When I saw this article come through the Google news alerts I thought: “Oh no, an article that’s going to say ‘she did it for attention’ because she has BPD and they are attention-seeking.” I was mightily surprised when I read the article and realized that here’s someone that actually knows what she’s talking about.
When news broke Thursday that a Vancouver woman admitted dousing herself with powerful acid, causing severe facial burns, one question reverberated:
Why would anyone do such a thing?
Friday, a leading researcher in the field of self-harm discounted theories that Bethany Storro, 28, was crying for attention, trying to manipulate others or attempting suicide.
“The biggest reason people do this,” said Kim L. Gratz, “is because it makes them feel better in the moment … It can really distract people from all the emotional pain that they’re feeling.”
Gratz, director of personality disorders research at University of Mississippi, is co-author of books on self-harm and borderline personality disorder. Before she was contacted by The Oregonian, Gratz hadn’t heard about Storro, 28, who told police an assailant threw acid in her face near Vancouver’sEsther Short Park on Aug. 30. Storro described the attack in detail, sending police searching for an African American woman in her 20s or 30s. A couple days later, before a crowd of reporters at Legacy Emanuel’s Oregon Burn Center, Storro said, “I have no enemies … I don’t get it.”
No one is sure how many people mutilate themselves each year; those who do typically hide it.
The U.S. Centers for Disease Control and Prevention put the number of emergency room visits for self-inflicted injury at 594,000 in 2006, the most recent data available. But the vast majority of people who intentionally hurt themselves don’t seek treatment, Gratz said, either because they don’t need medical attention or because they’ve become good at treating themselves.
“Our best estimate in adult populations,” she said, “is probably 4 percent … with much higher rates among adolescents and young adults.” Large-scale studies of college students around the world put rates of self-harm at 17 percent to 40 percent, she said. Incidence among females and males appears comparable.
The most common form of self-harm, or self-mutilation, as it’s also called, is by cutting; those who engage in the behavior frequently slice their arms, then wear long sleeves to hide the injuries.
Dr. Thomas Dodson said such patients describe a state in which they don’t feel any emotions. “They cut on themselves,” he said, “because they can’t tolerate a state of not feeling anything. It becomes habitual and relieves tension that they have.”
Dodson, a Southwest Portland psychiatrist, chairs the public information and education committee for the Oregon Psychiatric Association.
Beyond cutting, the list of self-harm behaviors is as long as it is gruesome, from burning to sticking the skin with needles, punching one’s self to banging the head or another body part repeatedly against hard surfaces. Use of acid, apparently, is rare.
The most typical diagnosis among self-harmers is borderline personality disorder, Gratz said. But the behavior also is associated with eating disorders, substance-use disorders, depression and anxiety.
If Storro has a diagnosed illness, it has not been publicly disclosed.
Self-harm is not a suicide try. Yet those who mutilate themselves are fragile, Gratz said, and are at higher risk of suicide than the general population.
Gratz has no idea what might have triggered Storro to hurt herself, but life transitions, always increase stress, she said. Storro recently divorced and moved from Idaho to Vancouver to live with her parents. She had just started a new job at Safeway.
The best treatment for self-harm, Gratz said, was developed by University of Washington’s Marsha M. Linehan, a psychology professor. Called dialectical behavior therapy, it involves a year of intensive psychotherapy, plus weekly group sessions in which patients learn to regulate emotions, tolerate distress, be more mindful of and negotiate relationships better. DBT, for short, includes telephone coaching, so therapists can help patients whenever a problem arises, and a consultation team offering peer support for the therapists themselves.
The method is the treatment of choice for borderline personality disorder.
At Portland Dialectical Behavior Therapy Program on Southwest Macadam Avenue, Tracy Jendritza, a psychologist on staff, estimated that half the clinic’s patients have engaged in self harm.
“People get so dysregulated emotionally that there’s something about self harm that actually calms people down,” Jendritza said. “Initially they feel better but in the long term it makes things worse.”
Self harm, Gratz said, frequently goes hand in hand with shame and feeling alone. She figures that Storro has landed in that deep well.
“My guess is that she’s experiencing incredible shame” since police learned the truth about the attack. “It’s so public … I’m sure she’s in a much more intense state of distress” than she was before applying the acid that burned the skin off her beautiful face.