http://www.straitstimes.com/opinion/the ... lf-cutting
The dynamics behind the sad phenomenon of self-cutting
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NON-SUICIDAL SELF-INJURY
Cutting and carving one's skin is but one form of what is known as non-suicidal self-injury (NSSI), which is defined as the intentional and direct injuring of one's body tissue without the intent of suicide.
Other methods of inflicting injury include scratching, burning, deliberating hitting one's body against a hard surface, biting and needle-sticking.
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Most young people engage in self-injury as a way to alleviate negative thoughts or feelings such as depression, anxiety, tension and emotional distress.
Some do so as a sort of self-punishment and as an expression of anger, derogation or self-loathing. The resultant physical pain is a way to release pent-up emotional pain; most self-injurers report that the jolt of pain calms them and brings a sense of relief (this possibly comes from the release of opioid-like endorphins in the brain that soothe the pain and even induce euphoria).
In a way, it is like using drugs or alcohol to try to feel better, which can lead to a psychological dependency, then a craving which soon becomes an addiction - with the person being seized by and in thrall to the thought of self-injury, even when it is not acted upon.
MENTAL HEALTH ISSUES
NSSI is an indication of some underlying problem and it may be symptomatic of other mental illnesses, which unbeknown to most people are by no means rare among young people.
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The onus of ensuring their well-being inevitably falls on those adults close to them - in particular, parents and teachers.
Recognising such problems and differentiating them from the expected and normal adolescent turmoil, however, can be difficult; this is compounded by the understandable tendency of most young people to hide their symptoms
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Parents obviously need to be vigilant but they often find themselves in the tricky situation of having to steer between what the British psychoanalyst Rozsika Parker called "the Scylla of intrusiveness and the Charybdis of neglect" - to expect that they should know exactly what their children feel and do is not reasonable; yet when something bad happens, there would be the usual explicit or implicit recrimination and censure that the parents are somehow culpable.
Good consistent parenting is devilishly difficult and, despite all the good intentions and efforts, the outcome can still be terrifyingly uncertain.
We do have counsellors in our local schools, polytechnics and universities who are trained to handle emotional and psychological issues, and while they have access to specialised child and adolescent mental health services, there will always be some young people who would not be identified and would fall through the cracks
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"We need to offer children better mental health screening and to understand that mental health service for children works best not on a vaccine model, in which a single dramatic intervention eliminates a problem forever, but on a dental model, in which constant care is required to prevent decay," writes author and professor of clinical psychology Andrew Solomon.
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Professor Chong Siow Ann is vice-chairman of the medical board (research) at the Institute of Mental Health.
