Random Thoughts Of Self

Suicide, Self Injury and Hospitalization: Can your therapist have you hospitalized?

2009-09-12T21:42:00.000+10:00

Allan N. Schwartz, LCSW, Ph.D.

Suicide, Self Injury and Hospitalization:
Can your therapist have you hospitalized?

Posting:

On March 7, 2009 someone posted this comment entitled:

"Distrust of Therapists"

http://www.mentalhelp.net/poc/view_doc.php?type=advice&id=3138&at=2&cn=91&ad_2=1&submit=I+Agree#ad8903

"I was hospitalized for self-injury and thoughts (not plans) of suicide and while the increased medication and enforced hospital stay did not help, I am now very afraid to report my true feelings to anyone and have actively avoided therapy, leaving me with no one to trust.

In the US, ethics usually doesn't have anything to do with it: as my callous former therapist explained to me, he was having me hospitalized because federal liability laws encouraged him to do so. These laws permit relatives of suicides to sue mental health care workers for neglect, and that's why you see rampant over hospitalization of patients in America."

______________________________________________________________

The anonymous writer of the posting cited above raises an interesting moral, ethical and practical dilemma for patients and their psychotherapist. The dilemma has to do with the question of when it is or is not proper to have a patient sent to the hospital emergency room?

Whether the therapist is a Licensed Clinical Psychologist, Licensed Clinical Social Worker, Psychiatrist or Licensed Marriage and Family Therapist, there is an obligation on their part to intervene under certain types of circumstances. By "intervene" is meant that they must report that someone is in imminent danger. This obligation overrides laws of confidentiality. The reason for this is that, under these circumstances, it is clear that a patient is in danger of committing suicide or homicide. If there is clear evidence that a child is being abused, the therapist must report this, as well. Outside of suicide, homicide and child abuse, the laws of confidentiality hold sway.

How does "reporting" really work?

In the case of a patient whom the therapist is convinced is in danger of suicide, a call can be made to 911 to report the suicide and have them go to the patient's home. In all of my years of practice there was one occasion where I asked 911 to come to my office and pick up the patient. I had to cancel my afternoon schedule to get this accomplished.

Other steps that can be taken are to call family, friends or neighbors and have them take the patient to the emergency room. One last possibility is to get the patient to go voluntarily go. The problem here is that, if someone is really suicidal and they are left to their own devices there is a good chance that they will attempt suicide.<>

Once sent to the emergency room of a hospital, there is absolutely no guarantee that a patient will be hospitalized. Instead, the hospital emergency room will do one of two things depending on where you live: 1. They will transfer the patient to a psychiatric hospital for evaluation or, 2. They have their own psychiatric emergency room and will do an evaluation right there.

In doing the evaluation, a group of psychiatrists, psychiatric nurses and clinical social workers, will decide whether or not the patient is truly suicidal and in need of hospitalization. Contrary to what the anonymous writer states above, it is not easy to be admitted to a psychiatric hospital. This is the reason why there is no such thing as "over hospitalization" in the United States. I have seen, on numerous occasions, where patients, brought to the hospital emergency room by 911 the emergency response team, were sent home.

In order to further elaborate on just how difficult it is to accomplish a psychiatric hospitalization, even if 911 is sent to the patient's home, the emergency response team does an immediate evaluation and can decide that a trip to the ER is not necessary.

In my opinion, the writer of the note above, was admitted to the hospital because she was deemed to be dangerously suicidal.

I cannot and will not defend the actions of every therapist because I do not know who they are or how well trained and experienced they may be. However, in the case of those therapists I have known, from New York to Colorado and California, the only time they will call 911 is when the fear for the safety of the patient.

What about self injury?

There are too many people, both male and female, who injure themselves. The most common type of self injury is probably self cutting, often with a razor. The cuts usually leave scars that bear witness to the self cutting. As a result and in order to hide the scars, people wear long sleeves even during the summer and long pants. Cutting occurs on the arms, legs and other parts of the body.

The goal of self mutilation is rarely connected to suicide. Instead, the strategy is to feel the sense of calmness that is followed by an episode of cutting. It is speculated that this calmness stems from endorphins that create a almost a euphoric state.

Therefore, it is unlikely that a therapist will feel impelled to report self cutting. Of course, there can be exceptions as for example, if it is believed that suicide is the intention. Just to repeat, suicide is very rarely the goal of self cutting. It should go without having to say it that there is always the risk of cutting in the wrong place, hitting an artery and causing a deadly bleed out. In my individual experience I have not come across or read about such an occurrence.

In by opinion, a psychiatric hospital will not admit a patient for self cutting unless the evaluating team lead by the psychiatrist, determine that the individual is suicidal. This even happens in cases of Anorexia Nervosa in which a patient will not be admitted unless the body weight places them in danger of death.

In an age where hospital and medical costs continue to surge and in which health insurance companies are reluctant to reimburse, it is unlikely that anyone will be admitted for frivolous reasons.

Trust:

It is true that trust is a key element to the successful completion of a psychotherapy. There are those times where a therapist may decide that a visit to the emergency room is important for a patient. In my experience, that happens with mutual cooperation between therapist and patient. Even in the case where I asked 911 to come to my office, the patient was cooperative, In fact, that individual was admitted and remained for quite a lengthy period (by today's standards, one week) and was not angry upon returning to treatment.

Trust is important because only with trust, can a person be willing to talk about all that they are thinking about and feeling.

Conclusion:

To answer the question within the title of this essay, a therapist can attempt to have you hospitalized if he has determined that you are in danger of attempting to kill yourself. However, in no way does that mean that, after being taken or going to the emergency room, will you be admitted. Only if you prove to the emergency room team and even the emergency response team, that you are suicidal, will you be admitted.

Your comments are encouraged.

Allan N. Schwartz, PhD

Source: MentalHelp.Net

Allan Schwartz, Ph.D.
Dr. Schwartz's Weblog

Bipolar Disorder Self Injury: Why You Must Be Concerned

2009-09-11T21:48:00.000+10:00

In bipolar disorder, there is often concern about bipolar disorder self injury. It is usually serious, and comes in different forms.

A form of bipolar disorder self injury that’s coming most lately into the general public consciousness is self mutilation, or “cutting”. This practice is found in folk with other diagnoses, too. In reality, only a fraction of those who self injure are bipolar.

Cutting, burning or other self hurting behaviors are often seen in adolescent girls and others, even in men. A lot of this is a part of bipolar disorder self injury.

These acts aren’t suicide attempts, whether or not the people who do them are depressed or suicidal. They’re often desperate acts of anger, worthlessness, and loss of control. This is often a case of bipolar disorder self injury, and it’s not surprising when the symptoms are similar.

Suicide, naturally, is the most extreme form of bipolar disorder self injury. There will be plans and attempts before an individual commits suicide. In any case, all threats of bipolar disorder self injury should be regarded seriously.

Suicidal thoughts may cloud the thinking about a depressed person to the limit that he or she will be able to think about nothing else. It may appear the world would be better off without them, or that they can prove to others that they should have been treated better. At this time there is concern of bipolar disorder self injury, but the concepts are just at a low heat.

The danger becomes more imminent when the person starts to make plans. A person may make elaborate plans for some years. Another person may only think about a plausible way to go about it. The difficulty is that either of these folk may at any point basically commit suicide. It isn’t easy to predict the chance of bipolar disorder self injury.

Many times a person’s suicidal bents will not be spotted unless an attempt is made. A sensible person should treat all attempts seriously, though some may seem more serious than others. More significant attempts could be identified when the result was more certain compared to other attempts, or a note was found. Bipolar disorder self injury is always possible in these scenarios.

There’s always the possibility that a person is serious, in any case what type of attempt was employed. Statistics show that people who have never tried to commit suicide during the past are 40 times less sure to be successful than people who have.

Suicide may be on a person’s mind if he starts to set his affairs in order or make last agreements. It could be so simple as giving away possessions, or as complicated as making monetary arrangements. If this is suddenly seen in a bipolar individual, it should be determined whether that person is in danger of bipolar disorder self injury.

Many thoughts, plans, or attempts actually do end in suicide. 11 percent of deaths in the States are as a result of suicide. Roughly eighty percent of suicide deaths are by males, although more ladies attempt it. Every year, more and more teens are committing suicide. Bipolar disorder self injury, then, is a definite and increasing issue.

The disease’s physical, social, and affective consequences are tricky enough to handle. Self harm and suicide make attention to bipolar disorder self-mutilate most necessary.

Source: Unknown

Wordless Wednesday

2009-09-09T22:04:00.000+10:00

Source

Tell them to remember hope. We have hope."

2009-09-08T01:00:00.000+10:00

-renee yohee,
the story and inspiration of to write love on her arms,
my biggest hero.

we are only asked to love,
to offer hope to the many hopeless.
we don't get to choose all the endings,
but we are asked to play the rescuers.
we won't solve all mysteries,
and our hearts will certainly break in such a vulnerable life,
but it is the best way.
we were made to be lovers bold in broken places,
pouring ourselves out again and again,
until we're called home.

the vision is that community and hope and help would replace secrets and silence.

the vision is people putting down guns and blades and bottles.

the vision is that we can reduce the suicide rate in America and around the world.

the vision is that we would learn what it means to love our friends, and that we would love ourselves enough to get the help we need.

the vision is better endings.

the vision is the restoration of broken families and broken relationships.

the vision is people finding life, finding freedom, finding love.

the vision is graduation, a Super Bowl, a wedding, a child, a sunrise.

the vision is people becoming incredible parents, people breaking cycles, making change.

the vision is the possibility that your best days are ahead.

the vision is the possibility that we're more loved than we'll ever know.

the vision is hope, and hope is real.

you are not alone, and this is not the end of your story.

-jamie tworkowski,
founder of to write love on her arms.
Source: Ashley Rosex

I Think ...

2009-09-07T21:30:00.001+10:00

Definitions of suicide and self-harm behavior in an Australian Aboriginal community

2009-09-06T21:23:00.001+10:00

Farrelly T, Francis K (2009)
Definitions of suicide and self-harm behavior in an Australian Aboriginal community.
Suicide and Life-Threatening Behavior;39(2):182-189

Journal Article

Source: Australian Indigenous Health Bulletin

View abstract: PubMed
View website: PubMed

Three out of 10 students in study intentionally harm themselves

2009-09-05T18:26:00.000+10:00

Three out of 10 students surveyed for a York University study acknowledged engaging in acts of deliberate self-harm, such as skin cutting, burning and using drugs or alcohol to excess.

The study evaluates the responses of 319 first-year university students who volunteered to answer a questionnaire that assessed their personality and personal history, and that asked whether they had ever intentionally engaged in 22 self-harm behaviours.

Of the 94 students who indicated they had, women were no more likely to self-harm than men, contrary to previous studies which suggest it is a predominantly female phenomenon.

There were, however, some clear differences in the type of self-harm acts engaged in by women and men.

Right: Cutting is one form of self-harm as seen in this photo of a person's arm

Among those who engaged in self-harm, the women surveyed (45 per cent) were more likely to report cutting the wrists, arms or other areas of the body, while men (23 per cent) were more likely to report engaging in gang activity or other forms of physical violence with the intention to harm themselves. The most frequent forms of self-harm were cutting, entering into risky situations, carving, scratching and the use of substances with the intent to self-harm.

The life circumstances of the participants are relevant to the study’s findings, says Gordon Flett, Canada Research Chair in Personality & Health at York, who co-authored the study with Abby Goldstein, (MA '00, PhD '05) now an assistant professor at the Ontario Institute for Studies in Education.

The average age of the participants was 19 years old and the majority (68 per cent) had just finished high school and were living with their parents (64 per cent). The sample was evenly split between Canadian-born students and those born outside of Canada.

“In many cases, these young people are throwing themselves into the student role as a way of overcompensating for some other emotional and relationship issue,” Flett says. “If they do well in university, that might get them over the hump, but if they don’t, they may be at risk for some more extreme behaviours.”

The latest clinical research suggests that self-harm may be a response to emotional pain that cannot be resolved in a more functional way. Goldstein hopes this information will begin to remove some of the secrecy often associated with self-harm.

“These findings suggest that a significant percentage of college students have engaged in an act of deliberate self-harm at some point in their lifetime,” Goldstein says. “Unfortunately, many people hide these acts or their intentions from others, which can often lead to isolation and greater suffering.”

By assessing the personality traits and personal history of the participants, the study was also able to identify factors which may help predict which students may be vulnerable to deliberately harming themselves.

“Some of these kids come from middle-class or affluent families but that’s no protection when the issue at hand is self-image,” Flett says.

"Personality, Child Maltreatment and Substance Use in Deliberate Self-Harm Among College Students" will be published in the Canadian Journal of Behavioural Science in October.

The study was supported by funding from the Canadian Institutes of Health Research.

Source: York files

Shelved report keeps suicide prevention reforms at bay

2009-09-04T19:22:00.001+10:00

RUTH POLLARD INVESTIGATIONS EDITOR

August 22, 2009

A HERALD INVESTIGATION

AN EVALUATION of Australia's main suicide prevention program - which found there was little evidence the strategy had reduced rates of suicide and self harm - has been kept secret for three years, stalling much needed national reforms.

The 2006 evaluation reveals the Howard government was urged to review the National Suicide Prevention Strategy to ensure that funds were better targeted to those in greatest need. ''The current goals and objectives … are too broad to provide sufficient guidance,'' it concluded.

And while the national program floundered, suicide rates remained at historically high levels. The Herald revealed yesterday that the national suicide statistics had been undercounted, and the toll could be as high as 3000 a year, rather than the 1800 reported by the Australian Bureau of Statistics, without any corresponding increase in funding to prevent further deaths.

The Federal Health Minister, Nicola Roxon, said the Government was working with the Australian Suicide Prevention Advisory Council to develop ways to improve the data and respond to the needs of people at risk. ''I'm concerned by these reports,'' Ms Roxon said.

To make progress, access to quality mental health services must be improved and structures developed to co-ordinate a new national response, said John Mendoza, the chairman of the Federal Government's National Advisory Council on Mental Health.

''We have seen our governments … implement an assertive response to swine flu [and] now we have had 121 deaths since the outbreak and … 460 people are … in hospital from H1N1.

''In the same period we have had at least 10 times the number of suicides and … 20,000 hospital admissions for self-harm. This is the scale of the problem, and it's time we addressed it.''

Training GPs and other health care providers in recognising the warning signs for self harm and suicide, as well as reducing access to the means of suicide and investing in self-help services would go a long way to reducing risk, Professor Mendoza said.

The chairman of Suicide Prevention Australia, Michael Dudley, said: ''We have absolute evidence that putting barriers around jumping points makes a huge difference - people do not automatically go and try something else, and it is the same with reducing access to firearms, medications and other methods.

''Maintaining a social connection can make a difference - we should be following people … after they have had contact with health services, because we know they are very much at risk.''

Lifeline: 131 114

Source: The Sydney Morning Herald

Brisbane Times

Young people's distress is a wake-up call

2009-09-03T19:18:00.001+10:00

The rise in self-harm points to something seriously askew in our priorities as a country

PARENTING INVOLVES an awful lot of stumbling along in the dark, hoping to God that you are doing something right. Every so often, parents are presented with situations that seem to confirm their worst fear: that they are actually doing everything wrong. As vividly illustrated by the two case studies written about by Sheila Wayman in the Healthplus supplement recently (August 11th, 2009), there is a particularly visceral feeling experienced by parents, like being punched hard in the stomach, when they discover that their child is harming him or herself.

Not unnaturally, most parents react with shame and panic, and become desperately worried about exacerbating the situation. The idea that a child would be so distressed that swallowing tablets or cutting oneself would constitute some kind of relief horrifies parents.

Levels of distress are clearly rising among young people, but that does not mean that parents are justified in shouldering all the blame. Young people resort to self-harm for complex reasons. For example, while it is more common in families where there are difficulties of one kind or another, it can also happen in so-called “good” families.

While no family is perfect, most families can learn to cope. Dr Keith Holmes, a consultant child psychiatrist in the Lucena Clinic, says that “the sign of a well-functioning family is not that bad stuff never happens, but that when it happens, it is dealt with well”.

Families who have kept the lines of communication open have an advantage when a crisis happens. Dr Holmes talks about how impressive it is that many families manage to get over the initial denial and sense of failure, and begin to do all that they can.

Even where things have gone awry, perhaps because of a messy and acrimonious breakdown, it is more than possible to help a child, if the parents can manage to retrieve enough of their relationship to make the welfare of the child a priority. Parents need to be parents more than ever, he says. They need to re-establish lines of communication, and healthy levels of discipline.

