The paper: "Alexithymia and emotional awareness in anorexia nervosa..." is particularly interesting. Some studies of alexithymia in high functioning autism/Asperger's syndrome have also produced surprising results in recent years. It makes me wonder whether the Toronto Alexithymia scale is rather duff....

I think the screening for self-injury article is interesting. I self-injured for a long time, and though I feared to admit that I did this to anyone but my boyfriend, I didn't really see it for the problem it was. No one ever asked me the right questions to identify my problem. It wasn't until I admitted doing this to my current therapist that anyone besides that boyfriend knew about my self-injuring behaviors.

I think it's important to ask these sort of questions, especially when the patient has OCD and a history of an eating disorder. Sometimes I didn't have the insight to recognize my own problems, including the self-injury. I was so caught up in my distorted ways of thinking that it seemed unnecessary to address. Taking cues from me and my insistence that I was "fine" was never very helpful. I needed someone to recognize my problems because I felt unable to report them until I absolutely couldn't take it anymore.

I also think that the questions related to self-injury need to be broadened. I didn't cut or burn myself, and because I didn't abuse myself in these ways I didn't really put my behavior in the same category. Cutting or burning would have been too obvious. As much as I probably would have liked to go that far to release my frustration with myself, the self-restraint that already ruled my life wouldn't permit such clear cut forms of self harm. Though I often had bruises that couldn't be seen, the signs of my self-injury weren't obvious to the outside world

I was a rather non-typical self harmer too. Many professionals like to try to label anyone who self harms with borderline personality disorder, but aside from the self harm I didn't fit any of the criteria. Self harming was my only 'risky' behaviour too, I didn't take drugs or drink and I certainly wasn't promiscuous. I get frustrated with stereotypes associated with certain types of mental health problem. It's rife in eating disorders too - aside from the fact that I didn't have body dysmorphia associated with my anorexia, I also wasn't a perfectionist or a "type A" personality and I was able to recover without hospitalisation or other intervention, despite being severely underweight and having been unwell for well over a decade. The presentation of mental illnesses is as varies as the individuals who suffer from them. I wish there were less stuffing of people into badly fitting boxes.

I am really curious to know if the statement in the article about men and eating disorders (one which I have been repeated in every other article about men and EDs) is actually true: is the prevalence of eating disorders in men really increasing, or are men just coming forward for treatment more often now because it's a less taboo subject?

...and I am apparently half asleep and can't type properly! That should have been varied rather than varies and seen rather than been. D'oh. I may not be a perfectionist, but I AM obsessive :P

lol, Carrie.

I am writing a paper on the biological basis of AN and your smorgusboards are helping me find pertinent and recent research!

I was weird with self-harm too. Through my teens I tended to bruise myself as opposed to cutting or burning and I didn't start cutting until my 20's. I felt that when I told clincians about self-harm they automatically assumed cutting and dimissed the relevance of any other harming behaviour even though my bruises were quite large and severe.

I was also not the typical self-harmer as I am not impulsive and overtly self-destructive or attention-seeking. The self-harm performed the same function as my ED -- which was a numbing release and "high," which allowed me to escape rampant anxiety. I think more studies need to be done on the anxiolytic affects of self-harm.

In terms of the alexithymia, I think I am more trouble identifying other people's emotions than my own! I think I am more prone to be surpised by my emotions because I am not used to feeling them, but this does not necessarily mean I cannot tell what I am feeling. However, I have great difficulty reading emotions from facial expressions and tend to automatically perceive negative emotions.

A:)

The research on alexithymia was particularly interesting to me, since my own research was regarding the correlations between alexithymia and a variety of self-injurious behaviours, EDs included. And we, of course, used the TAS-20!

I might have to break into a university library so I can get my hands on the journal and read the whole thing. :)

Lots of people practice "harmless" self-injury- that is, self-injury that might cause a few small scars, but no big damage, no extensive bleeding, no suicide risk at all. Is there a reason why it matters? I'd be curious to hear thoughts. Yes, it's sad- I've done it- and I admit, I can't quite call it "normal" or "healthy." But I've never thought it needed to be "fixed" b/c, unlike anorexia, it causes no life-threatening damage. Maybe there's a better way. Maybe not. Maybe it's no different than getting piercings or tattoos. (Except, I guess, that you hide cuts, not wear them as decoration.) Would welcome feedback- am trying to figure out what matters.

To hm
I know this is a late reply so I hope you see this. There are two reasons why 'harmless' SI, as you call it, matters. The first is that it can and often does escalate. I started out very small and over a decade later was covered in stitches. Maybe you've kept it on a small scale for years, but it is a highly addictive behaviour and can sometimes only begin to get out of hand decades after a person first cuts themselves.

The second reason is that it upsets your body chemistry and mental balance. Most people find that the more they self harm, the less they can cope with without self harming. This was my experience as well. When I finally stopped it was hell to start off with, but my distress tolerance began to grow almost immediately. I only stopped dissociating when I stopped self harming as well.

I used to feel the same way as you - even if there ARE stitches, the only person you are harming is yourself. But you are harming yourself far more than just the surface wound.

Thanks for the thoughts, Katie- I get the "slippery slope" idea- that it can escalate. I also see the connections btw. SI and dissociating, which, in my opinion, is much more dangerous b/c you cannot protect yourself (or your children) if you dissociate under stress- so if the one encourages the other, it needs to be dealt with. Thank you.