Supporting A Self harmer

It's difficult to know what to do and say when someone close to you is self harming, it may be that they won't let you help at all or aren't ready to stop.
Do:

• Educate yourself about self harm read books and resources;
• Self harmers are not attention seekers; they hurt themselves because they are in distress. If they want to talk about it focus on the underlying issue, not the symptoms (i.e. not the cutting);
• Accept how you feel about self harm, you may need help dealing with the situation, try support groups, helplines or counselling;
• Show you can separate the person from the self harm and that you love that person. "The best thing that my friends did was just being there for me and helping to support me as I was going through some tough times," explains Abbey;
• Show them that it is safe to talk openly about their problems to you, but dont push them if they do not want to. "The one thing I can think of that helps is just having someone to hold me when I'm upset," says Aimee;
• Listen, but also show an interest by asking questions, to make them realise you care about them. "Quite a few of my friends know that I self harm, and they realise that the best way to help is to never have a go at me, says Kirsty. "They just talk to me and make sure I am honest with them";
• Try and help them to work out what their triggers to self harm are and how they can find distractions instead when they feel vulnerable;
• Help to find other sources of support help groups, counselling, newsletters, forums and websites;
• Get them to keep a diary where they can write down how they are feeling and make notes of when, how and why they self harm;
• Allow them space, privacy and trust. "The best thing to do is to keep a distance," says David. "Make it clear that you are there for them but dont be pushy."

Don't:

• Ignore your friend; treat them as you would usually. Be supportive, patient, respectful and understanding.
• Shout at them, freak out, threaten them with ultimatums, judge, condemn or stereotype all these things are hurtful and will not help. "The worst thing people did was to tell me to 'snap out of it' and that 'you are crazy for cutting'," Abbey reveals. "They would tell me that they were going to lock me up and throw away the key if I didn't stop";
• Take it personally they arent trying to make you feel bad/guilty;
• Try and get them to stop self harming immediately, it will be difficult and they may not be ready to stop. It is a survival mechanism, so instead of taking it away suddenly, it should slowly be reduced by setting smaller goals at their own pace in their own time. "The worst possible thing you could do is to use emotional (or other) blackmail to get the cutter to stop - it makes the desire stronger, and it makes the cutter feel even more guilty for feeling like they need to," David says.
• Panic if it appears that your friend self harms more while they are trying to deal with their problems, it is a scary time for them but they can get through it.

[taken from: The Site]

Self Harm Myths & Facts

I came across this article on Experiments In Living ... Please feel free to share

Myth: Self-harm is just a way of attention seeking.

Fact: Self-harm is a coping strategy. People self-harm because they are finding something difficult and painful. They could also be trying to show that something is wrong. They need to be taken seriously.
Myth: Self-harm is rare in young people.

Fact: Lots of people self-harm. There is lots of secrecy around self-harm and because many young people do not tell anyone, it is hard to know exactly how many are self-harming. The Royal College of Psychiatrists (1999) found that as many as one in 10 teenagers have deliberately self-harmed.
Myth: Young people self-harm over trivial reasons.

Fact: All self-harm should be treated seriously. People self-harm to different extremes as it is a coping strategy and everybody is unique. The extent of the self-harm is not necessarily a reflection of the seriousness of the person’s difficulties.
Myth: Once you have self-harmed you cannot stop.

Fact: People can self-harm just once or twice. Some use self-harm over a long period of time. The frequency of the self-harm varies. Many people do stop self-harming but only when they are ready. This could be when they sort their problems out or when they find other ways to deal with their feelings.

Source: The Learning Mentor’s Source & Resource Book, Kathy Salter and Rhonda Twidle, Paul Chapman Publishing, 2006.
http://www.mandbf.org.uk/.

Fridays Readers Story

Anonymous said...
I'm 19, i started cutting when i was about 14. it started as a peer pressure thing, it was 'cool' within my group of friends. My parents then moved me from America to Scotland, at 16 so my schooling was interrupted, I had to leave all my friends and relationships behind. This plunged me into a state of depression and I started to cut as a way to 'feel' the mental pain I was going to. every day, all up and down my legs.