Many parents worry that something like cutting will lead to suicide attempts. Prof Carol Fitzpatrick of Children’s University Hospital, Temple Street, says it is important to realise that even though the risk of suicide is greater among people who self-harm, only a small minority will go on to die

by suicide. Some young people will have only a few incidents. Others will respond positively to parents’ willingness to listen and to help, and may not need further intervention.

However, if there are signs of deeper distress, or increasing isolation and depression, parents should seek help. Her advice to parents is to “trust your gut feeling”. Parents can go to their GP for a referral to child and adolescent mental health services for their child. It is a national scandal that so many of them will go on a waiting list for anything from six weeks to three years, depending on where they live.

A dedicated deliberate self-harm team was set up in Temple St some years ago, and while initially focused only on the young people, the need to provide support to parents soon became evident. The Space programme resulted. Initially only available on referral, a new course is available free to parents of children under 18, due to sponsorship by the ESB workers’ charity, Electric Aid.

The next course is being run in Wynn’s Hotel on Tuesdays, in October and November. It is important to register, as places are limited, by contacting Lorna Power, tel: 01-7166321 or e-mail Lorna.Power@cuh.ie.

The National Suicide Research Foundation suggests that the rise in unemployment may be a factor in the rise in self-harm among young men. Ironically, before the recession we blamed consumerism and conspicuous consumption instead.

Clearly, something deeper is going on. Why are people less able to deal with the challenges that life throws at them, or at least more likely to resort to self-harm as a deeply flawed way of trying to cope?

Ireland of the past was in many ways a dark and repressive place. However, we also have to face the fact that when we threw off the shackles of that time, we also inadvertently weakened societal constraints that helped to make self-harm and suicide much more rare.

While there is much greater openness in society, that same openness means that the idea of self-harm occurs to far more young people. It is one of the paradoxes of our age that we have never had so many means of communication, but more fundamental levels of communication, such as those between parents and children, have become much more difficult.

As Prof Kevin Malone of UCD has pointed out, many young people can live in a virtual cocoon, frantically interacting with peers, while parental influence is greatly diminished or even excluded. Behaviours such as cutting can even be become tacitly acceptable as a result.

Self-harm is not the only dysfunctional coping mechanism to which people resort. Our society has long had a problematic relationship with alcohol, while “workaholism” is often just a more acceptable way for adults to evade difficult emotions or situations.

Our young people’s distress is further evidence that something is seriously askew in our priorities as a country and a culture. It is an overt sign from our upcoming generation that all is not well, and perhaps we should pay more heed.

This article appears in the print edition of the Irish Times

Wordless Wednesday

2009-09-02T18:25:00.000+10:00

Janes, 'Free From Harm' website

Mental health drive to help gay people

2009-09-01T19:32:00.002+10:00

Published Date: 31 August 2009

A NEW mental health programme for lesbian, gay, bisexual and transgender people will aim to help tackle high levels of depression, anxiety, self-harm, suicide and attempted suicide.

The LGBT Centre for Health and Wellbeing in Edinburgh's Howe Street says prejudice and discrimination contribute to a rate of mental ill-health among the LGBT community three or four times that of the mainstream population.

Its autumn Mind Matters programme will include sessions on issues such as self-harm, support for carers, domestic abuse, safe alcohol use and parenting.

All the events are free of charge. For further information, contact the centre on 0131 523 1100, visit www.lgbthealth.org.uk or e-mail admin@lgbthealth.ord.uk

The full article contains 124 words and appears in Edinburgh Evening News newspaper.

Page 1 of 1

Last Updated: 31 August 2009 9:42 AM
Source: Edinburgh Evening News
Location: Edinburgh

Cutting and other self-harm- part 1

2009-09-01T18:50:00.002+10:00

Cutting and other self-harm- part 1

In the 1990s an epidemic spread throughout many American homes as a new fad erupted. With the emergence of the “Goth” scene, it was suddenly popular to be miserable. (How many of you can remember back to SNL’s famous “Goth Talk” skit?) You weren’t “cool” unless you had some kind of abuse at home to deal with…and one of the most popular ways to show-boat this was self-mutilation.

Unlike most fads, this one piggy-backed on a real problem, and while the fad may have faded, the problem still exists. Teens are still mutilating themselves, only now-a-days they are doing it in secret.

The most common reason, one that this writer cannot disclaim, is that the physical pain the mutilation provides masks the emotional pain the teenager cannot deal with. Even deeper, the teen has no control over the deliverance and intensity of the emotional pain, but is in control over the extent to which they inflict the physical pain on themselves.

Unfortunately, to what extent the emotional pain would have to be in order to cause this reaction can not be measured. There are too many factors to be able to give parents of this issue a clean-cut answer:

Whatever the initial emotional trigger, the Cutting is a tell-tale sign of what your teen needs in order to recover from whatever ails them.

Cutting and self-mutilation is a cry for help. Whatever it is that is plaguing your adolescent is too much for him or her to handle on their own. It is time for you to step in and go against their wishes of “leaving them alone”.
Cutting and self-mutilation can also be a method of attention seeking. While closely related to a cry for help, this is the one that many people ignore. You’ve heard the advice when your children were younger and threw a temper tantrum: “ignore them, when they realize you are not paying attention, they’ll stop”.

While cutting and self-mutilation may be a grandiose “temper-tantrum”, this one will not stop when ignored. If ignored, what may have started out as an attention-seeking tactic, will grow into a deep despair, and could transform into suicidal thoughts and tendencies.

To be continued…
Source
August 3, 9:35 AMHouston Teen Issues ExaminerJennifer Korenek

Violent cry for help all too common

2009-08-31T18:57:00.003+10:00

For many years, the wounds she inflicted on herself were her only way of communicating the pain she felt on the inside. Jess Senior talks about how she stopped self-harming.

The first time it happened, she was 13.

"I was in a lot of distress and everything just felt overwhelming ... I didn't remember doing it but became aware I was bleeding. I guess I was still in shock, I thought, 'How the hell did that happen?' "

For the next few years, self-harming became her main coping strategy for dealing with distress and depression. Even in summer, she would wear long sleeves, trousers and tights to hide the cuts.

It's hard to understand how someone could feel "helped" by such self-destructive behaviour, but Jess felt she had no other way to communicate what was happening to her inside.

"There's pain and with that you get a certain amount of adrenaline and endorphins, which is quite addictive and why people turn to it again and again.

"For a long time, I didn't have the language to articulate what was happening for me . . . I felt so out of control."

Despite the involvement of mental health services in her life from birth - because of her mother's serious mental illness - the pattern of hurting herself started very early. Her father remembers that as a preschooler, Jess would scratch herself in her sleep till she bled.

Her mother took her own life when Jess was 9, and for many years, she felt fated to follow the same tragic path. Admitted to hospital at 14 after a suicide attempt, she came under the formal care of mental health services, for better - and occasionally - worse.

Her father, who had won custody of her when she was four, has been a great source of strength and stability throughout her life. "It must have been really confusing and frightening for him . . . He once told me he had thought I would die by suicide. I thought that myself for a long time, but to hear your dad say that was really scary."

She tried to cover up the self-harm, telling "ludicrous stories" to her father and stepmother. "Of course they knew, parents aren't stupid. I made up lame excuses to friends about why I couldn't go swimming and why I dressed for winter year round."

However, chronic self-harming like Jess' would not show up on any of the official statistics. She never sought medical help, though she "probably should have".

"I know heaps of people who go into the emergency department or their GP, get stitched up and sent home in well under 48 hours, so they don't get recorded.

Despite failing seventh form "pretty miserably", she managed to get into university with a provisional pass. "I did pass one psychology paper. I loved it, and it was all pretty familiar territory to me . . . but I couldn't cope and dropped out."

After a couple of psychotic episodes, she was admitted to the regional Rangatahi (adolescent) inpatient unit. She had not been self-harming for some time, but within two days of being admitted, she started again.

"There were some benefits [to being an inpatient] - I stayed alive - and some of the other people in there are now my best friends . . . But for me, it was not a good place to be. While I was there, another patient suicided, which brought me massive secondary or cumulative trauma."

Thanks to her having a supportive family and psychiatrist, she was discharged relatively quickly.

The turning point for her on self-harm was being "told off" by a community psychiatric nurse. "I was outraged at the time and got all righteous, 'How dare she speak to me like that?' etc.

"But gradually I came to accept that she was right when she said it was in my power to do something about it . . . rather than me falling back on the excuse that I was dissociated, I didn't mean to.

"She wouldn't even let me off the hook when I was psychotic. She said, 'You know when your anxieties are getting bad and you can choose to do something about it before you get to that point. She put the responsibility back in my hands."

It took some time to be able to give up completely, but the clincher was when her favourite "coping strategy" stopped working. "On the few occasions where I thought 'F. . . it, I'm just going to do it', it didn't work for me because my headspace had changed. I just felt, 'What was the point of that? I don't feel any better'."

Then there was the moment when she threw out all her disposable razors. "A bit like an alcoholic tipping the whisky down the sink. It felt great."

Another big factor in her recovery was meeting her partner. They have been together seven years. "It's harder to hide what's going on when someone can see you."

It hasn't been easy for him either. "For both him and my dad, it must be really, really hard to see someone you love hurt themselves. They have both got frustrated and angry at times, but I know they are always there for me."

Her partner also lost his mother at a young age, which made it particularly difficult for him to understand her suicidal behaviour. One day, he came home to find her bleeding and distraught. "He got really mad and said, 'How can you do this to yourself? My mother wanted to live and she couldn't. You are perfectly healthy and you're throwing it away'.

"I felt really guilty, but at the same time I felt he didn't know what it was like."

Another turning point for her was becoming involved with Wellink's peer support helpline Warmline five years ago.

"It was fantastic to meet all these people who shared similar experiences. I didn't want my life to turn out like my mother's, but I thought I had no choice. Then I met all these amazing people living really great lives and doing amazing work and it opened my eyes to the possibilities. Instead of feeling like I was a big burden on society and my family, I felt empowered."

Now 24, she works as a peer development co-ordinator with Wellink, consulting for a range of organisations providing mental health services.

She is deeply disappointed by Capital and Coast District Health Board's recent decision to defer plans for an innovative community-based crisis treatment service in partnership with Wellink.

For people in crisis, Te Whetu Marama - New Zealand's first Short Term Assessment and Recovery Service (Stars) - was to be an alternative to staying at home or being admitted to an acute admissions unit.

Instead, ward 27 has been enlarged and the new service is set to open next April - though Jess points out this is the fourth firm date they have been given since the first one of May 2007.

She feels an opportunity has been missed. Self-harm and suicidal behaviour are symptoms of deep psychological distress and can't be fixed with a quick visit to ED for stitches or a stomach-pump.

"We're lucky to have HeadSpace [youth crisis respite] in Wellington, which operates on the same principle with no lockdown and no seclusion and has stopped many people being admitted repeatedly to the inpatient unit.

"But we need more flexibility in services. It's still the case that young people with severe levels of self-harm are shipped out of Wellington to Ashburn Hall in Christchurch, away from their support networks.

"People need to feel comfortable and safe and have their whanau and friends around them."

SELF-HARM DATA TIP OF ICEBERG, MENTAL HEALTH WORKERS SAY

Fewer people are being admitted to hospit for intentional self-harm, but critics say the official figures fail to show the true scale of suicidal behaviour.

The Health Ministry's latest data on intentional self-harm cases in hospitals, issued in the past fortnight, shows teenagers aged 15 to 19 had the highest rates of intentional self-harm and females were twice as likely to need hospital care.

In 2007, 2678 people were admitted to hospital for more than 48 hours for intentional self-harm, compared with 3030 in 1996, a drop of more than 25 per cent.

However, an Auckland University study covering four district health boards, including Capital and Coast, has found the official figures, based on narrow definitions and "flawed" data collection, "substantially underestimate the size of the problem".

The ACC-funded study, the first to use direct observation, found the number of people treated at Waitemata for self-harm increased 31 per cent over four years.

Writing in The Australian and New Zealand Journal of Psychiatry, Simon Hatcher, from the Department of Psychological Medicine, and his team described how suicide attempts often went unrecorded.

For example, overdoses of paracetamol were sometimes logged as "abdominal pain". Furthermore, some hospitals recorded patients seen in emergency departments, but others counted them only if they were admitted to a ward.

In the four health boards - Capital and Coast, Waitemata, Counties Manukau and Northland - 1600 people were treated for self-harm incidents 2000 times over a year, which suggested about 6200 self-harm episodes involving 4900 people nationally.

Researchers said even this was likely to be an underestimate.

According to the New Zealand Mental Health Survey, 0.4 per cent of the population, or 16,000 people, attempt suicide in a year, but less than one-third go to hospital. The group wants monitoring sites in representative health boards to track the true rate of suicidal behaviour.

Mental health director David Chaplow agreed official figures were likely to be an underestimate. "Hospitalisations are a crude indicator, but you have to start somewhere and it does indicate a trend."

From July 1, health boards have been required to report every person discharged from emergency departments after receiving treatment for three hours or more, removing the major cause of inconsistency in the reporting of intentional self-harm.

Dr Chaplow said hospitals were trialling new ways of reaching people who may have slipped between the cracks, including visits, phone calls and postcards. "[When] people feel they have no value, that no-one cares about them, something as simple as a postcard asking if they are OK is sometimes enough to make a difference."

Under the 10-year suicide prevention action plan, several measures are under way to improve care and follow-up, increasing understanding about depression and targeted programmes for Maori and youth.

"New Zealand is right up there with prevention, but any suicide is a tragedy, and while we can celebrate the trend, we can't stop working until there are no more suicides."

Source: NZ Dominion Post

By RUTH HILL - The Dominion Post

Last updated 14:45 31/08/2009

Self-harm admissions drop by a quarter

2009-08-30T19:13:00.002+10:00

Over 2500 people were hospitalised for more than two days after intentionally injuring themselves in 2007, with women almost twice as likely to do it as men, according to figures released today.

A report by the Ministry of Health called Intentional Self-Harm Hospitalisations 2007 (Provisional), showed that 2678 people spent more than 48 hours in hospital.

However, the results show the number decreased from 3030 in 1996.

Mental Health director Dr David Chaplow said this was consistent with the declining pattern over the past 11 years.

“Self-harm hospitalisation rates have dropped by 25.6 per cent for the total population and 40.1 percent for those aged 15 to 24 years old since 1996," he said.

For males, the highest rate was among the 35-39 year age group while women aged between 15 and 19 were the most at-risk group for females.

Maori, at 75.1 hospitalisations per 100,000 people, were more likely to self-harm than non-Maori, with rates of 61.6 per 100,000.

The Health Ministry said anti-suicide initiatives included better follow-up care, mental health awareness campaigns and addressing suicide rates among the Maori community in particular.

The data does not include those who harmed themselves but spent less than two days in hospital or readmissions less than two days after being released.

The Health Ministry said this was due to differences in the way District Health Boards recorded some of these events although this had now been addressed.

By removing the data, the ministry says it allowed them to make more accurate comparisons.

Source: NZ National Health

By Micahel Fox

Last updated 21/8/09

11% increase in male self-harm

2009-08-25T21:46:00.000+10:00

Dara Gantly

dara.gantly@imt.ie

Last year saw a dramatic 11 per cent increase in male deliberate self-harm cases, the National Suicide Research Foundation has revealed. In total, 11,700 deliberate self-harm presentations involving 9,218 individuals of both genders were made to hospital emergency departments in 2008.

The Annual Report of the National Registry of Deliberate Self Harm, published on July 20, found the national person-based rate of self harm increased by 6 per cent, from 188 per 100,000 in 2007 to 200 per 100,000 last year. The strongest increase in self-harm was observed in men, with a rise of 11 per cent (180 per 100,000 in 2008 compared to 162 per 100,000 in 2007). This is the highest rate since the start of the Registry in 2002. Among women, the increase was 4 per cent.

The report revealed that almost half of presentations were by people under 30, with the peak rate for women in the 15-19 age group and for men in the 20-24 age group. An increase in self harm was also observed amongst those aged as young as 10-14 years.

The incidence of deliberate self-harm was highest in HSE Dublin/North East and lowest in HSE South. City rates generally exceeded those of the counties, particularly for men.

The proportion of deliberate self-harm patients who left the emergency department without admission had increased, with particular concern for those who used highly lethal methods, such as attempted hanging and drowning. The admission rates varied considerably across hospitals and HSE regions reflecting a ‘lack of uniform assessment procedures’ for this patient group, the report said.

