Dr. Hat, I was wondering about the issue of cutting/"self-mutilation". I have had that problem in the past, and lots of people from the list seem to struggle with it.
Is there a correlation with OCD?
And how common is it for people in general?
do you have any suggestions about better ways to cope with stress?
For me anger is always what triggers it. I get angry or frustrated with someone, and I take it out on myself. Obviously, it's NOT a GOOD way to cope, but how dangerous do you think the problem is if people are not hurting themselves seriously?
Just wondering.

An OCD Teen

Hi *****, Yes, it seems to be a problem for lots of people with OCD (and for some without), and it's coming up right now in the group. Sometimes cutting can be a for of SIB, or Self-Injurious Behavior - a subset of Impulse Control Behaviors, where people do something because it feels good in the moment but they regret it later. Also, for people that notice they cut when they are angry or in emotional pain, it can be a way of "numbing out," since cutting causes the brain to release endorphins (among other chemicals) that create an anaesthetic result.

ICDs are common in about 30% of people with OCD, and often coping with anger or stress more effectively will help reduce the tendency to cut (or pick or pull or shop...). Learning to express anger in a constructive way is pretty important, since anger directed inward usually leads either to SIB or to depression.

It isn't dangerous in a life-threatening way, but it IS dangerous in another way: because endorphin is a very addictive compound, people can get addicted to their own brain chemistry. That means 1) you might end up cutting just because you need an "endorphin fix" and not because of any outside force, and 2) eventually you'll need more and more cutting (or deeper and deeper wounds) to get the same effect - this is due to building up tolerance to the endorphin. Not to mention the shame and secrecy that goes along with it, or the scars that result.

There is a behavior therapy for ICDs called Habit Reversal Training - see the angelfire web site for more on this. But anger expression and stress management are good ideas.

Cheers,

dr.hat