Cutting and other forms of derma-abuse in adolescents

Abstract

Cutting or self inflicted epidermal damage (derma-abuse) describes a number of blood- letting behaviours among adolescents. Unlike suicidal behaviour, it is associated with low lethality and the absence of suicidal attempts. The purpose of this study is two-fold: Firstly, to present and discuss vignettes of four young adolescents and secondly, to study the dynamics and characteristics of six derma-abusers who have attended Dual Group Therapy (DGT) concurrently with their parents for a six month period. Our findings suggest that patients involved in derma-abuse are generally non-suicidal but engage in comfort cutting for the psychological release of pain, tension reduction and anger management. There is a preponderance of females (80%) with an over-representation of mixed origin and borderline cultural states. In this small group, males amounted to 20% and were more bizarre, gruesome and brutal in their self-abuse. Of the total sample, 10% were of African origin, 60% were of Indian descent and 30% were of mixed ancestry. Psy- chodynamic factors explored in Dual Group Therapy (DGT) are the emphasis on non-suicidal intent, association with tension reduction, reclaiming power and mastery over self and others, life and death instincts, the significance of bloodletting in a socio-cultural context, trans- generational conflicts, dysfunctional family dynamics frequently with parental separation and sexual abuse and early sexual induction.