I Wasn’t Trying to Kill Myself…
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Transcript of I Wasn’t Trying to Kill Myself…
I Wasn’t Trying to Kill Myself…
Prepared and Presented By: Julia Valley, MSW
Youth Community DeveloperWestern Ottawa Community Resource Centre
What is Self-Injury?
Self-injury is the act of inflicting physical harm on oneself without
the intent to cause death
Favazza, A. (1998)
Why?
People engage in self injury for a variety of reasons…
Self-Injury
Affect Regulation
To escape from emptiness and depression To ease tension To provide relief
By causing pain, an individual may engage in self-injury in order to reduce emotional and physiological arousal to a more bearable level
To relieve anger Individuals who engage in self-injury may find
that the act helps them to vent their feelingsFavazza, A. (1998)
Affect Regulation
To escape numbness Many of those who self-injure say they do it in order
to feel something… to know that they're still alive To ‘ground’ themselves
When feeling overwhelmed by emotions, individuals may use self-injury as a way to centre their thoughts
To maintain a sense of security To achieve a feeling of euphoria To prevent themselves from engaging in a
suicidal actionFavazza, A. (1998)
Communication To express emotional pain To obtain/ maintain influence over the behavior
of others To communicate to others the extent of their
inner turmoil To communicate a need for support To express or cope with feelings of alienation/
isolation To validate emotional pain
The wounds can serve as evidence that the feelings are real Favazza, A. (1998)
Control/ Punishment
To punish oneself for being "bad" To obtain biochemical relief
There is some thought that an individual can become addicted to crisis behavior… and self-harm can perpetuate this kind of crisis state
To divert attention (inner or outer) from issues that are too painful to examine
To exert a sense of control over one's body Favazza, A. (1998)
Video
Self-Injury in Adolescence
Adolescents are Particularly Vulnerable
Prevalence rate – 16.9% of youth between the ages of 14 and 21 Mean age of onset – 15.1
Most adults who self-injure began in adolescence
Nixon, M., Clouthier, P., & Jansson, M., (2008)
Why Adolescence?
Stress levels drastically increase during adolescence
Less likely to have developed alternative coping skills
Less likely to consider possible long-term consequences (i.e. scarring)
Risk Factors
Being female (77%) Symptoms of:
Depression Anxiety Impulsivity Disruptive disorders Borderline Personality Disorder
Low self-esteem Problems with anger control and
anger discomfort Nixon, M., Clouthier, P., & Jansson, M., (2008)
Risk Factors
Substance misuse Familial problems
Having self-harming family members Emotional neglect Impaired communication Family-related stressors Poverty
History of physical and/or sexual abuse Awareness of self-harm in peers History of suicidal ideation and attempts
Nixon, M., Clouthier, P., & Jansson, M., (2008)
Protective Factors
Family cohesiveness Social connectedness Confidence re: problem-solving ability Positive self-image Academic success
Nixon, M., Clouthier, P., & Jansson, M., (2008)
Types of Self-Injury
In adolescence, the most common types of self-injurious behaviours are: Cutting (83.2%) Scratching (80.4%) Self-hitting (79.3%) Ingesting a medication in excess of the prescribed
or generally recognized dosage (31.5%) Ingesting a recreational or illicit drug or alcohol as a
means to harm self (16.9%) Other non-specified forms of self-injury (9.4%)
Nixon, M., Clouthier, P., & Jansson, M., (2008)
What to Look For
What to Look For
Cut or burn marks/ scars Arms, legs, and abdomen are most common
Finding sharp objects within the individual’s possession i.e. Knifes, razor blades, box cutters, pieces of
glass Wearing inappropriate seasonal clothing
(in order to hide injuries/scars) i.e. Wearing long-sleeved shirts and/or pants
during the summer
What to Look For Low self esteem Problems handling emotions Problems with relationships The teen's peers cut or burn themselves Reports from others about suspicions that the
individual is engaging in self-injurious behaviours