My guidance counsellor at school found out when my well meaning friend found out and went to find my help. Instead of helping me my guidance counsellor thought it would be much more fun to black mail me into psychiatric help, and letting the entire school know and making things even worse. as I spoke to my shrink I learnt different ways to cope (I have since stopped cutting and live with my boyfriend and attend university, after getting my life back on track) but my guidance counsellor got bored hearing how well I was improving, and told my parents i was mentally deranged. they were hurt and confused, I took me a while to get back their trust, and it damaged my relationships with my siblings dramatically, setting me back in my recovery.

I just wanted to let people know, that even with people trying to set you back, when your ready to stop, you will. but only you can make that choice, no one can make you stop, eventually you just will, some thing else will take its place. don't let any one drag u down.

Medication & Dealing With Teen Depression

Both medication and psychotherapy play a part in the treatment of teen depression. Each method of treatment goes hand-in-hand with one another. Even if a troubled teenager is under medication for his or her depression, supporting psychotherapy is vital to his or her treatment. On the other hand if he or she is undergoing psychotherapy, supporting medication is crucial.

Medications like Zoloft (sertraline) or Prozac (fluoxetine) are often prescribed for the disorder because of their effectiveness in restoring a patient’s normal mood, appetite, and sleeping patterns. While the patient is dealing with his or her issues behind the depression in psychotherapy, medication can help him or her deal with the symptoms of the disorder.

All patients are unique individuals

But it is important to consider the fact that all patients are unique individuals. Just because one medication worked for this patient doesn’t necessarily mean that it will be the most beneficial for another patient. If a certain medication prescribed for depression does not show favorable results in your troubled teen, don’t be quick to shun medication in the treatment of your teen’s disorder. A different kind of medication for depression may have a positive effect on your teen’s progress. For some people, the class of drugs called selective serotonin reuptake inhibitors (SSRI’s) are helpful in the treatment of atypical depression, while others prefer monoamine oxidase inhibitors (MAOI’s). Tricyclic antidepressants (TCA’s) are also another class of drugs which are frequently used in the treatment of melancholic depression.

Have realistic expectations

It is important to note that medication for the treatment of teen depression is not a magic pill which can induce wellness with one swallow. Both parent and patient should have realistic expectations of the effectiveness of the drug in relation to a timetable. For most medications, there is a certain period of time that the patient must be taking the medication for it to take proper effect.

Achieve a proper balance of medication and psychotherapy

Some parents may still be skeptical of the use of medication to treat disorders which are known for their symptoms of feelings. But many studies have shown that there are certain chemicals that may affect our disposition. Because of these new studies, parents ought to be more open to the use of drugs in the treatment of disorders of this type.

As long as a parent is not relying solely on the medication for the treatment of his or her troubled teen, he or she can expect a smoother transition into wellness for his or her teen with the proper balance of medication and psychotherapy.

[Link: Troubled Teen]

Who?

• All different kinds of people, with all different backgrounds, in all different social classes. There are not many unifying factors among people that self injure. Most of them are women, but not all, and most of them begin to self-injure in their early teenage years, but not all. Chances are that more men self injure than we know about, but are less likely to seek medical and emotional support.
  
  People who SH generally share these characteristics:
  strongly dislike/invalidate themselves
• are hypersensitive to rejection
• are chronically angry, usually at themselves
• tend to suppress their anger
• have high levels of aggressive feelings, which they disapprove of strongly and often suppress or direct inward
• are more impulsive and more lacking in impulse control
• tend to act in accordance with their mood of the moment
• tend not to plan for the future
• are depressed and suicidal / self-destructive
• suffer chronic anxiety
• tend toward irritability
• do not see themselves as skilled at coping
• do not have a flexible repertoire of coping skills
• do not think they have much control over how/whether they cope with life
• tend to be avoidant
• do not see themselves as empowered (R1)
• Do not regulate their emotions well, and there seems to be a biologically based impulsivity.

[Taken from: Face The Issue]

Treatments for self-injury

One danger connected with self-injury is that it tends to become an addictive behavior, a habit that is difficult to break even when the individual wants to stop. As with other addictions, qualified professional help is almost always necessary. It is important to find a therapist who understands this behavior and is not upset or repulsed by it. Call your doctor or insurance company for a referral to a mental health professional who specializes in self-injury.