Posted in Public Health on 28 July 2009

Suicide attempts and self-harm ‘by 5 year olds’

2009-08-24T09:43:00.000+10:00

By Jennifer Hough

Wednesday, August 19, 2009

CHILDREN as young as five have been treated for suicide attempts and self-harm, according to a leading child and adolescent psychiatrist.

Professor Carol Fitzpatrick, a specialist in child psychiatry, said children as young as five and six have presented to Children’s University Hospital, Temple Street, Dublin, because of self-harm or suicide attempts.

She said that as adolescence approaches, the problem becomes more common.

Data from a special deliberate self-harm team at Temple Street also reflects the growing trend.

Prof Fitzpatrick said the figures for last year were up "very significantly".

She also said that, looking at the figures so far this year, it appeared as though they were set to increase again.

In seven years, the team has seen 566 cases of children aged 16 and under with self-harm or suicidal behaviour.

Paul Kelly, director of Console, a charity that supports those bereaved through suicide and promotes mental health in the community, said deliberate self-harm and suicidal ideation were growing problems in young people.

Console had seen children aged six and seven who were "at risk".

He said Console was hoping to increase its psychotherapy services to adolescents and younger children owing to the worrying trend.

According to latest figures from the National Suicide Research Foundation, published last month, an increase in self-harm was "observed" in the 10-14 age bracket.

An estimated one in 10 adolescents in Ireland resorts to self-harm. Hospitals reported 197 cases of girls self-harming and 63 of boys in this age group last year.

The report urged: "Considering the high rates of deliberate self-harm in adolescents and the increase in self-harm among those aged 10-14 in 2008, there is a need to prioritise evidence-based mental health programmes for children and adolescents as well as specialist mental health services."

Mr Kelly said Console was appealing for help resource counselling for young people at risk.

"We are all feeling the effects of the recession and know now is not the time to ask people to delve into their pockets to donate. Instead, we are doing all in our power to create events and services to continue to fund our work this year," said Mr Kelly.

He said the charity was seeking 1,000 people from across Ireland to pack bags in Dunnes Stores on Saturday, August 29, to raise essential funds for people devastated by the suicide of a loved one.

* Anyone wishing to help out on the day can contact 01-6102638 or email info@console.ie.

This story appeared in the printed version of the Irish Examiner Wednesday, August 19, 2009

Self-harm in Northern Ireland

2009-08-23T21:33:00.001+10:00

Researchers from Queen's University and the University of Ulster in Northern Ireland have been asking 941 sixteen-year-olds about self-harm. One in ten had self-harmed in the past year and another 14% had thought about it but had not done so. Girls were much more likely than boys to say that they had thought about harming themselves (18% vs 7%) or had actually done so (13% vs 5%). There were strong links between self-harm and high levels of stress, high expectations the youngsters felt they could not fulfil and experiences of bullying in school. 25% of the sample said that they had suffered from serious mental and emotional health problems in the past year for which they felt they needed professional help although only 9% had actually asked for it. Youngsters from less well-off backgrounds were significantly more likely to be affected by mental-health issues and to have self-harmed or considered self-harming.

You can find out more about this research at

http://www.sciencedaily.com/releases/2009/07/090730073921.htm

Screams

2009-08-22T21:12:00.004+10:00

Does anyone really care if you hurt yourself. Are you sending out blatent messages that no one reads.

Do you scream 'what do I have to do'

do u beg for love and understanding that no one reads

Welcome to my world

Working with Self-harm – a One Day Workshop (Swansea)

2009-06-06T20:54:00.005+10:00

Date:- Thursday 25th June 2009

Venue:- Maritime Museum, Oystermouth Road,
Swansea, SA1 3RD

This one-day workshop explores self-harm and is suitable for workers whose clients may be exhibiting self-harming behaviours. Participants will explore this complex subject that is often mistakenly seen as attempted suicide.

This workshop starts from the basic principles of understanding the issues leading to and surrounding destructive and harmful behaviours, the function of the behaviour(s) and appropriate responses. Self-harm is a relevant issue for all of those working with children and young people and is of grave concern.

The aims of this workshop are: To increase awareness and understanding of the reasons why young people may use destructive and harmful behaviours. To develop competence and identify relevant skills to enable professionals to respond confidently when presented with and in identifying self-harming behaviours.

To book contact:

Glyn Jones,
Network Manager,
Mid and West Wales CAMHS Commissioning Network

glyn.jones@wales.nhs.uk

Music, Self Harm & Slipknot

2009-06-04T20:49:00.000+10:00

Corey Taylor defends the band's lyrics...

by Daniel Melia
Thursday, May 21, 2009
Photo by: wenn.com / Carsten Windhorst

Vibrant Slipknot frontman Corey Taylor has hit out suggestions the band's music encourages children to self harm.

The band previously come under fire over the dark imagery in some of their song lyrics, but Taylor insists the tracks do not influence impressionable youngsters.

And he understands why angst-ridden teenagers feel depressed - he suffered the same problems in his youth.

Taylor says, "If you're setting out to hurt yourself, it's not the music that's causing it. There's something else wrong. We get a lot of kids that cut themselves but I go out of my way to try and stop it.

"It may feel artistic to carve our names in your arm but to us, it's just hurting yourself. As bleak as Slipknot can be, it's supposed to be positive in the long term and the last thing we want is for anyone to hurt themselves.

"I used to be one of those kids and I always try to explain to them that I know what it's like to feel like you're the last person on Earth. All you have to do is reach out and someone will be there."

Slipknot live in London

Slipknot fans @ Hammersmith Apollo

“I can actually talk to them now” – Educational intervention for nurses

2009-06-02T20:45:00.000+10:00

Posted on June 1, 2009 by sjennings29

‘I can actually talk to them now’: qualitative results of an educational intervention for emergency nurses caring for clients who self-injure, Journal of Clinical Nursing, online early view, 2009

Margaret McAllister, Wendy Moyle, Stephen Billett and Melanie Zimmer-Gembeck

Authors: Margaret McAllister, RN, Ed D, Associate Professor, University of the Sunshine Coast, Maroochydore, Australia; Wendy Moyle, RN, PhD, Professor, Griffith University, Brisbane, Queensland, Australia; Stephen Billett, PhD, Professor, Griffith University, Brisbane, Queensland, Australia; Melanie Zimmer-Gembeck, PhD, Associate Professor, Griffith University, Brisbane, Queensland, Australia

Correspondence to Dr Margaret McAllister, School of Health and Sport Sciences, University of the Sunshine Coast, Maroochydore,

ABSTRACT

Aim and objectives. This Australian study evaluated the effectiveness of a solution-focused education intervention in extending and improving emergency nursing responses to patients who present because of self-injury.

Background. Emergency nurses commonly report lack of training and feeling unskilled in managing people who present because of self-harm. Most educational interventions have provided content knowledge, yet rarely have they focused on conveying the value of health promotion strategies such as proactive skills and coping strategies.

Design. A mixed method pretest–posttest group design was used.

Methods. Nurses (n = 36) were interviewed to examine differences in professional identity, awareness of self-injury and clinical reasoning.

Results. The qualitative results are presented in this paper and these showed improvements in knowledge and understanding of self-harm, self-belief in nurses’ capacity to positively influence clients and the value of health promotion skills. The intervention produced a positive attitudinal shift towards clients and an expressed intention to act in ways that were more person-centred and change oriented.

Conclusions. The solution-focused education intervention appears to show promise as an intervention for enabling nurses to value their unique contribution to providing a health service that is more proactive and health-promoting.

Relevance to clinical practice. Interactive education bringing psychosocial skills to technical nursing staff builds confidence, competence and more person-focused care.

Lancashire Care staff can request the full-text of this paper, email: susan.jennings@lancashirecare.nhs.uk

Harmless (DVD Trailer)

2009-06-01T20:32:00.001+10:00

'Out of harm's way' is a DVD featuring seven short documentaries exploring the meaning of self harm and the factors which lead to recovery.

The full DVD is available to purchase from http://www.harmless.org.uk, and all proceeds from its sale will be used to provide services to people who self harm.

This Week At . . .

2009-05-31T20:42:00.000+10:00

Post Secret

Guest Post - Dr. Kevin Keough

2009-05-30T19:29:00.004+10:00

Understand Self Injury- Awareness Video

This is a video on self-harm I made to help those who don't understand. Please check it out and ask any questions if you have any. If there is hate comments, rude or disrespectful I will delete and block you. Below I have posted a lil more details about those who self-harm. Please take a moment to read it. http://www.recoveryourlife.com/ http://www.meetup.com/ http://www.psyke.org

====================== Song: Breathe-Sia ======================

SI is something I go through personally everyday of my life. I think about it all the time. Even tho the thoughts are there, most likely I'll be able to control myself & not hurt my body. Sometimes I slip & hurt myself but it shows how hard I work towards being heathly & safe. DBT is a good source to help the urges & to find safe ways to cope with the feeling.

Self-injury or self-harm is when somebody damages or injures their body on purpose. Self-injury is a way of expressing deep emotional feelings or problems that build up inside.

Cutting the skin is probably the most common form of self-injury. The cuts are not usually deep but in some cases, medical attention is needed to clean, dress or stitch the wounds. The most common places on the body to cut are the wrists, upper arms, inner thighs and upper chest. Less common are the face, breasts, abdomen and genitals.

Often people who cut themselves will use one or two methods, for example, knives, glass or razor blades. The person tends to have a certain area of the body that they prefer to cut, such as the arms.

Burning the skin (usually with cigarettes) is also common. People may also self-harm by scratching, hitting or punching, sometimes using an object. Other forms of self-injury include picking at the skin, pulling out hair, swallowing poisonous substances, taking an overdose of tablets or drugs or deliberately breaking bones.

Although, there is a connection between self-harm and suicide, the majority do not risk their lives. For many people who self-injure, their actions are only an attempt to cope with the stress and difficulties they face; their purpose is not to end their life.

However, there is a possibility that those who self-injure may commit suicide either deliberately or accidentally as the result of their actions.

Self-harm is much more common among girls than boys, often starting in adolescence (between 13 and 18 years of age), although it can affect children from as young as 11 years. Fear of discovery, shame and embarrassment often means that people keep self-injury a secret. Because of this, it is difficult to know how many people self-harm.Some people self-harm only once or a few times while others do it on a regular basis, sometimes throughout their life.

People who self-injure are very careful to hide the damage and scars. They will often injure themselves in places that can be easily hidden by clothing so friends and family members may be unaware of the person self-injuring in private. Another sign that someone could be self-harming is that the person will insist on keeping covered up at all times, even in hot weather.

People self-injure for a variety of reasons and sometimes, the person doesnt actually know why they are doing it. However, it is commonly thought to provide a release for pent-up emotions and feelings. For some people it is their way of coping with a specific problem. Self-injury is a sign of emotional distress and is not an attempt to seek attention.

People who self-harm often describe feelings of numbness or deadness or they may feel detached from reality, as if they are not part of the world. Some may injure themselves to stay separated from reality but others do it to make them feel more real, connected and alive.People who self-harm often describe feelings of numbness or deadness or they may feel detached from reality, as if they are not part of the world. Some may injure themselves to stay separated from reality but others do it to make them feel more real, connected and alive.

People who self-injure risk infections if their wounds are not treated properly. Cuts can become infected if a person uses non-sterile or dirty cutting instruments.

Source:Healing From Addictions

Friday Readers Story

2009-05-29T19:45:00.002+10:00

Anonymous said...

im a 14 year old and i started cutting about a year ago. to be honest i dont really remember why i started self harming. i think it began with me just wanting to express some emotion without having to explain myself to anyone. it was the one thing in my life that i felt like i could control. now things are going badly at school and i self harm more. i paniced and tried to find a site to get help. but then i read about all these people who were abused or close relatives and friends had died so they started self harming. that just made me fell worse because i had no real right to self harm, i had no real problem. of course i got depressed and cut myself because i was so ashamed of myself and it ended up going round in a loop. i was cutting to let out my hatred of myself, to get rid of my bad blood which made me want to cut even more. my cuts are getting deeper.

i dont really know why i left this comment i just felt like i needed to tell someone who wasnt going to come up to me the next day and ask me why i did it. thank you

American Self Harm Information Clearing House

2009-05-28T19:57:00.000+10:00

Approximately 1% of the population has, at one time or another, used self-inflicted physical injury as a means of coping with an overwhelming situation or feeling. ASHIC - the American Self-Harm Information Clearinghouse - strives to increase public awareness of the phenomenon of self-inflicted violence and the unique challenges faced by self-injurers and the people who care about them.

Self-harm scares people. The behavior can be disturbing and difficult to understand, and it is often treated in a simplistic or sensational manner by the press. As a result, friends and loved ones of people who self-injure often feel frightened, isolated, and helpless. Sometimes they resort to demands or ultimatums as a way of trying to regain some control over the situation, only to see things deteriorate further.

The first step toward coping with self-injurious behavior is education: bringing reliable information about who self-injures, why they do it, and how they can learn to stop to people who self-injure and to their friends, loved ones, and medical caregivers. ASHIC was founded to meet this need for honest, accurate information.

Wordless Wednesday

2009-05-27T20:02:00.001+10:00

Post-traumatic Stress Disorder

2009-05-26T20:14:00.001+10:00

Written by HealthyPlace.com Staff Writer Jan 03, 2009

Full description of Post-traumatic Stress Disorder (PTSD). Definition, signs, symptoms, and causes of PTSD.

Description of Post-traumatic Stress Disorder (PTSD)

Post-traumatic Stress Disorder is a severe reaction to an extremely traumatic event. The person can actually experience the event (i.e. be in a plane crash) or be a witness to the event (i.e. rescue worker at a plane crash).

Over time and with psychological help, some people learn to cope with the aftermath of the event. However, for others, symptoms such as flashbacks and depression can become worse, lasting a long period of time, and seriously disrupting the person's life.

Sometimes symptoms do not begin until many months or even years after the traumatic event took place. If post-traumatic stress disorder has been present for 3 months or longer, it is considered chronic.

PTSD is an anxiety disorder which can affect both children and adults. About 7% of the population will develop PTSD in their lifetime; 5 million adults in the U.S. have PTSD during any given year.

Diagnostic Criteria for Post-traumatic Stress Disorder (PTSD)

The person has been exposed to a traumatic event in which both of the following were present:

the person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others
the person's response involved intense fear, helplessness, or horror. Note: In children, this may be expressed instead by disorganized or agitated behavior

The traumatic event is persistently reexperienced in one (or more) of the following ways:

recurrent and intrusive distressing recollections of the event, including images, thoughts, or perceptions. Note: In young children, repetitive play may occur in which themes or aspects of the trauma are expressed.
recurrent distressing dreams of the event. Note: In children, there may be frightening dreams without recognizable content.
acting or feeling as if the traumatic event were recurring (includes a sense of reliving the experience, illusions, hallucinations, and dissociative flashback episodes, including those that occur on awakening or when intoxicated). Note: In young children, trauma-specific reenactment may occur.
intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event
physiological reactivity on exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event

Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma), as indicated by three (or more) of the following:

efforts to avoid thoughts, feelings, or conversations associated with the trauma
efforts to avoid activities, places, or people that arouse recollections of the trauma
inability to recall an important aspect of the trauma
markedly diminished interest or participation in significant activities
feeling of detachment or estrangement from others
restricted range of affect (e.g., unable to have loving feelings)
sense of a foreshortened future (e.g., does not expect to have a career, marriage, children, or a normal life span)

Persistent symptoms of increased arousal (not present before the trauma), as indicated by two (or more) of the following:

difficulty falling or staying asleep
irritability or outbursts of anger
difficulty concentrating
hypervigilance
exaggerated startle response

Duration of the disturbance (symptoms in Criteria B, C, and D) is more than 1 month.

The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Causes of Post-traumatic Stress Disorder (PTSD)

Living through or seeing something that's upsetting and dangerous, psychological trauma, can cause PTSD. This can include:

Being a victim of or seeing violence (kidnapping, torture, sexual abuse)
The death or serious illness of a loved one
War or combat
Car accidents and plane crashes
Hurricanes, tornadoes, and fires
Violent crimes, like a robbery or shooting.

Studies indicate the amount of dissociation that directly follows a trauma predicts PTSD. Individuals who are more likely to dissociate during a traumatic event are considerably more likely to develop chronic PTSD.

There also seems to be a genetic component to post-traumatic stress disorder. PTSD runs in families. And, as with many psychological disorders, a person's temperament, brain chemistry and other environmental factors likely play a role in the development of PTSD. In addition, having an existing psychiatric disorder, a family history of depression, or a poor support system following a traumatic event are all risk factors for PTSD.

