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Self-Embedding Disorder

********** Trigger Alert **********



I have written before about the psychological aspects of Cutting and Self Injury. This psychological phenomenon has been on the rise in recent years, and now the Radiological Society of North America is highlighting a unique trend called Self-Embedding Disorder.

Self-Embedding is different than Cutting and other Self-Injurious behaviors in that patients identified with Self-Embedding Disorder often have suicidal ideation (Most who cut are usually non-suicidal. With cutting, the goal is to inflict physical harm on one's body to relieve emotional distress. Not end life).

Individuals who Self-Embed take the behavior of cutting a step further by introducing an object or objects inside the wound or into deeper soft tissue. Only when the pain becomes excruciating, do such patients find their way to hospital settings or doctor offices. In the reported cases from the RSNA study, 90% of the patients they saw with such injuries were adolescent girls. The photo above, from the RSNA conference, shows three staples in the lower part of the hand of a teenage girl.

If you are self-harming or know someone who is, please consider seeking professional medical and psychological help to aid you in understanding this behavioral disorder. Often, self-harm is a way to express what feels unbearable. Or is unspeakable. A mental health specialist will help you learn ways to find the words, ease the pain and find a sense of well being.

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Christian Depression Testimony

This is my testimony (in a nutshell) in dealing with and eventually overcoming severe depression.

For me, 1989 had been a productive and hope filled year. After graduating from Bible College in 1988, I had joined a church planting team as the assistant pastor. I expected 1990 to be one of best years of my life as I planned to further my theological training and join another church planting venture in pursuit of my goal of becoming a missionary in Thailand.

Probably the primary factor in causing my depression was genetic inheritance, both of my parents had suffered from it. However, there were many other factors that contributed to its severity and duration. Throughout that year a number of factors combined to cause the gradual decline of my mental and physical health. I had neglected physical exercise, eaten poorly and devoted little time to rest and recreation. I worked full time as well as serving part time in the church. The sleeplessness which had troubled me in recent years had developed into chronic insomnia. As I became ever more fatigued, panic attacks and obsessive fearful thoughts afflicted me in increasing frequency and severity, even though I had no idea what they were at that time. Undiagnosed complex partial epilepsy could have been another factor.

On the other hand, throughout that year I remained positive and full of zeal for life, excitedly pursuing my goals.

In late November 1989 I went to Thailand for a hectic ten-day missionary orientation course, where I barely slept at all. When I returned to Melbourne, I fell apart emotionally, physically, mentally, and spiritually. Although 178cm tall, my weight had fallen to 55kg. The final straw came a few days later - I suffered a shock so powerful that for almost 24 hours I was unable to complete a single thought in my mind.

After eight nightmarish days that defied all reason, I suddenly bounced back to some semblance of normality. Unfortunately, I collapsed again two weeks later, where my mind unravelled to the extent that for the next several days, I did little else but lay on my bed, rocking from side to side as I tried in vain to pull myself out of terrifying panic attacks that would not cease.

This time, instead of bouncing back, I remained stuck in the hellish nightmare, which continued without respite into the New Year. I felt disturbed and ill at ease all day and could barely sleep at night. My mind became sluggish, stuck in a rut of thinking fearful, anxious thoughts all the time. Many physical complaints assailed me, missed, palpitating and racing heart beats, very painful aches in the shoulders and jaw, nausea and chest pains, difficulty breathing, and more. Emotional symptoms included anger, confusion, irritability, loss of interest in life, fear that I would never escape the nightmare, and I withdrew from almost all relationships. My spiritual life was equally a shambles, I struggled with anger and bitterness towards God, could no longer feel His presence, and felt guilty all of the time.

Although I continued to languish in this miry pit of bleak hopelessness for the next seven months, there were a number of things that slowly helped me cope with the ordeal.

When my mother, who had been away, returned to find me bedridden, she bundled me off that bed and kept me busy me with menial chores around the home. Although this required a massive effort on my part, I soon realised that the distraction provided by these activities slightly lessened the inner pain. When I had to return to work a few days later, although I was still a complete and utter mess, I found that being busy at work further dulled depression’s intensity.

