"Cutting"
Links:
SELF-INFLICTED VIOLENCE: HELPING THOSE WHO HURT THEMSELVES
by Tracy Alderman, Ph.D.
After having an awful day at work and an even worse time
fighting the traffic to come home, Joan wanted nothing more than to sit
down on her couch, turn on the television, order out for pizza and relax
for the rest of the evening. But when Joan walked into the kitchen, what
she saw indicated that this would not be the evening of her dreams.
Standing in front of the sink was her fourteen year old daughter, Maggie.
Maggie's arms were covered with blood, long slashes on her forearms
dripping fresh blood into the running water of the kitchen sink. A single
edged razor blade sat on the counter along with several once-white towels,
now stained crimson by Maggie's own blood. Joan dropped her briefcase and
stood before her daughter in silent shock, unable to believe what she saw.
It is likely that many of you have had a similar
experience and reaction to learning of the self-injurious activities of a
loved one. This article is intended to provide some support, advice, and
education to those of you who have friends and family who engage in
activities of self-inflicted violence.
Self-Inflicted Violence: The Basics
Self-Inflicted Violence (SIV) is best described as the
intentional harm of one's own body without conscious suicidal intent. Most
types of SIV involve cutting of one's own flesh (usually the arms, hands,
or legs), burning one's self, interfering with the healing of wounds,
excessive nail biting, pulling out one's own hair, hitting or bruising
one's self, and intentionally breaking one's own bones. SIV is more common
than you might think with roughly 1% of the general population engaging in
these behaviors (and this is likely to be greatly underestimated). The
explanations for why people intentionally injure themselves are numerous
and diverse. However, most of these explanations indicate that SIV is used
as a method of coping and tends to make life more tolerable (at least
temporarily).
How Can I Help Those Who Are Hurting Themselves?
Unfortunately, there is no magic cure for self-inflicted
violence. However, there are some things which you can do (and some things
you shouldn't do) which can help those individuals who are hurting
themselves. Keep in mind though, that unless someone wants your help,
there is nothing in the world that you can do to assist that individual.
Talk About Self-Inflicted Violence
SIV exists whether you talk about it or not. As you
know, ignoring anything does not make it disappear. The same is true with
self-inflicted violence: it will not go away because you are pretending it
doesn't exist.
Talking about self-inflicted violence is essential. Only
through open discussions of SIV will you be able to help those who are
hurting themselves. By addressing the issues of self-injury you are
removing the secrecy which surrounds these actions. You are reducing the
shame attached to self-inflicted violence. You are encouraging connection
between you and your self-injuring friends. You are helping to create
change just by the mere fact that you are willing to discuss SIV with the
person who performs those behaviors.
You may not know what to say to the individual who is
performing acts of SIV. Fortunately, you don't have to know what to say.
Even by acknowledging that you want to talk, but you're not sure how to
proceed, you are opening the channels of communication.
Be Supportive
Talking is one way to provide support, however, there
are numerous other ways to show your support to another. One of the most
helpful ways by which to determine how you could offer support is to
directly ask how you might be helpful. In doing so, you might find that
your idea of what is helpful is vastly different from how others view what
is helpful. Knowing what kind of assistance to offer and when to offer it
is necessary in order to be helpful.
Although it may be difficult for you, it is really
important that in being supportive you keep your negative reactions to
yourself. Because judgments and negative responses contrast with support,
you will need to put these feelings aside for the time being. You can only
be supportive when you act in supportive ways. This is not to say that you
should not or will not have judgments or negative reactions to SIV.
However, conceal these beliefs and feelings while you are performing
helpful behaviors. Later, when you are not assisting your friend, go ahead
and release these thoughts and emotions.
Be Available
Most individuals who injure themselves, will not do so
in the presence of others. Therefore, the more you are with those
individuals who hurt themselves, the less opportunity they will have to
inflict self-harm. By offering your company and your support, you are
actively decreasing the likelihood of SIV.
Many people who hurt themselves have difficulty
recognizing or stating their own needs. Therefore, it is helpful for you
to offer the ways in which you are willing to help. This will allow your
friends to know when and in what ways they are able to rely on you.
