Forgiveness Letter

gottman 6

Below is a letter from the known Actor, director, screenwriter, playwright Tyler Perry.  I received this letter months ago from Tyler Perry himself when I signed up through his mailing list. It’s a letter he wrote privately to a friend who is struggling with forgiveness for an absentee father.  I have this posted in my office at work because it reminds me that we are human and as humans we make mistakes that affect us in many ways.  Some mistake are realized and some are not but in spite of we have to learn to forgive and move past our wrongdoing and others.  As a counselor I deal with feelings almost everyday, teaching children and adults the skills for dealing with feelings.  Such as knowing your feelings, expressing your feelings and understanding the feelings of others.  Tyler Perry’s letter to his friend open my own eyes on feelings and forgiveness.  I’m sure you have heard the statement “When you forgive it’s not for the other person, it’s for you”.  Such a true statement because when you forgive someone for wronging you or spitefully misusing  you you gain a strength that has more power than you can imagine.  The dictionary defines forgiveness as the intentional and voluntary process by which a victim undergoes a change in feelings and attitude regarding an offense, lets go of negative emotions such as vengefulness, with an increased ability to wish the offender well. For Christians forgiveness is throughout the bible such as in Matthew 6:14-15, For if you forgive men when they sin against you, your heavenly Father will also forgive you.  But if you do not forgive men their sins, your Father will not forgive your sins.  This say’s that our Heavenly Father loved us enough to forgive us for our sins and if we want to live and be more like him we have to exercise forgiveness just as well.  So exercise forgiveness and see the power of God in your life…

Hey guys,

I wrote this note privately to a friend of mine whose father has never been there for him. Even though he’s not a kid anymore and is a husband and soon to be a father himself, he’s still being affected by it. I told him I would share it with you because I know that there are millions of you in this same situation. I used to be there too. Here’s what I wrote to him.

Hey bud,

Your dad is getting older and facing his mortality. He’s going to become a different man soon. In life, we all become different people. At 20, you’re not the same person you are at 50, and if you are, something is wrong. We are built to evolve. Life is an oven that will incubate us into change. Most times it’s for the better, although there are some people that are so resistant to it that sometimes they won’t change. But if he remains the same that’s ok too.

My challenge to you my friend is to start looking at your father like a person. Not the man you see but the boy he was, how he grew up, what he went through. Realize that just like you have had, he has had his own life, pain, heartbreak, struggles, secrets, disappointments and sadness. In other words, he had a life and a story long before you were born and in that life he wasn’t given the tools to be what you needed him to be.

As a parent your job is to help your child pack a suitcase for this journey called life. Just like when you go on a trip you pack everything you need. This is the same thing. You must help that child pack love, faith, confidence, patience, joy, hope, how to give love, how to accept it, faith and God. All these things and so much more should be in that suitcase and if they aren’t, that child is going to have a tough life. Find out what’s in your father’s suitcase. It will help you understand. What’s in his suitcase is not an excuse for the way he treats you, but it is a part of your understanding of him.

I know he’s a closed door and I know you don’t know much about him, but if he won’t tell you then maybe there is a family member on his side of the family that can tell you his story. His past is important in understanding your present. Do you understand? At any rate, I don’t care who or what he is. I’m just glad he was used to bring such a great and awesome soul to this world, whether he will ever know it or not. I thank him for that. I thank him for you. I love you my friend.


It’s Hard Out Here For A Single!


Some say Christian dating is difficult and yes it can be but God never said it would be easy but he said it would be worth it if we have faith and wait on the Lord. You see the bible says in Isaiah 40:31 “But they who wait for the Lord shall renew their strength; they shall mount up with wings like eagles; they shall run and not be weary; they shall walk and not faint.”  So this scripture tells me as a Christian that if I wait on The Lord and let him guide me I will have strength to endure through any difficulty in my life. Sometimes we as Christian trust God with our families, finances and career but when it comes to our personal relationships the word of a God fails on deaf ears.  We forget that God is able to handle all aspects of our lives, so we have surrender to Christ even in our dating lives. I’ve been to a few singles conferences and their was one singles group that I joined some years back through Oak Cliff Bible Fellowship Church under the leadership of Pastor Tony Evans.  This is where I learned biblical principles for a dating relationship. This article that I’m referencing is from a Christian website called Christian Answers (christian  These biblical principles coincide with what I’ve learned and strive to abide by.

