Hope and Healing Group

• I just finished the first round of this group and it went well. I’m doing it again in February, if you or anyone you know may be interested, let me know. You have to be in NY or NJ to participate, it’s an online group on a secure platform.

Staying Sober During the Holidays

The holidays can be a difficult when you’re trying to stay sober. This is  especially true for people who have recently stopped drinking or using drugs.  . Here are a few ideas on how to help you with your sobriety during these times.

Meetings

If you attend meetings regularly,  keep attending them

The holidays can be a stressful time when trying to “fit in” seeing family, buying gifts and all of your regular activities. But if going to a meeting is helping you stay sober than it is important that you continue going.

A good idea is to have your meetings planned out. That way you can make your schedule around your meetings and be prepared. This makes it much easier to get to all the places you need to without getting stressed out.

Parties

If you plan on attending parties , try to bring a friend who will not be drinking.  If you make the decision to attend a holiday party, always remember that you can leave at any time.  Don’t worry about hurting someone’s feelings or what people will think.

Seeing the Family

Families are often a trigger for many struggling in sobriety. Make sure your family knows where you stand with your sobriety. If you find yourself struggling, call a sober friend or sponsor  and talk to them about it.  Don’t ever feel guilty if you feel you need to remove yourself from a family situation. This may be uncomfortable for you in the short term, but it is important to look at the big picture.

Talking to Someone

Talking to someone is always a good idea.  No matter what the circumstances, having someone to talk to can change your perspective.

Remove Expectations

The holidays bring with them a variety of expectations, whether they be on you or on someone else. Don’t let these presumptions deter you in any way. You can’t pretend to know anyone else’s situation and you can’t expect them to know yours. Keep it simple and enjoy the season.

 

Help Someone Else

 

When you make someone else’s life better, you will be filled with a feeling of joy and purpose.  You will be amazed at what this does for your own life.

Enjoy the Season

Try and enjoy what’s going on around you. People are festive this time of year and instead of resisting that feeling, embrace it.  Joy spreads.

Stay Away from Things that Recall Bad Memories

This is the time of year for reruns of old movies and Christmas songs that may jar certain feelings. You know what is going to stir up these emotions.  Try to stay away from  people, places and things which may cause you to use.  .

Down Time

The holidays provide a lot of down time. Don’t use these days to dwell, instead try and find a way to help someone else, go to a meeting or do some shopping for yourself or someone else. Find something productive to do with your time.

Use Your Resources

There are many tools at your disposal to stay sober, many of which I listed here, use them.  Help is there  but you just have to reach out.

Coping with Being Alone for the Holidays

Many people find themselves alone and without family and friends to share the holidays. This can often lead to feeling sad and depressed but there are ways to alleviate these feelings and have a wonderful holiday.

No matter the reason that you’re alone for the holidays, you can make it a wonderful holiday season. First, make your time alone special. Then, when you’re through with personal time, pick some activities that will surround you with others.

A little time to yourself is often very rare. When you have some, it is something to cherish. Forget about what’s “supposed” to happen and that you’re suppossed to be surrounded by others. Remember that many people are doing what’s expected, and probably running themselves a little ragged. They may actually wish they had some time alone. Once you’ve put aside the weight of expectations, consider how you might treat yourself to some special time.

Get out, go somewhere. Find places that will stimulate and amuse you. Museums, festivals or streets decorated for the holidays might recharge you.
Take on a home project.
Rediscover an old creative talent.
Treat yourself to a personal spa. Spoil yourself with comfort. Read a novel. Take a candlelight bubble bath. Curl up on the couch with hot chocolate, a warm blanket and a movie.
Call or write to family and friends. Just because you’re not with them doesn’t mean you can’t make contact. But plan your calls, so you don’t go broke. And make sure the calls are a nice diversion for the day, not the centerpiece of it. You should enjoy the moments of contact, not dwell on the fact that you’re not with family and friends.

Make plans to be around other people when that alone-time limit comes. There are many activities to do and places to go where you can share the holiday spirit with others.

Return to the real holiday tradition by helping others. When you volunteer, you receive two big rewards. First, you’ll be surrounded by people — by volunteers and staff who share your spirit of giving and by those you are helping. Second, it’s good for the soul. Helping others in need is fulfilling.