For comprehensive information on post-traumatic stress disorder (PTSD), visit the HealthyPlace.com Anxiety-Panic Community.

Sources: 1. American Psychiatric Association. (1994). Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Washington, DC: American Psychiatric Association. 2. Merck Manual, Home Edition for Patients and Caregivers, last revised 2006. 3. NIMH, Post-Traumatic Stress Disorder, July 2008. 4. Brown, Scheflin and Hammond (1998). Memory, Trauma Treatment, And the Law. New York, NY: W. W. Norton.

Book Review: Freedom from Self-Harm

2009-05-25T20:32:00.000+10:00

Publisher's Site

Post-traumatic stress disorder and deliberate self-harm (also called non-suicidal self-injury) are often linked.

"Deliberate self-harm" means doing something to cause immediate physical harm to yourself but not for the purpose of ending your life. Self-harm behaviors include cutting, burning, scratching, punching, or carving words or pictures on oneself.

Self-harm behavior can be difficult to stop and many people are reluctant to seek out treatment for self-harm due to the shame they feel about the behavior. Fortunately, there is a new self-help book available for people who deliberately self-harm.

A New Resource for Coping with Deliberate Self-Harm Behavior

Freedom from Self-Harm: Overcoming Self-Injury with Skills from DBT and Other Treatments (published by New Harbinger Publications) by Doctors Kim L. Gratz and Alexander L. Chapman may help those struggling with self-harm behavior.

Freedom from Self-Harm is an easy-to-read and accessible book that provides a wealth of information on:

Why people often engage in self-harm
Myths about self-harm
Causes of self-harm behavior
Mental health disorders that often co-occur with self-harm, such as PTSD and borderline personality disorder
The consequences of self-harm
Psychological treatments and medication that may be helpful for self-harm
Coping skills for self-harm

The information provided in the book is up-to-date and presented in a validating and respectful manner. The authors also provide case examples throughout the book to help illustrate more complicated points.

Probably one of the greatest advantages of the book is its presentation of coping skills that someone struggling with self-harm could implement right away. For example, the book provides information on healthy ways of managing emotions (given that self-harm is often thought of as a way, albeit unhealthy, of regulating emotions), as well as worksheets to help people use these skills.

If you struggle from deliberate self-harm and are looking for a way to stop this behavior, you may benefit from checking out this great resource.

Publisher's Site

Burn Out

2009-05-24T21:29:00.001+10:00

Maslach & Leiter define burnout as:

"the index of the dislocation between what people are and what they have to do. It represents an erosion in values, dignity, spirit and will--an erosion of the human soul. It is a malady that spreads gradually and continuously over time, putting people into a downward spiral ..."

Symptoms include exhaustion, cynical detachment from our work, and feelings of ineffectiveness.

Why are so many social workers are burning out? We're good people who are staunchly committed to helping others. Here's where we think the problem lies:

Too many of our employers fail to empower us with the ability to perform effectively, doing so in a multitude of ways.

Mismanagement While social workers may be nice people, many social work middle managers do not appear on the surface to be skilled administrators. However, looking at the problem more closely, when upper management mandates cost-cutting, middle management is often left powerless to support front line staff. This results in front line workers who are overburdened with unmanageable workloads. We suspect that social work middle managers, squeezed between the directives to "do more with less" and "work smarter," experience burnout just as intensely as front line workers. And we further suspect that we "front line workers" fail to recognize burnout in our supervisors as quickly as we recognize it in our same-level peers. But regardless of the reason for mismanagement ... lack of training, lack of experience, lack of insight, etc. ... when we find ourselves poorly treated by a social work supervisor, it seems to have an especially biting sting because it happens at the hands of "one of our own."

Schedule Imbalance Many of us are employed in agencies which provide 24 hour services, such as hospitals, crisis centers, protective agencies, etc. It is to be expected that we all have to share the burden of working holidays, weekends, and off-shifts. Some employers, however, repeatedly assign undesirable shifts to the same workers. Additionally, the distinction between being at work and time off from work becomes blurred when we are required to carry beepers and/or make ourselves available for consultation or crisis intervention on an on-call basis during our time away from the work setting.

Intense Work Days It is our observation that the most intensely burned out social workers are those with the most relentless work days. Far too many social work employers schedule exhausting shifts with no provision for meal breaks or short-term, essential mental/emotional refreshment. Burnout under these conditions appears quite pervasive to us.

Chronic Fear of Downsizing Money is the bottom line for most of our employers. Social workers in mental health, health care, and many public agencies function with constant fears and sometimes threats of staff reduction. Who's next ... me? This type of atmosphere does little to encourage professional autonomy, growth, or performance.

Lack of Professional Projects We've discovered from personal experience that when we do nothing but patient care day after day, week after week, month after month, we begin to lose enthusiasm for our job and our profession. Feelings of professional isolation emerge, as well as the decreased ability to contribute meaningfully to the organization. Time and an opportunity to work on projects promoting better care of clients would lead to much more professional satisfaction!

Office and Inter-Agency Politics Who doesn't hate this one? We'd all rather just do our jobs and forget the power struggles that take up time needlessly. Many of our work days suffer from reduced productivity caused by the need to jump through internal or inter-agency hoops that are of little value for the care of our clients.

Lack of Appreciation This certainly occurs in all professions. But have you ever noticed how social workers are supposed to routinely deal with difficult and stressful situations without so much as a "please" or "thank you?" Management sometimes compounds the our feelings of being unappreciated with last-minute schedule changes, denial of employee benefits, staff reductions, etc.

Personal Risk Frequently social workers are expected to perform effectively in hazardous situations without adequate protective measures for our health and safety. Dangerous situations are common for psych social workers and child protective workers. Medical and prison social workers often face patients with an airborne-communicable diseases such as TB without being informed of the risk and without adequate protective masks. Social workers frequently must interact with clients on a crisis basis without security staff or basic safety precautions. In our opinion, nothing else more clearly communicates an employer's lack of appreciation and respect than to jeopardize social workers in this way during the course of our work day.

2009-05-23T20:16:00.000+10:00

It has been a couple of months since I wrote about my teen daughter’s cutting, and what it was like to be a parent surviving through self-injury. Now I see parents arrive here at MereWisdom.org from time to time with searches that break my heart - for I typed so many of the same things trying to find answers. For these visitors, I offer the following wisdom gained from making a million mistakes in responding to my daughter’s self harm.
For those looking for people who are getting through this, I would point you to my daughter’s site where she wrote to share some of her story of Survival of a Self Injurer. Worthy of note and celebration in this is that she now has nine months free of self-injury, one day at a time.

Caring for Myself and Family

1 - There is nothing I can do to save her or protect her completely - The belief that if I just try harder to protect her, to limit her choices, and keep her safe to get her through this without being able to harm herself further is, in the end, a lie. I had to accept my powerlessness to stop her from harming herself before I could stop dying inside from whether she has or has not self-injured today. It’s her behavior and only she can make different choices.

2 - I did not cause it - I struggled with my own guilt for a long time. A long, long time of second guessing myself, thinking that my own faults and failures ends up, really, only another form of the false beliefs in item one, above.

3 - Her Self-Injury is not the most important thing in my life - She is more important to me than what she does. My son is equally important to me, and can’t be ignored because of constant crises in her life. Self-injury can pull a family out of a normal orbit into a tight orbit only around the self injury. This reinforces the self-injury from my experience, and it harms everyone else now out of orbit.

4 - I needed help for myself and my family and not just my daughter - It’s her behavior, but it affects all of us. More importantly as the family increasingly becomes centered on the self-injury, the more the family systems break down and require conscious rebuilding. Normal systems and family behavior that act as balancing forces for our children and ourselves become reinforcing factors for out of control behavior instead. And as we broke down, it was invisible to us. Outside help is critical.

5 - Learn to live in Daytight Compartments - The notion of “One Day at a Time” is almost a cliche in dealing with these situations, but there is some truth to the idea that just for today I can endure and do the things that I could never do for the rest of my life. For me, the idea of daytight compartments, like watertight compartments on a ship, helped me get through tough times.

Responding to Self Injury

6 - Talk about it - One of the things I did right in this was insist from day one that we would not act ashamed about it and talk freely about self-injury. It is always ok to ask if injuries need immediate treatment, for example. It’s ok to talk about feelings - from my feelings about specific events to her feelings before or after cutting. It’s also ok to talk about other things besides self-injury - there is a whole life taking place at the same time.

7 - Set Boundaries on Behavior - I mentioned above that trying to control her behavior stems from a false belief that somehow I can do it for her. This is one of the broken systems that reinforces negative behavior, rather than balancing or opposing it. Natural consequences are much better. One of the first consequences we had was that all cuts had to be examined by a medical professional within 24 hours.

8 - Build a Team - My daughter’s recovery team became her school nurse, her family doctor, her psychologist and later a psychiatrist. Each of them got a copy of the Bill of Rights for People Who Self-Harm and it made a very real difference in the level of care she received.

9 - Stay the Parent - My daughter at one point was using her self-injury as a point of leverage to take control of the family. She would threaten to cut herself to get herself out of situations, and these tools helped get us past that point. She would threaten, and I would respond that I can’t stop her if she chooses self-injury but then medical care is required, and if self-injury was a part of any behavior contract, then those consequences would happen as well.

10 - Love her enough to respect her decisions - This is the hardest one, and a recent bit of learned wisdom. I think this is because the same need I have to protect her from harm is also in play to keep her from harm by way of her consequences of her actions. This is still an ongoing struggle for me as it is a great theory until I see behavior that is likely to cause problems for yars to come or legal issues and so on. In our case, it meant loving her enough to respect decisions even when the consequences included not living at home for a while, hospitalization, school settings that took her away from music, and so on.

Brilliant post written by James at Mere Wisdom, I thoughly recommend his site

Self Harm & Glucose Metabolism in Women with ED

2009-05-21T20:11:00.002+10:00

Self-injury (such as cutting or burning oneself) is fairly common amongst people with eating disorders- approximately 25% to 45% of people with eating disorders self-injure, and approximately half of those who self-injure also have eating disorders (full article here). Many people report a sense of dissociation while self-harming, a desire to turn emotional pain into physical pain (ie, "real" pain), and also that this behavior reduces anxiety. Whether self-harm is from issues relating to impulse control, a more compulsive pattern of behavior, or something else entirely, the amount of overlap between self-injury and eating disorders is significant.

An interesting new paper from the journal Psychoneuroendocrinology looked at the relationship between self-injury and glucose metabolism in women with eating disorders, and what they found was significant. Women engaging in self-harm behaviors were given an oral glucose tolerance test, in which they were asked to drink a sweet solution to measure how the body handles sugar. The self-harming women who also had an eating disorder had higher levels of blood glucose after the test, but also higher levels of a hormone called glucagon.

Glucagon is essentially insulin's opposite: when the blood sugar is low, the pancreas secretes glucagon to prod cells into breaking down long chains of carbohydrates called glycogen into small sugars that can be released into the bloodstream and readily used by the body. When blood sugar rises after a meal, the pancreas secretes insulin, which stimulates cells to pull excess sugars out of the bloodstream and store them as glycogen for a rainy day*.

Besides low blood sugar, several other factors can stimulate the release of glucagon, including epinephrine (aka adrenaline), which is involved in the fight or flight response. Though I was unable to find any specific studies linking high levels of epinephrine and self-injury, it's certainly plausible to think that people who self-harm would have higher levels of epinephrine, especially right after an incident where such behavior occurs. Alternately, if high levels of glucagon also stem from high levels of epinephrine, the sufferer may be caught in a cycle of self-harm during episodes of low blood sugar.

For instance, a common pattern in those who binge and purge is binge-purge-self harm, where the self-harm typically occurs after the completion of the binge/purge cycle. After a binge, blood sugar goes up and glucagon levels go down. After a purge, blood sugar goes down, and glucagon and epinephrine levels go up.

No one knows at this point where the relationship between self-harm and glucose metabolism lies on the cause/effect scale. Certainly there is a feedback cycle between all of these systems. But one good point to keep in mind is the importance of helping sufferers regulate blood sugar levels by frequent meals and snacks that involve complex carbohydrates, proteins, AND fats. Food is medicine for the eating disorder, but it also might be true for self-injury.

*Aren't you glad I paid attention in my 8am biochem lecture 10 years ago?

Crosspost from ED Bites

8 Common Myths about Self-Harm

2009-05-20T19:54:00.000+10:00

May 8, 2009

We recently received a copy of Freedom from Self Harm: Overcoming Self-Injury with Skills from DBT and Other Treatments by Kim Gratz and Alexander Chapman and can highly recommend this book.

One of my favorite parts of the book is titled 8 Common Myths about Self-Harm. Here’s what the authors came up with:

1. Self-harm is the same as a suicide attempt.
2. Self-harm is superficial and not dangerous.
3. Self-harm is manipulative.
4. If you self-harm, you have borderline personality disorder.
5. Self-harm is a female problem.
6. Self-harm is crazy, sick, and irrational.
7. You must resolve your underlying issues before you can stop self-harm.
8. If you resolve all your underlying issues, your self-harm will go away.

Although this book is specifically intended for those who engage in self-harm, it should be a helpful resource for families and mental health professionals as well.

Birmingham

2009-05-19T19:49:00.000+10:00

Support For People at Risk of Self Harm

Last Friday I attended an open day at the Zinnia Centre in Sparkhill, Birmingham where I met staff, volunteers and members of a support and action group for people who are at risk of self harm. The group is called SASH and meets every first tuesday of the month between 5.30 and 7.30pm.

The programme of forthcoming events includes a talk on Distraction techniques on 2nd June, 'Mind,body and soul' - alternative therapies to reduce self harm on 7th July and Good turn week - volunteering your way to happiness on 1st September.

To find out more about the SASH Forum please contact the Zinnia Centre on 0121 301 5700. You will need to check out whether you are eligible to attend the group beforehand (are you living in the right area...there may be a group in your own area).

The group have various resources around self-harm including an information pack full of guidance, information, contact details of support groups and coping systems and strategies.

Self harm is defined as "An intentional self poisening or self injury (such as cutting), irrespectove of the apparent purpose of the act".

The Information Pack goes on to say:

"Self harm is therefore a way of releasing and dealing with emotions, and includes the idea of punishing the bbody. This may be caused by many factors such as:

past / present trauma
low esteem - lack of confidence
feelings of isolation - (agoraphobia)
fear of being different or misunderstood
lack of support, including lack of communication

For anyone who knows someone, a relative, friend or service user at risk of slef harming, the pack offers the following Methods for Help:

Be open about self harm
Offer advice and understanding
Support, care and friendhsip
Offer sources of help
Show the person is not alone
Offer the opportunity to share experiences - either in specialist group or 1 to 1
Give direct answers
Offer distraction techniques and work through these
Building on trust (counsellor or psychiatrist)

For information from Birmingham and Mental Health Trust contact 0121 678 2000

As well as local groups such as the one based at the Zinnia Centre, SASH run a national support line on self harm matters on:

07805073590 or 078050735573

Other useful numbers include:

Childline

0800 1111

Samaritans

0845 90 90 90

Focusline (all issues regrading mental health)

0800 027 2127

Dosti Men's Group (Birmingham self harm support group)

0121 685 7120

There are also websites worth visiting for further information:

http://www.selfharmuk.org/

http://www.siari.co.uk/

http://www.youngminds.org.uk/

Source: Spaghetti Gazetti

New Risk Factors For Teen Self Harm

2009-05-18T19:45:00.000+10:00

Main Category: Pediatrics / Children's Health
Also Included In: Psychology / Psychiatry
Article Date: 19 May 2009 - 8:00 PDT

A lack of emotional intelligence leads to poor coping strategies and seriously increases the likelihood of self-harm in teenagers, claims a study published yesterday, in the British Journal of Clinical Psychology.

The study, carried out by Moira Mikolajczak from the Universite Catholique de Louvain, Belgium, K. V. Petrides from the London Psychometric Laboratory at University College London and Jane Hurry from the Institute of Education examined the levels of self harm, emotional intelligence and coping strategies of 490 British secondary school pupils.

Dr Petrides said: "People who turn to self harm claim to do so to regulate their emotions, which indicates that they cannot manage their feelings in a healthy way. We wanted to better understand the underlying psychological issues that lead adolescents to harm themselves."

Of the 490 students who took part, 132 (27 per cent) reported having deliberately self harmed, either hitting or cutting themselves or taking an overdose of recreational drugs. 65 per cent of self harmers were found to have mild to severe symptoms of depression.

