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SELF-INJURY: Understanding Why Kids Harm Themselves Kirsten Bolt, MEd, LMFT Open Sky Clinical Therapist

Today’s Presentation: WHAT is self-injury? WHO self-injures? WHY do people self-injure? HOW do we work with SI at Open Sky? HOW can parents help their kids? CAN people stop self-injuring?

WHAT is Self-Injury?

“I didn’t cut my wrists because I wanted to die… “I didn’t cut my wrists because I wanted to die…. I cut because I wanted to live.”

WHAT is Self-Injury? Common Myths… SELF-INJURY DOES NOT EQUAL SUICIDE Not the same as Body Modification Does not occur only in teenage girls “Crazy” / “Freak” “Manipulative” “Attention-Seeking” vs. Attention-Needing Severity of SI does not necessarily indicate severity of emotional pain Self-Injury IS treatable Graphic warning for next slide

Two reasons: Desensitize yourself - so your response does not increase child’s shame, or feed the behavior Check your response … If cringe, it’s because this hurts. Dispel the manipulation myth. Plus realize depth of emotional pain What other forms of SI….

WHAT is Self-Injury? Non-Suicidal Self-Injury: Cutting Burning Carving words/symbols Scratching Hair-pulling Biting to bleed Intentionally harming body tissue, without suicidal intent, in a manner that is not socially sanctioned Preventing wounds from healing Hitting to bruise or otherwise damage Tattooing/piercing/body modification—IF done to moderate emotion

WHO Self-Injures?

WHO Self-Injures?

WHO Self-Injures?

WHO Self-Injures?

WHO Self-Injures? Approximately 1% of population (~2 or 3 million Americans) Across gender, nationality, socioeconomic status, age, ability-level, sexual orientation, etc. High incidence in adolescents, but occurs (or can begin) in children, adults, and the elderly Tends to be more visible in females, but appears to be about an equal ratio for males – higher risk methods in males Increasing incidence No longer only among clinical population: found among general population High number of abuse survivors use SI for coping May be genetic predisposition to depression, anxiety, or other disorders that makes SI a desirable coping strategy Animals: particularly those in isolation without other contact

WHY do People Self-Injure?

WHY do People Self-Injure? Like any coping mechanism, BECAUSE IT WORKS. Three primary reasons: Decrease overwhelming emotions Help FEEL emotions Communicate distress

WHY Do People Self-Injure? Underlying Issues: Abuse / Neglect Depression Bipolar Anxiety Obsessions/ Compulsions Personality Disorders Post-Traumatic Stress/Trauma Eating Disorders Dissociation Impulse-Control Issues Homelessness

HOW Do We Work with Self-Injury at Open Sky?

HOW Do We Work with Self-Injury at Open Sky? Thorough Re/Assessment Therapeutic Interventions: Behavioral Regulation Emotional Regulation Communication Skills Accountability Focus on the emotions, NOT the behavior Explore counterproductive nature of SI Compassion and Empathy Understanding, without judgment Medical Treatment, as needed Peer Support Safety Watches, as needed Medical Checks, as needed

HOW Can Parents Help Their Kids?

HOW Can Parents Help? STAY CALM - monitor your reaction Take it seriously (whether overt or covert) Don’t mistake SI for suicidal intent, but consider that Focus on the underlying emotions, NOT the behavior Don’t ignore it Ask to see injuries and advocate for proper treatment Take away obvious implements Have your child work with a therapist Do your own emotion regulation work Avoid shaming your child Be mindful of websites and media that promote SI Stay compassionate and be patient

CAN People Stop Self-Injuring?

CAN People Stop Self-Injuring? YES, Absolutely. It just takes time and support.

Thank you for participating! Please keep this browser window open. When the presentation is complete, it will take you to a short survey for today’s webinar. With further questions, please contact: Kirsten Bolt, LMFT kirsten@openskywilderness.com