Student Mental Health Workshop Counseling Issues and Practice CSA 583 Susie Becker 12-15-06

1. http://galleryofpain.self-injury.net/ Student Mental Health Workshop Counseling Issues and Practice CSA 583 Susie Becker 12-15-06

2. Learning Goals • Participants will learn the definition of self-injury. • Who is at risk, and the signs to look for. • Participants will learn what self-injury is and is not. The difference between suicidal behavior and an attempt to communicate pain. • Participants will leave feeling better prepared to support their friends and loved ones who self-injure. Gallery of Pain: Alone by Julie Li http://galleryofpain.self-injury.net/

3. Workshop Outline • I. What is Self-Harm? (10 Min) • II. Who is at Risk? (15 Min) • How is this Behavior Different than Suicidal Behavior? (10 Min) • Stories of Self-Harm. (5 Min) • V. How Can I Help? (5 Min) Gallery of Pain: Blade by Molly http://galleryofpain.self-injury.net/

4. What is Self-Harm? Self-harm is defined as deliberate and voluntary physical self-inflicted injury that is not life-threatening and is without any conscious suicidal intent (Laye-Gindhu, Aviva and Kimberly, Schonert-Reichl, 2005). The forms and severity of self-injury can vary, although the most commonly seen behavior is cutting, burning, and head-banging. Other forms of self-injurious behavior include:

5. Who Is At Risk? Self-harm is often linked with a history of sexual abuse or mental health disorders such as depression, Obsessive- Compulsive disorder (OCD), eating disorders, and Borderline Personality Disorder (BPD). Please Hide Me by Ophelia http://galleryofpain.self-injury.net/

6. How is this Behavior Different than Suicidal Behavior? Suicidal Ideation: Thoughts of suicide or of taking action to end one's own life. Suicidal ideation includes all thoughts of suicide, both when the thoughts include a plan to commit suicide and when they do not include a plan. • Signs of Suicidal Risk • Talking about suicide (killing one's self). • Always talking or thinking about death. • Making comments about being hopeless or worthless. • Saying things like "It would be better if I wasn't here“. Depression (deep sadness, loss of interest, trouble sleeping and eating) that gets worse. • A sudden, unexpected switch from being very sad to being very calm or appearing to be happy. • Having a "death wish," tempting fate by taking risks that could lead to death, like driving fast or excessive drinking. • Visiting or calling people to say goodbye Gallery of Pain: Bound by Cori http://galleryofpain.self-injury.net/

7. Stories of Self-Harm: Why Do You Harm Yourself? • "Release of tension, so I don't have to deal with what is really going on inside me" [female, age 17, began to SI at age 12] • "I had felt really bad for a really long time when I started. I just had this urge to hurt myself, I wanted to feel pain. Then it just became a magic solution to any little problem." [female, age 16, began to SI at age 15] • There are many reasons why I do it. I do it to focus my attention from emotional pain to physical pain (it's easier to deal with). I do it because I'm angry, hate myself, feel like I need to punish myself, are stressed out, to bring on a dissociative episode or end one. Sometimes I do it just to prove to myself that I'm still real." [female, age 28, possibly began to SI at age 13] • "When my body hurts it allows me to forget how much my heart hurts. I guess cutting my arms and legs and burning myself with cigarettes is a distraction from the emptiness and loneliness I feel." [male, age 19, began to SI at age 15]

8. How Can I Help? If your friend is showing signs of being at risk for committing suicide— Get them help as soon as possible. • Be a PAL: • Ask if they have a Plan • Ask if they have Accessibility to their plan. • Asses how Lethal their plan is. Hope

9. How Can I Help? If you have a friend or relative who engages in self-harm, it can be very distressing and confusing for you. You may feel guilty, angry, scared, powerless, or any number of things. • Take the self-harm seriously by expressing concern and encouraging the individual to seek professional help. • Don't get into a power struggle with the individual-ultimately they need to make the choice to stop the behavior. You cannot force them to stop. • Don't blame yourself. The individual who is self-harming initiated this behavior and needs to take responsibility for stopping it. Hope

10. How Can I Help? • If the individual who is self-harming is a child or adolescent, make sure the parent or a trusted adult has been informed and is seeking professional help for them. • If the individual who is engaging in self-harm does not want professional help because he or she doesn't think the behavior is a problem, inform them that a professional is the best person to make this determination. • Suggest that a professional is a neutral third party who will not be emotionally invested in the situation and so will be able to make the soundest recommendations. Hope

11. Web Resources about Self-Harm • National Center for Health Statistics: http://www.cdc.gov/nchs/datawh/nchsdefs/Suicidal%20Ideation.htm • Focus Adolescent Services: • http://www.focusas.com/SelfInjury.html • Safe Alternatives (Self Abuse Finally Ends): • http://www.selfinjury.com/sifacts.htm • Mirror-Mirror: • http://www.mirror-mirror.org/selfinj.htm • Mental Health Touches Everyone: http://www.athealth.com/Consumer/disorders/selfharm.html • Cool Nurse: • http://www.coolnurse.com/self-injury.htm • Self Injury: • http://self-injury.net/ • Help Guide: • http://www.helpguide.org/mental/self_injury.htm • Mayo Clinic: • http://www.mayoclinic.com/health/self-injury/DS00775

12. What Next? If you need to talk with someone following this presentation there will be members of the Student Counseling Center and Residence Life Office to help answer any questions or concerns you might have.