Do something with friends. Many people don’t think of it. Most of us have been conditioned to think of holidays as time for family only. We’re not used to thinking of this as a time to gather with friends. If you’re on your own, a few friends might be, too. Get in touch with them, and make some plans. If you’re single, look for a singles organization.

Take advantage of what being alone during this time can bring you: a chance for some quality personal time, and a chance to get out, meet some new people and help those in need.

Depression and the Holiday Season

Feeling down during the holidays can be hard especially since everyone seems so happy.  Believe it or not many people who you seem happy during the holidays are also stressed and depressed.  So if the family gatherings, the endless parties, and the shopping get you down, you’re not alone. However people with depression need to be especially careful when coping with holiday stress. . Here are some tips to reduce stress and hopefully  find holiday joy.

Finding the Holiday Spirit: Emotions

1. Have modest expectations. Don’t worry about  what the holidays are supposed to be like and how you’re supposed to feel.  Don’t worry about holiday spirit and take the holidays as they come.

2. Do something different. If the  prospect of the usual routine fills you with dread rather than  joy try not to  surrender to it. Try something different to get into the spirit.

3. Lean on your support system. During the holidays, take time to get together with your support team regularly or at least keep in touch by phone to keep yourself centered.

 

4. Don’t assume the worst.  Don’t start the holiday season anticipating disaster. If you try to take the holidays as they come and limit your expectations you may enjoy them more.

5. Forget the unimportant stuff. Don’t run yourself ragged just to live up to holiday tradition. Give yourself a break.

6. Volunteer.  Consider taking time to help people who have less than you. Try volunteering at a soup kitchen or working for a toy drive.

Finding the Holiday Spirit: Family

7. Head off problems. Think about what people or situations trigger your holiday stress and figure out ways to avoid them.

8. Ask for help .  People may be more willing to help out than you expect; they just need some guidance from you on what to do.

9. Don’t worry about things beyond your control. You can’t control others but  you can control your own reaction to the situation.

 

10. Make new family traditions.  While it’s nice to keep old traditions, you can also add new traditions for the holidays.

11. Find positive ways to remember loved ones. Holidays will remind you of the loved ones who aren’t around anymore, try to do something to celebrate their memory.

Finding the Holiday Spirit: Parties

12. Don’t overbook.   Don’t say yes to every invitation.  Think about which parties you really want to attend.

13. Don’t stay longer than you want. Going to a party doesn’t obligate you to stay until the end.  Stay as long as you can and leave when you are ready.

14. Have a partner for the party. If the prospect of an office party is stressful, talk to a friend and arrange to arrive  and leave together.

Finding the Holiday Spirit: Shopping

15. Forget about the perfect gift. If you’re already feeling overwhelmed,  don’t worry about finding the absolute best gift.   Remember: everybody likes a gift card.

16. Shop online. Save yourself the inconvenience, the crowds by doing most of your shopping online.

17. Stick to a budget. The cost of holiday shopping can grow very quickly,   try to stick to a budget.

Finding the Holiday Spirit: Self-Care

18. Stay on schedule. As much as you possibly can, try to stick with your normal routine during the holidays.  Disrupting your schedule  can make your mood deteriorate.

19. Exercise. While you may not feel like you have the time to exercise during the holidays, the benefits are worth it.

20. Eat sensibly. When you’re facing a dozen holiday parties and family gatherings between now and New Year’s, it’s hard to stay committed to a sensible diet. But try. . On the other hand, don’t beat yourself up if you go overboard some days.   It’s not a big deal. Just get back on track the next day.

21. Try a sun lamp. As the daylight grows shorter, lots of people feel more depressed and sad.  A sun lamp may help to improve your mood.

 

22. Give yourself a break. “The holidays can make some people dwell on their imperfections, their mistakes, the things they’re not proud of,be  gentle with yourself. Remember it  is the season of kindness and forgiveness, so  save some of it for yourself.