"We found that teenagers who self harmed had both significantly lower scores on a measure of emotional intelligence and were more likely to use maladaptive coping strategies such as self criticism or self blame. This suggests that self harm is a desperate attempt to reduce the negative feelings that are worsened by their poor and ineffective emotional coping strategies."

"However efficient self harm may be at reducing negative emotions in the short term, this is at the cost of serious physical injury and longer term psychological problems. These findings will help us develop coaching programmes for the treatment of self harm patients that focus on developing both better methods of coping and boosting emotional intelligence."

Source
British Psychological Society

2009-05-17T05:28:00.003+10:00

Did you forget me?

Did you forget you loved me?

Did you forget Im one of your children?

or did you chose this path for me?

did I?

I am an incredible woman

did you not notice?

or is the harm, the hurt that I have known

as a girl child, a woman

given to only the special, the strong

I am me, I am strength

You, my God, my poor man,

cant take that back

It is mine, I am me

2009-04-28T23:32:00.002+10:00

Hey people, sorry I havent posted.. going through a lot of turmoi.

Update: this week I havnt burnt myself & the scars are healin, but I cant seem to straighten my life. This world of quiet numbness will do me.. a tiny escape of no responsibility...

Hope you guys are doing better. I just have little strength..

2009-04-14T19:30:00.006+10:00

I had trouble posting tonight...

how does one do an update on nothing, no growth, no solutions, no movement.

The best description I have is lethagy.

Just holing up in my home space

Hoping like hell people will go away, problems dont need solutions, bills wont need to be paid, no one invades my space, myself, I dont have to make decisions, be relied upon. Id just want a rest from the world. Don't ask anything of me, I dont have the answers, I dont even have the energy to consider the questions. Im tired of being to rock everything revolves around. Im so exhausted, by others demands, by my own demands

I dont want it anymore, let me curl up and sleep, let me heal, let me go.

*I hate this remix, but its the best I can come up with, welcome to my life in techno...x

I do not want to be afraid
I do not want to die inside just to breathe in
I'm tired of feeling so numb
Relief exists I find it when
I am cut

Negative Self Talk - What Is It

2009-04-13T19:52:00.000+10:00

Ponder the following quote:

“If you had a friend who talked to you like you sometimes talk to yourself, would you continue to hang around with that person?”

~Rob Bremer

Entwined with SH, depression and other mental health issues is negative self talk.

This self-critical voice works by...
Emphasizing past failures.
Ignoring anything good that happens.
Setting impossible standards of perfection.
Assuming others' thoughts about you are negative.
Calling you names.

Negative self-talk is usually a mixture of half-truths, poor logic, and distortions of reality, or an unbalanced focus on a problem, that perpetuates negative emotions, such as pessimism, guilt, fear, anxiety as well as self-sabotaging behaviors. It often occurs when in times of emotional turmoil, or when we are going through stress or a personal transition. For some of us, it has become our daily inner dialogue.

There are many ways to free ourselves from negative self-talk. For some, the best step may be to work with a good therapist or counselor. Others may just need to pay attention to the negative self-talk and use some of the suggestions provided here. Support groups (in person or online) may also be beneficial.

So how do we stop negative self-talk?
Step 1. Become aware of it.
Step 2. Find out where the negative self-talk originated.
Step 3. Acknowledge the pay-offs.
Step 4. Take conscious steps to stop the negative self-talk.

Its these four steps I want to go deeper into in later posts. How do we turn it around? In fact, an astonishing 45,000 – 51,000 thoughts go through our heads on an average day. Many of these thoughts are harmless, such as “I must remember to pick up my clothes at the cleaners” . When you keep repeating the negative messages to yourself, you create a limiting belief that goes on to become a self-fulfilling prophecy.

So just for this week lets start being aware of what we are saying ...

2009-04-12T00:21:00.000+10:00

Depression 101

2009-04-11T17:06:00.010+10:00

One of the hardest things in dealing with depression, for me, is guilt. With people who don't understand, family, Dr's. friends. Even friends who 'understand' lose patience.

To make an appointment and keep it, to go to the supermarket, to others is a simple task and when I cant do these things my mind goes into overdrive. I question why I cant do such simple tasks, why I have let people down again.

I avoid phones, the door as it will just be someone wanting more than I can't deliver, conversation, coffee. What others take for normal is so out of my depth with the my mind is fogged.

My sister rang last night (accidentally picked it up), no big deal, good Friday. 'Did i want to go to church then have dinner at hers' No, can't, busy, work, evasions etc....

Next question... 'are you drinking again' (instant frown tone in her voice)

Here leads to self medication.. fancy term for getting drunk or stoned. For trying to balance emotions, depression, voices, doubts, prescribed medication with whatever will shut off your mind. So that becomes the primary concern for everyone. Its easier to deal with addiction than depression. I don't want to let people down, seems to go with the territory though. Then each plays on your mind till it seems insurmountable. My husband, children, friends.....

My husband came, 'Dont do this to the children again' ... more guilt.. Like I have a choice & each barb he so accurately throws keeps me here. My daughter says symathetically, 'just walk the dogs mum' each tiny guilt grows like a heap of bricks.

No one understands how much it takes to just sit in the sun when your so bone achingly tired.

To want to live life but have no idea how to reconnect, to have so many, yet still be alone ...till you lose the will to.

You just want to be left alone...

I have been diagnosed with chronic depression for two years...This spiral took 3 weeks ... I dont know how to get back to reality

Alone

2009-04-10T18:15:00.001+10:00

To harm, to hurt oneself, anger, dealing with depression, your so incredibly alone.

You can expain it (and often do), rationalise it, to yourself, to a trusted few, mum, dad, your doctor, counsellor, wife, husband.. a friend maybe

but you feel so incredibly alone...

I find when most isolated, When Im most at risk. How to ask for help when you really dont believe in it, dont believe in yourself.

You know your alone, and cant ask, but it often takes just one to understand and stand by you, often at a time you dont feel worthy of it, is a start, for someone to step in and take the burden from you.

When Someone Who Self-injures Comes To You

2009-04-09T01:01:00.000+10:00

What do you do when someone tells you they are self-injuring?

Most just want you to be there to listen, but realize that more often than not, they may share their story gradually. They’ll test the waters, see if they can trust you, but also if they can trust themselves to handle telling the story. Doing so may be difficult, painful, or shameful for them. For some, the anxiety they feel while even speaking about their struggle could trigger the compulsion to self-injure again.

More tips . . .

Listen with compassion and patience, even when your time with them is short

Ask questions that are helpful for them to move forward, not just to satisfy your curiosity

Help them network with others who can be supportive and encouraging

Talk about strategies for when life is tough–different ways to cope and handle disappointments, hurts, anxiety, anger, shame

Also strategize for those intense moments when they want to hurt themselves—options for what to do for fifteen or twenty minutes or until the urge passes

Make sure you end your time with them with some form of encouragement

Pray for them often and for those times you are meeting and talking

One of the questions I’m often asked is, “When do you refer to a professional counselor?” My answer is to always suggest it. Some may not feel they need it because their self-injury isn’t severe or frequent. But when self-injury is a consistent way of coping, when anxiety and other strong emotions are often present, professional counseling is needed. In that case, involve them in the decision and the plans as much as possible. Work with them to get that help they need.

Finally, be willing to learn more about self-injury. One resource is Scars That Wound, Scars That Heal—A Journey Out of Self-Injury. It tells Jackie’s true story and the stories of others, both girls and guys. It is written to the teen or young adult, but also provides background, help, and tips for those who want to come alongside to help.

Posted by jankern on March 28, 2009

Wordless Wednesday

2009-04-08T17:16:00.000+10:00

2009-04-07T21:05:00.010+10:00

Awakening, my arms ache
Am cut? ...
No burnt...
familiar, hot, seared flesh
seared to my mind
gasping , ragged breathe
and know life

After 10yrs did I drink?
Yes
Smoke? ... will take what you have...
hands clutch the floor
broken glass, spilled wine
Will it calm?
Stop the voices

Your pills, your powder
taste, lick, smell
I breathe them in

combine them
and curl in death?

Do the demons of guilt bite at my feet?
Its ok, they are puppies to me
We are old friends.

Why does self-injury make some people feel better?

2009-04-04T16:00:00.000+11:00

There are a few possibilities, and the answer is probably a mixture of them. Biological predisposition, reduction of tension, and lack of experience in dealing with strong emotions are all factors.

It reduces physiological and psychological tension rapidly.
Studies have suggested that when people who self-injure get emotionally overwhelmed, an act of self-harm brings their levels of psychological and physiological tension and arousal back to a bearable baseline level almost immediately. In other words, they feel a strong uncomfortable emotion, don't know how to handle it (indeed, often do not have a name for it), and know that hurting themselves will reduce the emotional discomfort extremely quickly. They may still feel bad (or not), but they don't have that panicky jittery trapped feeling; it's a calm bad feeling.

This explains why self-injury can be so addictive: It works. When you have a quick, easy way to make the bad stuff go away for a while, why would you want to go through the hard work of finding other ways to cope? Eventually, though, the negative consequences add up, and people do seek help.

Some people never get a chance to learn how to cope effectively
We aren't born knowing how to express and cope with our emotions -- we learn from our parents, our siblings, our friends, schoolteachers, -- everyone in our lives. One factor common to most people who self-injure, whether they were abused or not, is invalidation. They were taught at an early age that their interpretations of and feelings about the things around them were bad and wrong. They learned that certain feelings weren't allowed. In abusive homes, they may have been severely punished for expressing certain thoughts and feelings. At the same time, they had no good role models for coping. You can't learn to cope effectively with distress unless you grow up around people who are coping effectively with distress. How could you learn to cook if you'd never seen anyone work in a kitchen?

Although a history of abuse is common among self-injurers, not everyone who self-injures was abused. Sometimes, invalidation and lack of role models for coping are enough, especially if the person's brain chemistry has already primed them for choosing this sort of coping.

Problems with neurotransmitters may play a role
Just as it's suspected that the way the brain uses serotonin may play a role in depression, so scientists think that problems in the serotonin system may predispose some people to self-injury by making them tend to be more aggressive and impulsive than most people. This tendency toward impulsive aggression, combined with a belief that their feelings are bad or wrong, can lead to the aggression being turned on the self. Of course, once this happens, the person harming himself learns that self-injury reduces his level of distress, and the cycle begins. Some researchers theorize that a desire to release endorphins, the body's natural painkillers, is involved.

R

2009-04-03T20:24:00.007+11:00

I came to love this man R. He was the first Korri man, who related to me, talked to me one on one, probably knew as a new Social Worker I was out of my depth. I'd have long conversations with his mother who was at the time, ironically doing the same degree as I. By the time he left most staff had had enough but always he would sing this song to me, when I was just ready to ring his neck. He was hard work but with a great sense of humour ...lol..

He'd sing

'How many love you like this Abbey
Not many, if any'
he would laugh and smile...

he would say
how many men look as good as this
Not many, if any''

he was a 16yr old boy

He'd sing it all night, while I was trying to cook dinner,
play basketball, watch tv
or if he saw my attention was with another

He had dreams of being a mechanic
wanted his mother to be proud of him

He left me
and went out to the world.
He drove a car into a service station
held it up and demanded money...
he was gaoled for that.

and is still there

and he rang to say he was ok
he said
'how many men go like this Abbey
not many if any..

I cried my heart out

but I loved R.

2009-04-01T20:17:00.001+11:00

Excuse me if this site becomes a little self indulgent, a little about me, a little about the beautitful people I have met. Not all self harmers, but most who were troubled and all who made an impression on me & it may help me process my feeling of loss
..., luv Abz

Intentional self-harm NSW Department Of Health

2009-03-26T18:14:00.001+11:00

Data table

View data table

Note

Includes suicide (attempted) and purposedly self-inflicted poisoning or injury. Hospital separations were classified using ICD-9-CM up to 1997-98 and ICD-10-AM from 1998-99 onwards. Rates were age-adjusted using the Australian population as at 30 June 2001. Numbers for 2006-07 include an estimate of the small number of interstate hospitalisations, data for which were unavailable at the time of production.

Source

NSW Admitted Patient Data Collection and ABS population estimates (HOIST). Centre for Epidemiology and Research, NSW Department of Health.

Commentary

Completed suicide is only one outcome of intentionally self-harming behaviours.

One other outcome of these behaviours is hospitalisation. It is not accurate to regard hospitalised self-harm as equivalent to 'attempted suicide' for comparison with 'completed suicide'. There is some overlap between hospitalised self-harm and suicide, as some suicide deaths occur after admission to a hospital, however, hospitalised self-harm is more frequent than completed suicide. (Steenkamp et al, 2000).

Most people who contact health services after an episode of intentional self harm are seen by emergency departments. They may or may not be admitted as hospital inpatients, and the injury may or may not be recorded as intentional. In recent years, there have been more than 10,000 hospital separations per year following an episode of intentional self harm.

Hospitalisation rates for intentional self-harm are consistently higher in females than in males, while the death rates from suicide are about 3 - 4 times greater in males than in females. This is thought to be mostly due to males using more lethal methods than females. The numbers of young females aged 15-24 hospitalised for self harm has begun to decrease after a peak in 2004-05 (483.0 per 100,000 in 2004-05), however the numbers remain significantly higher than among any other age group (435.6 per 100,000 population compared to 185.3 per 100,000 for females of all ages in 2006-07).

[back to top]

For more information

NSW Department of Health. Suicide prevention in NSW. Sydney: NSW Department of Health, 2003. Available at www.health.nsw.gov.au/pubs/s/pdf/well_suicide.pdf.

NSW Government New South Wales Interagency Action Plan for Better Mental Health Sydney: Available at http://www.dpc.nsw.gov.au/__data/assets/pdf_file/0015/11490/interagency.pdf

NSW Department of Health. Policy guidelines for the management of patients with possible suicidal behaviour for NSW Health staff and staff in private health facilities. Sydney: NSW Department of Health Circular 92/31, 1998.

Pirkis J, Burgess P, Dunt D. Suicidal ideation and suicide attempts among Australian adults. Crisis 2000; 21: 16-25.

Steenkamp M, Harrison J. Suicide and hospitalised self-harm in Australia. Injury Research and Statistics Series. AIHW Catalogue no. INJCAT 30. Adelaide: Australian Institute of Health and Welfare, 2000.

Australian Government of Health and Aged Care's suicide prevention information available at Suicide prevention, national suicide prevention strategy www.health.gov.au/internet/wcms/publishing.nsf/Content/mental-suicide and at Healthinsite www.healthinsite.gov.au/topics/Suicide_Prevention.

Print version with data

Although this page can be printed directly from your Web browser, a higher quality version of this entire page (graph, table and text) is available as an Acrobat PDF file which can be printed or viewed on screen using free software.

Downloadable files

The data contained in the table on this page are available for download as a CSV file which can be imported into many software packages. The graph is available for download as an EPS (Encapsulated PostScript) file and as an EMF (Enhanced Metafile Format) file. Files in these formats can be imported into most word processing, presentation and graphics software packages.

Copyright notice

This work is copyright NSW Department of Health, 2006. It may be reproduced in whole or in part, subject to the inclusion of an acknowledgement of the source. Commercial usage or sale is prohibited.

Suggested citation

Population Health Division. The health of the people of New South Wales - Report of the Chief Health Officer. Sydney: NSW Department of Health. Available at: www.health.nsw.gov.au/publichealth/chorep/. Accessed (insert date of access).

Produced by

Centre for Epidemiology and Research, Population Health Division, NSW Department of Health.

Last updated on 15 December 2008

Wordless Wednesday

2009-03-25T17:47:00.000+11:00

The Internet and Self-Injury: What Psychotherapists Should Know

2009-03-24T17:30:00.000+11:00

Abstract

The Internet affords information gathering and sharing previously impossible. For individuals who practice self-injury, this capacity allows rapid identification of others with shared history, experience, and practices. For many of those who self-injure, the ability to find others like themselves reduces the isolation and loneliness which so often characterizes the behavior.

For others, however, active participation in on-line communities may effectively substitute for the real work required to develop positive coping and healthy relationships. Our experience suggests that regular assessment of self-injury Internet use is uncommon in therapeutic settings. Proliferation of self-injury message boards, informational websites, blogs, and YouTube posts is a clinical challenge. In this article, we review the research on self-injury and Internet use and then make a series of recommendations for clinicians.

Read entire report here

Professional Help

2009-03-23T17:08:00.001+11:00

What problems may be encountered when getting professional help?