Cognitive-behavioral therapy may be used to help the person learn to recognize and address triggering feelings in healthier ways

• Because a history of abuse or incest may be at the core of an individual’s self-injuring behavior, therapies that address post-traumatic stress disorder such as EMDR may be helpful (see Helpguide’s article on Eye Movement Desensitization and Reprocessing)
• Hypnosis or other self-relaxation techniques are helpful in reducing the stress and tension that often precede injuring incidents (see Helpguide’s article on Yoga, meditation and other relaxation techniques)
• Group therapy may be helpful in decreasing the shame associated with self-harm, and help to support healthy expressions of emotions
• Family therapy may be useful, both in addressing any history of family stress related to the behavior, and also in helping other family members learn how to communicate more directly and non-judgmentally with each other
• In cases of moderate to severe depression or anxiety an antidepressant or anti-anxiety medication may be used to reduce the impulsive urges to self-harm in response to stress, while other coping strategies are developed.
• In severe cases an in-patient hospitalization program with a multi-disciplinary team approach may be required

[From: Helpguide.Org]

Psychotherapy & Dealing With Teen Depression

Psychotherapy plays an important part in the treatment of a depressed teenager. For those parents who may think that being in a slump is something that their teen can just shrug off, here is where you may be mistaken. The despair and prevailing sadness that a teenager may experience from depression is a serious matter. If a parent were to simply wait for his or her teen to shrug it off, that parent could be waiting for nothing.

The important issue to remember here is that when a teen is suffering from depression this may not be the only problem he or she is faced with. In fact, a crucial problem that any depressed person may face is suicidal tendency. This is precisely why active help and steps in treatment of the disorder are vital.

Getting to the root of a teen’s depression

When a depressed teen is undergoing psychotherapy, the issues which lie behind his or her disorder are being addressed. A psychotherapist may want to talk with him or her about his or her feelings in different situations. By getting to the root of a teen’s depression the likelihood of it resulting in suicide is greatly reduced, if not eliminated. It is vital for a depressed teen to be in psychotherapy because it gives him or her a chance to air out the negative feelings he or she may be keeping inside.

This gives the therapist a chance to correct any misconceptions that the patient may have about him or herself, or life in general. Instead of leaving these misconceptions to brew negativity within your teen, he or she gets a chance to release them.

Talk therapy

Talk. Talk itself can be a very therapeutic activity. By having your troubled teen speak with a psychotherapist you are also engaging him/her in an activity where you are sure that he/she will not be isolating him/herself. When dealing with a disorder such as depression, any activity that can keep the patient from isolation or loneliness can be helpful.

Once the issues behind your teenager’s depression are addressed in psychotherapy, he or she may face a smoother road to recovery. Without the therapy, you are not certain that your troubled teen’s issues are being dealt with or just tucked away inside by your teenager.

Taking that first step to recovery

At first it may be scary for you and your teen to seek professional help, but it is an empowering step to take. By acknowledging that he or she has a problem and getting help, he or she is taking his or her first step to recovery.

[Link:Troubled Teens Info]

Friday Readers Story

Tiarra said...

Hi

I have self harmed once in the past. I have a history of sexual abuse and the first time I self harmed was because I allowed a stranger to be sexually intimate with me - some crazy way of me proving to myself that I wasn't afraid of sex, that I was capable of engaging and enjoying sexual relationships. Needless to say I was terrified, and wasn't ready that at all, and I self-harmed to deal with all the emotions. But recently stuff has been building up and the urge to go back to that place of cutting is becoming stronger and stronger as more and more crap compounds itself into the already limited space of what I can handle.

But to speak to the post, there is also stigma that comes with self-harming - that people do it for attention, they do it because they want to die, etc. And I believe the first step to effectively helping the people that use this coping mechanism is to erase the stigma and stereotypes and realize that it is a cry for help, often times the only way of expressing a pain so great, a pain for which there are no words.

Just Listen

Listen with not just your ears,

Listen with your eyes, your mind, your emotions but most importantly LISTEN WITH YOUR HEART
to the silent cries of those who need you the most.

[Feb 27, 2008: Taken from Random1]

Dynamics Of Shame & Guilt

Yesterdays Readers Story included the fact that shame was one of his major reasons for hiding that he self harms and I agree this can be a a hurdle for us not speaking out and asking for help. So I thought I would explore just what shame is in this post.

Shame is the feeling of being unworthy, inadequate, or defective, expressed in the belief that: "There's something wrong with me." It is a feeling of remorse about one’s worth as a person. The self, more than one's behavior, becomes the target of attack.

