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DECATUR - Self-injury is often misunderstood.

While not an addiction, the practice of cutting, burning or bruising oneself offers an "addiction-like" release from emotional pain. It doesn't mean the person is suicidal, but it does increase the risk of an attempt.

About 80 percent of people who deliberately and repeatedly hurt themselves also have an eating disorder. Not all are young females either; males and adults injure themselves, too.

Finally, the behavior is a cry for help rather than a bid for attention.

This was among the information shared Wednesday at the Decatur Public Library by Michelle Seliner, chief operating officer of SAFE Alternatives in St. Louis, a medical facility devoted exclusively to treating nonsuicidal self-injury. SAFE stands for Self Abuse Finally Ends.

Seliner conducted two educational sessions, attended by teachers, school social workers and nurses, probation officers, therapists and families.

She said treatment involves medications for concurrent depression and/or anxiety, identifying patterns and triggers through keeping a log and coming up with healthier coping behaviors.

"It's important to hold these patients accountable for their actions," Seliner said. "They're the only ones who can keep themselves safe."

Forms of self-injury include imbedding objects under the skin, head banging, scratching, biting, hair pulling, skin picking, ingesting sharp objects or toxic substances, breaking bones, amputation of fingers, blinding and sexual promiscuity.

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"I see a very wide range of cases," Seliner said. "Right now I have a little girl who burns herself with an eraser, but then I also have a boy who was requiring at least one surgery a week to remove objects he had stuck into his penis."

Allie Lanphear, a social worker for Decatur public schools, asked during the afternoon session how to handle students who make excuses about repeated injuries. Seliner said brutal honesty and humor can help get to the truth. "Simply ask why they are hurting themselves," she said.

She also recommended students be asked if they are thinking about suicide when self-injury is occurring.

Mary Peck, school nurse for the Decatur School District, was among several people who asked if Seliner would be willing to return to Decatur and conduct a daylong session.

"I could ask you 14 questions and still not be done," Peck said.

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