Noticing that the individual tends to respond to stressful issues by locking him/herself away in a room or by stepping out to go to the washroom
How To Help
How to Help (During a Self-Injurious Episode)
Respond to all medical concerns, as appropriate (i.e. call EMS, provide access to first aid supplies)
Ask what is going on/ what triggered the behaviour
Listen non-judgmentally
How to Help (During a Self-Injurious Episode)
Complete a suicide risk assessment Ask if they are thinking of dying by suicide
Current plan, history of previous attempts, access resources
Take an ASIST Suicide Intervention Training Report, as required
How to Help (After a Self-Injurious Episode)
Help the individual to put words to their feelings
Set a time to re-connect and/ or connect the individual with appropriate support personnel
Help to develop a safety plan
The Don’ts
DO NOT demand that the person has to stop or tell them not to do it
DO NOT shame the person or dismiss the behaviour as manipulation or attention-seeking
DO NOT label the person DO NOT minimize the feelings/ situation
which has led to self-injury
The Do’s
Respond to injuries on a medical level… and not an emotional one
Tell the person you know something is going on and will assist in getting some help
Be there to talk Be patient
The Do’s Try to empathize
Look at the situation from the person's perspective instead of your own This behavior is not horrible to this individual - It
is helpful Recognize that the person may need
more help than you are able to provide Offer to help the person to find alternative
coping strategies to resist the urge Take time out yourself
Suggestions to Help Manage the Urge
Managing the Urge Call a friend, therapist or a crisis line Do some deep breathing exercises/ yoga Work with paint, clay, play-dough, etc. Try not be alone (visit a friend, go
shopping, etc.) Draw a picture Go to a church/ place of worship Take a hot bath Do some household chores (i.e. cleaning)
Managing the Urge Listen to music Cook/ bake Go for a walk Write in a journal Wear an elastic around wrist and snap it
when the urge arises Break the object that is being used to self-
injure as a symbolism of the ability to re-assert control
Take up a sport
Managing the Urge Write a letter to someone to express emotion
One needs not to give the letter to the person that it was written to but it is a great way to release the feelings that are being carrying within
Some people find destroying the letters help (i.e. tearing them up, throwing them in a lake, etc.)
Hold ice cubes The cold causes pain in the hands, but it is not
dangerous or harmful Draw red lines on themselves with washable
markers (instead of cutting) Punch a bed or a pillow
Managing the Urge Go outside and scream and yell Avoid temptation (i.e. avoid the area where the
razor blades are kept, etc.) Massage the area that tends to be injured
This may serve as a reminder of self-worth Compare the advantages and disadvantages of
engaging in self-harm Advantages:
Gets feelings out Improves mood
Disadvantages: May leave a scar Never seems to work for very long
Questions?
For More Information…Julia Valley, M.S.W.
Youth Community DeveloperWestern Ottawa Community Resource Centre
Favazza, A. (1998). The coming of age of self-mutilation. The Journal of Nervous and Mental Disease, 186, 259-268.
Fortune, S., Sinclair, J., & Hawton, K. (2005). Adolescent views on the prevention of self harm, barriers to help seeking for self harm and how quality of life might be improved - A qualitatitve and quantitative study of school pupils in England. Centre For Suicide Research, Oxford University.
Laye-Gindhu, A. & Schonert-Reichl, K. (2005). Nonsuicidal self-harm among community adolescents: Understanding the “whats” and “whys” of self-harm. Journal of Youth and Adolescence, 34, 447-457.
Nixon M K, Cloutier P, Jansson M. Nonsuicidal self-harm in youth: a population-based survey. Canadian Medical Association Journal 2008;178(3):306-312.
Trepal, H. & Webster, K. (2007). Self-injurious behaviors, diagnoses,and treatment methods: What mental health professionals are reporting. Journal of Mental Health Counseling, 29, 363-375.
References