However, unlike secular self-mutilators
who generally recognize themselves as the cause of their wounds, true stigmatics likely engage in self-mutilation during altered states of consciousness involving an experience of the divine, while retaining no overt awareness of their actions.
 Other forms of less dangerous treatment for self-mutilators
often include such seemingly benevolent measures as pacts against self-mutilation.
Although there has been a growing interest in early trauma as a factor in the development of self-mutilative behavior (e.g., Favazza, 1996; Favazza & Conterio, 1989; Himber, 1994; Low, Jones, MacLeod, Power, & Dugan, 2000; Van der Kolk, Perry, & Herman, 1991), relatively little is known about what motivates self-mutilators
and many professionals are at a loss to understand the behavior (MacAniff Zila & Kiselica, 2001).
Students who tolerate self inflicted pain to achieve a certain look need a different plan of action than the aforementioned self-mutilator
. This leaves school counselors with an ethical concern of determining a student's intent before devising a plan of action.
A review of the literature indicates that researchers tend to agree on the general profile of a chronic self-mutilator
. A typical self-injurer is a female, in her mid-20s to early 30s, who has been hurting herself since her teens.
(1988).The plight of chronic self-mutilators
. Community Mental Health Journal, 24, 22-30.
report that they do this behavior to escape from emotional pain, release anger, slow racing thoughts, end episodes of dissociation, or have a sense of control.
Female habitual self-mutilators
. Acta Psychiatrica Scandinavia, 79(3), 283-289.
"These are head-bangers, feces-smearers, cell-flooders, self-mutilators
, screamers," she said.
The results suggest that school counselors may be some of the only people to whom self-mutilators
believe they can talk.
It seems that the ability to wheedle surgical assistance is the chief practical criterion that distinguishes "sane" sexual self-mutilators
from "insane" ones.
In fact, sexual abuse is now recognized by experts as the primary diagnoses of self-mutilators
" (Strong, 1998).