Why did Sadie Frost hurt herself? New ideas about non-suicidal self-injury

In her new autobiography, Crazy Days, English actress Sadie Frost, 45, describes her turbulent six-year marriage to English actor Jude Law. The couple had three children together and after each child was born, Ms. Frost suffered from postpartum depression (called postnatal depression or PND by British doctors), a condition that has also affected Gwyneth Paltrow, Lisa Rinna and Brooke Shields. As her marriage with Jude Law was ending, Sadie suffered what was called a “breakdown” in Los Angeles that apparently  caused her to be placed on an involuntary psychiatric hold for evaluation and was committed to psychiatric hospital for 28 days.

In her book (excerpts of which are being published in the London Daily Mail), Ms. Frost describes an incident in 1997, after the birth of her second child, Rafferty (her first child with Jude Law), where she “wanted to press the self-destruct button” and went out partying all night after arranging a babysitter for the children. The next day she was “racked with guilt” and

“…was sitting at my dressing table, not feeling anything – just numb. I watched my hand slowly pick up a pair of scissors. If was as if I was being sucked down lower into the chair and scissors seemed to be drawn to my arm. I appeared to have cut myself. Blood dripped down my arm. There was no sense of panic within me – I just felt empty.”

This incident of self-injury, apparently without suicidal intent, caused us to remember a lecture we attended last March on “Why People Hurt Themselves” by noted Harvard psychologist Dr. Matthew Nock. Dr. Nock has researched and written extensively on the social functions of self-injury which has puzzled doctors, scientists and philosophers for thousands of years. Professor Nock explained the important differences between suicidal and non-suicidal thoughts and behaviors which are shown in the diagram below.

In a recent article in the Annual Review of Clinical Psychology, Dr. Nock describes the characteristics of self-injury. He writes that the “most commonly used method of self-injury…is cutting or carving oneself with a sharp implement such as a knife or razor, with most self-injury occurring on the arms, legs, and stomach.”  He goes on to say that other characteristics of self-injury  include “Thoughts of engaging in self-injury [that] typically occur when the person is alone and experiencing negative thoughts or feelings…” and the “…widely held belief that self-injury is performed in most cases as a means of self-soothing or of help-seeking…most self-injurers report feeling little or no pain during episodes of this behavior.”

In this article, Dr. Nock also writes about the risk factors, prevention, assessment, monitoring and treatment of non-suicidal self-injury (NSSI). He also provides references to some other books on this and related subjects:

If you or anyone you know has thoughts about hurting themselves, this is not a situation to deal with on your own. You must seek the advice of a mental health care professional.

Mark Boguski, M.D., Ph.D. is on the faculty of Harvard Medical School and is a member of the Society for Participatory Medicine, "a movement in which networked patients shift from being mere passengers to responsible drivers of their health" and in which professional health care providers encourage "empowered patients" and value them as full partners in managing their health and wellness.

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