Re: Teenage son gouging, clawing face until bloody
I definitely believe this is a problem associated with SI, for I have done this myself when I was very young but was more out of anger and frustration than anything else. It is a lot like cutting but I found my cutting was more from sadness and other depressive issues and things like scratching myself and hitting myself leaned more towards an anger management issue than anything else.
Counseling may be just what he needs but I find that most of the time the type of counseling needed does not come from Doctors but from someone closer to the age range of the person in question and from someone who can relate to them most, personally. When I was a teenager there was a rec. center in my neighborhood that held a teen counseling group where the teenagers were all assigned another "close to teenage" person that related most to their personal lives. I am sure that there are a lot of places to find help that is along the same lines.
My Brother was diagnosed with Bipolar disorder w/ psychotic episodes when he was 16 and through netcare was assigned a caseworker that was close to his age that picked him up twice a week, they went shopping, to lunch, to games and spent a lot of time talking and it seemed almost a cure all for him at the time. Maybe there is a program like that where you live.
Also, on the medication note, it can be a long process for some people to find a medication that works well with them and then sometimes it's just that they don't need medication. To determine both sides of that, meeting with a psychologist for a psychological evaluation would be best suited.
Hopefully for his sake they will find that he does not need medication and just needs some emotional management.
Good Luck and God Bless.