Just For You

Despite (or because of) the credit crisis, the war in Iraq, people passing, what he/she did or didn't say, relationships ending, the world tilting on it's axis, it being "that time of the day/month/year/life", the normal run-of-the-mill-stress-of-life ...

Just stop for a moment.

Breathe.

Breathe again.

Have a hug.
Give yourself one if there is no-one else around.
Take this one.

Fridays Readers Story

Tranquilium (anonymous) said...

Dear Abbey,

I am currently sixteen, nearly seventeen. Up until somewhat recently, I'd been self-harming in various different ways since I was seven years old. It started out as bruising, slamming my arms in drawers, punching myself, etc. ("banging" as it's most commonly referred to. or, more specifically, "wrist-banging." That began due to loss of family members, and bulling in school. I remember thinking that "there must be something wrong with me, nobody wants to be around me." I was trying to fix myself through beating myself up. That went on for awhile.

When I was eleven, I began cutting, as my depression worsened and there were many more deaths and painful events happening in my life as well. Then, two weeks after my thirteenth birthday - my older sister died. I blamed myself for a very long time.

Later on, the same year (I was thirteen) I began burning myself. with lighters, cigarettes, whatever I could get a hold of. (salt and ice was always a favorite of mine as well)

Things just escalated from there. I attempted suicide 8 times before being hospitalized. then 9 times before I was finally sent to a long term psychiatric hospital for six months. That was May of '07 through November of '07.

The time at that hospital (Havenwyck RTC) was a HUGE turning point in my life. I've made an amazing recovery, and while I'm still dealing with severe anxiety, my depression is under control, as are my other issues that aren't entirely related to this specific topic.

If you or anybody, want any details or information on stopping self-harm, getting help, or just.. needing any advice. Anyone can email me at tranquilium@live.com
Or you can go to my website and leave me a message - I'll get back to you. :)

~ You're truely,
Tranquilium

Dissociation

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

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

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

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

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

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

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

Image: Out of Body Experience by ~parallelspaces

Link: NHS (pdf)

Treatment Strategies

Self-injurious behavior can be reduced and eventually extinguished once the adolescent is ready to embrace alternative behaviors designed to promote healthier communication, self-comfort and genuine healing.

Psychotherapy — It is extremely important to work with a helping professional who has an expertise in self-injurious behavior or related disorders. Psychotherapy can provide a non-judgmental and supportive environment where self-injury can be processed openly and the meaning behind the injury can be explored. Trained therapists can provide safer, alternative ways to communicate, self-soothe and cope. The use of journaling, art therapy, relaxation techniques, visualizations, cognitive re-framing and affect management are all recommended and useful.

Appropriate contracts that encourage the teenager to write, draw, exercise and self-soothe before engaging in self-injurious behavior are more effective than contracts that demand the immediate cessation of the behavior. When the self-injury is severe, the teenager is unable to integrate strategies and abide by a safety contract or additional problems such as substance abuse or a threatening eating disorder are evident, inpatient treatment is often required.

In addition to working with a trained therapist some teens are able to utilize resources such as personal journaling and drawing, meditation, spiritual support and healthy self-injurious behavior substitutes such as physical exercise.

Psychopharmacology — When self-injurious behavior connects to untreated depression or anxiety, medication can be extremely useful. Anti-depressants can dramatically reduce the negative feelings and cognitions associated with the cycle of self-harm. Anxiolytics prevent the escalation of panic and generalized anxiety, which decreases the need for dissociation and self-injury. Providing a pharmacological safety net also may allow adolescents to process painful trauma memories without becoming flooded or overwhelmed.

[taken in part: *PRP Online]* Performance Resource Press

Who Is Likely To Engage In Self-injurious Behavior?

Both males and females engage in self-injurious behavior. Self-harm often begins in early adolescence, peaks between the ages of 18 and 24, and decreases as the person enters the 30s and 40s. There are, however, cases of self-harm occurring in much younger children and continuing into middle age.

Adolescents are particularly vulnerable as they face many difficult and inherently stressful developmental challenges. The body undergoes profound change during adolescence. It is a time of physiological and psychological turbulence and uncertainty. Faced with abrupt and embarrassing changes, teens can feel a loss of control of their bodies. For many adolescents, experiencing a sense of alienation from their own bodies becomes a powerful catalyst for and predictor of self-injurious behavior. In addition, teenagers struggle with the need for peer acceptance, shifting peer allegiances, a greater desire for autonomy and control and complicated decisions and conflicts that demand resolution.

Within this overwhelming context, adolescents are at even greater risk when their parents are physically or emotionally unavailable to them. In some families, there may be unhealthy communication, parental alcoholism, untreated mental illness, financial stress, domestic violence and parental neglect or pro-longed absences. Teens are unable to negotiate these challenges, process their feelings and articulate their needs without the guidance, support and feedback of a nurturing caretaker. They simply do not have the required coping skills to manage on their own, and they discover that self-injurious behavior is one way to deal with life.

Teenagers who have undiagnosed and untreated depression and anxiety are more likely to engage in self-harming behaviors as a way to self-soothe and self-medicate. Teens who struggle with low self-esteem and feelings of worthlessness are equally at risk. Adolescents with dissociative disorders, posttraumatic stress disorder, substance abuse problems and eating disorders are at increased risk to cut or burn. One of the greatest risk factors is a history of physical, emotional or sexual abuse. Trauma survivors learn to internalize their rage and dissociate or "check out" to escape pain. In addition, they have had their perpetrators model a blatant disregard for the safety and well being of their bodies. This combination of experiences almost inevitably sets the stage for some form of self-destructive behavior.

Taken from *PRP Online

*Performance Resource Press