Self-injury brings out many uncomfortable feelings in people who don't do it: revulsion, anger, fear, and distaste, to name a few. If a medical professional is unable to cope with her own feelings about self-harm, then she has an obligation to herself and to her client to find a practitioner willing to do this work. In addition, she has the responsibility to be certain the client understands that the referral is due to her own inability to deal with self-injury and not to any inadequacies in the client.

People who self-injure do generally do so because of an internal dynamic, and not in order to annoy, anger or irritate others. Their self-injury is a behavioral response to an emotional state, and is usually not done in order to frustrate caretakers.

What problems may be encountered in the emergency room?

In emergency rooms, people with self-inflicted wounds are often told directly and indirectly, that they are not as deserving of care as someone who has an accidental injury. They are treated badly by the same doctors who would not hesitate to do everything possible to preserve the life of an overweight, sedentary heart-attack patient.

Doctors in emergency rooms and urgent-care clinics should be sensitive to the needs of patients who come in to have self-inflicted wounds treated. If the patient is calm, denies suicidal intent, and has a history of self-inflicted violence, the doctor should treat the wounds as they would treat non-self-inflicted injuries. Refusing to give anesthesia for stitches, making disparaging remarks, and treating the patient as an inconvenient nuisance simply further the feelings of invalidation and unworthiness the self-injurer already feels.

Although offering mental health follow-up services is appropriate, psychological evaluations with an eye toward hospitalization should be avoided in the emergency room unless the person is clearly a danger to his/her own life or to others. In places where people know that self-inflicted injuries are liable to lead to mistreatment and lengthy psychological evaluations, they are much less likely to seek medical attention for their wounds and thus are at a higher risk for wound infections and other complications.

taken from Focus Adolescent Services

Why Does Self-injury Make Some People Feel Better?

2009-03-22T17:05:00.000+11:00

Some people never get a chance to learn how to cope effectively.
One factor common to most people who self-injure, whether they were abused or not, is invalidation. They were taught at any early age that their interpretations of and feelings about the things around them were bad and wrong. They learned that certain feelings weren't allowed. In abusive homes, they may have been severely punished for expressing certain thoughts and feelings. At the same time, they had no good role models for coping. You can't learn to cope effectively with distress unless you grow up around people who are coping effectively with distress. Although a history of abuse is common about self-injurers, not everyone who self-injures was abused. Sometimes invalidation and lack of role models for coping are enough, especially if the person's brain chemistry has already primed them for choosing this sort of coping.

Problems with neurotransmitters may play a role.
Just as it's suspected that the way the brain uses serotonin may play a role in depression, so scientists think that problems in the serotonin system may predispose some people to self-injury by making them tend to be more aggressive and impulsive than most people. This tendency toward impulsive aggression, combined with a belief that their feelings are bad or wrong, can lead to the aggression being turned on the self. Of course, once this happens, the person harming himself learns that self-injury reduces his level of distress, and the cycle begins. Some researchers theorize that a desire to release endorphins, the body's natural painkillers, is involved.

taken from: Focus Adolescent Services

Strength

2009-03-21T15:48:00.002+11:00

How do you find strength when you have nothing left? I use quotes, things others have said I am honest and say 'I just cant do this'.

One of the signs that I am in 'trouble' is that I isolate, cut off friends, create petty arguments, wont answer phones etc I turn inward, I can go days without seeing people. At the time I most need people, I shut them out.

The Proverbial Wall...

2009-03-20T22:31:00.001+11:00

Spiral

2009-03-19T21:47:00.007+11:00

What happens when all your coping mechanisms are destructive . . .

Well not all (yes there is yoga, painting, blah blah blah), but the ones that work, that are instant gratification...

When your mind is screaming, or worse talking in dull monotone, repetitive suggestion . . .

When you just want to scream 'Shut the F*ck Up!'

When your first thought is 'No one will know' and the second is where is my kit . . .

Who does it harm?, nobody ... doh! that's why its called Self Harm

If you give someone 50 reasons why they shouldn't, they could give you 50 why they should.

But the main ones are

"I cant deal with this pain"

and 'It keeps me alive'

So before you judge, think about that

Stereotypes

2009-03-18T21:59:00.000+11:00

I had a client once, beautiful, vibrant. Her father (perfectionist, career man) sounded proud of her recovery, her determination to not cut. After our session was finished he confided 'Im not really concerned about the self harm business. I read that its a teen thing and I'm sure she will grow out of it'

Wrong Mr W. , its not a teen thing . . .

Hope

2009-03-17T00:52:00.002+11:00

Most of the important things in the world have been accomplished by people who have kept on trying when there seemed to be no hope at all.

Dale Carnegie
American Author

No matter how many times I try and fail, how stupid I feel for daring, how many promises I make to myself that end broken, I will keep trying because deep in my soul, where no one treads but me, I know I am worth more than this, I know I deserve better and I will keep trying till I succeed . . . Love Abbey

About Self Injury

2009-03-13T13:32:00.001+11:00

Self harm is when someone deliberately hurts or injures themselves. Self injury can take a number of forms including:

cutting or burning - the most common forms of self-harm
taking overdoses of tablets or medicines
punching themselves
throwing their bodies against something
pulling out their hair or eyelashes
scratching, picking or tearing at their skin causing sores and scarring
inhaling or sniffing harmful substances
swallowing things that are not edible
inserting objects into their bodies

Why Do People Self Injure?

Psychological motivations: What self-injurers say SI does for them.

Many papers on self-harm (Miller, 1994; Favazza 1986, 1996; Connors, 1996a, 2000; Solomon & Farrand, 1996; Ousch et al., 1999; Suyemoto, 1998; and others), have uncovered possible motivations for self-injurious behaviours:

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 depersonalisation 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 behaviours 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 behaviour. 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

The assumption is that the alternative to self injury is acting normal but on the contrary…the alternative to self injury is total loss of control and possibly suicide.

Hence the need to carefully manage a young person’s self harm is crucial to enable them to remain safe. Ensuring that they are empowered to minimise the harm that they do to themselves and maximise their potential to gain positive control over their lives.

[taken from Newcombe House UK]

Dissociation World

2009-03-12T10:40:00.001+11:00

Dissociation exists on a continuum with these everyday symptoms at one end and at the other more severe symptoms such as amnesia and identity alteration. At this end dissociation is often described as ‘going away’ as the sufferer voluntarily leaves their own body. These severe symptoms usually indicate a dissociative disorder especially if they are persistent, difficult to control and affect the sufferer’s everyday life.

There are five dissociative disorders:

1. Dissociative Amnesia – this is indicated when there is an inability to recall important personal information

2. Dissociative Fugue – this refers to the situation where a sufferer finds themselves in a place with no memory of getting there and sometimes with no knowledge of who they are.

3. Depersonalisation Disorder – this is a recurrent feeling of being detached from yourself or your feelings.

4. Dissociative Identity Disorder (DID) – previously known as multiple personality disorder this is characterised by the existence of two or more separate identities within one person who are able to take control.

5. Dissociative Disorder Not Otherwise Specified (DDNOS) – this often precedes a diagnosis of DID and is used until a definitive diagnosis of DID is able to be made.

Causes

Although dissociation is a common experience those with an actual dissociative disorder almost universally have a background of childhood trauma especially sexual and physical abuse. Over 99% of those diagnosed with DID have a history of prolonged and severe childhood sexual abuse usually with an early age of onset (before the age of eight) and the abuser being one or more of the child’s caregivers. There has been no genetic link indicated. This is probably because everybody is capable of dissociation as a young child but few people are in the situation of having to use it on a regular basis. This regular usage as a defence leads to the ability to dissociate being retained into adulthood and therefore leads directly to dissociative disorders.

There are a few cases where dissociative disorders have developed after a single trauma and they have been observed in those kept in captivity for long periods of time. Little is currently known about the phenomenon of dissociation itself. It is currently considered to be a highly creative and intelligent defence and a ‘trick of the imagination’. However newer studies have shown that dissociation is a biological phenomenon – brain imaging has shown that associative pathways in the brain are shut down during the dissociative experience. This suggests that the dissociative experiences may well be ‘real’ as opposed to imaginative.

Link to the excellent site is in the banner...

The Mind

2009-03-11T16:35:00.002+11:00

" Each thought has power of its own.
Positive thought has a power and negative thought also has a power.
With positive power we build; with negative power we break.
Each positive thought is creation and each negative thought is destruction."

" When a negative thought comes, we have to feel that it is a thief.
A negative thought comes in the form of doubt, fear, jealousy, hypocrisy or meanness.
We have to feel that each negative thought has come to commit a theft,
to take something away from our inner life and inner wealth."

*"Negative Thoughts" - Excerpt from The Soul's Evolution by Sri Chinmoy."

The Black Dog

2009-03-10T23:08:00.002+11:00

Since Churchill, people have related to the term of depression being a black dog, in fact in Australia the depression institute is named that. Its not like that for me.

Depression is more of a person, a shadow self. This friend is familiar to me, no surprises. Even at his worst and most destructive this friend is there. He envelopes me in negativity, talks to me in sense, 'You cant do that, dont try that, dont believe others, you know your not good at that' He is like the life coach, holding my hand, drawing me deeper.

With a deep slow voice, he entices me to stay with him, 'you know your not good enough, stay here with me where you belong' I fall into his arms as easy as too a lover & a blackness envelopes me, even the air is thick. There is no need for me to eat, to bathe, to dress or go outside. I slow my breathing, my thoughts and movements to his pace. Everything is slow, everything is meaningless.

Even living seems meaningless, his seductive voice whispers on, it all makes sense when you hear it from him & you fail to hear your own voice or the voice of others but give in to his as fighting is just too hard.

Cutting and Self-Injury

2009-03-08T21:59:00.000+11:00

By John M. Grohol, Psy.D.

January 5, 2009

This entry may be triggering or difficult to read for some people.

Self-injury behavior is something that is more common than many people realize. (In one study by researchers at Brown University of high school students, 46 percent had injured themselves in the past year on multiple occasions.) It is often misunderstood, not just by the lay public, but also by the mental health professionals who ostensibly should know what self-injury it is and how best to treat it.

Self-injury is used by people as over-drinking is used by others — to drown out emotional pain with something else. In the case of self-injury, that something else is physical pain. It focuses your attention and takes your mind off of your emotional pain, if only for a little while.

Cutting is the most common form of self-injury — making skin-deep cuts on one’s arms, wrists, or less noticeable areas on one’s body. The cuts are not meant to cause permanent damage or harm, nor are they meant as a suicidal gesture. The cuts are the means to an end themselves — they provide a source of immediate but non-serious physical pain (as long as they are allowed to heal cleanly). Other forms of self-injury include burning, or keeping old wounds open or inviting infection in them to keep them painful.

The people with the most severe self-injury behavior often can think of little else as they go through their day — it becomes something more than just a way to deal with emotional pain, it becomes its own obsession, as it did with Becki, a person who self-injured and is profiled in an article that appeared online in Newsweek last week:

Becki describes it as an obsessive battle, and one she often lost. At her worst, she says she spent every hour living and breathing self-injury. She dreamed about it. She’d think about it at school. She bought every book published on it. She searched for self-injury Websites, and compiled what she found into a 13-page Website of her own. “I was cutting 10-plus times a day, and still, if I didn’t do it, I would feel like I was missing something,” she says.

Newsweek’s article is a fairly good read on self-injury and self-harm, describing what self-injury is, using Becki as a case study, and brings us up-to-date on treatment options and the latest research into self-injury. If nothing else, it helps bring this behavior out into the open more, helping people understand that it is not something that one should be ashamed of and that it can be treated.

As the article notes, self-injury isn’t recognized as a mental disorder by itself. But that doesn’t mean it can’t be treated. Treatment usually is done through psychotherapy, and focuses on helping the person identify their own triggers for self-injurious behavior, and find alternative methods for helping them deal with the emotional pain in their life.

Read the full article: Why She Cuts (Potentially Triggering)

Dr. John Grohol is the CEO and founder of Psych Central and has been writing about mental health and psychology issues online since 1992.

What Depression Feels Like

2009-03-06T23:17:00.001+11:00

The following is a description of how I feel when I'm going through a depressed period. It is not how I feel most of the time.

Useless: When I get depressed, I feel useless. I have this feeling that everything I've ever done is worthless, and that anything I'll ever do will be equally worthless. I feel like nothing I do matters. When I do try to accomplish something, I feel like it isn't good enough no matter how hard I work on it. Even worse, I feel like everybody is aware of my failure, and I feel incredibly guilty for being a failure. I look at my lazy housekeeping and feel like a failure as a homemaker. I mentally replay all of the mistakes I've made with my kids, and I feel like a failure as a mother. I look at my body and feel like a failure as a wife because I'm not as attractive as I'd like to be. My self-esteem plummets, and I feel like a burden on my poor husband.

Tired: When I get depressed, I'm too tired to do anything. Everything feels like an overwhelming task, even getting dressed or brushing my teeth. If somebody tries to convince me to do anything, I feel guilty for not wanting to comply and resentful at the idea that they would ask me to do anything when I'm feeling so tired. Along with my physical fatigue I feel mentally fatigued. I have to force myself to do everything I do.

Irrational: When I get depressed, I have a hard time thinking. Problem solving is difficult, even for little things like adding two numbers or figuring out which tool to use to complete a task. I react to situation emotionally rather than logically, so I end up making mistakes I regret. I lose my temper with my kids and pets when they don't follow the family rules, and I start yelling at them rather than logically disciplining them. In extreme cases of depression, I may even think about running away or suicide even though I don't plan on doing either.

Unsocial: When I get depressed, I don't want to socialize even though I realize that it probably would be good for me to get around other people and lift my spirits.

Stuck: When I get depressed, I feel like I'm trapped, stuck in this pit of worthlessness. While I'm trapped, I feel like life is passing me by. I sometimes think that things will never get better.

Source

Friday Readers Story

2009-02-20T00:02:00.000+11:00

Dear Abbey,

Wow, from the little entry it started as, well, it's grown.

I think that you are an amazing being, just from the wisdom that you share, the advice that you offer and the fact that you care. Something, in this day and age is rare. As a "cutter" of 6 years myself, I can empathasise with so many of these people.

It's hard, recently things have been getting worse, but my biggest help and safety is my partner. He will encorage me to talk it all through, even if I don't want to, my god, is he determined.

But I didn't comment to talk about me, I just wanted to say thank you Abbey, for giving some people a place to voice their thoughts, feelings and emotions without fear. Just providing a safe place.

As posted by "tiarra" earlier"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."

Love SR

Posted April 4, 2008

Self Harm & Suicide

2009-02-19T12:08:00.000+11:00

The relationship between self-harm and suicide is complex. Most commonly the motivation for self-harming behaviour is to cope with, or to gain a sense of relief from painful emotions and distressing personal experiences, not to result in death.

Any action that is deliberately intended to cause death is best regarded as a suicide attempt.vii Any deliberate attempt on one’s life that results in death is best understood to be a suicide.

Since most self-harm experts agree that self-harm and suicide are distinct and separate acts, some have suggested that self-harm should be established as an independent clinical syndrome viii .

According to published research, more than half of individuals who self-harm do not have suicidal thoughts at the time of self-harm and self-harm has been described as a way to avoid suicide ix . In one study x a participant reported that her self-harming behaviours helped her to feel more ‘in control’ whereas her suicidal behaviour occurred when she felt out of control.

This being said, acts of self-harm need to be taken seriously. Individuals who self-harm may be considered at higher risk of further, more severe self-harm and later suicide xi . Self-harm and suicide attempts can be performed by the same individual – and in some cases the intent may not be completely clear. A British study xii observed that 16% of people who self-harm repeat their self-harm within one year and 7% suicide within nine years.

Regardless of the specific intent in any single instance, acts of self-harm or attempted suicide reflect a degree of emotional distress by an individual that requires skilled assessment and support.

[taken from: Mind Frame]

Wordless Wednesday

2009-02-18T00:02:00.000+11:00

Who are the kids who self-harm?

2009-02-17T00:01:00.000+11:00

An Australian self-report school survey

Authors: Diego De Leo and Travis S Heller

[Australian Medical Journal]

MJA 2004; 181 (3): 140-144

Introduction —
Methods —
Sampling —
Survey instrument —
Procedure —
Data treatment —
Results —
Sample —
Prevalence of DSH —
Factors associated with DSH —
Time to engage in DSH —
Help-seeking behaviours —
Discussion —
Conclusion —
Acknowledgements —
Competing interests —
References —
Author details

A Life You'll Never Know

2009-02-16T00:04:00.000+11:00

I have to see my blood

I have to know my heart
I have to feel the flood
That flows to keep us apart

I have to taste the salt
I have to cry the tears
I have to know its my fault
I have to face my fears

I have to feel the pain
I have to see the colour
I have to hid the stain
For it must remain undercover

I have to blame myself
I have to use the blade
I know I need no help
Sooner or later the cuts will fade

I have to deal with things in my way
I have no choice
Look at them and hear what I say
These cuts are my voice

I have to tell you go get away from me
I have to tell you to go
I have to make you see
A life you'll never know.