Around that time a friend who had experienced depression, gave me a very helpful piece of advice. “Find anything that you enjoy and pursue it. Just try to have fun.” My unspoken response was, “How can I have fun when I am like this?” However, although very difficult to do, with Christ's help I was able to put his advice into practice. (‘I can do all things through Christ which strengtheneth me.’ Philippians 4:13 KJV.) I bought a computer, played engrossing computer games, and over the next five years wrote three novels. These hobbies helped keep my mind productively occupied and were a significant factor in helping to break my mind’s habit of thinking fearful thoughts. I can remember one day when I was lying on my bed stuck in the grip of a savage panic attack, when I managed to fix my eyes upon Jesus, and He said, “Peter, you don't need to do this. Come with Me - I have lots of constructive things for us to do together.” So I got off the bed, sat at my desk and lost myself in one of my hobbies, and started to feel better.

'Let us fix our eyes on Jesus, the author and perfecter of our faith,' Hebrews 12:2

In March 1990 I admitted I needed professional help, so I forced myself to see a trained counsellor. She counselled me once a month for several months, sympathising with what I was going through, giving practical advice, and through prayer, God’s Word, and her own experiences, helped me to face and deal with several deep emotional wounds and flawed thought processes. She also helped me to see the fearful thoughts that were terrorizing me from another perspective – the true Biblical perspective.

Following my counsellor’s advice, I went onto anti-depressants under my doctor’s supervision. Although the tablets did not heal the depression, within two weeks they had significantly dulled its effects. My diary entries began to contain a faint glimmer of hope. With the symptoms dulled, I found myself more able to concentrate on the task of recovery.

During those first eight months, I frequently blamed Jesus for allowing such a thing to afflict me. Why would not He heal me? I read the Bible constantly, spent hours in prayer, but these provided little relief. However, although I could no longer feel His presence, I knew Jesus held me in His hands. I continually reminded myself that He is Faithful and True, and kept reaching out to Him. It was in this time, when my feelings and emotions utterly betrayed me that I learnt to stand fast upon God’s Word and on promises such as: ‘I will never leave you nor forsake you.’ Joshua 1:5 and “And surely I am with you always, to the very end of the age." Matthew 28:20. This next verse was particularly comforting, “My sheep listen to my voice; I know them, and they follow me. I give them eternal life, and they shall never perish; no one can snatch them out of my hand.” John 10:27

In late July 1990, by a miracle of the Lord’s provision, I came across the book, ‘Self Help for Your Nerves’ by Dr Claire Weekes. My life changed when I read the comprehensive list of symptoms that can be caused by anxiety and depression and how they are caused. The bewilderment and confusion that had terrorised me for eight months were replaced by understanding, which brought a tangible sense of relief all in itself. ‘Give me understanding, and I will keep your law and obey it with all my heart.’ Psalm 119:34

Hope also returned to my life when I put into practice the practical steps presented in the book. The most helpful technique was learning how to face, accept, and learn to live with the symptoms of depression rather than fighting, fleeing or fearing them - and then letting time pass. Putting these techniques into practice slowed down and eventually stopped the endless flow of negative adrenalin, reducing the severity and duration of depression’s symptoms, until they eventually faded away.

As I read ‘Self Help for Your Nerves,’ I realised that her techniques were practical applications of Bible verses that teach us how to cope with anxiety and troubling circumstances, such as these:

Acceptance:
'Consider it pure joy, my brothers, whenever you face trials of many kinds, because you know that the testing of your faith develops perseverance.' James 1:2-3

'Be joyful always; pray continually; give thanks in all circumstances, for this is God's will for you in Christ Jesus.' 1 Thessalonians 5:16-18

Learning to Live with it
‘I have learned the secret of being content in any and every situation, whether well fed or hungry, whether living in plenty or in want.’Philippians 4:12-13

Letting Time Pass
“Do not let your hearts be troubled. Trust in God; trust also in me.” John 14:1

'Blessed is the man who perseveres under trial, because when he has stood the test, he will receive the crown of life that God has promised to those who love him.' James 1:12

“Therefore I tell you, do not worry about your life, what you will eat or drink; or about your body, what you will wear…Who of you by worrying can add a single hour to his life?” Matthew 6:25,27

'Trust in the LORD with all your heart and lean not on your own understanding.' Proverbs 3:5.