God wants the best for us in every area of our lives. This includes relationships with boyfriends or girlfriends. We should date for fun, friendship, personality development and selection of a mate, not to be popular or for security. Don’t allow peer pressure to force you into dating situations that are not appropriate. Realize that over 50% of girls and over 40% of guys never date in high school. The Bible gives us some very clear principles to guide us in making decisions about dating.

Guard your heart.
The Bible tells us to be very careful about giving our affections, because our heart influences everything else in our life.

Above all else, guard your heart, for it is the wellspring of life (Proverbs 4:23).
You are known by the company you keep.
We also tend to become like the company we keep. This principle is closely related to the first one and is just as important in friendships as in dating.

Do not be misled: Bad company corrupts good character (1 Corinthians 15:33).
Christians should only date other Christians.
Although it is fine for Christians to have non-Christian friends, those who are especially close to our heart should be mature believers who are seeking to follow Christ with their lives.

Do not be yoked together with unbelievers. For what do righteousness and wickedness have in common? Or what fellowship can light have with darkness? (2 Corinthians 6:14).
Is it really love?
1 Corinthians 13:4-7 defines real love. Ask yourself these questions:

Are you patient with each other?
Are you kind to each other?
Are you never envious of each other?
Do you never boast to or about each other?
Is your relationship characterized by humility?
Are you never rude to each other?
Are you not self-seeking?
Are you not easily angered with each other?
Do you keep no record of wrongs?
Are you truthful with each other?
Do you protect each other?
Do you trust each other?

Many students ask the question, “How far should I go on a date?” Here are some principles that will help you decide what is appropriate behavior on a date.

–  Does the situation I put myself in invite sexual immorality or help me avoid it?
1 Corinthians 6:18 says to “flee from sexual immorality.” We cannot do this if we are tempting ourselves through carelessness.
–  What kind of reputation does my potential date have?
When you accept a date you are essentially saying, “My values are the same as your values.” That in itself can put you in a position you may regret later. Remember 1 Corinthians 15:33, “Bad company corrupts good character.”
–  Will there be any pressure to use alcohol or drugs?
Don’t give up your values for a date.
–  Am I attracting the wrong type of person?
Make sure that the message you send with your actions doesn’t attract people who will lead you to compromise your values.
–  Am I aware that sin is first committed in the heart?
Matthew 5:28 says, “But I tell you that anyone who looks at a woman lustfully has already committed adultery with her in his heart.”
–  Are you going to the right kind of place for a date?
Many good intentions have been forgotten because the temptation and opportunity were too great.
–  Am I doing anything to encourage sexual desire?
Don’t engage in any impure contact that is sexually motivated, such as petting.










Fake Marijauna


I recently received a message on Facebook about a young teenage boy on life support after smoking K2 synthetic marijuana for the first time and now he’s brain dead. This sent me into an immediate panic because I have 2 nephews around the same age as this teen whom I often have drug prevention talks with. I immediately did my research on the synthetic drug craze and realized this would be a great blog post.  Most of my research came from WebMD, K2drugfacts and addiction support internet pages.

Fake Marijuana also known as K2, Spice, Blaze and Mr. Smiley is a dangerous synthetic drug that is afflicting and killing our youth today. According to WebMD, Synthetic marijuana is made by blending plants and herbs including bay bean, blue lotus, and red clover. These ingredients are sprayed with a chemical that gives it its marijuana-like effects in the brain.

When smoked or ingested, these drugs produce a similar high to marijuana. Until recently, these compounds were sold in gas stations and convenience stores. The Drug Enforcement Administration has banned five chemicals found in Spice and K2, but people may still be able to find these substances on the Internet.

