VISTAS Online is an innovative publication produced for ACA by Dr. Garry R. Walz and Dr. Jeanne C. Bleuer of Counseling Outfitters, LLC. Its purpose is to provide a means of capturing the ideas, information and experiences generated by the annual ACA Conference and selected ACA Division Conferences. Papers on a program or practice that has been validated through research or experience may also be submitted. This digital collection of peer-reviewed articles is authored by counselors, for counselors. VISTAS Online contains the full text of over 900 proprietary counseling articles published from 2004 to 2017.
Self-Injurious Behavior: Understanding and Working with Clients
Kelly L. Wester and Heather C. Trepal
The topic of self-injurious behavior (SIB) has been gaining widespread attention in both the media and professional literature. Self-injury has been defined as “all behaviors involving the deliberate infliction of direct physical harm to one’s own body without the intent to die as a consequence of the behavior” (Simeon & Favazza, 2001, p. 1). Thus, SIB encompasses an extensive array of behaviors, ranging from skin picking and hair pulling to bone breaking and self-surgery. The most common types of SIB tend to be cutting and
burning. SIB has typically been mistaken by clinicians and medical doctors for a suicide attempt. This mistake may be due to either the high correlation between suicide and SIB, or because the behavior tends to appear to be similar. Although suicide attempts and self-injury can look similar, and have been found to be highly correlated, SIB is not a suicide attempt. Another way to think about the difference between SIB and suicide is that SIB is an escape from an intense affect, or an attempt to achieve a certain level of focus, in order for an individual to sustain and continue life, while suicide is a way to end life with death being the ultimate goal.