Three months after reading ‘Self Help for Your Nerves’ my counsellor said I no longer required counselling. Although I was still suffering from many of depression’s side effects, she said it was time to get back into things. Over the next six months, I joined a new church, became a musician in a home group, started teaching Sunday School, and engaged in normal social activities again.

It took about four more years to recover from depression, but I kept busy throughout that time, staying involved with the church, joining a gym, and pursuing engrossing hobbies. Some of depression’s symptoms took longer to fade away than others, especially the mental ones, but by changing the way I reacted to them robbed them of their power as I no longer feared them.

Today I can look back at that time and say that I have no regrets. It was during those years that I learned to rely completely and utterly upon Christ and His Word, rather than upon my feelings and circumstances. I can see how He brought good out of that trial, drawing me closer to Him and setting me free from lifelong anxieties. I also found myself better equipped to deal with future trials.

And now I share my story so that others may find comfort and encouragement, as I received from the Lord in my time of great distress. 'Praise be to the God and Father of our Lord Jesus Christ, the Father of compassion and the God of all comfort, who comforts us in all our troubles, so that we can comfort those in any trouble with the comfort we ourselves have received from God.' 2 Corinthians 1:3-4



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(All verses from the NIV unless otherwise stated)

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    Your Mind's Eye

    Face Recognition is the ability for the mind and brain to recognize faces. Many scientists agree that this skill is present from birth on.

    Our tendency to be hardwired to see faces can extend to finding faces in things as well. This is called Pareidolia. I've blogged about this before, so here I add more pictures to the list.


    Can you see the faces?











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    They Could Have Been the Worst Four Years of My Life

    The years of 2003 to 2006 could have been the worst four years of my life. My health was literally disintegrating before my eyes.

    Although I had been gradually going deaf since my late teens, in 2004, my thirty-eighth year, I lost all hearing in my left ear. This crippled me. I had to leave the church band, could not engage in social dialogue, stopped listening to music (one of my greatest pastimes), could not hear the television, and almost drove my family crazy asking them to constantly repeat themselves. Otosclerosis, an inherited disease that causes the calcification of the bones of the middle ear, was the cause of this ailment. Yet of equal concern to me was the accompanying tinnitus. Although both ears suffered from it, my deaf ear produced a cacophony of continuous, ‘deafening’ sounds, including roaring, thundering, grating, and an extremely deep humming that was extremely unsettling.

    Not long before losing my hearing in one ear, I was diagnosed as suffering from complex partial epilepsy, confirmed by undergoing MRI and EEG scans. Prior to this, I had never heard of this condition, thinking the partial-seizures to be a symptom of depression. At this time I ceased taking anti-depressants and took anti-seizure medication, which had (and still has) quite horrid side effects. I lost interest in almost all of my hobbies, entered a continual state of exhaustion, and both short term and long term memory deteriorated significantly.

    During these years a recurring injury received from my childhood worsened to the point that I was frequently afflicted by agonising, throbbing pain for ten hours a day, for up to three months at a time. (An operation in 2006 healed this injury.)

    It was a Sunday morning in November 2004, when I had come down with the flu for the sixth time in a row, (which may have had something to do with burning the candle at both ends recently…) that I reached a crossroads. With the deafness, epilepsy, injury and apparent inability to return to any semblance of health, I felt the crushing weight of despair threatening to descend upon me. This was the last straw.

    I had a choice. My life appeared to be in a state of utter disarray. I could succumb to despair and slip into the miry pit of depression, or I could turn to Jesus and rely upon His strength in my weakness, as He said to Paul in 2 Cor 12:9, "My grace is sufficient for you, for my power is made perfect in weakness."

    I chose the second option. While I drove down Canterbury Road that November summer morning, I waited upon Jesus and recalled something I had heard in a sermon. My life was like riding in a bus, and the bus driver was Jesus. I was comforted by the fact that the bus driver always knew the destination and how to get there. This was my situation in a nutshell. Although my life appeared to be a complete mess and out of control, this was not the truth. The truth was that Jesus was in control of my life. I had nothing to fear. Jesus said in John 10:27-28, “My sheep listen to my voice; I know them, and they follow me. I give them eternal life, and they shall never perish; no one can snatch them out of my hand.”

