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)

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)

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


Protective Factors

Family cohesiveness Social connectedness Confidence re: problem-solving ability Positive self-image Academic success


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%)


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

[email protected]

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

i wasn’t trying to kill myself…

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