Question
What is self-mutilation and how do OTs deal with it?
Answer
Self-mutilation is a maladaptive coping skill for dealing with uncomfortable feelings. Once I asked an adolescent why she cut, and she said, "When I see the blood flow, I feel better." Naturally, it is our job to teach coping skills that are not harmful to one's body. However, I have read that there is a certain euphoria that comes with cutting.
For self-management, how do we help our clients to handle and cope with those uncomfortable feelings better? We can teach self-management strategies for stress, anger, and emotions. Two alternative coping strategies for self-mutilation are holding an ice cube on the skin, which presents a burning feeling, or snapping a rubber band. Both are not going to cause permanent damage. The key is that these are temporary alternative coping strategies.
We want them not to engage in self-harm and develop positive coping strategies through cognitive-behavioral therapy, dialectical behavioral therapy, and sensory approaches. This is perfect for occupational therapy. We can also work on problem-solving, tactile stimulation, massage, self-soothing, communication skills, and things like that.
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