The Stigma of Mental Health Treatment in the West Indian American Community

Many Caribbean immigrants in particular first generation immigrants are very wary of going to see a mental health professional.  Problems are usually handled at home and many families have someone in their family who is mentally ill but has never gotten treatment and is often whispered about by others in the family and community.  Many immigrants are also very religious and feel that by going to church and praying everything will be better.  Many Caribbean immigrants also believe that admitting to being depressed or anxious is a moral failing and won’t seek out help and will try to feel better on their own.   Many also wonder if a clinician who does not share their background will be able to understand their background and some beliefs such as “obeah” which is a form of voodoo practiced or believed in by some members of the Black Caribbean community.

Faith, Spirituality And Community

In the West Indian community, family, community and spiritual beliefs are often  great sources of strength and support.  Many West Indians  rely on faith, family and social communities for emotional support rather than turning to health care professionals.

While faith communities can be helpful at times they can be a source of distress and stigma if they are misinformed about mental health or do not know how to support families dealing with these conditions.

 

Reluctance And Inability To Access Mental Health Services

Less than 30% of West Indians  seek mental health care during their lives. Here are some reasons why:

• Distrust and misdiagnosis. Historically, African Americans and West Indians  have been and continue to be negatively affected by prejudice and discrimination in the health care system. Misdiagnoses, inadequate treatment and lack of cultural competence by health professionals often causes distrust and prevent many people  from seeking or staying in treatment.
• Lack of  West Indian mental health professionals.   Unfortunately there is a lack of mental health professionals who are from the West Indian or Caribbean community.  Many immigrants feel more comfortable and relate better to people who they perceive as being more familiar with their culture.

Provider Bias And Inequality Of Care

Conscious or unconscious bias from providers and lack of cultural competence result in misdiagnosis and poorer quality of care for African Americans and West Indians. .

West Indians, particularly women, are more likely to experience and mention physical symptoms related to mental health problems. For example,  describing  bodily aches and pains when talking about depression. A health care provider who is not culturally competent might not recognize these as symptoms of a mental health condition. Additionally, men are more likely to receive a misdiagnosis of schizophrenia when expressing symptoms related to mood disorders or PTSD.

Given this bias and the negative impact they have on your care, it is easy to understand why so many people  mistrust health professionals in general and avoid accessing care. While there may be reason to doubt whether professionals will mistreat you or not, don’t let this fear prevent you from seeking care..

Finding The Right Provider

For West Indian and Caribbean people it will be important to find someone whom they feel is culturally competent and understands them.  The therapist doesn’t have to be West Indian but should be someone who understands or is willing to learn the nuances of Caribbean culture.   When meeting with a  provider, ask questions to get a sense of their level of cultural sensitivity. Do not feel bad about asking questions. Providers expect and welcome questions from their clients  since this helps them better understand you and what is important to you.  If a provider seems put off by being asked questions, they may not be the right provider.

 

Understanding Paranoia and Delusional Disorders

What is Paranoia?

Paranoia involves intense anxious or fearful feelings and thoughts often related to persecution, threat, or conspiracy. Paranoia occurs in many different mental  health disorders, but is most often present in psychotic disorders. Paranoia can become delusions, when irrational thoughts and beliefs become so fixed that nothing can convince a person that what they think or feel is not true. When a person has paranoia or delusions, but no other symptoms (like hearing or seeing things that aren’t there), they have what is called a delusional disorder.  Since  only thoughts are impacted, a person with delusional disorder can usually work and function in everyday life, however, their lives may be very limited and isolated.

Signs of Paranoia

Symptoms of paranoia and delusional disorders include intense and irrational mistrust or suspicion, which can bring on sense of fear, anger, and betrayal. Some  beliefs and behaviors of people with symptoms of paranoia include mistrust, hypervigilence, difficulty with forgiveness, defensive attitude in response to imagined criticism, preoccupation with hidden motives, fear of being deceived or taken advantage of, inability to relax, or being very argumentative.

What Causes Paranoia?

The cause of paranoia is a breakdown of various mental and emotional functions involving reasoning and assigned meanings. The reasons for these breakdowns are varied and uncertain. Some symptoms of paranoia relate to repressed, denied or projected feelings. Sometimes  paranoid thoughts and feelings are related to events and relationships in a person’s life, which often increases isolation and difficulty with getting help.