Guilt is a feeling of regret about what one has done or not done that hurt someone. Guilt is the uncomfortable or painful feeling that results from doing something that violates or breaks a personal standard or value, or from hurting another person, or even from breaking an agreement or a law. Guilt thus concerns one's behavior, feeling bad about what one has done, or about what one didn't do that one was supposed to have done.

As John Bradshaw says, "When I feel guilt, I feel that I have made a mistake, and when I feel shame, I feel that I am a mistake."

Shame or low self-esteem plays a major role in stifling the 'inner self' or 'true self'. Shame is both a feeling or emotion, and an experience that happens to the total self.

We all experience shame. Shame is universal to being human. If we do not work through it and then let go of it, shame tends to accumulate and burden us, until we even become its victim.

In addition to feeling defective or inadequate, shame makes us believe that others can see through us, through our facade, into our defectiveness. Shame feels hopeless: that no matter what we do, we cannot correct it. We feel isolated and lonely with our shame.

Shame, is the only emotion that attacks the self by making one believe that one is inherently defective and unlovable. This crippling emotion destroys self-confidence and prevents one from achieving or enjoying success. When shame pervades one’s day-to-day existence, one is torn between one’s need to empower and the need to preserve one’s relationships.

Shame is a learned emotional reaction to an actual or perceived attack on the worth of an individual

• Dealing with shame involves:




• Recognizing the aspects of the self that were shamed.




• Figuring out rationally and logically if there is any validity to those comments or beliefs.




• Recognizing the effect of that experience.




• Feeling the anger, sadness, hurt and pain.




• Letting go of the past feelings and beliefs.

Overcoming the paralyzing effects of shame that keeps one limited starts with developing an awareness of how and what one believes about one's self, then questioning and exploring that belief with logical, realistic and rational thinking.

[taken in part from © Uzma Mazhar 1999]

Helping A Friend or Family Member Who Is a Self-Harm'er

No matter how you look at it, self-harm scares people. It is very hard coming to terms with the fact that someone you care about is physically harming themselves. From the depths of your own fear and helplessness you may feel frustrated if you are unable to get the person to stop hurting themselves which can further drive the person away.

Some helpful tips in dealing with someone who self-injures

* Understand that self-harming behavior is an attempt to maintain a certain amount of control which in and of itself is a way of self-soothing. Think of it as a way to relieve pain rather than inflict it.

* Tough as it may seem, this isn't about you and how you feel (save that for your own therapy) its about the friend or family member who is hurting. Statements such as 'look at what you are doing to your mother, father, brother' etc are useless and damaging. You cant make a SH'er feel more guilty than they already do.

* Let the person know that you care about them and are available to listen ... then Listen, Listen, Listen, ... don't fill the gaps with meaningless chatter (usually as you are uncomfortable with what you are hearing) often silence and a hand held says more than words.

* Encourage expressions of emotions including anger, sadness.

* Spend time doing enjoyable activities together, its not all about the act of SH, just being there for someone is supportive (distraction)

* Offer to help them find a therapist or support group.

* Don’t make judgmental comments or tell the person to stop the self-harming behavior – it's not a priority. Finding other ways of relieving distress and in due course working on the underlying reasons is whats needed. People who feel worthless and powerless are even more likely to self-injure.

* The person needs support and not punishment or threats of abandonment unless they stop the behaviour.

* Focus on the persons strengths & positives always. Don't minimise what they are saying, 'oh you'll be fine.' etc.

* If your child is self-injuring, prepare yourself to address the difficulties in your family. Start with expressing feelings which is a common factor in self-injury – this is not about blame, but rather about learning new ways of dealing with family interactions and communications which can help the entire family

* Don't disempower the person by trying to take decisions out of their hands and making choices for them. Help them to explore options but don't take over.

* Don't minimise why they are hurting or what triggered them and focus on the SH, they need to be heard and not judged.

These points are for using if a someone near has disclosed that they self harm or you may bring it up if you see there scars, bandage etc. Chances are if you can ('normally' they may be hidden by clothing etc.) But if you can see them, ask they may respond. A simple statement of 'I'd like to understand' is often enough. Again I can't emphasis a non-judgemental approach. If you choose to do this be aware of your own feelings & body language.