Parents and teens need to be aware of the signs and symptoms of synthetic marijuana use and know that it is out there.  Synthetic marijuana or K2 as it is also known by, is readily available to almost anyone with access to a convenience store. Even though there are stern warnings from many medical journals about K2’s side effects, people continue to smoke it. What many people don’t know is, the side effects are sometimes very bad and can even result in death.

Some of the most commonly reported side effects of K2 are:

Extreme Paranoia
Temporary Paralysis of Motor Skills
Elevated Heart Rate
Uncontrollable Sweating
High Body Temperature
Manic Rage
Rapid Heart Rate

Many teens may be drawn to these drugs because they are so easy to come by and can’t be detected in drug tests. The American Association of Poison Control Centers reported 4,500 calls involving them since 2010.

ADHD Epidemic

Multiethnic Arms Raised Holding ADHD


The Not-So-Hidden Cause Behind The A.D.H.D. Epidemic

ADHD is definitely an epidemic that has risen to enormous heights in the last 5 years.  I see it everyday working with children and families in the office where I am employed.  This article by The New Your Times is so on point and it explains the reason behind the ADHD epidemic.  Check it out please this is republished from that  article by Kimberly Hutchins, LPC Intern.

Between the fall of 2011 and the spring of 2012, people across the United States suddenly found themselves unable to get their hands on A.D.H.D. medication. Low-dose generics were particularly in short supply. There were several factors contributing to the shortage, but the main cause was that supply was suddenly being outpaced by demand.  

The number of diagnoses of Attention Deficit Hyperactivity Disorder has ballooned over the past few decades. Before the early 1990s, fewer than 5 percent of school-age kids were thought to have A.D.H.D. Earlier this year, data from the Centers for Disease Control and Prevention showed that 11 percent of children ages 4 to 17 had at some point received the diagnosis — and that doesn’t even include first-time diagnoses in adults. (Full disclosure: I’m one of them.)

That amounts to millions of extra people receiving regular doses of stimulant drugs to keep neurological symptoms in check. For a lot of us, the diagnosis and subsequent treatments — both behavioral and pharmaceutical — have proved helpful. But still: Where did we all come from? Were that many Americans always pathologically hyperactive and unable to focus, and only now are getting the treatment they need?

Probably not. Of the 6.4 million kids who have been given diagnoses of A.D.H.D., a large percentage are unlikely to have any kind of physiological difference that would make them more distractible than the average non-A.D.H.D. kid. It’s also doubtful that biological or environmental changes are making physiological differences more prevalent. Instead, the rapid increase in people with A.D.H.D. probably has more to do with sociological factors — changes in the way we school our children, in the way we interact with doctors and in what we expect from our kids.

Which is not to say that A.D.H.D. is a made-up disorder. In fact, there’s compelling evidence that it has a strong genetic basis. Scientists often study twins to examine whether certain behaviors and traits are inborn. They do this by comparing identical twins (who share almost 100 percent of the same genes) with fraternal twins (who share about half their genes). If a disorder has a genetic basis, then identical twins will be more likely to share it than fraternal twins. In 2010, researchers at Michigan State University analyzed 22 different studies of twins and found that the traits of hyperactivity and inattentiveness were highly inheritable. Numerous brain-imaging studies have also shown distinct differences between the brains of people given diagnoses of A.D.H.D. and those not — including evidence that some with A.D.H.D. may have fewer receptors in certain regions for the chemical messenger dopamine, which would impair the brain’s ability to function in top form.

None of that research yet translates into an objective diagnostic approach, however. Before I received my diagnosis, I spent multiple sessions with a psychologist who interviewed me and my husband, took a health history from my doctor and administered several intelligence tests. That’s not the norm, though, and not only because I was given my diagnosis as an adult. Most children are given the diagnosis on the basis of a short visit with their pediatrician. In fact, the diagnosis can be as simple as prescribing Ritalin to a child and telling the parents to see if it helps improve their school performance.

