Diagnosis? Nonsuicidal Self-Injury – DSM-V // Mental Health with Kati Morton | Kati MortonArticles . Blog
Hey everybody! Today I’m going to talk with you about nonsuicidal self injury. We’ve heard it’s a new diagnosis in the DSM. Is that true? What does that mean? *Intro Music* So like I said today I’m going to talk about nonsuicidal self injury. That is exactly like what it sounds like. And we have been talking about this on my channel for years. We talk about self harm, self injury, whatever you want to call it. It’s when we harm ourselves and hurt ourselves without intending to kill ourselves. And everybody’s been excited, because they’re like ‘Oh, it’s in the DSM, Kati. You have to talk about it. It’s a new diagnosis.’ And everybody’s been chatting and commenting. And that is great. But I want to talk to you about what it actually means that it’s in the DSM. It is actually, and I’m looking down because I have … dun dun dun … my DSM with me. It’s actually in conditions for further study. And I just want to read you what it says about this area of the DSM, so that you understand why I hadn’t done a video about this diagnosis. Because it really isn’t a diagnosis. That doesn’t mean it doesn’t exist, but it’s not a new diagnosis. Okay. It says “Proposed criteria sets are presented for conditions on which future research is encouraged.” And it actually is kind of frustrating, but I understand the APA, who makes the DSM, can’t force people to do research on things. Nor do they have the funding to make all sorts of research studies happen. But they’re just proposing these certain diagnosis and criteria, hoping that more research will be done so that they feel they can actually put it into the DSM with real sets of diagnostic criteria. Are you following me? I know that can get kind of convoluted. But it really just means that ‘these are things that we think might be a problem, and maybe be in the DSM soon. Maybe if research is done, we can conclude something. Yay!’ Right. So that is what it falls under. And it also says, “These proposed criteria sets are not intended for clinical use.” Meaning I’m not even supposed to use these in my practice. These are just things pretty much that they’re thinking more research should be done on. Okay? You follow? So onto the proposed criteria. It states that in the last year, and I think this criteria definitely needs some work. You can definitely comment in the comments, and let me know what you think. But this is just what they have so far. It says that “In the last year the individual has on 5 or more days engaged in intentional self inflicted damage to the surface of his or her body.” I do like that they include all sorts of different ways that you can self injure. A lot of you have said like ‘Well what if I just bang my head against the wall? What if I do this? What if I do that?’ It includes any self injurious behavior when it’s not because we have autism or any other spectrum disorder like that. It’s because we want to injure ourselves and inflict pain on ourselves without the intention of committing suicide. That’s pretty much what would fall under this. Some of the other criteria is that you’re doing it for one or more of the following reasons: “To obtain relief from a negative feeling or cognitive state, to resolve an interpersonal difficulty, to induce a positive feeling state” Like we get that euphoria from cutting ourselves. And I know that a lot of us, however we self injure ourselves, you reported to me that it’s for some variation of those reasons. Right? So I think they’re kind of on the right path there. The second portion says “That you have to have at least one of the following” Self injury is associated with one of these. “Interpersonal difficulties or negative feelings or thoughts such as depression, anger, generalized distress, etc. 2: Prior to engaging in the act, a period of preoccupation with the intended behavior that is difficult to control.” Like we talk about those self harm urges. Right? We think about it. We almost plan it. A lot of us have rituals around it. We spend all this time thinking about it, and it becomes completely out of our control then. We have to do it. Impulses get so strong we can’t stop. Then the third it says “That we also think about self injury that occurs frequently even when it’s not acted upon.” So it means that you’re thinking about it all the time. So it takes up a lot of our brain space. Another criteria that I think is really interesting, and something that I’m glad they included. It says “that this behavior is not socially sanctioned.” It’s like not body piercing, tattooing, or part of religious or cultural ritual. “It’s not restricted to picking a scab or nail biting.” Because that would be a completely different diagnosis. If you want more on that topic, click over here. I’ve talked about that before. They also talk about how we need to separate it out from like trichotillomania, hair pulling, because that could be injuring ourselves, but that’s a different set of diagnostic criteria. Those are usually because of different reasons. They also make sure to rule out that these things aren’t happening because we’re in a psychotic episodes or we have delirium or substance abuse. Like we’re using a substance that’s caused us to think maybe bugs are under our skin, so we pull on that. They want to make sure that this has nothing to do with that. That would be a completely different diagnosis. Now the most important thing for me as a clinician who actually utilizes the DSM, regardless of what you think about it. It’s something that I have to reference for insurance purposes, for any kind of diagnostic purposes. It’s the only thing that’s accepted in the United States, and so therefore I have to use it a lot. And self injury used to only fall under BPD, borderline personality disorder. If you want to know more about that, you can click over here, check that video out. There’s a lot of criteria associated with that. It was one of the symptoms of BPD. Now they’re making it, potentially in the future, they may be making it into its own diagnosis. And they talk about how it would be separating itself from BPD, because the cool thing is there has been research done where they’ve studied people with BPD and those who self injure. And they found that although there are instances where it does occur together, it’s not always occurring together. So they’re finally realizing what you and I have already known. That self injurious behavior can happen outside of BPD. I have many clients with complex PTSD. I have a video about that, if you want to watch that. Where they use self injury as a way to deal with that. I’ve also had eating disorder patients who have done self injury, different behaviors and it has nothing to do with borderline personality disorder. And I’m glad that they’re finally seeing that distinction. So my hope is that they do do more research on this, because we know that it’s not just BPD. It’s not just a symptom of that. It should be it’s own diagnosis. But at least it’s in the DSM in some capacity. Right? Things are moving forward. They are recognizing that it is it’s own diagnosis. And I think that that’s really the best news. Because we know that it doesn’t only exist in BPD, and now everyone’s finally catching up. And as far as treatment options, you know I’ve talked about DBT for many moons. CBT is also very helpful. I will link a video here that I’ve talked about self injury and the treatment options for it, because there are ways to get better. You can overcome it. Trust me. I know it seems really hard and the urges could be really strong. But I’ve seen so many people overcome it. And many of our Kinions have too, so if you have any tips and tricks that have helped you fight those urges and get into recovery, let us know below. And if you’re new to my channel or if you’re old to my channel and you haven’t subscribed, why? Click over here to subscribe. And if you want more information about topics such as these, click here. And if you want to see what else I’m up to in my regular life, like filming right now … You might know behind the scenes what’s happening. Click all these icons and you can follow me all over. I’ll see you next time.
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