In this there is no 'right' way but there are ways to minimise the distress to you or the person who SH. I hope these points help. If you have others that you know of please leave a comment. Each little piece helps.

[taken in part from Help Guide.Org]

Medication & Teen Depression

While the patient is dealing with his or her issues behind the depression in psychotherapy, medication can help him or her deal with the symptoms of the disorder.

It is important to consider the fact that all patients are unique individuals. Just because one medication worked for this patient doesn’t necessarily mean that it will be the most beneficial for another patient.

If a certain medication prescribed for depression does not show favorable results in your troubled teen, don’t be quick to shun medication in the treatment of your teen’s disorder. A different kind of medication for depression may have a positive effect on your teen’s progress. For some people, the class of drugs called selective serotonin reuptake inhibitors (SSRI’s) are helpful in the treatment of atypical depression, while others prefer monoamine oxidase inhibitors (MAOI’s). Tricyclic antidepressants (TCA’s) are also another class of drugs which are frequently used in the treatment of melancholic depression.

Refer to Role of Medication in dealing with Teen Depression for more information.

[Link: Troubled Teens]

Changing Your Mind

Positive (or negative) self-talk can be very powerful. If you go into an exam, thinking “I can do this. I’m totally prepared. I’m going to ace this thing!” you’re far more likely to be successful than if you go in, worrying “I’m not ready for this. I’m going to fail!”

In addition to affecting your academic performance, self-talk influences your athletic performance, your ability to overcome personal crises, and your eating and physical activity behaviors.
Some tips:
1. Listen to your thoughts.
2. Decide if your thoughts help or hurt your progress.
3. STOP your negative thoughts.
4. Re-word your negative thoughts to make them into positive messages. Check out the guidelines and examples below:

Consider these guidelines...
• Think about successful changes you’ve already made. Imagine good results with changes you plan on making.
• Say what you are doing now. Use the present tense.
• Make it as positive as you can. Be specific.
• Forget what should be.
• Make it personal.

What Kinds Of People Self-injure?

Self-injurers come from all walks of life and all economic brackets, although most come from a middle-class to upper-class background. People who harm themselves can be male or female; straight, gay, or bisexual; Ph.D.s or high-school dropouts or high-school students; rich or poor; from any country in the world.

Some people who self-injure manage to function effectively in demanding jobs; they are teachers, therapists, medical professionals, lawyers, professors, engineers. Some are on disability. Their ages range from early teens to early 60s.

Nearly 50% report physical abuse and/or sexual abuse during his or her childhood. Many self-injurers report that they were discouraged from expressing emotions, particularly anger or sadness.

The incidence of self-injury is about the same as that of eating disorders, but because it's so highly stigmatized, most people hide their scars, burns, and bruises carefully. They also have excuses ready when someone asks about the scars.

Aren't people who would deliberately cut or burn themselves psychotic?

No more than people who drown their sorrows in a bottle of vodka are. It's a coping mechanism, just not one that's as understandable to most people or as accepted by society as alcoholism, drug abuse, overeating, anorexia and bulimia, workaholism, smoking cigarettes, and other forms of problem avoidance.

[taken in part from Focus]

Define Yourself

"Never be bullied into silence. Never allow yourself to be made a victim. Accept no one's definition of your life; define yourself."

Harvey Fienstein

Teen Depression

During the teen years not only does it become difficult to understand what behavior is then teen just being a teenager but it also becomes difficult to decide if the teen is depressed. One of the easiest ways to decide if these mood changes are depression is to take a look at how long these symptoms have been present with the teen, how severe the issue is and how different your teen is acting compared to his usual self.

This is a stage in life when you can expect to see several different changes and growing pains because of all of the challenges that face your teen such as school, activities, fitting in with peers and so much more. Here are several other signs that will help you and your teen be able to see what signs and changes are depression and what is just normal growing up.

· Your teen might be angry, irritable or hostile for long periods of time or often.
· You may notice that your teen is often sad or has feelings of hopelessness.
· Depression might cause frequent crying episodes.
· Depression will also cause your teen to withdraw not only from family but also from his friends.
· Watch for a loss of interest in the activities that might have been enjoyable prior to the depression.
· Your teen might experience a change in both sleeping and eating habits. Either in excess or not enough.
· There may be obvious restlessness or your teen might be easily agitated.
· A lack of energy or fatigue might be evident.
· The teen might have difficulty concentrating along with a lack of both motivation and enthusiasm.
· There might also be thoughts of suicide, death or causing physical harm to themselves.

