Body modification & risk of self harm

[Ceke2002]

By body modification I mean things like piercings, tattoos, and some corsetry (to a degree).

I had a rather bemusing conversation with a social worker acquaintance of mine, who maintains the position that any, or all of the aforementioned activities immediately deems a person in their care as a 'high risk' for self harm and/or suicidal behaviour. Of course I immediately dismissed this point of view as complete balderdash, especially considering I have several piercings, a tattoo on my chest, regularly wear a corset for the comfort and support factor, and have no immediate or long term plans to either self harm or start eyeing off tall buildings in preparation for a very short lived career in cordless bungy jumping.

But it did get me thinking, in between the 'LOLWUT-ing'. Does anyone here take into consideration these types of activities or interests when assessing patient risk for SH or SI? Would there be cases where such activities would be considered part of a maladaptive coping mechanism, or perhaps symptomatic of a mental health disorder?

Curious minds and all that.

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[WisNeuro]

Methinks this SW is simply an idiot who injects their personal biases into their clinical work, at the detriment to the patients that unfortunate enough to be under their care. Next time as this person what empirical literature they are relying on for this assertion.

 

[annoyedpsychiatrist]

These activities are done based upon personal enjoyment rather than suicidal intent. Involuntary hospitlization is unlikely to act in the patients best interest, and would just ultimately cause more harm than good. Plus once they leave the hospital in 3-5 days, theyre ultimately going to do what they want anyways. Its like the people who get 1,000 cosmetic surgeries. Ultimately cant stop people from making personal choices, we can just temporarily help someone in immediate crisis. Its hard to argue body modifications are an imminent risk to themselves/others unless its a very extreme form

 

[wolfvgang22]

I have a patient who has a history of serious self cutting who gets tattoos as an alternative, often in more painful locations.

 

[TexasPhysician]

Body modifications do not correlate with risk of self-harm.

On the flip side, the way we look does have a potential clinical or psychological role in defining who we are and what conditions we may be struggling with. It could reveal aspects of our culture, influences in our life, or the struggles we are encountering. It could also reveal some countertransference issues.

 

[Liquid8]

Hate to say it, but the quality of social worker training in Australia can be absolute garbage and some courses are well known for promoting very odd ideas.

Piercings/tattoos aren’t something I’d consider as part of my risk assessment for SI/DSH. If anything, someone who gets their names of their kids tattooed on their arm might be more inclined to use that as a reminder and it could serve as a protective factor.

 

[Fan_of_Meehl]

By body modification I mean things like piercings, tattoos, and some corsetry (to a degree).

I had a rather bemusing conversation with a social worker acquaintance of mine, who maintains the position that any, or all of the aforementioned activities immediately deems a person in their care as a 'high risk' for self harm and/or suicidal behaviour. Of course I immediately dismissed this point of view as complete balderdash, especially considering I have several piercings, a tattoo on my chest, regularly wear a corset for the comfort and support factor, and have no immediate or long term plans to either self harm or start eyeing off tall buildings in preparation for a very short lived career in cordless bungy jumping.

But it did get me thinking, in between the 'LOLWUT-ing'. Does anyone here take into consideration these types of activities or interests when assessing patient risk for SH or SI? Would there be cases where such activities would be considered part of a maladaptive coping mechanism, or perhaps symptomatic of a mental health disorder?

Curious minds and all that.

If we're talking about an individual patient presenting with these (or any) characteristics, the onus is on the clinician to point to empirical data (history, observations, self-report, legal/occupational/academic records, collateral interviews) supportive of the idea that the characteristic is dysfunctional or causes harm. The more and more popular these body modifications become in the population, the less distinctive they become.

Doctoral-level psychologists are trained to think in an organized and disciplined manner in their approach to clinical assessment. Other professions (often)...not so much.

 

[WisNeuro]

To put this into perspective, at least in the US, something between 26-33% of adults have a tattoo, and more than 50% have at least one piercing. This incompetent provider is asserting that, at any given time, more than half of the population is at "high-risk" for suicide. It's just a stupid idea if you stop to think about it for one second.

That being said, I have no idea about how this pertains to the extreme ends of the body mod spectrum. But, this would constitute a very small percentage of those with a tattoo/piercing.

 

[Ceke2002]

Hate to say it, but the quality of social worker training in Australia can be absolute garbage and some courses are well known for promoting very odd ideas.

Piercings/tattoos aren’t something I’d consider as part of my risk assessment for SI/DSH. If anything, someone who gets their names of their kids tattooed on their arm might be more inclined to use that as a reminder and it could serve as a protective factor.

Actually an acquaintance in the US, not sure where she got her license or training from (bottom of a weetie's box I'm guessing). The odd thing is that I've mostly known her to be someone of reasonable intelligence and critical thinking skills, so when she came out with this it was a tad mentally whiplashing to say the least.

My sister in law has a Masters in Social Work from Flinders University in Adelaide. I know she has a fair amount of frustration working with, or overseeing other social workers with lesser or not so well trained qualifications.

 

[Ceke2002]

To put this into perspective, at least in the US, something between 26-33% of adults have a tattoo, and more than 50% have at least one piercing. This incompetent provider is asserting that, at any given time, more than half of the population is at "high-risk" for suicide. It's just a stupid idea if you stop to think about it for one second.

That being said, I have no idea about how this pertains to the extreme ends of the body mod spectrum. But, this would constitute a very small percentage of those with a tattoo/piercing.

That is pretty much what I, and many others in the conversation pointed out to her. It was very odd, to say the least. It's almost in the category of one of my good friend's partners thinking she could fix his depression by getting him to wear pastel coloured clothing instead of basic black (yeah I'm not kidding with that).

 

[Ceke2002]

I have a patient who has a history of serious self cutting who gets tattoos as an alternative, often in more painful locations.

I got my first (and so far only) tattoo done on my chest, apparently one of the more painful spots to get one done. I found it so relaxing I fell asleep during the session. I've known people who've battled urges to self harm by replacing the behaviour with something similar, but more positively driven, and also who have rewarded themselves with ink, or piercings, for resisting the urge to self harm.

 

[Ceke2002]

Body modifications do not correlate with risk of self-harm.

On the flip side, the way we look does have a potential clinical or psychological role in defining who we are and what conditions we may be struggling with. It could reveal aspects of our culture, influences in our life, or the struggles we are encountering. It could also reveal some countertransference issues.

Have you ever looked at the case of Empress Elizabeth (Sisi) of Austria? Interesting historical example where obsessive corsetry tightlacing was likely associated with BDD and Anorexia with potential psychosocial influences and stressors of the period.

 

[Ceke2002]

Methinks this SW is simply an idiot who injects their personal biases into their clinical work, at the detriment to the patients that unfortunate enough to be under their care. Next time as this person what empirical literature they are relying on for this assertion.

Funnily enough one of her favourite phrases is 'cite your sources' when anyone else is making sweeping claims re history, mythology et al. The conversation is over, and she did get a lot of clap back from folks, but darn I wish I'd thought to just reply to her discussion with 'cite your sources'.

 

[comp1]

It's all a spectrum. Of course there are people who utilize all kinds of body modification (including scarification) as physical pain to distract from emotional pain. There are millions more who don't. This is not an all or nothing kind of thing. Also, self injurious behavior does not necessarily or even commonly directly relate to suicidal intent.

 

[Mad Jack]

While some people absolutely use tattoos and piercings as a means of self-harm, these are a minority by far and it's more of a case of people that would be self-harming anyway but happen to also like body mods and figure they can turn it into a two-for-one special. Generally, people with tattoos and piercings are just like anyone else and at no higher or lower risk than the general public in my eyes