Ask Dr. E – advice column

Ask Dr. E – advice column – Brief Article

Robert Epstein

Answers to your questions about self-mutilation, nail-biting, hypochondria and more.

Dear Dr. E,

Our 19-year-old daughter is a cutter. She’s been in treatment, but it hasn’t helped. How can we find effective treatment?

P, Long Island, New York

Dear P,

As many as 3 million Americans are self-abusive in some way. As a young man, behavioral psychologist B.F. Skinner cut himself over the pain of a failed relationship, and in a 1995 interview with the BBC, even Lady Diana admitted to cutting herself repeatedly when her marriage was failing. Self-abusive individuals can often be helped through a combination of cognitive-behavioral therapy, group therapy and medication. For treatment alternatives, contact Self-Abuse Finally Ends at www.selfinjury.com.

Dear Dr. E,

I’m a 52-year-old woman and have bitten my fingernails since I was a child. This is a common habit in my family, but it’s quite undesirable. How can I break it?

J, via e-mail

Dear J,

If your nail-biting is anxiety-related, you could probably benefit from learning and practicing some relaxation techniques (see books such as my Big Book of Stress-Relief Games or Eshelman and McKay’s Relaxation and Stress Reduction Workbook). The best way I know to stop nail-biting, however, is to use the Nail File Technique: Buy 50 cheap nail files and scatter them everywhere you work and play. When a rough edge begins to bother you, grab a file and sand the nail smooth. People rarely bite or pick at nails with smooth edges. By the way, this technique worked beautifully for me when I was 20.

Dear Dr. E,

Why do people exhibit hypochondriacal behavior?

J, Eureka, Ilinois

Dear J,

“Hypochondriasis” is a label applied to someone who imagines, incorrectly, that he or she is suffering from a major disease. It’s one of a number of different somatoform disorders, the most serious of which is somatization disorder, a condition that is roughly 10 times more common in women than in men. No one knows for sure why these disorders exist, but at least in some cases, they’re maintained by what Freud called “secondary gain”–the attention and care one gets from complaining about illness. It’s nearly impossible to ignore such complaints, because now and then, even hypochondriacs get sick.

Dear Dr. E,

What is borderline personality disorder? How does it come about?

J, Winnetka, California

Dear J,

This widely used label encompasses a veritable potpourri of symptoms, including frantic fears of abandonment, difficulties in maintaining relationships, extreme impulsivity, suicidal tendencies, unstable moods and poor anger control. The one characteristic that seems to cut across all these symptoms is instability, but some professionals consider this label too muddled to be useful. Childhood trauma is common among people labeled with this disorder, but the sheer vagueness of the label makes it impossible to identify an actual cause.

Dear Dr. E,

Will a person who was adopted have more turbulent adolescent years? How can I research this topic?

C, Snohomish, Washington

Dear C,

Teenagers tend to distance themselves from their parents and rely on peers for direction and support. It’s a fairly natural, sensible phenomenon that helps keep the species going. Adopted teenagers could certainly use their adoption as an excuse for creating such distance, but other factors, such as the nature of the peer group, are probably more important in producing turbulence. You can find the latest research on this and other topics in the behavioral sciences by searching the PsychINFO database, accessible without charge at many university libraries or for a small fee at www.apa.org.

Dear Dr. E,

My grandmother constantly criticizes me and tries to control everything I do, even though I’m in my thirties. How can I get her to stop?

R, Covina, California

Dear R,

Assuming she doesn’t actually hate you, your grandmother’s interference is probably just an awkward expression of her love. I’d suggest, as odd as this may sound, that you treasure every criticism. It’s much easier to understand someone especially a well-meaning grandma–than to change someone.

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