This lack of rigor leaves room for plenty of diagnoses that are based on something other than biology. Case in point: The beginning of A.D.H.D. as an “epidemic” corresponds with a couple of important policy changes that incentivized diagnosis. The incorporation of A.D.H.D. under the Individuals With Disabilities Education Act in 1991 — and a subsequent overhaul of the Food and Drug Administration in 1997 that allowed drug companies to more easily market directly to the public — were hugely influential, according to Adam Rafalovich, a sociologist at Pacific University in Oregon. For the first time, the diagnosis came with an upside — access to tutors, for instance, and time allowances on standardized tests. By the late 1990s, as more parents and teachers became aware that A.D.H.D. existed, and that there were drugs to treat it, the diagnosis became increasingly normalized, until it was viewed by many as just another part of the experience of childhood.

Stephen Hinshaw, a professor of psychology at University of California, Berkeley, has found another telling correlation. Hinshaw was struck by the disorder’s uneven geographical distribution. In 2007, 15.6 percent of kids between the ages of 4 and 17 in North Carolina had at some point received an A.D.H.D. diagnosis. In California, that number was 6.2 percent. This disparity between the two states is representative of big differences, generally speaking, in the rates of diagnosis between the South and West. Even after Hinshaw’s team accounted for differences like race and income, they still found that kids in North Carolina were nearly twice as likely to be given diagnoses of A.D.H.D. as those in California.

Hinshaw, as well as sociologists like Rafalovich and Peter Conrad of Brandeis University, argues that such numbers are evidence of sociological influences on the rise in A.D.H.D. diagnoses. In trying to narrow down what those influences might be, Hinshaw evaluated differences between diagnostic tools, types of health insurance, cultural values and public perceptions of mental illness. Nothing seemed to explain the difference — until he looked at educational policies.

The No Child Left Behind Act, signed into law by President George W. Bush, was the first federal effort to link school financing to standardized-test performance. But various states had been slowly rolling out similar policies for the last three decades. North Carolina was one of the first to adopt such a program; California was one of the last. The correlations between the implementation of these laws and the rates of A.D.H.D. diagnosis matched on a regional scale as well. When Hinshaw compared the rollout of these school policies with incidences of A.D.H.D., he found that when a state passed laws punishing or rewarding schools for their standardized-test scores, A.D.H.D. diagnoses in that state would increase not long afterward. Nationwide, the rates of A.D.H.D. diagnosis increased by 22 percent in the first four years after No Child Left Behind was implemented.

To be clear: Those are correlations, not causal links. But A.D.H.D., education policies, disability protections and advertising freedoms all appear to wink suggestively at one another. From parents’ and teachers’ perspectives, the diagnosis is considered a success if the medication improves kids’ ability to perform on tests and calms them down enough so that they’re not a distraction to others. (In some school districts, an A.D.H.D. diagnosis also results in that child’s test score being removed from the school’s official average.) Writ large, Hinshaw says, these incentives conspire to boost the diagnosis of the disorder, regardless of its biological prevalence.

Rates of A.D.H.D. diagnosis also vary widely from country to country. In 2003, when nearly 8 percent of American kids had been given a diagnosis of A.D.H.D., only about 2 percent of children in Britain had. According to the British National Health Service, the estimate of kids affected by A.D.H.D. there is now as high as 5 percent. Why would Britain have such a comparatively low incidence of the disorder? But also, why is that incidence on the rise?

Conrad says both questions are linked to the different ways our societies define disorders. In the United States, we base those definitions on the Diagnostic and Statistical Manual of Mental Disorders (D.S.M.), while Europeans have historically used the International Classification of Diseases (I.C.D.). “The I.C.D. has much stricter guidelines for diagnosis,” Conrad says. “But, for a variety of reasons, the D.S.M. has become more widely used in more places.” Conrad, who’s currently researching the spread of A.D.H.D. diagnosis rates, believes that America is essentially exporting the D.S.M. definition and the medicalized response to it. A result, he says, is that “now we see higher and higher prevalence rates outside the United States.”

According to Joel Nigg, professor of psychiatry at Oregon Health and Science University, this is part of a broader trend in America: the medicalization of traits that previous generations might have dealt with in other ways. Schools used to punish kids who wouldn’t sit still. Today we tend to see those kids as needing therapy and medicine. When people don’t fit in, we react by giving their behavior a label, either medicalizing it, criminalizing it or moralizing it, Nigg says.

