Self-injury is not in the DSM-IV as an actual diagnosis. There is a controversy in the psychiatric field as to whether or not self-injury, or self-mutilation, should be considered an "illness" in and of itself. As of now, it is only a symptom of other diagnoses, the most popular one being Borderline Personality Disorder. Others include Anti-Social Personality Disorder, Schizophrenia, and any disorder relating to Autism. A lot of people who have an eating disorder also self-injure. A lot of people who are depressed self injure. A lot of people who are manic self-injure. People with DID can self-injure as well. Basically, self-injury is not an uncommon symtpom when combined with any mental illness.

I generally do not use the term self-mutilation, although that is technically the term used in the DSM-IV. Mutilation is an ugly, violent word, and people who self-injure (SI) generally do not SI to be violent, or to be seen as ugly. Mutilation has a stigma to it. Self-harm and self-injury are less threatening terms. This may be a mere technicality, the wording I choose, but it does mean something to me.

This is what I want to make clear: Self-Injury is always a choice, unless the person is in a psychotic state. Autistic children are often seen banging their heads. This is not their choice for the most part, they are doing that in order to achieve some need that is not fulfilled in any other way and they are not in a state of mind to ask for what they need. Paranoid Schizophrenics can become psychotic and hurt themselves without realizing it. Unless you are psychotic, you are choosing to hurt yourself. I know I am going to get flack for this one. People say the need to cut, or burn. They don't need to, they want to. There is a huge difference.

It took me a long time to realize that whenever I cut, or burnt myself, or hit myself, it was an act of will. No one needs to cut themselves.

This is going to sound contradictory to what I just said: self-injury is effective. In the short-term It is very ineffective in the long term. Look at the page entitled 429. That number represents the permanent scars I have aquired since I was 11 years old. God himself only knows how many other times I have cut and not have it result in a scar. There was no need for this. There is no need for it to happen to other people. There are alternative ways of coping with stress that do not result in any bodily and/or mental harm It takes time to learn these coping skills, but they are worth it.

Trust me. I spent six months "tied" to a hospital being treated for self-harm. But you know what, that program saved my life. I honestly believe that. In upcoming pages, I will suggest some coping skills. The thing is that not every single coping skill works for every single person. That is why you have to try different ones to see what ones fit your style. The best thing to do is to practice the skills when you are not stressed, that way when you need them, they are like second nature.

more to come from the recovering self-injurer.