If you notice any of these signs in your teen in is time to seek professional help. Call your family doctor right away if you notice any of the signs lasting for long periods of time.

[Link:Depression Hurts]

Friday Readers Story

Anonymous said...

Ive been cutting since I was 11 and I'm now 17, at first it was the one in a month then as I got older it got worse. It all started because I lost 2 of the most precious things in my life and now I do it because I get upset and don't how to deal with it.

I tried to stop I last about 3 months without cutting but then everything just kept building up and I cut again.

I hate what I do it looks horrible but I have no way stopping.

I just think last one but then after that"last one" it happens again and again I'm scared to tell my parents if I told people it would affect everything my job my relationships with sisters and brothers.

I don't really have friends or go out because I'm an outsider people at work thing I have a great social life but iI lie to cover up how alone I actually am.

I don't know what to do or how to help myself.

What can I do to help myself?

Stopping self harm is difficult. The first step is to decide that you want to stop. Thinking about it for the first time, you may see more reasons not to stop and decide that the time is not yet right. Perhaps keep a list of reasons for and against self harm. Often people need a good support network before they can think about stopping.

Deciding to stop

Everybody is unique and what works for one person may not necessarily work for another. Here are some suggestions of things you can do to help yourself gain control over your self-harm and in time these might help you stop completely.
Most of these suggestions are based on the ideas that self-harm is usually a coping mechanism to express distress that you can't find another way of expressing, and that self-harm is often a result of you feeling helpless and out of control over your life.

By finding different ways to express distress and by exercising choice you are loosening the grip of self-harm. Try experimenting with different ideas to find things that help you.

For example:

• seek social support from friends and family
• talk to someone who understands what you are going through, this could be a friend, a relative or another person who self-harms
• find other ways to express feelings and relieve tension, such as hitting something, writing, drawing or doing sport
• do anything but self harm, such as doing things that cause intense sensation, such as biting into ginger or squeezing ice. The important thing is that it causes intense sensations, perhaps even pain for a brief time, but does not cause lasting harm
• try to delay self-harming for a short time (e.g. start with 15 minutes and gradually increase this time)
• get up and go round to a friend or relatives house
  do something soothing such as having a hot bath with bath oil or make a hot cup of cocoa and snuggle under the duvet
• do something practical, like write a letter to a friend, choose a random object and think of 30 different uses for it

Before you cut...Try to ask yourself the following questions and give answers:

• Why do I feel I need to hurt myself?


• What has brought me to this point?


• I been here before?


• What did I do to deal with it?


• How did I feel then?


• What I have done to ease this discomfort so far?


• What else can I do that won't hurt me?


• How do I feel right now?


• How will I feel when I am hurting myself?


• How will I feel after hurting myself?


• How will I feel tomorrow morning?


• Can I avoid this stressor, or deal with it better in the future?


• Do I need to hurt myself?

[taken in part: Rethink]

Attitude

When you cannot get a compliment any other way pay yourself one.

Mark Twain

Art: "Compliment" by NAL01

Limiting The Damage (Part2)

I do not recommend self-harm and would strongly urge people to always consider alternatives to self-harm first, such as talking about your feelings (if you can), distracting yourself, or trying safer alternatives. If you are going to self-harm, or you already have, I hope you find the following information useful. (Also see part 1)

General advice: Make sure anything you cut yourself with is clean; for example, use new blades. Never cut near your wrists over visible major blood vessels. Don’t cut deeply.

If you have a small cut, scratch or graze, you should:
1.Clean the wound with running water (avoid antiseptic lotions or creams).
2.Pat the area dry with clean, non-fluffy material.
3.Cover the cut completely with a sterile dressing or plaster.

For more serious cuts that bleed more, you should:
1.Apply direct pressure to the wound using a clean, non-fluffy pad or cloth. Apply the pressure for a good 10 minutes, and avoid lifting up the pad to look – give it a few minutes.
2.Raise the injured area (unless it is broken) above the level of the heart to slow down the bleeding.
3.Bandage the pad or dressing firmly to control bleeding, but not so tightly that it stops the circulation to fingers or toes.
4.Do not remove bandages as this can interfere with blood coagulation (when your blood cells clot together to seal the wound). If bleeding seeps through the first bandage, cover with a second bandage. If bleeding continues to seep through, remove the bandage and reapply.
5.If you lose a lot of blood, you can go into shock. This can be very serious and needs medical attention.

