QUESTION:
Dear Dr. Heller,
My daughter is 19, she has had 4 self-cutting episodes since eighth grade. The last 2 were within the past seven weeks. She is now home from college. She had to spend 48 hours in the (good) psyche ward of our local hospital (her Psychiatrist wanted it) as a result of her last episode. There were dozens of light razor cuts on both arms – elbow to hand and one leg. She actually called us to come home from friends’ in the middle of the episode – she was in a very catatonic state for many hours.
ANSWER:
Self-mutilation is using a physical technique to temporarily stop the horrible sensation called dysphoria (anxiety, rage, depression and despair). Cutting doesn’t hurt, but stops the dysphoria much like scratching temporarily stops the horrible sensation of itching. It is almost uniformly a BPD phenomenon, and is effectively treated by treating the BPD with SSRI’ medications like Prozac combined with Tegretol and temporary antipsychotic medications like haloperidol and risperidone.