What is a Delusion?

A delusion is an odd belief that a person  insists is true despite evidence that it is not. Cultural beliefs that may seem odd, but are widely accepted do not fit the criteria for being a delusion. Two of the most common types of delusions are delusions of grandeur or persecutory delusions.

What is Delusional Disorder?

Delusional disorder is characterized by irrational or intense belief(s) or suspicion(s) which a person believes to be true. These beliefs may seem bizarre and impossible or fit within the realm of what is possible (non-bizarre). Symptoms must last for 1 month or longer in order for someone to be diagnosed with delusional disorder.

How are Paranoia and Delusions Treated?

Treatment of paranoia is usually with  medication and cognitive behavioral therapy. The most important element in treating paranoia and delusional disorder, is building a trusting and collaborative relationship to reduce the impact of irrational fearful thoughts and improving social skills. It can be difficult to treat a person with paranoia since symptoms result in increased irritability, emotionally guardedness, and possible hostility. Often  progress on paranoid delusions and especially delusional disorder is slow. Although the process is often slow , recovery and reconnection is possible.

Online Counseling

Online counseling  also known as  e-therapy – is when a professional counselor or psychotherapist talks with you over the Internet, to give you emotional support, mental health advice or some other professional service.

Online therapy is an  alternative source of help when traditional psychotherapy is not accessible. Its effective. Its private. Its conducted by skilled, qualified, ethical professionals.  It works as well as face to face therapy with most clients.

Online therapy is usually offered either by private practitioners who will meet with you in a secure site which is HIPPA  compliant or there are online therapy clinics where you chose the therapist whom you would like to work with from a list of mental health practitioners.

Some websites such as Talkspace offer email and text based counseling.  This type of counseling is not the same as psychotherapy because you do not see the person and it’s difficult to gauge how well the person is doing via text and also you may not be able to have a continuous conversation with the person.

 

Online therapy works well if you have a very busy schedule, you live somewhere without many therapists, you have young children at home or it’s difficult for you to get to an office.  Online therapy is not suitable for people suffering from severe mental illness such as schizophrenia or schizoaffective disorder.  It is very helpful for people with anxiety or depression.  While online therapy is not for everyone it is a viable alternative to face to face psychotherapy.

Antisocial Personality Disorder

Antisocial personality disorder,   is a mental health  condition in which a person consistently shows no regard for right and wrong and ignores the rights and feelings of others. People with antisocial personality disorder tend to antagonize, manipulate or treat others harshly or with callous indifference. They show no guilt or remorse for their behavior.

Individuals with antisocial personality disorder often violate the law, becoming criminals. They may lie, behave violently or impulsively, and often have problems with drug and alcohol use. Because of these characteristics, people with this disorder typically can’t fulfill responsibilities related to family, work or school.

 

Symptoms

Antisocial personality disorder signs and symptoms may include:

• Disregard for right and wrong
• Persistent lying or deceit to exploit others
• Being callous, cynical and disrespectful of others
• Using charm or wit to manipulate others for personal gain
• Arrogance, a sense of superiority and being extremely opinionated
• Recurring problems with the law, including criminal behavior
• Repeatedly violating the rights of others through intimidation and dishonesty
• Impulsiveness or failure to plan ahead
• Hostility, significant irritability, agitation, aggression or violence
• Lack of empathy for others and lack of remorse about harming others
• Unnecessary risk-taking or dangerous behavior with no regard for the safety of self or others
• Poor or abusive relationships
• Failure to consider the negative consequences of behavior or learn from them
• Being consistently irresponsible and repeatedly failing to fulfill work or financial obligations

Adults with antisocial personality disorder typically show symptoms of conduct disorder before the age of 15. Signs and symptoms of conduct disorder include serious, persistent behavior problems, such as:

• Aggression toward people and animals
• Destruction of property
• Deceitfulness
• Theft
• Serious violation of rules

Although antisocial personality disorder is considered lifelong, in some people, certain symptoms — particularly destructive and criminal behavior — may decrease over time. But it’s not clear whether this decrease is a result of aging or an increased awareness of the consequences of antisocial behavior.