For some kids, getting medicine might be a better outcome than being labeled a troublemaker. But of course there are also downsides, especially when there are so many incentives encouraging overdiagnosis. Medicalization can hurt people just as much as moralizing can. Not so long ago, homosexuality was officially considered a mental illness. And in a remarkable bit of societal blindness, the diagnosis of drapetomania was used to explain why black slaves would want to escape to freedom.

Today many sociologists and neuroscientists believe that regardless of A.D.H.D.’s biological basis, the explosion in rates of diagnosis is caused by sociological factors — especially ones related to education and the changing expectations we have for kids. During the same 30 years when A.D.H.D. diagnoses increased, American childhood drastically changed. Even at the grade-school level, kids now have more homework, less recess and a lot less unstructured free time to relax and play. It’s easy to look at that situation and speculate how “A.D.H.D.” might have become a convenient societal catchall for what happens when kids are expected to be miniature adults. High-stakes standardized testing, increased competition for slots in top colleges, a less-and-less accommodating economy for those who don’t get into colleges but can no longer depend on the existence of blue-collar jobs — all of these are expressed through policy changes and cultural expectations, but they may also manifest themselves in more troubling ways — in the rising number of kids whose behavior has become pathologized.


Stress Eater!



How many people are stress eaters? In reality stress is normal, Stress is the body’s method of reacting to a challenge.  Stress typically describes a negative condition or a positive condition that can have an impact on a person’s mental and physical well-being.  We all experience stress at times in our lives, now the negative conditional reaction is the kicker.  Stress becomes negative when a person faces continuous challenges without relief or relaxation between challenges.   Most people respond to stress negatively with negative behaviors. My own personal response to stress is a decreased appetite. Some stressful days at work I can go all day without eating anything. By the time I get home my body and brain has crashed then I end up eating a very unhealthy dinner and head straight to bed.  For 8 hours or more I’ve starved my body and brain from nutrients that were needed to keep me afloat throughout the day. Most have the opposite effect that I have to stress, they become stress eaters. Meaning they eat whatever is in sight or smell. Those foods are called comfort foods because afterwards they are on cloud 9 and that stress challenge has been remedied. Well, if stress eating is your response to life’s challenges I have found 10 foods to improve your moods.  Having a stressful day and you feel the need to pig out I challenge you to try these 10 foods from the article provided by Mother Nature Network.

1. Pumpkin seeds
The humble pumpkin seed is a mighty source of potassium, phosphorus, zinc and especially magnesium. Only about one-third of Americans meet their daily magnesium needs; not enough of this important mineral can lead to a higher risk of headaches, anxiety, fatigue, insomnia, nervousness and high blood pressure. Magnesium is a brain super food, and a whole lot of it is getting thrown out when you carve pumpkins and toss those seeds!

2. Dark, leafy greens
Kale, Swiss chard and other dark, leafy greens are packed with magnesium, a deficit of which can lead to the complaints listed above, which work to create the perfect environment in which stress thrives.

3. Eggs
The gold standard of protein, eggs also provide calcium, iron, zinc, selenium, phosphorous, and vitamins A, D, E, and K – all in one little 80-calorie package – making them one of the most nutritionally-dense foods around. Drew Ramsey, a psychiatrist at Columbia University and author of “The Happiness Diet,” praises nutrient-rich foods for battling stress and notes that scrambled eggs are part of his favorite anxiety-reducing breakfast.

4. Carrots and celery
Carrots, celery and their crunchy brethren work more on a mechanical level. Chomping and chewing work as physical relief to stress, and may be particularly helpful for those who have a habit of grinding their teeth. Bonus: They also help to fight bad breath!

5. Fish rich in omega-3 fatty acids (like sardines, salmon, canned tuna)

Omega-3 fatty acids can help soothe your mood by quelling the body’s response to inflammation, says Joe Hibbeln, a researcher at the National Institutes of Health who has spent decades studying how omega-3 fatty acids in fish effect emotional health. He notes that studies show how omega-3s help buffer neurons from the harm that chronic stress can create. Omega-3 fatty acids have also been linked to helping with depression as well as encouraging more positive social behavior in children. (And yes, there’s the mercury issue, but there are ways around that problem.)

