian and professor of human development at Cornell University.

Classifying self-embedding or self-injury as a specific disorder is a double edged sword. On the one hand, inclusion in the DSM would make the conditions easier to diagnose and treat. It would also probably lead to more funding for research and make obtaining insurance coverage easier. Even the media hype over the "new" medical disorders can help make people aware that self-injury is a "real" problem, not just something "silly" that girls do.

The danger is that defining self-industry or embedding as one neatly-packaged disorder can oversimplify the issue. People who self-injure usually say they do it as a way to cope with stress, but the specific reasons vary widely. As anyone who has self-injured, or been close to someone who self-injures knows, each person's motivations for doing it are complex and varied. Some say it's about control, others say it lets them feel release, and some are seeking a euphoric feeling, but in all cases boiling someone's mental issues down to a few bullet points and packaging it as the "hot new trend" in medical disorders isn't likely to help.

Why She Cuts: One Woman's Battle With Self Injury [Newsweek]

[Image via Flickr.]