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More Than Skin Deep: Indian Leaders Address Self-Injury Prevention

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When she was 14 years old and living in a boarding school in Arizona, Alex Exendine cut her forearms with everything from broken mirrors to scissors to cope with her grief. The Lakota teen from the Pine Ridge Indian Reservation had lost her best friend to a brain tumor, and the grandmother who helped raise her died shortly after.

“I was so lonely,” Exendine told the Rapid City Journal. “I just never thought anyone understood how I felt.”

Now 19, Exendine shared her struggle and how she overcame self-injury with Indian leaders and medical experts at the conference “Wakanyeja Ihawicakta Pi, Looking Out for Our Children: a Cultural Learning Opportunity on Self-Injury Prevention” in Rapid City, South Dakota from May 12-13.

Exendine told the Journal that her internal suffering and bottled feelings led to physical self-harm. “I felt like I had no emotions anymore,” she said. “I started cutting and I’d at least feel something.”

During her sophomore year in high school, a friend encouraged her to channel her pain through writing. Exendine began expressing her feelings in journals and participating in traditional Indian practices like sweat lodges and praying with Lakota elders. “Since then, I have felt like a new person,” she said.

Studies on cutting do not focus on American Indian youths, said Richard Two Dogs, a traditional Lakota healer who organized the self-injury prevention conference that attracted social workers, youth counselors and youth leaders. The conference, hosted by the Children First, Knife Chief Buffalo Nation Society and Village Earth, urged participants to raise awareness of the high incidence of self-injury among Native youths and discuss ways to prevent it.

Cutting is “called the anorexia of the era,” said Blackfeet member and psychologist Dr. Joseph Stone at the conference, reported the Journal. As the chief of behavioral health at the Gallup Indian Medical Center in Gallup, New Mexico, Dr. Stone has treated many “relatives,” as he refers to his patients, in the emergency room for self-inflicted cutting wounds.

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Self-injury includes intentional scratching, cutting, burning or gouging, which sometimes requires stitches and antibiotics to avoid infection, Dr. Richard Laughter, a Diné psychiatrist and conference attendee, told Indian Country Today Media Network.

Creating physical pain temporarily diverts the mind and lowers the chemical cortisol. Cortisol not only triggers stress, it increases serotonin, which spikes when we experience pleasure and happiness. A good workout provides the same boost in serotonin. “People who sweat also release anxiety and stress,” Dr. Laughter said.

The addictive behavior of cutting is more common among girls than boys, with about 70 to 80 percent of cutters having experienced some kind of trauma as a child, reported the Journal. Lack of acceptance is a common cause of cutting among female teens. “Two of the most common things teens get frustrated about are peer pressure and relationship problems,” Dr. Laughter told us.

Other issues that commonly drive cutting are financial, housing and employment problems; domestic violence; and a poor support system. Dr. Laughter often recommends treating a chemical imbalance in the brain with medication in addition to therapy. “From a psychiatrist’s point of view, there’s a deficiency of chemicals in the brain. Serotonin regulates the mood and controls anxiety and panic attacks. With cutters there is a high association of chronic stress, which leads to depression.”

Dr. Laughter’s prescription for healing straddles Western and traditional medicine, and he hopes a future conference will initiate a merger of the two treatment methods. “People want to get healing, and they want Western medicine to be more holistic.” There are, he added, many aspects to healing—mental, physical, emotional and spiritual among them.

Similarly, Dr. Stone believes that Native youth benefit from embracing their traditional ways. “If you want to treat inner generational pain, you have to connect people back to their culture to develop a positive Indian identity,” he told us. And he wants to raise awareness that “people who cut are not crazy. It is an expression of deep-seeded pain.”

Exendine hopes her personal experience will help other youth who self-harm realize they are not alone and there are other ways to cope. “I would tell them there are other ways than cutting themselves,” she told the Rapid City Journal. “You can write to people or just write to yourself. Express yourself in other ways.”