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Compulsive Skin Picking – A Form of Self-Mutilation

The term self-mutilation includes a variety of forms of intentional self-harm without the intention to die. It results from feelings of shame or a need to relieve tension. The harm is done to oneself, without the involvement of another person, and the damage can be sufficient enough for tissue damage (such as scarring) to result. But this category excludes acts that are committed with conscious suicidal intent, body decoration, spiritual enlightenment through ritual or are associated with sexual arousal.

A mood state can be positive or negative, or even though. Some people harm themselves to end a dissociative episode, to ground them and come back to reality. Self-mutilation is a way of stopping this dissociative episode. Dissociation is a process in which the mind splits off certain memories and thoughts that are too painful to keep in conscious awareness. Some people report that they feel numb during the dissociation phase and injuring themselves allowing them to feel "alive."

Compulsive skin picking (CSP) should not be taken lightly. It is a form of self-mutilation and in time can be very serious. Other variations of this disorder are cutting, burning, skin-picking, hair pulling, bone-breaking, hitting, and interference with wound healing. These behaviors are repetitive, intentionally performed behaviors that cause substantive physical damage, and result in clinically significant distress or functional impairment.

CSP is often classifies as an impulse control disorder under the obsessive compulsive disorder (OCD) spectrum as the skin picking is often occurring, ritualistic and stress reducing. This disorder tends to run in families. As a result of constant picking, this can cause infections, bruises, bleeding, or permanent disfigurement of the person's skin.

The symptoms of self-mutilation typically include wearing long-sleeved or baggy clothing, even in hot weather, and an unusual need for privacy. People with this disorder are often hesitant to change their clothes or undress around others. Other behaviors include not wearing a bathing suit because areas of the body have been picked or wearing heavy make up to cover scabs and picked areas of the face. In most cases the individual also shows signs of depression.

The behavior is often unconscious, and people with this disorder may fail to stop because they are often unaware of their actions. There is no specific disorder name for this problem in the Diagnostic and Statistical Manual (DSM-IV) published by the American Psychiatric Association (APA), but some researchers believe that the disorder describes recognition as a separate diagnostic entity.

Thus, skin-picking is a self-injurious behavior in which many sufferers feel that they need to create pick capable surfaces that will allow them to satisfify their compulsions and also relieve them of their tensions. Individuals undertake these behaviors in order to produce scabs which can then be picked. CSP can be linked to another condition called dermophagia which involves swallowing the skin or scabs that have been picked by the sufferers.

Prevention of self-mutilation should focus on increasing coping mechanisms, facilitating decision-making strategies, encouraging positive relationships, and cultivating self-esteem.

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