[Poem: Anon, Icet]

Listen

2009-02-15T15:07:00.000+11:00

She's back!

2009-02-14T16:14:00.004+11:00

Hey everyone,

Im back after 8 weeks. . . not sure how healthy I am but I want to try and write through it, so will start working on my blog again . . .

Sorry about the delay in writing . . .

may take me a week or so to get up to speed but I'll do my best to get around and visit after that... Ive missed whats happening and saying Hi, hope your all safe and healthy...

Love to all

Stop The Bleeding

2008-12-04T01:13:00.007+11:00

Artist's Comments

Love is the Movement. Stop the Bleeding.

"The truth is that according to the World Health Organization, depression is one of the leading causes of disability, with approximately 121 million people suffering with depression worldwide. The National Institute of Mental Health states that approximately 18 million people suffer from depression in America alone. Depression does not discriminate across age, race, gender, or class. Among teenagers it is estimated that 20 percent will suffer from depression at some point by the time they reach adulthood. There are also as many as 8.3 percent of teens suffering from depression for at least a year at a time, compared to 5.3 percent of the general population.

Insprired by the work of TWLOHA (To Write Love On Her Arms), an organization created to spread awareness for teen depression, self-injury, and suicide, we are coming together to make sure the whole world knows. We are not directly affiliated with TWOLHA, but are in great support of their work To find out more about TWLOHA visit their Facebook Group here: [link]

During the time of year that suicide rates are at their highest, we chose February 13, the day before Valentine's Day, as our opportunity to start showing people how much they are loved. We will physically write the word LOVE on our arms (with a sharpie, or whatever other ink suits you best). If someone asks you what it’s for, tell them about TWLOHA. Tell them they are loved, that they are important. And ask if you can write LOVE on their arm as a symbol of that. Don't be afraid to reach out to those who need love, those who you often walk right by every day. They need our care.

There is NO set time, there is NO set location. Where you are, when you are there, speak out.

Some of us may choose to share the love of God, but we want you to share whatever love is strongest for you. Depression has no boundaries, but neither does our love.

Stop the bleeding. Rescue is possible."

Artist: Gypsy Magic

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Study: Most Depressed Kids Get Antidepressants But NoTherapy

2008-12-02T00:59:00.001+11:00

By Marilyn Elias, USA TODAY

At least half of U.S. children who take antidepressants aren't in therapy, a large study suggests, and that delays recovery while greatly increasing the number of kids on the medication who are suicidal.

"Therapy with antidepressants is the standard of care. But is it what's going on in the real world? No," says Sheila Marcus, child and adolescent psychiatry chief at the University of Michigan Medical School.

The report tracks insurance claims for antidepressants from a database of 6.8 million children and teens from 2002 to 2006. The analysis was done by the health care business of Thomson Reuters, a research firm.

BETTER LIFE: U.S. kids more likely than Europeans to take drugs for mental disorders

In the six months after getting at least one new prescription for antidepressants in 2006, just over 40% of children had insurance claims for one or more therapy sessions, says Tami Mark, the Thomson study leader.

The Food and Drug Administration has put the strongest safety warning on antidepressants, saying they could increase suicidal behavior in people 24 or younger.

A government study last year found that depressed kids recover most rapidly with antidepressants and counseling that teaches problem-solving and stress management. Also, 15% of children on Prozac only were suicidal — either thinking about killing themselves or trying to — compared with 8% on Prozac plus therapy and 6% receiving therapy alone.

The low therapy-claim rates in the new study could be partly a result of some parents paying out-of-pocket or not taking children for counseling because of poor insurance coverage, Mark says.

A federal law passed last week requires employers with more than 50 workers to provide comparable benefits for mental health and medical care. "Lack of insurance has been a big barrier for kids with mental illness," she says.

There's also a great shortage of child psychiatrists, Marcus says.

Some children probably went off antidepressants because of side effects or because they improved, so they weren't referred for counseling, says Kevin Kalikow, a child psychiatrist in Mount Kisco, N.Y.

Many parents are embarrassed to take their kids for therapy, says Jana Martin, a child psychologist in Long Beach, Calif.

"If kids take a pill, the parents don't feel it's as bad a reflection on them. The pill helps, but if kids get bullied on the playground, it doesn't teach them how to respond and not get depressed, while therapy does. You can't go take another pill every time someone bullies you."

Your Brooding Teen-Could There Be A Problem

2008-12-01T00:39:00.001+11:00

Attentive parents are a bipolar child’s best chance at getting vital treatment. If you answer yes to the majority of the following questions, consider having your child evaluated by a child psychiatrist or clinical therapist who specializes in bipolar disorder.

Does your child have rapidly alternating moods that fluctuate numerous times a day from being elated to being extremely irritable?

Is your child incredibly hard to wake up and equally hard to get to sleep?

Have other parents warned you that your child tends to be aggressive with their children or does your child get into fights?

Is your child explosive at times?

Would you describe your child as unstoppable once he or she gets a notion to obtain something? (i.e. Have you ever gone out to pick up pizza, ice cream or a video just to stop the tension your child is causing in the home?)

Does your child often describe activities that are enjoyable to most children as boring or not stimulating enough?

Have others described your child as withdrawn?

Is your child often sad without a reason?

Does your teen drive erratically or engage in other highly risky behavior (i.e. Promiscuity or substance abuse)?

Has your child been diagnosed with attention deficit hyperactivity disorder or depression, but doesn’t seem to respond well to treatment?

Does your child have trouble maintaining friendships?

Has your child been in trouble numerous times at school?

Has your child ever been in trouble with the law?

Is there any family history of mood disorders and/or substance abuse?

* Remember, no one of these symptoms by itself constitutes bipolar disorder. And, most importantly, in order for any problem to reach the level of a psychiatric disorder, it needs to be interfering with the child’s life. The bottom line is that parents must ask themselves if their child’s behavior is causing him or her not to function at home, at school or with friends.

This Week At ...

2008-11-30T21:03:00.000+11:00

Post Secret

Thinking

2008-11-29T21:58:00.002+11:00

“As you begin changing your thinking, start immediately to change your behaviour. Begin to act the part of the person you would like to become. Take action on your behaviour. Too many people want to feel, then take action. This never works.”

John Maxwell

Art: Freedom

The Uncomfortable Reality of Self-Injury

2008-11-27T00:40:00.000+11:00

October 19th, 2008

By Rachel Keranen

Angelina Jolie did it—so did Johnny Depp and Princess Diana. According to recent research studies, between 10-20 percent of college students do it too. Self-injury is an increasing phenomenon in today’s young adult culture, but it’s often misunderstood.

According to the Mayo Clinic, the majority of those who self-injure are adolescents. Risk factors include depression, anxiety disorders, substance abuse disorders, eating disorders, and other mental health conditions. Victims of childhood trauma are especially likely to self-injure—those haunted by neglect or abuse often have an impaired ability to control their emotions and behavior.

A common misperception of self-injury is that those who commit it are suicidal. In reality, those who harm themselves are usually not trying to kill themselves, but instead trying to hold their lives together. Everyone has coping mechanisms to let out feelings of hurt, anger, and frustration: some go for a run, some write in their journal, and some throw a temper tantrum. Others, in silent secrecy, choose to take a blade to their skin. The sight of blood swirling down the drain can be as therapeutic to a cutter as a deep tissue massage; and the phrase, “it hurts so good” takes on a new, much more disturbing meaning.

There are many reasons that those who self-injure choose to hurt themselves. In her book A Bright Red Scream, Marilyn Strong writes that self-injury often occurs when the perpetrator feels abandoned or alone. The feelings build until they are unmanageable, and then the act is committed and dissociation is attained. Dissociation is commonly described as a feeling of numbness, a sensation of separation from one’s body. Unable to cope with the chaotic emotions they are experiencing, self-injurers use dissociation to distance themselves from the pain of reality.

A completely opposite motive for self-injury is the feeling of life it brings. Some who cut themselves report that the sight and sensation of bleeding is the only way to prove that they are still alive. For those who are depressed, the pulsating red release can be the sole sign of life in an otherwise gray existence. Some cutters feel that the blood is a symbol of the negative feelings or impurities inside their bodies. By cutting, they are letting the bad blood escape. This idea echoes the historical method of using leeches and bloodletting to cure ailments: once the evil has been evicted, the body can be pure and healthy.

Self-injury can also grant a feeling of power or control. People who have had many of their freedoms and choices taken away turn to the one thing they can control—their bodies. It is interesting, though not surprising, that many women who suffer from eating disorders also self-injure. Both disorders can stem from the need to maintain whatever control they can in a world of perceived powerlessness. In a study published in the American Journal of Psychiatry by Drs. Winchel and Stanley, 35 percent of anorexics and 39 percent of bulimics reported self-injuring.

In the end, self-injury can be a cry for help. While most self-injurer hide their wounds, some are also hoping that someone notices their silent suffrage. Scars, usually on the arms, legs, and torso, may casually flicker in and out of sight. Unable to express emotion in conventional ways, some resort to their bodies as their medium of communication.

The scars left from self-injury can be viewed as burdens or battle wounds. Some self-injurers try to erase their scars with creams or surgical procedures so they can forget their bloody past. Others view their scars as life markers too important to disregard.

While cutting is one of the most well known modes of self-injury, numerous others exist. Other methods include carving, burning, hitting, pulling out hair, biting, and many more. According to the Mayo Clinic, scars, injuries, bruises, frequent “accidents”, the constant carrying of sharp objects (knives and razors, but also paper clips, pins, or pieces of jagged metal), and wearing long sleeves and pants even in hot weather are signs of self-injury.

If someone reveals that they self-injure, or have done so in the past, it’s important to remain supportive. If they are willing to talk, be willing to listen without judgment. Self-injury is unsettlingly common –it occurs in somewhere between 1 in 10 and 1 in 5 college students, and some studies suggest it’s even more frequent than that. By increasing awareness and understanding of the phenomenon, society can give a voice to those who carry silvery secrets and facilitate outward expression rather than inward aggression.

[taken from The Wake]

University of Minnesota Student Magazine

Wordless Wednesday

2008-11-26T00:42:00.000+11:00

by aperitif

Im A Cutter

2008-11-25T00:28:00.001+11:00

ImACutter.com is a brand new non-profit movement dedicated to presenting hope and finding help for those struggling with self-injury, cutting, addition, and suicide.

“See they label me a cutter,
but it stables me enough that,
I can make it through the cludder,
but it aint about the cuttin,
its just something about the rush and all the rage involved,
until all the hate is gone the pains resolved,
to waken all the neighbors cuz im bangin on the walls,
all the hatred and entertainment for this nation at war,
i see this world its so much wrong,
ask me why and ill show you why theres no such god, My arm!”
- Mint from Steppin Stone

The poem is from the new website. I've only had a little look around but they seem to have some good information. The only issue I had was that I couldnt access the Forum, but as they are new it may be just a glitch.

My Week

2008-11-24T12:43:00.004+11:00

This week, I absolutely refuse to slump into a full blown 'God I hate my life" depression. I can feel it sneaking up, like black fog. I may not be able to control it, but I think I can take steps to minimise the impact. Just pushing myself to a shower and work is a 3hr exercise in 'why bother'

Each day Im going to try to do something for myself. Not spend money (which just gives a flash of satisfaction and leaves me broke) but just do something small, see something unique, 'enjoy' being with others (this one is hard for me, as like a turtle I just retreat) eat something nice.

It may be a futile gesture but Im giving anything a go. Ive been here before and the alternatives suck. If you have any ideas that work for you let me know ... So that is the cunning plan for now.

Depression

2008-11-23T12:58:00.000+11:00

by tommyboii

Research

2008-11-22T22:29:00.003+11:00

Published 18 November 2008, doi:10.1136/bmj.a2278

Cite this as: BMJ 2008;337:a2278

Hospital admissions for self harm after discharge from psychiatric inpatient care: cohort study

Abstract

Objective To determine the risk of non-fatal self harm in the12 months after discharge from psychiatric inpatient care.

Design Cohort study based on national hospital episode statistics.

Setting England.

Population Patients aged 16-64 years discharged from psychiatricinpatient care between 1 April 2004 and 31 March 2005 and followedup for one year.

Results 75 401 people were discharged from psychiatric inpatientcare over the study period, 4935 (6.5%) of whom were admittedat least once for self harm in the following 12 months. Riskof self harm was greatest in the four weeks after discharge;one third (32%, n=1578) of admissions for self harm occurredin this period. The strongest risk factor for self harm afterdischarge was admission for self harm in the previous 12 months(hazard ratio 4.9, 95% confidence interval 4.6 to 5.2). Therisk of self harm was also higher in females, younger people,those with diagnoses of depression, personality disorders, andsubstance misuse, and those with short lengths of stay.

Conclusion More than 6% of patients discharged from psychiatricinpatient care are readmitted for an episode of self harm within12 months, with one third of these episodes occurring in themonth after discharge. Self harm after discharge from hospitalshares many of the features of suicide after discharge. Interventionsshould be developed to reduce risk in this period.

Entire Findings Here; BMJ Medical Publication

Fridays Readers Story

2008-11-21T21:41:00.000+11:00

Anonymous said...

This one goes out to Daisy who posted on the 5th December 2007.

I hope she sees it.

Daisy, you giving into temptation doesn't make you weak and dumb. I harm mainly for the same reasons as yourself. You feel the need to convert your emotional pain to physical pain where you can truly feel it (at least, that is what I understood from your comment).

I think you should find someone to talk to - be it a good counsellor, a relative or a friend/boyfriend/girlfriend that you can talk openly too, cry in front of, show them the things you've done and trust them with your life - know that they won't tell a soul on this planet unless you tell them to.

OR find a site (such as this one) where you can post regularly and have people try to help you. Sometimes not knowing someone very well makes it easier because they can't tell anyone you know.

As for things at school (i don't know where you live but where I am we have uniforms) but if it is a school where you wear your own clothes and people are saying things about your style - forget them they're scared of what is different from them. If they are saying anything about you at all FORGET THEM! Chances are what they say isn't true. Instead walk right by with your head held high, don't let them see that it gets to you otherwise - they'll keep at you. If it does just try your best not to let it show and they might stop. (if that's the case) If that isn't well I've tried to help you.

This has been long especially as I literally just found this website.

Take care Daisy and try to find someone you can talk to. It really, really helps knowing that you can open up to someone. Anytime you feel the urge to hurt yourself you should try to talk to that someone that I hope you find and can trust.

A lot of this advice goes to anyone in general. Giving into temptation does not make you weak or dumb or stupid! Don't let any one's words affect you and change who you are. Remember - people are only scared of what's different, what's unique and what's extraordinary! Don't let them make you scared of yourself for being a brilliant person.

I hope this (very long!) comment hopes at least one person out there. If it does I'd be ever so happy to know I've helped someone.

Hugs to all those that need/want them =] Be strong and never lose sight of goals you have in life - no matter what.

The people that run this site are doing a brilliant job. Keep it up!
AJ
XoXo

Learning to Love Yourself:

2008-11-20T20:51:00.003+11:00

Ideas To Love Yourself

Strip naked (yep, get it ALL off!)
Go stand in front of a full length mirror.
Now, instead of focusing on all those moles, hair patches and love handles…
…concentrate on all the drop dead gorgeous things about yourself.
Yep, it’s bloody hard, but you can do it!
Try three things to start with.
Say them out loud to yourself - and mean it! Things like:
“Addy - my god - you have the cutest smile you’ve ever seen!”
“Look at those nipples, they’re damned awesome, how could anyone not like those?”
“And good god, look at that adorably spankable ass? Absolutely mind blowing,”
See, you’re starting to see yourself differently already…
…now do this everyday, every-single-day!
Adding one more thing each time.
Within a few weeks there’ll be nothing left you don’t love.