If something is embedded (stuck) in the wound:
1.Leave it in place – don’t try to remove it as this may cause further bleeding.
2.Raise the body part if possible.
3.If you can, firmly push together the edges of the wound to try to stem blood loss.
4.Gently cover the wound and object with a sterile dressing if possible.

Your cut may need stitches if:

1. The cut will not stop bleeding.
2. The cut is more than ¼ of an inch or 1 cm long.
3. The cut is gaping (i.e. the edges don’t stay together and you can see tissue or fat).
4. If you go to the hospital for stitches, you may be offered traditional stitches (suturing), steri-strips, or surgical glue.

IMPORTANT! If you’re ever in ANY doubt as to how serious the injury is,always seek medical advice.

[taken in part: Docstoc]

Tuesdays Alternatives To Avoid Self-harm

Each Tuesday I've been writing on alternatives to self harm. One of the key points is to identify what you are trying to cope with. So far we've looked at anger & dissociation. Today I'll look at wanting some measure of control & focus in your life.

Control and focus : Feeling that so much is out of your control that the only thing that you can control is the harm you inflict on yourself.

Here are some of the alternatives young people have suggested,

• Try squeezing ice. (more for anger/grounding)
• Try putting a rubber band around a wrist then pinging it when you need to.
• Try taking a cold/hot shower.
• Try biting into something like a lemon. (again, instant grounding)
• Try to focus energy into something positive like exercise, sport or noticing how you breathe. (tennis against a brick wall is good)
• Try ripping or crumpling paper, could collage the ripped pieces or scribble on them.
• Try doing something creative like making play dough models. (Journalling page of 'I Am' statements)
• Try screaming, breaking sticks, punching pillows.
• Try getting out of the house, going to talk to a friend or getting a haircut. (walking/jogging counting each step)
• Try solving a puzzle, playing solitare, tetris, minesweeper or snake. (Anything that requires concentration ie xbox, guitar,Suduko)
• Try setting a target time, for example saying you can harm in 15 minutes, then if you can last, going another 15 minutes.
• Try cleaning. (Amazingly this can work if you get into it 100%, clean room, cupboard, drawer)
• Try thinking in another language.
• Try learning something new. (again, concentration)
  

[taken in part from lcet.Org]

What self-injurers say SI does for them

Many papers on self-harm, have uncovered possible motivations for self-injurious behavior:

• Escape from emptiness, depression, and feelings of unreality.
• Easing tension.
• Providing relief: when intense feelings build, self-injurers are overwhelmed and unable to cope. By causing pain, they reduce the level of emotional and physiological arousal to a bearable one.
• Relieving anger: many self-injurers have enormous amounts of rage within. Afraid to express it outwardly, they injure themselves as a way of venting these feelings.
• Escaping numbness: many of those who self-injure say they do it in order to feel something, to know that they're still alive.
• Grounding in reality, as a way of dealing with feelings of depersonalization and dissociation
• Maintaining a sense of security or feeling of uniqueness
• Obtaining a feeling of euphoria
• Preventing suicide
• Expressing emotional pain they feel they cannot bear
• Obtaining or maintaining influence over the behavior of others
• Communicating to others the extent of their inner turmoil
• Communicating a need for support
• Expressing or repressing sexuality
• Expressing or coping with feelings of alienation
• Validating their emotional pain -- the wounds can serve as evidence that those feelings are real
• Continuing abusive patterns: self-injurers tend to have been abused as children.
• Punishing oneself for being "bad"
• Obtaining biochemical relief: there is some thought that adults who were repeatedly traumatized as children have a hard time returning to a "normal" baseline level of arousal and are, in some sense, addicted to crisis behavior. Self-harm can perpetuate this kind of crisis state.
• Diverting attention (inner or outer) from issues that are too painful to examine
• Exerting a sense of control over one's body
• Preventing something worse from happening

[taken in part from 'Suicide & Mental Health Association International']

Epidemiology of Deliberate Self-Harm

For an estimated one to three million Americans, self-harm is a serious problem. Research has demonstrated that approximately one percent of the general population engages in deliberate self-harm. This statistic is likely to be grossly underestimated due to the secrecy and the stigma of the behavior.

