Episode 9: Self Injurious Behaviour

Individuals living with a history of trauma and emotional pain cope day to day with the use of a variety of strategies. Some will use coping mechanisms that are considered harmless, while others will engage in less safe strategies. Self injurious behaviour is a response that many would find difficult to understand. It is best viewed as a maladaptive response to overwhelming and intolerable emotions. Self harm or injury is a deliberate behaviour that causes tissue damage or marks that last several hours or more. It is not considered to be part of body modification such as tattoos and piercing for the sake of making an artistic statement. It is difficult to obtain an accurate picture of the incidence of self-harm due the shameful stigma that is associated with it. It is often ignored or unreported to the medical profession. In the United States the best available research indicates that approximately 1% of the population engages in chronic self-harm. Canadian statistics are similar, with reported lifetime prevalence rates ranging from 14 to 17% (www.insync-group.ca). In the following video, presented by suicide intervention consultant Yvonne Bergmans, the viewer will be presented with insights as to what leads an individual to participate in this behaviour and the meaning behind it. Crisis/distress line volunteers will be introduced to effective methods for responding to self injuring callers and strategies to minimize the lethality of their actions. Questions for Further Consideration: 1. For many, this topic is so intolerable that it may be considered taboo. How comfortable are you in supporting a caller who describes their participation in this behaviour? How has this learning module prepared you for this? Do you need more information? Self injury is a behaviour that may be very frightening or difficult for people to talk about. It may be helpful to reflect on how prepared you are to work with these callers and discuss concerns with your training coordinator. It may also be helpful to explore the links provided in this learning module to obtain more knowledge and confidence on this subject. What are some of the most useful strategies or pieces of information that you have learned from this presentation that will help you feel competent when responding to a caller who is engaging in self injurious behaviour? This may include any of the following: There are several forms of self injurious behaviour Self injury does not necessarily mean the individual is suicidal Not all suicidal individuals engage in self harm There is meaning behind the behaviour, it is essential to ask about it Realize you can’t stop the self injurious behaviour but you can talk about keeping as safe as possible Talk to these callers about how they perceive the level of risk their behaviour is causing them Individuals who engage in self injurious behaviour come from all walks of life, no matter the race, gender, culture, social economic status, education, or age 3. What is your centre’s policy regarding how volunteers deal with callers who are causing themselves physical harm? Check with your training coordinator as to what the policy is for your centre. Each program may deal with it a little differently. If there is no written policy, perhaps a training evening can be requested to hold discussions as to what should happen. In the meantime, it is valuable to focus on the callers’ emotions and work toward de-escalating their level of anxiety