Presentation on theme: "Troubled Minds & Scarred Bodies A Presentation by Dr Terence Nice Maidstone 2013."— Presentation transcript:
Troubled Minds & Scarred Bodies A Presentation by Dr Terence Nice Maidstone 2013
This Presentation Informative Interactive Inspiring Interesting
Where are we going? Poem What is Self-harm? Wounded Narratives Equilibrium Video Clip
It calls me closer, its calls me near "Just once and it'll be over" Death whispers in my ear Irresistible is its sweet entice Staring down, which one to slice, I observe my previous tries My unseen hurt and earlier cries No peace in my mind, no peace in my head The quiet intelligent me, long since fled Anger and rage consumes me My minds demons bursting to be free The walls of my cage finally cave "Just be still, just be brave" I slash down with an improvised knife "Forget this world, forget my life" Blood oozes and drips down the drain A slight tingle but no real pain A Calmness comes over me My last attempt please, it's got to be "Screw everyone, that's made me into this" The very same people who I'm going to miss Tears stream down my cheek, My head feels heavy, I get dizzy and legs go weak Darkness surrounds me, I get a glimpse of the abyss I embrace the darkness, then hear a shriek...
NICE 2011 Self-harm: any act of self-poisoning or self- injury carried out by an individual irrespective of motivation. This commonly involves self- poisoning with medication or self-injury by cutting. Exclusions: harm to the self caused by excessive alcohol, recreational drugs, starvation arising from anorexia or accidental harm.
NICE 2011 In a recent UK survey of year-olds more than 10% of girls and more than 3% boys self-harmed in the previous year. Annual prevalence for all age groups is 0.5%. Self-harm increases the likelihood of completed suicide by fold above the rest of the population in a 12 month period. Self-harm is highly correlated with depression, borderline personality disorder, psychosis, bi-polar disorder, drug and alcohol conditions.
Self-Harm and Suicide Why do adolescents self-harm and commit suicide? What is going on in their minds?
Terminology Self-harm Deliberate Self-Harm Self-Injury Non-Fatal Self-Harm USA Self- Mutilation Europe Self-Injurious Behaviour Parasuicide Self-Abuse Attempted Suicide Suicide
Table of Participants 12 Participants Title AgeDate of Birth GenderEthnicityTablets Taken Intent 0-10 School Status A1 Andy 1613/10/93MaleWhite British /10College B2 Bess 1519/11/93FemaleWhite British 132-3/10State School C3 Carol 1612/11/92FemaleWhite British 204/10State School D4 Daisy 1608/09/94FemaleWhite British 113/10State School E5 Emma 1325/05/95FemaleWhite British 236/10State School F6 Freda 1530/01/93FemaleWhite British Cut Self 9/10Out of School G7 Gill 1616/07/92FemaleWhite British 567/10Out of School H8 Harry 1518/05/94MaleWhite British Hit Self1-10/10State School J9 Josie 1518/10/93FemaleWhite British 13 & Alcohol2-3/10State School K10 Kay 13 11/01/96FemaleWhite British 288-9/10State School L11 Larry 1622/12/93MaleWhite British 215/10State School M12 Mary 1527/10/94FemaleEnglish- Iranian 118-9/10Private School
Deconstruction & Reconstruction A1 Word by Word Equilibrium – The Chief Construct Master Story & Master Construct Concept-Category Micro-Stories Grounded Theory Nvivo 8 (A1-M12) Narrative Method (A1-M12) A1 Theme by Theme StoriesConstructs Synthesis of findings
Primary Recurring Themes A1 TextThemesHigher Order Themes Primary Recurring Themes R: What did you expect would happen? A1: Err…Just that I would not wake up really … but I just couldn’t get to sleep because it was that painful, so… R: There was something physically painful or psychologically painful? A1: Just being sick constantly and… R: You were being sick … A1: Yeah… every 10 minutes R: Did you think you would go off to sleep and never wake up again? A1: Yeah, I was expecting it to be quite easy T: Was it? A1: No…Not as easy as I thought T: Okay…At the time of taking the tablets what was in your mind? A1: Just to hurry up and finish taking them really, okay Expectations Wish – not to wake up A1 in pain Sick every 10 minutes Being sick Expecting it (OD) to be quite easy Going off and not waking up Thought it would be easy but doing it hard Hurry up and finish taking them. Wish to escape Bodily pain Vomiting Harder doing than A1 thought Urgency of self- harm Bodily pain of taking tablets and being sick.
Wounded Narratives R: If your cuts could have spoken what would they have said? Freda: Look at me, look …look at this person…shameful… R: What would they have needed to see? Freda: This person needs help… if my arm could have spoken at the time it would have said ‘ow’ I’m in terrible pain, but I didn’t feel the pain because I was numb, but I could feel, my arm could feel the pain, but I couldn’t…if you know what I mean …if my arm could have spoken it would have said look everybody help this person, help her … (R = Researcher Freda = Participant)
Four Cardinal Constructs (1) The Upset – Affect Dysregulation (2) Who Cares? The M/other-Adolescent Relationship (3) The Telling- Self/Other Relations (4) Equilibrium-Disequilibrium.
Equilibrium The BodyEmotionsCognitionsLife EventsThe ActFriends & Family The UpsetWho Cares?The TakingThe Telling Relational UpsetsSelf out of Balance Equilibrium Disequilibrium
Equilibrium – A Treatment Model
Applications A Tripartite Self-harm Training (Introduction, Intermediate and Advanced). Risk Assessment Checklist Emergency Advice Sheet for Families and Caregivers Map of Strengths and Vulnerabilities Self-harm pamphlet for Schools and Colleges Development of a Short-term Dynamic Treatment Model A Post-doctoral Research Project (Quantitative)