DSH tends to begin in childhood or adolescence; the typical age of onset is between ages 10 and 16. While the majority of people who harm themselves are females between the ages of 13 and 30, there are self-injurers of every age, gender, and economic group. DSH tends to peak between the ages of 18 and 24, and decreases as an individual enters his or her 30s and 40s.

Princess Diana was a self-cutter; she also threw herself down a flight of stairs. The most common professions of self-injurers are teachers, nurses and managers.

[taken in part from Publicsafety.com]

Quote

'Most people find stopping self-harm is very difficult. Even if stopping completely is too hard at the moment there is plenty you can do to increase your control over your self-harming behaviour'

Dissociation

Grounding Skills are interventions that assist in keeping a person in the present. They help to re-orient a person to reality and the immediate here-and-now. Grounding skills are useful in many ways.

However, then can be used to help re-orient oneself when experiencing intense and overwhelming feelings and intense anxiety. They help to regain one’s mental focus. These skills usually occur within two specific modalities:
1. Sensory Awareness
2. Cognitive Awareness

Sensory Awareness Grounding Skills
• Keep your eyes open, look around the room, notice your surroundings, notice details.
• Hold a pillow, stuffed animal or a ball.
• Place a cool cloth on your face, or hold something cool such as a can of soda.
• Listen to soothing music.
• Put your feet firmly on the ground.
• FOCUS on someone’s voice or a neutral conversation.

Cognitive Grounding Skills
Re-orient yourself in place and time by asking yourself some or all of these questions:
• Where am I?
• What is today?
• Whatis the date?
• What is the month?
• What is the year?
• How old am I?
• What season is it?

• List as many grounding skills as you can.
• Practice several grounding skills every day
• Construct a list of those which are most helpful and effective.

Goals When Using Grounding Techniques
1. To keep myself safe and free from injury.
2. To re-orient myself to reality and the here-and-now.
3. To identify what I attempted to do to prevent the dissociative experience.
4. To identify skills that I can use in the future to help myself remain grounded.
5. Choose a new response: What action, if any, do you want to take to feel better in the present?

For example, a flashback
may indicate that a person is once again in a situation that is in some way unsafe. If this is the case, self-protective actions should be taken to alter the current situation. On the other hand, a flashback may simply mean that an old memory has been triggered by an inconsequential resemblance to the past such as a certain colour or smell. In such cases, corrective messages of reassurance and comfort need to be given to the self to counteract the old traumatic memories.

Image: Out of Body Experience by ~parallelspaces

Link: NHS (pdf)

Friday Readers Story

Anonymous said...

I am 19 years old, and I've been cutting myself since I was 15. My boyfriend at the time committed suicide, which I think I read someone else on here has been through, and it is really hard. I was there, when he did it, so I never really got over it. I tried to kill myself twice before my next birthday. I have his name cut into my arm. I met and got into a relationship with another guy, that ended up being an abusive relationship.

That went on for..almost two years. I came out of that with a daughter (born at 25 wks), and several more scars.I recently attempted suicide again and was diagnosed as bipolar, as well as suffering from PTSD, which I now have medication for. I think the reason I do it, (I still do it) is because when I do it, and I bleed, it just..I don't know..gives me a physical reason for the pain, which kind of helps..

But, I am trying, /trying/ to work past it, so I can be there for my kids, and my soon to be husband.I don't know why I felt like I needed to go into that here, but I did..so..I dunno, maybe it'll help someone.
January 19, 2008

For Others

People who self-harm often get caught up in a cycle of behaviour which is difficult to break.
The cycle is:
Feeling + Self-harm behaviour + Relief +Disgust/depression/shame


Family and friends
• Take care of yourself so that you can help the other person. Promote a greater understanding by accidentand emergency staff so that the person is treated with sympathy and is offered counselling if injuries aresuspected to be a result of self-harm.
• Don’t take the behaviour personally but try and see it as a symptom of distress.
• Don’t turn away, instead try to educate yourself about the disorder. Acknowledge the pain that the person is going through.Try and talk about what is happening without being judgemental or angry.

Link QLD.Dept Health (pdf)