    So rather than let these burdensome troubles drive me to depression, I surrendered them to Jesus and placed my trust in Him. The pressures faded away and hope, joy, and peace prevailed.

    May I ask you, the reader, a question here?

    Considering the breadth of my troubles at this time, does it seem too easy?

    I know the Bible says in James 1:2 to ‘Consider it pure joy, my brothers, whenever you face trials of many kinds,’ but trust me, although I reach this place eventually, this is not my initial reaction to trials!

    Perhaps you are wondering why it did not take me days, weeks or months to learn to cope with these trials. How could I, after going through so much, ‘seem’ to shrug off their debilitating affects and yet live a normal life?

    The only reason these afflictions did not drag me headlong into depression’s merciless grip was because I had already been down that road, back in 1990. It began with an eight-month period of living hell which included an endless cycle of debilitating anxiety attacks, chronic insomnia, crippling feelings of guilt, low self-esteem, utter despair at what was happening to me, and much more. As the days turned to weeks and then to months, I was crippled by the fear that this ‘thing’ that had overcome me would never lessen or end.

    Here is an extract from my diary dated February 20th, 1990. (At this time, I had no idea what was wrong with me.)

    Oh Lord, when will this end?
    Day after day, I remain trapped
    In this endless personal hell of pain and confusion.
    I want to get out of myself!
    To be someone else, anyone but me.
    The me I know is gone, yet somehow I am still me.
    I must escape from myself, but
    I'm trapped in a suffocatingly small, dark room.
    I know there is sunlight outside.
    I run, push, and strive to reach that light,
    But the room comes with me--I cannot get out!
    Why? Because I am the room.
    Jesus, for what reason have you allowed this?
    Where are you? How long will you remain silent?
    They say that others who have been down this route
    Have left signposts along the way
    To help those like me find the way out.
    But where are these signposts?

    By His grace and provision, Jesus helped me overcome depression and live a normal life again. And in learning how to cope with depression, Jesus set me free so that I need never again succumb to its depths. Galatians 5:1 ‘It is for freedom that Christ has set us free. Stand firm, then, and do not let yourselves be burdened again by a yoke of slavery.’ In conclusion, it was because of what I learnt during my trials of the early 1990s, that I was able to endure the trials of 2003 to 2006 and through Christ, overcome them.

    The purpose of this blog is to encourage all (myself included!) undergoing trials and tribulations to establish Jesus Christ as the cornerstone, or foundation upon which to build our lives, and through His strength, endure and overcome those trials in order to live life to the full. John 10:10 Jesus says, “I have come that they may have life, and have it to the full.”

    Download a pdf booklet of this blog's articles

    (All verses from NIV)

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    Grand Rounds: 5.9
















    Welcome to Grand Round 5.9 - a weekly rotation of blogposts in the medical and health fields. I am delighted to be your host again, and present to you the following for your listening pleasure.














    "A Sudden Jolt of Sadness" by The Sterile Eye
    "Annual ACAAI Meeting" by Allergy Notes
    "Crestor and other CRP" by Covert Rationing
    "Diagnostic Acumen" by In My Humble Opinion
    "Doctors Empowering Parents" by Dr. Nancy Brown
    "Flu Vaccine Recommendations for Children" by Dr. Paul Auerbach
    "I Am Not Special" by Bongi
    "Interview with Dr. David Newman" by Detroit Receiving
    "It's Elementary" by The D-Log Cabin
    "Medicine in Media" by Medical Pastiche
    "My Favorite VBAC" by Rural Doctoring
    "Ritual" by Dr. Bruce Campbell
    "Sciatica and the Saline Story" by Back Pain Blog
    "Selenium/Vitamin E Don't Prevent Prostate Cancer" by Laika
    "Should Doctor Sex Scandals Be Made Public" by Canadian Medicine
    "Sometimes Death is a Good Thing" by You Just Gotta Keep Livin'
    "Teratoma: One Patient One Disease" by Dr. Am Ang Zhang
    "Tips for New Medical Bloggers" by Clinical Cases & Images
    "Which Stretch Stops Back Pain" by Dr. Jolie Bookspan















