Coping with Self-Harm Behavior and Moving On

 How can I find hope and healing?

          Some people who engage in self-harm behavior are able to stop without intervention.  They simply outgrow the need to resolve their emotional troubles in this way.  Others benefit from self-help groups, cognitive therapy to address the thinking behind the behavior, and behavior management strategies to examine the act of self-harm (Van der Kolk, 2002).  In A New Earth, Tolle (2005) describes the process of healing.  Awakening becomes integrated with the authentic self and gradually transforms everything we do and think.  Tolle continues “Instead of being lost in your thinking (and acting) you recognize yourself as the awareness behind it” (Tolle, 2005, p. 259).

            The work of deliberately healing personal pain that has led to self-harm behaviors is accomplished through the development of new behaviors (Favazza, 2011).  These new choices will create the ability to make a positive contribution first to the self and then to others.  It is simple to observe the effect the healing process can have on only one.  It is possible for a person to become one of the few who have confronted unbearable emotional pain, ripped bandages from tender flesh, and allowed wounds to heal.

            It is imperative that any therapeutic approach is specifically designed to meet the needs of the individual (Prout, 2007).  Self-harm behaviors do not occur in a vacuum.  There are other damaging behaviors that go hand in hand with self-harm, e.g. drug and alcohol use.  Treatment must address the needs of the holistic person.  Therapy Associates is a group of competent, compassionate professionals who tailor each treatment plan to the needs of each client.  We are compelled to reach out to those who have been wounded to assist in the achievement of awareness.  We can each take another by the hand and draw them into the circle of joy and laughter that is life.

References

Favazza, A. (2011). Bodies under seige. Baltimore, MD: The Johns Hopkins University Press.

Prout, H. T. (2007).  Counseling and psychotherapy with children and adolescents: Historical developmental, integrative, and effectiveness perspectives. In H. T. Prout & D. T. Brown (Eds.), Counseling and Psychotherapy with Children and Adolescents: Theory and Practice for School and Clinical Settings (4th ed.), (pp. 1-31). Hoboken, NJ: John Wiley & Sons, Inc.

Tolle, E. (2005). A new earth: Awakening to your life’s purpose. London, England: Penguin Group.

Van der Kolk, B. A. (2002). Posttraumatic therapy in the age of neuroscience. Psychoanalytic Dialogues, 12(3), 381-393.

How can I understand self-harm behavior?

 Everyone experiences emotional pain to some degree (Van der Kolk, 2002).  Emotional pain can be perceived as the path toward growth, or as harmful to all that is good.  There are those among us who have experienced seemingly unbearable emotional pain.  As a result of the personal response to these types of experiences, some people may overflow discouragement.  They may feel that they have no purpose and believe themselves to be burdens to the world.  In this case, emotional pain becomes unresolvable.  Many believe that this unanswered woundedness is carried in the body and expressed through mental illness, anxiety, mood disorders, and depression. 

 In fact, Armando Favazza (2011), a leading researcher of self-harm behavior describes all self-mutilative behaviors as forms of self-help that provide rapid, although temporary, relief from upsetting symptoms like growing anxiety, feelings of being disconnected from one’s own body, hurried thoughts, and rapidly shifting emotions.  Adults and teens who engage in self-harm behaviors are making attempts to resolve intense feelings of angst.  These behaviors can restore a sense of control and temporarily provide relief from extreme emotions.

 Imagine riding a roller coaster that is traveling faster and faster along the track.  Your head spins, your neck aches, and you wish to stop, but you have no way to free yourself from the straps holding you to the speeding car.  You want to put out your hand or foot or anything that will stop your plummet into the abyss.  You resist these urges because you know two things.  You know that the ride will eventually end, and you know that the consequences for extending a limb to stop yourself would be disastrous.  A person who engages in self harm does not know when or even if the ride will end; and this person does not consider the physical consequences of extending a foot to be worse than the mental anguish currently being experienced (Kortge, Meade, & Tennant, 2013).

 If you are interested in understanding more about self-harm, pick up A Bright Red Scream: Self-Mutilation and the Language of Pain by Marilee Strong and I Know Why the Caged Bird Sings by Maya Angelou.  Maya Angelou can also be found at her website mayaangelou.com

References:

Favazza, A. (2011). Bodies under seige. Baltimore, MD: The Johns Hopkins University Press.

Van der Kolk, B. A. (2002). Posttraumatic therapy in the age of neuroscience. Psychoanalytic Dialogues, 12(3), 381-393.

Kortge, R., Meade, T., & Tennant, A. (2013). Interpersonal and intrapersonal functions of deliberate self-harm (DSH): A psychometric examination of the inventory of statements about self-injury (ISAS) scale. Behaviour Change, 30(1), 24-35.

What is “self-harm”? What is “cutting”? What is “self-mutilation”? What is “self-injury”?

The terms self-harm, cutting, and self-mutilation are all terms used to describe behavior wherein a person copes with extreme feelings of distress through intentional infliction of a physical injury upon their own body.  Self-harm behavior was once considered an unfulfilled suicide attempt.  A more recent attempt at understanding self-harm placed these behaviors in the same group as addictive behaviors.  Both of these perspectives may describe the observable acts of self-harm, but fail to explain the actual phenomenon.  Self-harm behavior is not attention seeking, is not a result of suicidal ideation, and is not the same as a drug or alcohol addiction. 

            Armando Favazza (2011) has spent more than 20 years working to make sense of this group of puzzling behaviors over time and across specific cultural groups, including teens.  Non-suicidal self injury most commonly involves minor cutting and burning behaviors.  Favazza is successful in thinking “outside the box” and presenting self-harm behaviors as more than symptoms of a specific mental illness.  These behaviors can occur within any population including teens.  This group of deliberate acts may indicate the need for positive or negative reinforcement, a low ability to tolerate distress, ineffective coping skills, and personal expectations (Favazza, 2011).

            In short, self-harm, cutting, self-mutilation, and self-injury are “morbid” forms of self-help (Favazza, 2011).  These behaviors provide temporary relief from painful feelings of distress like anxiety, feelings of being detached from one’s own body or emotions, and desperation (Nock & Prinstein, 2004).  Although alarming for those who do not engage in self-harm, Favazza (2011) describes persons who are able to control self-harm behaviors as courageous and disciplined.  The majority; however, are the others who are unable to control self-harm behaviors.  These people often experience unwanted, serious consequences like unsightly scarring and permanent physical loss.  Favazza (2011) believes that self-harm behaviors, rather than attention seeking, indicators of suicidal ideation, or addictive, demonstrate a strong will to live.  Effective treatment approaches offer more effective coping strategies for depression, anxiety, and mood disorders without the potentially high price tags.  The possibility of assisting these loved ones instills hope.

References:

Favazza, A. (2011). Bodies under seige. Baltimore, MD: The Johns Hopkins University Press.

Nock, M. K. & Prinstein, M. J. (2004). A functional approach to the assessment of self-mutilative behavior. Journal of Consulting and Clinical Psychology, 72(5), 885-890.

Check back for parts 2 through 5 on this blog series

II. Symptoms of Self-Harm

            What does it look like when my loved one is engaging in self-harm behaviors?

III. Why Do Some Adults and Teens Choose to Self-Harm?

            How can I understand self-harm behavior?

IV. What Can I Do when My Loved One Engages in Self-Harm Behavior?

            What professional help is available for those who self-harm and those who love them?

            How can I find an intensive outpatient treatment program for self-harm?

V. Coping with Self-Harm Behavior and Moving On

            How can I find hope and healing?