You will need to set and maintain clear and consistent
limits with your self-injuring friends. Thus, if you are not willing to
take crisis calls after nine in the evening, than indicate this to your
friends. If you can only offer support over the telephone, rather than in
person, be clear about that. When individuals need support around issues
of SIV, they need to know who is available to help them and in what manner
they can offer help. While what you do for your friends is important,
establishing and maintaining appropriate boundaries is equally necessary
for the relationship (and your own sanity).
Don't Discourage Self-Injury
Although this may seem difficult and irrational, it is
important for you to not discourage your friends or family from engaging
in acts of self-inflicted violence. Rules, shoulds, shouldn'ts, dos and
don'ts all limit us and place restrictions on our freedom. When we
maintain the right to choose, our choices are much more powerful and
effective.
Telling an individual to not injure herself is both
aversive and condescending. Because SIV is used as a method of coping and
is often used as an attempt to relieve emotional distress when other
methods have failed, it is essential for the person to have this option.
Most individuals would choose to not hurt themselves if they could.
Although SIV produces feelings of shame, secrecy, guilt and isolation, it
continues to be utilized as a method of coping. That individuals will
engage in self-injurious behaviors despite the many negative effects is a
clear indication of the necessity of this action to their survival.
Although it may be incredibly difficult to witness a
loved one's fresh wounds, it is really important that you offer support,
and not limits, to that individual.
Recognize the Severity of the Person's Distress
Most people don't self-injure because they're curious
and wonder what it would be like to hurt themselves. Instead, most SIV is
the result of high levels of emotional distress with few available means
to cope. Although it may be difficult for you to recognize and tolerate,
it is important that you realize the extreme level of emotional pain
individuals experience surrounding SIV activities.
Open wounds are a fairly direct expression of emotional
pain. One of the reasons why individuals injure themselves is so that they
transform internal pain into something more tangible, external and
treatable. The wound becomes a symbol of both intense suffering and of
survival. It is important to acknowledge the messages sent by these scars
and injuries.
Your ability to understand the severity of your friend's
distress and empathize appropriately will enhance your communication and
connection. Don't be afraid to raise the subject of emotional pain. Allow
your friends to speak about their inner turmoil rather than express this
turmoil through self-damaging methods.
Get Help For Your Own Reactions
Most of us have had the experience at some point in our
lives of feeling distressed by our reactions to someone else's behavior.
Al Anon and similar self-help groups were created to help the friends and
families of individuals dealing with problems of addiction and similar
behaviors. At this point in time no such organizations exist for those
coping with a loved one's SIV behaviors. However, the basic premise upon
which these groups were designed clearly applies to the issue of
self-inflicted violence. Sometimes the behavior of others affects us in
such a profound manner that we need help in dealing with our reactions.
Entering psychotherapy to deal with your responses to SIV is one such way
to handle the reactions which you may find to be overwhelming or
disturbing.
You may find it strange to seek help for someone else's
problem. However, the behaviors of others can have profound effects on us.
This effect is further strengthened by the mysteriousness, secrecy, and
misconceptions about self-inflicted violence. Thus, entering psychotherapy
(with a knowledgeable clinician) can educate you about SIV as well as
assist you in understanding and altering your own reactions. When you
learn that a friend or family member is injuring herself, you are likely
to have an intense emotional reaction and psychotherapy will help you deal
with these reactions.
Sometimes asking for help is really difficult. The
individuals who have come to you telling you of their SIV and asking for
your help are highly aware of this. Follow in their path. If you need (or
want) help, get it. Seek a trained professional. Ask some friends for
support. Speak with a religious counsel if that's helpful. Whatever you
need to do in order to take care of yourself, do it. You have to take care
of yourself before you can assist another. When trying to help friends and
family members who are injuring themselves, this point is critical. We
cannot be of much use to anyone else if we, ourselves are in a state of
need.
Tracy Alderman, Ph.D.,
is a licensed clinical psychologist residing in San Diego, California. She
is the Director of Research at the University for Humanistic Studies and
an adjunct instructor at Chapman University. She is also a staff
psychologist for the California Department of Corrections. Dr. Alderman is
currently writing a book on the topic of self-inflicted violence.
Members of
Asbury contact your Youth Director.
Note:
This is the church office number and may not be answered
after office hours.
Crisis Help - Asbury UMC provides these pages as a service & is not responsible for any information contained at any referenced institution. We respectfully suggest that you look at these services from a scriptural and prayerful point of view. If in doubt, contact your minister, rabbi or priest.
Revised:
May 11, 2009 |