    "1,000 Cranes" by Dethmama Chronicles
    "Bariatric Surgery: Psychological Considerations" Suture for a Living
    "Borderline Personality" by Clinically Clueless
    "Can We Pick Your Brain" by Dr. Joshua Steinerman
    "Freezing and Unfreezing" by In Sickness & In Health
    "Kudos for the General" by Doc Gurley
    "Marx" by CBTISH
    "New DSM Diagnosis" by Tiny Shrink
    "Obsession with Internal Medicine" by ACP Internist
    "Resilience" by Health Psych
    "Studing Sin" by Neuroanthropology
    "The Future of the Aging Society" by Dr. Alvaro Fernandez
    "Understanding Social Anxiety" by Psych Central
    "Virtual Reality Therapy for PTSD" by Dr. Shock













    "Gluten Free Eating" by A Chronic Dose
    "Rules of Engagement" by Diabetes Mine
    "The Diving Bell & The Butterfly" by How to Cope With Pain
    "The Things I Carried" by Duncan Cross
    "Understanding Stress" by Mother of Shrek
    "Walking From The Heart" by Own Your Health
    "What I've Learned from Being One Armed" by ChronicBabe
    "When a Doctor is a Patient" by e-Patient Dave















    "Coordination of Care Fractures Medical System" by Dare to Dream
    "Dear President-Elect Obama" by Repairing the Healthcare System
    "DNV David Harlow & Hospital Accreditation" by HealthBlawg
    "Heart Failure Hospitalizations Rates Surge" by Dr. Mercola
    "Live from the Operating Room" by Change:Healthcare
    "One in Five Hospital Stays Involve Mental Illness" by MHA Society
    "The Implications for Live Tweeting Surgery" by Healthcare Law Blog
    "Was It a Very Good Year" by InsureBlog
    "World Diabetes Day" by International Diabetes Foundation

    Many thanks to "Executive Producers" Colin Son and Dr. Val Jones, as well as "Grandmaster" Dr. Nick Genes. For without them, none of this would be possible. Grand Rounds drops again at Canadian Medicine on Tuesday, November 25th. But before you go, check out my playlist of music inspired by your Grand Round submissions.




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    Just Do It

    Talking while doing something non-verbal can throw you off. In fact, many athletes believe that being in their head too much can disrupt performance - so they focus on the action of the moment.

    Researchers from the University of Michigan Psychology Department and the University of St. Andrews in Scotland agree. They found that, for some, trying to verbalize a performance distracted the brain by putting the focus on language. This is called verbal overshadowing and has been shown to interfere with the non-verbal aspects of a memory, resulting in a decreased performance on tasks. For more, read here

    I can relate to this phenomenon. I can cook a great meal, sink a golf putt or drive the quickest way to a destination, but ask me to explain what I'm doing as I'm doing it and my performance will suffer. So, verbal overshadowing when performing can be a good thing or it can throw a monkey wrench into your world. See how this works for you and adjust accordingly.

    Me? I'll be the quiet one on the Just-Do-It bench.

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    Genetic Indicators for Gender Identity

    From an early age, we develop an inner sense of being a boy or a girl - male or female. This is called gender identity.

    Individuals who have a gender disorder identify with the sex opposite of their assigned biological sex. They feel as if they are not in the right body, and yearn to be someone other than who they are.

    These feelings begin in early childhood and have been considered "disordered" thinking in the past. A psychological problem, like homosexuality was perceived years ago. Not too long ago, such gender issues were seen as "choices", not biologically bound within one's DNA. And as a result, many children, teens and adults would hide in shame. Some even choosing suicide.

    More research, like this recent one from Australia, show that there is a genetic link for gender identity. "There is a social stigma that transsexualism is simply a lifestyle choice, however our findings support a biological basis of how gender identity develops, " reports Dr. Vincent Harley, Head of Molecular Genetics at Prince Henry's Institute.

    This research will be published in the January 2009 journal Biological Psychiatry and suggest that pathologizing "Gender Identity Disorder" will be a thing of the past.


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