[Eliminate the Stigma]

Wordless Wednesday

2008-11-19T13:30:00.000+11:00

Self Destruction by Love Me Dont

Outlook

2008-11-18T00:54:00.001+11:00

"The soul would have no rainbow had the eyes no tears. "

~John Vance Cheney

An Emergency Box

2008-11-17T11:01:00.002+11:00

This is an awesome idea I came across whilst browsing the net one day…and no, it’s not another name for a first aid kit! It’s a box you can whip out in an emergency chock full of happy, fun and exciting things which you can look at to distract yourself from all those self harm urges.

Get yourself a shoe box, gift box, cardboard box, cereal box and cram it full of:

Photos of family, loved ones, friends, pets…etc…
Crossword Puzzles, word searches, suduko puzzles…
CDs of relaxing music…
A small journal with pens, colouring pencils and crayons…
Letters from family, loved ones, friends, pets…etc…
A list of reasons not to self harm…
Pictures and magazine clippings you like…
Chocolate :p

Basically anything which, upon ripping open that box will make you smile and laugh and feel all gooey inside enough to eradicate those evil self-harm ideas from your head. You see once you’ve got that box in place you can then let others know about it, friends and family who are helping you cope, then this way they can…

Hide letters in there which you don’t know about…
Secreat little presents in there…
Fill it with your favourite candy or sweets…

So then whenever you feel like self harming you can actually end up feeling pretty good instead.

[Thanks to Addy]

Emotional Posts

2008-11-16T17:51:00.001+11:00

Are the planets out of whack? Is it to do with the seasons, the tidal flows.?

Ive been wandering blogland today. Its cold and stormy here so I snuggled up with a coffee and read.

So many, at least 80% that Ive read, are going through some emotional turmoil, heartbreak, arguments, moving home. Others are talking of deep issues such as rape, domestic abuse, anorexia.

This isn't from this site, which most are amazingly positive given the topic, but posts by average people trying to get a handle on life issues. Some angry, some sad but all with a high level of emotional purging. Perhaps its the anonymity of the internet, or perhaps its relating to others posting that gives the prompt to write their own. All the commentors on these posts have been positive, understanding and empowering.

I guess I just wanted to say I think your brave and brilliant to write as you do. I admire and envy that. Tis not something Ive allowed myself to do, nor would find easy. And to all those who are reading, relating, offering support how beautiful of you to take the time to acknowledge the pain in another. There are some beautifully strong people out there.....

[*Reposted From Random]

You Are Unique

2008-11-15T03:19:00.000+11:00

“Those who dance are considered insane by those who can't hear the music.”

–G.Calin
*Thanks to 'Tha' Minx'

Fridays Readers Story

2008-11-14T03:34:00.003+11:00

Anonymous said...
I have been self harming for 4 years now. i began because i couldnt cope wih my parents divorce but then stress from other things influenced it too such as exams and family problems.

I met this boy when i was 14 and i managed to stop cutting for 4 months. i thought i was 'in love' but then the relationship got really violent and i started again because i couldnt tell anyone he was hitting me. i was ashamed in what i was doing but got made to feel that i deserved it. in my mind i wasnt good enough for anybody and deserved all i got including self inflicted scars.i saw a support worker for a while and with her help i managed to finish with this boy and eventually get my life back.

i have had many other things going on within the last year such as putting up with my mums drinking and her abusive boyfriend but i blocked this out of my life when i moved to a boarding school in the summer. i thought this allowed me to disconnect myself from my family and start fresh. in january we started a new term and i began to disconnect myself from my life at boarding school too. i would skip meals, and just lock myself in my bedroom, often doing nothing. thinking. cutting.

eventually i cried for help but i was treated as if i wanted attention. all i wanted was help because i knew i needed it. within the last month i have taken 6 overdoses and constantly cut myself.

i dont want to die, i want to stop feeling the way i do. i want to be able to socialise but i cant bring myself to it.all i can think about is harming mysle and alhtough i dont want to, i lose the strength and willpower. i managed to get an appointment with the gp, they want to put me on medication to sort the way im feeling but i just feel as if its too late.

Seven Ways To Distract Yourself

2008-11-13T03:28:00.000+11:00

a) The classic “stout rubber band” – i.e.; attach a rubber band around your wrist as if it were a bracelet and when things get tough FLICK IT HARD!! Bloody hurts, doesn’t do any major damage, and you can make it look like you’re just playing/fiddling.

b) Bag of Frozen Peas – hadn’t thought of this one until someone at the hospital mentioned it. Again, when the urge strikes, grab a bag of frozen peas and hold it. Really does hurt more than you think! And again, no damage, awesome.

c) Take a very hot or very cold shower – I’ve done this one a lot, and it really helps (plus, gets you clean – and naked – always a bonus!)

d) Chew something with a very strong taste such as chili or ginger root.

e) Beat the living shit out of a pillow! God this can help relieve stress! I mean it; just spank the living daylights out of the thing. You won’t be harming yourself, or someone else, both bonuses!

f) Distract yourself. It’s a tough one this because when I get into the self-harm mode it’s hard for me to focus on something else, but this does work. Have a bubble bath and read a book, listen to music, dance, sing, jive, boogey, write, something! It’s great if you have a friend to call, give them a ring and just chat about anything, even if they don’t know about the self harm just talking to someone about anything can take your mind off things. Or if they know you self-harm, see if they can come over for a while to help take your mind off things. Most friends are willing to do this if they’re able. You could always check out a list of ways to distract yourself here…

g) Lastly for today, if it’s the blood which you need to see grab yourself a red texta and draw your own wound!

This is best used with one of the other examples above, but maybe not all at the same time, eh?

[Eliminate The Stigma]

(Some) True Confessions of a Self Harmer

2008-11-12T02:44:00.005+11:00

Overcoming the urge to self-inflict has been one of the hardest things I have had to deal with through this tumultuous time suffering from depression.As I said above, IT IS AN ADDICTION. Pure and simple!

And anyone who has tried giving up smoking or gambling or Lindt or badgers will know that overcoming addiction is fucking hard! Not only because of the pure level of addiction, but also because it means having to face up to whatever problem is feeding that addiction in the first place. Whatever buried pain is making us smoke, drink or gamble needs to be faced up to. In essence, we need to become whip-wielding dominatrixies in order to tame and eventually command our problems.

To overcome self-harm we, like with every form of mental illness, we need to start talking about it in order to understand it, in order to help people overcome and control their addiction.

So how can you help? If you know someone who self-harms here are a few pointers:
- Whatever they’re doing DON”T take it personally. It isn’t about YOU!

- Be available and LISTEN to them if they need to talk.

- ACKNOWLEDGE their pain, it won’t make it go away, but it will make it more bearable.

- DON’T avoid the subject or pretend it’s not there.

- ASK THEM “I know you hurt yourself and I would like to understand it a little more, could you maybe explain why you do it? I’d be grateful if you could.”

- DON’T confiscate their “tools” (because I guarantee you this will lose their trust and they will just get more creative anyway)

- BELIEVE in them and BE HOPEFUL

- DON’T push them

- TAKE the initiative and distract them; take them to the cinema, rent a DVD, bake some chocolate brownies, go to a trivia night, go for a walk, have a playful pillow or water pistol fight, hell, if they’re your bf or gf, do a seductive strip tease and get them thinking about that cute butt of yours.

- DO spontaneous acts of kindness

- Be available, and willing, to LISTEN if they need to talk.

- EDUCATE yourself

– slip on your Willow hat and hop on the net for some research.

- SUPPORT them physically; call them up and tell them you’re worried about them and invite them over for a game of scrabble or a blueberry muffin.

- SUPPORT them emotionally; go to the Doctor/Psychologist with them.And please, please…whatever you do…

- DO NOT TRY TO MAKE/ORDER THEM TO STOP!!!!!!!!!

If you make them feel guilty, or punish them in any way, this will just add fuel to their addiction.
And please, please, please, please…whatever you do…remember to…

- Take TIME OUT and recuperate, caring/loving someone who suffers from any form of mental illness is exhausting and you need to look after yourself.

Although it’s confronting, brutal and painful to think that people you care about are inflicting this pain on themselves remember that to them it is merely an addiction. A symptom of a larger, possibly unknown illness or condition, and they just need some help and support in order to get them through it.

As we’ve all experienced from time to time: the over-riding feeling of loneliness and emptiness is a powerful influence. It’s time to stop judging people who self harm, and start understanding what they are feeling; it’s the only way to understand their pain.

by Addy

[Eliminate The Stigma]

Journals

2008-11-11T11:42:00.007+11:00

It seems to me that those who live with Self Harm, addiction or Mental Health are some of the most creative people I know. Maybe due to life experience, maybe due to introspection, maybe due to their unique view of the world.

I have always kept journals and diarys, some date back to when I was 16. Most reflect where my mind was at any given time, some so black, some with hope, some I look at and think 'my God, did I write that' , some with sketches, some with poetry,but it is my nature to write.

I recommend writing, scrapping,painting, doodling to work through things, but also with caution. Sometimes when we write where we are at, it can be pages of negative thoughts & images, of ourselves and the world. If you constantly go back and read these, you are reinforcing a negative view. Those I have written like this and I can be my worst enemy, I now write often just on a scrap of paper and I put awayin my 'black folder' (symbolic eh), never to be read again. Those thoughts are valid at the time, and I need to get them out but I consiously dont fill my head with them.

I keep a positive journal, I fill it with scraps I find in magazines, quotes from on-line, compliments people have given me. This can be as simple as someone saying 'I like your shirt' gradually and often slowly I fill each book. Ive even asked those close to me to write something positive in it.

Your blog can be an online journal but again caution. Others may read it and reinforce a negative view. Some may read it whom you dont intend, work colleagues, siblings, friends and take the wrong slant on it. Remember the net is a public domain.

If writing is not your forte, paint, draw, its not about being Michaelangelo this is purely for your expression. I did a quick search and here are some sites to get you started;

Soul Collage
Journals & Papers
Facing Us (has an online wellness book)

Self Harm Cycle

2008-11-10T14:11:00.003+11:00

And Breathe...

2008-11-09T17:31:00.002+11:00

This works for me when the world gets too hectic... just throw my arms back, look up and breathe .... helps put things in perspective & no one can touch me ... What works for you?

Characteristics of True Adulthood

2008-11-08T16:59:00.000+11:00

Accepts criticism gratefully. Being honestly glad for an opportunity to improve
Does not indulge in self-pity. Has begun to feel the laws of compensation operating in all life.
Does not expect special consideration from anyone.
Controls temper.
Meets emergencies with poise.
Feelings are not easily hurt.
Accepts the responsibility of own acts without trying to "alibi'.
Has outgrown the ‘all or nothing’ stage. Recognizes that no person or situation is wholly good or wholly bad. And begins to appreciate the golden rule.
Is not impatient at reasonable delays.
. Have learned they are not the arbiter of the universe and that must often adjust to other people and their convenience.
. Is a good loser can endure defeat and disappointment without whining or complaining.
. Does not worry unduly about things he cannot help.
. Is not given to boasting or "showing off" in socially unacceptable ways.
. Is honestly glad when others enjoy success or good fortune.
. Has outgrown envy and jealousy.
. Is open-minded enough to listen thoughtfully to the opinions of others.
. Is not a chronic 'faultfinder'.
. Plans things in advance rather than trusting to the inspiration of the moment.

Fridays Readers Story

2008-11-06T19:48:00.003+11:00

Tasha + Kay said...

Hello..
This is just Kayleigh at the moment.

Me and my friend Natasha posted a comment a few mins ago thanking Abby for her kindness..she made me feel safer and happy but now all of that has gone.

Ive just had a phone call off my Nana telling me my cuzans baby girl, Daisy has died. She was 3 weeks old and there wasnt any thing wrong with her. It has took us all by surprise. I loved her to death. My cuzan wanted her to be just like me and it felt like she was the little sister i have always wanted.

Daisy May Lakin..3 Weeks old :(

It might sound like im seeking attention but im not..im seeking answers..answers to help me deal with ANOTHER family death.
There are many questions i want answering but i want the answer to the question evey one in my position wants an answer to..Why me?
Why my family?
What did we ever do?

Nothing!
Thats the answer.
No one can ever do some thing so bad that half there family dies in a year.
My mother is a christian and i was once until all of this. They arnt from my mothers side of the family so she dosent feel the pain ad sad ness but they are still part of my family as they are from my dads side so it will effect me more then her.
Every now and again i become happy, it surprises me until i look down at the gashes in my wrist and across my legs and i then remember why i did it.
Maybe if i didnt self harm i wpuldnt have to marks to remin me so often but whn i dont i feel like i have the world on my shoulders o i self harm to let out all my anger, stress and sadness.

I want answers.!.

Love Kayleigh..x
This post follows Natasha + Kays from last week.

Negative Self-talk & Your Self-esteem

2008-11-06T17:40:00.001+11:00

Self image is how we see ourselves, and how we think others see us. Self image plays a HUGE role in how we behave and feel.

Q: What is self esteem?

A: Self-esteem is our internal feelings and evaluation of ourselves based on our "perceived" self-image.

Self-esteem and self image are closely inter-related. And, are largely based on our feedback while growing-up (parents, peers, other important figures).

Fact: it takes about 20 positive statements ABOUT OURSELVES (the foundation of our self-image---self-esteem) to counter-act even just 1 negative personal statement!

Here's the difficult part: it doesn't take a continual repetition of negative statements from our parents, peers, and others throughout our childhood to cause low self-image-self-esteem...fact is, once we get a couple in our head, we can use them over and over again. Again and again we take those false negatives and repeat them unconsciously (completely unaware). It's like having a constant heckler with you.

Can counseling help? Most definitely. Negative self-talk is a big problem that most counselors are able to help with using a cognitive-behavioral counseling approach. We need to replace negative self-talk with positive self-talk we're willing to let ourselves accept. You can't draw on a chalkboard if there's an eraser following close behind. That's what negative self-talk is....it erases the good, and replenishes it with bad.

Help For Family Or Friends

2008-11-05T20:02:00.004+11:00

Be supportive without reinforcing the behavior.

It's important that your friend, lover, child, sibling know that you can separate who they are from what they do, and that you love them independently of whether they self-injure. Be available as much as you can be. Set aside your personal feelings of fear or revulsion about the behavior and focus on what's going on with the person.

Some good ways of showing support include:

Don't avoid the subject of self-injury. Let it be known that you're willing to talk, and then follow the other person's lead. Tell the person that if you don't bring the subject up, it's because you're respecting their space, not because of aversion.

Make the initial approach. "I know that sometimes you hurt yourself and I'd like to understand it. People do it for so many reasons; if you could help me understand yours, I'd be grateful." Don't push it after that; if the person says they'd rather not talk about it, accept this gracefully and drop the subject, perhaps reminding them that you're willing to listen if they ever do want to talk about it.

Be available. You can't be supportive of someone if you can't be reached.

Set reasonable limits. "I cannot handle talking to you while you are actually cutting yourself because I care about you greatly and it hurts too much to see you doing that" is a reasonable statement, for example. "I will stop loving you if you cut yourself" isn't reasonable if your goal is to keep the relationship intact.

Make it clear from your behavior that the person doesn't need to self-injure in order to get displays of love and caring from you. Be free with loving, caring gestures, even if they aren't returned always (or even often). Don't withdraw your love from the person. The way to avoid reinforcing SIV is to be consistently caring, so that taking care of the person after they injure is nothing special or extraordinary.

Provide distractions if necessary. Sometimes just being distracted (taken to a movie, on a walk, out for ice cream; talked to about things that have nothing to do with self-injury) can work wonders. If someone you care about is feeling depressed, you can sometimes help by bringing something pleasant and diverting into their lives. This doesn't mean that you should ignore their feelings; you can acknowledge that they feel lousy and still do something nice and distracting. (This is NOT the same as trying to cajole them out of a mood or telling them to just get over it -- it's an attempt to break a negative cycle by injecting something positive. It could be as simple as bringing the person a flower. Don't expect your efforts to be a permanent cure, though; this is a simple improve-the-moment technique.)

If you live apart from the person you're concerned about, offer physical safe space: "I'm worried about you; would you come sleep over at my house tonight?" Even if the offer is declined, just knowing it's there can be comforting.

Don't ask "Is there anything I can do?" Find things that you can do and ask "Can I ?" People who feel really bad often can't think of anything that might make them feel better; asking if you can take them to a movie or wash those (month-old) dishes (if done nonjudgmentally) can be really helpful. Spontaneous acts of kindness ("I saw this flower at the store and knew you'd love to have it") work wonders.

[Read More]

Quote

2008-11-04T20:29:00.003+11:00

“I watch out my window as the planes take off into space. Oh, that I could fly away and start fresh. But I must realize that fresh starts also come in the pretty wrapped gift called 'tomorrow.'”

[Anonymous]