6. Flaxseed
Some consider flaxseed to be one of the most powerful foods around, and with good reason. There is some evidence showing it may help reduce the risk of heart disease, cancer, stroke, and diabetes. Its high omega-3 content lands it in NPR’s list of stress-busting foods, and there are testimonies across the Internet of people who praise flaxseed oil for saving them from depression and mental illness. Meanwhile, the National Institutes of Health notes that there is some evidence that taking flaxseed oil might improve attention, impulsiveness, restlessness, and self-control in children with ADHD

7. Whole grains
Whether on their own — like brown rice, quinoa or oatmeal — or in whole-grain products like breads and pasta, we’re talking hearty carbohydrates that have not had all of their nutritional integrity processed out of them. Carbs prompt the body to produce more serotonin, the chemical that is commonly known as the “happiness hormone.” By getting your serotonin from complex carbs that are not as easily digested as simple carbs, your blood sugar levels will also be more stabilized.

8. Red peppers, papaya and kiwi
What do these three foods have in common? They have more vitamin C per serving than oranges; and vitamin C is the key here. Multiple studies point to C for curbing stress hormones. As Psychology Today reports: “People who have high levels of vitamin C do not show the expected mental and physical signs of stress when subjected to acute psychological challenges. What’s more, they bounce back from stressful situations faster than people with low levels of vitamin C in their blood.” Berries, broccoli, Brussels sprouts and leafy greens all boast high vitamin C levels as well.

9. Tea

Drinking black tea may help you recover from stressful events more quickly, notes WebMD. One study looked at people who consumed four cups of tea daily for six weeks, compared with people who drank something else. At the end of the study, the tea drinkers reported feeling calmer and had lower levels of the stress hormone cortisol after stressful situations. Meanwhile, chamomile tea has been used for ages to calm jitters and relieve stress.

10. Dark chocolate
Cocoa flavanols in chocolate can help boost the mood and sustain clear thinking; and study after study touts dark chocolate’s ability to increase feelings of wellness and decrease stress. Not to mention, it might make you smarter. Is it just a coincidence that the higher a country’s chocolate consumption, the more Nobel laureates it creates? More chocolate, please.
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Teenage Self-Injury

Problems of teenagers


As a counselor for adolescents and their families I’ve come across a rise in teenage self-injury.  To improve my knowledge of this wave of teenage self-injury I’ve read many books and articles on self-injury to help me as a counselor and help my clients reduce the self injury behaviors.  Here is an article that I’ve run across many time by the New York Times, its very informative and helpful to counselors and parents of children and teens who self-injure.

“I feel relieved and less anxious after I cut. The emotional pain slowly slips away into the physical pain.”

“It’s a way to have control over my body because I can’t control anything else in my life.”

“It expresses emotional pain or feelings that I’m unable to put into words.”

“I usually feel like I have a black hole in the pit of my stomach. At least if I feel pain it’s better than nothing.”

These are some of the reasons young people have given for why they deliberately and repeatedly injure their own bodies, a disturbing and hard-to-treat phenomenon that experts say is increasing among adolescents, college students and young adults.

Experts urge parents, teachers, friends and doctors to be more alert to signs of this behavior and not accept without question often spurious explanations for injuries, like “I cut myself on the countertop,” “I fell down the stairs” or “My cat scratched me.”

The sooner the behavior is detected and treated, the experts maintain, the more quickly it is likely to end without leaving lasting physical scars.

There are no exact numbers for this largely hidden problem, but anonymous surveys among college students suggest that 17 percent of them have self-injured, and experts estimate that self-injury is practiced by 15 percent of the general adolescent population.

Experts say self-injury is often an emotional response, not a suicidal one, though suicide among self-injurers is a concern.

The Canadian Mental Health Association describes it this way: “Usually they are not trying to end all feeling; they are trying to feel better. They feel pain on the outside, not the inside.”

