The Self-Injury Experiences of Young Adult Women: Implications for Counseling.

Many counselors lack a Hear understanding of the phenomenon of self-injury. This article presents results of a qualitative study examining the experiences of young adult women who engage in self-injurious behaviors, Interpretation of the participants' narrative data offers insight into the value of a humanistic approach to counseling this population. ********** Self-injurious behavior is an emerging phenomenon that affects an increasing number of women in the United States (Adler & Adler, 2007; Nock & Prinstein, 2005). Because of the privacy associated with this phenomenon, accurate statistics are difficult to determine. Nonetheless, estimates of the prevalence of self-injury range from 14% to 39% of adolescents in the general population, and the numbers are predicted to increase (Gratz, 2001; Gratz, Conrad, & Roemer, 2002; Muehlenkamp & Gutierrez, 2004). Furthermore, self-injury--in the form of cutting--has gained attention in the mainstream media through movies such as Girl Interrupted and Thirteen. Additionally, the Internet contains numerous message boards and websites addressing self-injury. Pro-self-injury personal blogs and videos can be found on popular websites such as MySpace (http://www.myspace.com/) and YouTube (http://www.youtube.com/). These sites allow women to communicate, view testimonies, and support one another regarding their self-injurious behaviors. Despite the alarming prevalence of self-injury, the field of counseling has only just begun to pay attention to this phenomenon, and the limited research available has been quantitative in nature. As a result, the data have failed to provide an in-depth understanding of the lived experiences of those who self-injure. To assist counselors to respond in a more humanistic manner with this population, qualitative research is needed (Craigen & Foster, 2009). The current study aimed to address this gap. The primary purpose of this research study was to examine young adult women's overall experiences with self-injury; thus, a phenomenological approach was best suited. The qualitative themes that emerged from this study reflect humanistic perspectives and will contribute to a more humanistic approach to treating self-injury. A description of these themes and a discussion of their implications for counseling follow a review of the literature related to the characteristics of individuals who self-injure and treatment of self-injury. CHARACTERISTICS OF INDIVIDUALS WHO SELF-INJURE Researchers have indicated that self-injury is 3 to 4 times more common in women than in men (McAllister, 2003). However, these findings are not without controversy. Many have argued that the statistics are much higher for men yet are minimized because men may be less likely to report incidences of self-injury and counselors may not be as adept at examining self-injury among the male population (Shaw, 2002). Moreover, statistics are limited on the examination of racial and ethnic groups; thus, little is known concerning this activity in marginalized or nondominant groups. Individuals who self injure are also commonly given differing diagnoses: depression, dissociative identity disorder, obsessive-compulsive disorder, schizophrenia, anxiety disorder, adjustment disorder, borderline personality disorder, and other personality disorders (Nock & Prinstein, 2005). Women who self-injure are commonly diagnosed with an eating disorder. An investigation of a study that examined the prevalence rates of eating disorders in the self-injuring population yielded eating disorder rates of 30% (Paul, Schroeter, Dahme, & Nutzinger, 2002). These comorbid diagnoses may be valid. On the other hand, many individuals who self-harm may be diagnosed inaccurately because no official diagnosis exists for self-harm, and the clinician treating the individual may not properly understand the phenomenon of self-injury. Understanding the phenomenon of self-injury is difficult because of the complex nature of the behavior and the multitude of reasons why an individual may choose to engage in the behavior. …