Self-injury is a behavior people rely on to relieve or distract themselves from difficult feelings, or to communicate emotions that they seem unable to verbalize. For years, teens have written to "We’re Talking Teen Health" asking for help with self-injury. Until now, all we could do was refer them to counselors, and 1-800-DONT CUT at Self Abusive Finally Ends (SAFE). Now I am pleased to say that we can encourage them to purchase the book Bodily Harm as well.

Authors Karen Conterio and Wendy Lader are founders of the first short-term self-injury treatment program (SAFE) in the country. Together with Jennifer Kingson Bloom, they have written a book that provides help for self-injurers, as well as support for the people who love them or treat them.

Most importantly, this book addresses the hopeless and desperate feelings of the self-injurer. The principles of this book can help them choose a more meaningful and productive life, and realize that they are not alone. Not that treatment is easy -- there is no easy way to break a highly comforting pattern of behavior. However, this book tells self-injurers how to start the treatment process and provides the support and many of the "tools" they will need. There is even a 90-item questionnaire included in the book that addresses important issues a self-injurer should consider when seeking help.

I cannot say that I really understand self-injury, but after reading this book, my heart goes out to every person suffering alone with this secret. There is no "typical" self-injurer, but many are successful (on the outside): female, middle-class, white, and intelligent, with low self-esteem and trouble forming intimate relationships. There is no "cause" of self-injury, although many of the people who choose self-injury perceived their childhoods and parenting as traumatic, and many were physically, emotionally and sexually abused.

How will you know I'm hurting
If you cannot see my pain?
To wear it on my body
Tells what words cannot explain.
- C. Blount

If you are suffering, please do not delay seeking treatment. The earlier the better and remember, you are not alone! You can have a life that is stable and comfortable.

• Help for Families
• For Therapists

Help for Families

Families of self-injurers will appreciate the chapter that includes questions and answers about how to discuss your concerns and how best to support the self-injurer. This includes a useful section on warning signs of self-injury, such as:

• Scars on the arms or legs
  
• A pattern of curious abrasions
  
• Wearing long sleeves
  
• Social withdrawal
  
• Sensitivity to rejection
  
• Difficulty handling anger
  
• Coincident symptoms, such as compulsive behavior, eating disorders, alcohol and drug abuse, and kleptomania

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For Therapists

For therapists who treat self-injurers, there are appendices with tools like samples of no-harm contracts and an impulse control log in the back of the book. The book points out that the wish to self-injure is a thought, not a feeling and that self-injury is a behavior that has been distracting the person from difficult feelings, and a behavior that can be changed. The impulse log is a tool to help self-injurers see that the desire to self-injure is a signal that they are experiencing a feeling -- anger, sadness, loneliness -- that can be addressed without self-injury.
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