Transcript On the cutting edge: - Indian Trail High School

On the cutting edge:
Working with teens who self injure
On the cutting edge
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History of self-injury
Why do people self-injure?
Types of self-injury
Description of a self injurer
Role of the counselor
Family dynamics
Types of self-injury
Cutting skin
Burning oneself
Hitting oneself
Head banging/extracting hair to excess
Scratching to excess
Severe nail biting/biting oneself
Interfering with healing wounds
Chewing lips, tongue, or fingers
Ingesting sharp or toxic objects
Facial skinning
Breaking bones
Amputation of limbs, breasts, digits, etc...
Eye removal
Self-injury characteristics
• Self-injury is a behavior done by yourself
• Self injury means there is some kind of physical
violence
• Self-injury is not performed with the intention of
suicide
• Self-injury is an intentional act
• Self-injury is not an alteration of appearance
• Self-injury is not ritual mutilation
• Self-injury is not a fad
• Self-injury is a purposeful act of self-help
Why do people self-injure?
Self-injury is a maladaptive coping style
Self-injury is a means of escape from over-whelming feelings
Self-injury is a release of pain
Self-injury is an addiction (the endorphin theory)
Self-injury is a way to feel something
Self-injury is an abuse pattern
Lack of role models and invalidation as a child
Brain chemistry/biological predisposition theory
The self-injurer
•All types of backgrounds
•Typical onset is puberty
•Above average to superior intelligence
•Low self-esteem
•Problem avoidance
•Eating disorder/alcohol and substance abuse
•Angry, impulsive, anxious, aggressive
•Senses are overwhelmed (dissociation)
•Relies on actions to gain relief
•An attempt to maintain psychological integrity
•Self-injury quickly and dramatically calms the body
•Trouble forming intimate relationships
The family
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Traumatic losses, illnesses, or instability
Neglect or abuse-physical,sexual,emotional
Rigid, dogmatic code of values
Impossible standards of perfection
Lack of role models and invalidation
Child takes adult responsibilities
Poor communication
Expressing feelings not allowed
What the family and friends
should know
• Look for telltale signs; scars on arms or legs, a
pattern of abrasions
• Signs can also be scarce or very subtle
• Being secretive or disappearing frequently
• Makes weak excuses for the wounds and may
become guarded or anxious
• Wearing long sleeves and pants in warm weather
• Finding miscellaneous tools like razors or paper
clips in odd places
Psychological issues
• A history of trauma
• Physical or sexual abuse
• Dissociation
• Eating disorders
• Substance abuse
• Borderline personality disordrer
Behavior changes to watch for
• Social withdrawal
• Sensitivity to rejection
• Difficulty handling anger
• Negative comments about themselves
• Showing feelings of shame,
worthlessness, or self-loathing
What parents need to know
• Openly talk with your teen as soon as you find out,
more importantly, be a non-judgemental listener
• Clearly say that you want to help, acknowledge their
feelings
• Avoid punishment and calling them crazy
• Control initial reaction
• Avoid power struggles and threats
• Consider the self injurer’s privacy
• Be available and supportive
• Take care of yourself and seek your own counseling if
needed
• Although difficult, examine your part in the problem
What the counselor needs to know
• Your theoretical orientation does not matter
• Your ability to form a therapeutic relationship does
• Your gender does not matter
• Do not try to control your clients use of self-injury
• Lack of experience is not a barrier to working with
self-injuring clients
• Self-injury us a symptom of a more serious problem
Any Questions?