Why Teens Insert Objects Under Their Skin

About 6% of all teens engage in 'self embedding.' Do you know what drives this harmful behavior?

From the WebMD Archives

A 17-year-old girl jammed six metal staples into the soft skin near her wrist.

A 15-year-old girl pushed a length of pencil lead under the skin of her forearm. One 18-year-old inserted 35 objects over a period of two years, including staples, a comb tooth, a fork tine, a cotter pin, and nail polish wands.

The dangerous practice of pushing objects directly into the flesh or inserting them into cuts is called self-embedding. While it's not a new trend, it's often misdiagnosed, ignored, or under-reported.

Doctors sometimes discover self-embedding by accident, most often when an embedded site becomes infected. Radiologists who reviewed three years of patient records at Nationwide Children's Hospital in Columbus, Ohio, found that of 600 people treated to remove foreign bodies from soft tissue, 11 had inserted them deliberately.

The Roots of Self-Embedding

As many as 6% of teenagers admit to inserting objects under their skin.

Why would they do this? Self-embedding is a psychiatric disorder involving deliberate, non-suicidal self-injury, or NSSI, says Peggy Andover, PhD, an assistant professor in the psychology department at Fordham University and a clinical psychologist. It's most common among teenagers, but new research shows children as young as 7 self-injure. Andover has found a fairly even split between the genders.

Researchers have not given much attention to self-embedding, according to Andover, but psychologists have some theories about why people do it. It may be a coping strategy: a way to calm anger, anxiety, or stress. It may be a way to signal emotional distress, or it might be a behavior learned from others. Andover says many people who self-embed report that friends or family members also have done it.

While some researchers consider embedding and other forms of NSSI a symptom of borderline personality disorder, Andover says it happens in people with other disorders, as well as in people without another diagnosis. Her research has also discovered a troubling connection: Many people who report self-injury also report suicidal thoughts and suicide attempts.

Treating Self-Embedding

Dialectical behavior therapy (DBT), which is used to treat borderline personality disorder, also seems to help reduce self-injury. DBT is a type of cognitive behavioral therapy that teaches patients skills to cope with and change unhealthy behaviors. Andover is developing a new cognitive behavioral treatment specifically for NSSI.

What can parents do? Talk to your teen. "Parents should realize that asking the question won't start the behavior. It won't put an idea into his or her head," Andover says. "It will potentially open up the lines of communication."

Continued

Detecting Self-Embedding

Teens may try to hide self-embedding. Clinical psychologist Peggy Andover, PhD, says it's important to stop it.

  • Look for signs. If your kid wears turtlenecks in the summer or refuses to be seen in a bathing suit, he or she may be trying to cover up self-embedding injuries.
  • Talk about it. When your child mentions that a friend has done this, or you see a news report about self-embedding, use the opportunity to discuss why kids hurt themselves and how to stop it.
  • Get your child into therapy. If you find out your child has embedded an object into his or her flesh, take it seriously. Therapy can help with the problem that's causing this behavior. A psychiatrist can prescribe medication, such as an SSRI (selective serotonin reuptake inhibitor), that can be effective.

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WebMD Magazine - Feature Reviewed by Patricia A. Farrell, PhD on May 15, 2012

Sources

SOURCES:

Margaret S. Andover, PhD, clinical psychologist; assistant professor, department of psychology, Fordham University, New York, N.Y.

Young, A.S., et al. Radiology, October 2010.

Andover M. Psychiatry Research, June 2010.

Stanley, B. Archives of Suicide Research, November 2007.

Nock, M. Journal of Counseling and Clinical Psychology, October 2004.

Penn, J.  Journal of the American Academy of Child And Adolescent Psychiatry, July 2003.

Lloyd-Richardson, E.  Psychological Medicine, August 2007.

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