Janis Whitlock, a psychologist who has interviewed about 40 people with histories of self-injury and is participating in an eight-college study of it, says the Internet is spreading the word about self-injury, prompting many to try it who might not otherwise have known about it.

“There is a rising trend for teens to discuss cutting on the Internet and form cutting clubs at school,” the Canadian association has stated.

Celebrities, too, have contributed to its higher profile. Among those who have confessed to being self-injurers are the late Princess Diana,Johnny DeppAngelina Jolie, Nicole Richie, Richie Edwards, Courtney Love and the lead singer on the Garbage band album “Bleed Like Me.”

Common self-injuries include carving or cutting the skin, scratching, burning, ripping or pulling skin or hair, pinching, biting, swallowing sublethal doses of toxic substances, head banging, needle sticking and breaking bones. The usual targets are the arms, legs and torso, areas within easy reach and easily hidden by clothing.

Self-injury can become addictive. Experts theorize that it may be reinforced by the release in the brain of opioidlike endorphins that result in a natural high and emotional relief.

Dr. Whitlock, director of the Cornell Research Program on Self-Injurious Behavior in Adolescents and Young Adults, said in an interview that self-injury mainly seemed to function to “self-regulate feelings and help people cope with overwhelming negative emotions they have no other way to dispel.”

Self-injury makes some people feel part of a group. Teenagers who self-injure often report that there is no adult they could talk to who accepts them for who they are.

“A 13-year-old can go on the Internet and instantly find community and get hitched to this behavior,” Dr. Whitlock said. “When they don’t want to self-injure anymore, it means they have to leave a community.”

Self-injury can be manipulative, an effort to make others care or feel guilty or to drive them away. More often, though, it is secretive. Self-injurers may try to hide wounds under long pants and long sleeves even in hot weather, and may avoid activities like swimming.

Who Is Vulnerable?

Self-injury often starts in the emotional turmoil of the preteen and early teenage years and may persist well into adulthood.

Although female self-injurers are more likely to be seen by a professional, in-depth studies indicate that the behavior is practiced equally by young men and women. No racial or socioeconomic group has been found to be more vulnerable, although self-injury is slightly less common among Asians and Asian-Americans, Dr. Whitlock said.

Interviews with self-injurers have found background factors that may prompt and perpetuate the behavior. A history of childhood sexual, and especially emotional, abuse has been reported by half or more of self-injurers. Some seek relief from the resulting emotional pain. Others self-inflict pain to punish themselves for what they perceive as their role in inviting the abuse.

Low self-esteem is common among self-injurers. Childhood neglect, social isolation and unstable living conditions have also been cited as risk factors. In about 25 percent of self-injurers, there is a history ofeating disorders, as well as an overlap with risky drinking and unsafe sex.

The families of self-injurers commonly suppress unpleasant emotions. Children grow up not knowing how to express and deal with anger and sadness, instead turning emotional pain on themselves. Depression, for example, is often described as anger turned inward.

Although 60 percent of self-injurers have never had suicidal thoughts, self-injury can be a harbinger of suicidal behavior. It can also accidentally result in suicide.

“Those who self-injure should be evaluated for suicidal potential,” Dr. Whitlock said. There is some evidence that self-injury is more common among those with family histories of suicide. And some self-injurers suffer from chronic yet treatable emotional problems like depression,anxietypost-traumatic stress disorder or obsessive-compulsive disorder.

Self-injury can be set off by certain events like being rejected by someone important, feeling wronged or being blamed for something over which the person had no control.


Although there are no specific medications to treat self-injury, drugs that treat underlying emotional problems like depression and anxiety can help. Most effective in general is a form of cognitive behavioral therapy called dialectical behavior therapy. People learn skills that help them better tolerate stress, regulate their emotions and improve their relationships.

The therapy also helps them see themselves not as victims, but as powerful agents, Dr. Whitlock said.

In addition, self-injurers can learn more wholesome ways to relieve stress like practicing meditation or yoga, engaging in vigorousphysical activity or reaching out to a friend.

Some self-injurers have noted that they can sometimes avoid the behavior, Dr. Whitlock said, simply by doing something else for several minutes when the urge arises.