Ask Dr. E

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.E 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.

PHOTO (COLOR): One in eight young people deliberately harm
themselves at some point in their lives.