When to see a doctor

People with antisocial personality disorder are likely to seek help only at the urging of loved ones. If you suspect a friend or family member may have the disorder, you might gently suggest that the person seek medical attention, starting with a primary care physician or mental health professional.

Causes

Personality is the combination of thoughts, emotions and behaviors that makes everyone unique. It’s the way people view, understand and relate to the outside world, as well as how they see themselves. Personality forms during childhood, shaped through an interaction of inherited tendencies and environmental factors.

The exact cause of antisocial personality disorder isn’t known, but:

• Genes may make you vulnerable to developing antisocial personality disorder — and life situations may trigger its development
• Changes in the way the brain functions may have resulted during brain development

Risk factors

Certain factors seem to increase the risk of developing antisocial personality disorder, such as:

• Diagnosis of childhood conduct disorder
• Family history of antisocial personality disorder or other personality disorders or mental illness
• Being subjected to abuse or neglect during childhood
• Unstable, violent or chaotic family life during childhood

Men are at greater risk of having antisocial personality disorder than women.

Complications

Complications, consequences and problems of antisocial personality disorder may include:

• Spouse abuse or child abuse or neglect
• Alcohol or substance abuse
• Being in jail or prison
• Homicidal or suicidal behaviors
• Having other mental health disorders such as depression or anxiety
• Low social and economic status, and homelessness
• Gang participation
• Premature death, usually as a result of violence

 

People with antisocial personality disorder are unlikely to believe they need help. However, they may seek help from their health care provider because of other symptoms such as depression, anxiety or angry outbursts or for treatment of substance abuse.

People with antisocial personality disorder often do  not provide an accurate account of signs and symptoms. A key factor in diagnosis is how the affected person relates to others. With permission, family and friends may be able to provide helpful information.

After a medical evaluation to help rule out other medical conditions, the health care provider will usually  make a referral to a mental health professional for further evaluation.

Diagnosis of antisocial personality disorder is typically based on:

• A psychological evaluation that explores thoughts, feelings, relationships, behavior patterns and family history
• Personal and medical history
• Symptoms listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

information.

After a medical evaluation to help rule out other medical conditions, the health care provider may make a referral to a mental health professional for further evaluation.

Diagnosis of antisocial personality disorder is typically based on:

• A psychological evaluation that explores thoughts, feelings, relationships, behavior patterns and family history
• Personal and medical history
• Symptoms listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association

.

Treatment

 Though antisocial personality disorder is difficult to treat, for some people, treatment and close follow-up over the long term may be beneficial. It’s important to have a medical and mental health professionals with experience in treating antisocial personality disorder.Treatment depends on each person’s particular situation, their willingness to participate in treatment and the severity of symptoms.   The more severe the symptoms, the less likely for there to be a positive outcome in treatment.

Psychotherapy

Psychotherapy is sometimes used to treat antisocial personality disorder. Therapy may include, for example, anger and violence management, treatment for substance abuse, and treatment for other mental health conditions.  However  psychotherapy is not always effective, especially if symptoms are severe and the person can’t admit that he or she contributes to serious problems.

Medications

There are no medications specifically to treat antisocial personality disorder. Doctors may prescribe medications for conditions sometimes associated with antisocial personality disorder, such as anxiety or depression, or for symptoms of aggression. Drugs are usually prescribed cautiously because some have the potential for misuse.

The outcome for people with this disorder is not usually positive however in less severe cases it can be controlled.

 

Abstinence vs Harm Reduction in Addiction Treatment

A very common philosophical debate in addiction counseling is between abstinence and harm reduction.   Abstinence-focused addiction counseling believes that recovery only exists if the addictive substance is completely removed from the life of the individual it affects.  The issue is seen as largely black or white: either you drink/use drugs and deal with the consequences, or you abstain and live a life in recovery.  Harm Reduction-focused addiction counseling generally follows the belief that not everyone is in a place to completely abstain; and therefore, it is best to take steps to reduce the risks to the person and others when the individual chooses to partake in the addictive substance.  The notion is that some people may not currently be willingly or able to completely give up the substance of their addiction.

Philosophy of Abstinence in Addiction Counseling

The definition of abstinence means refraining from the unwanted behavior.  Many people in the addiction world see abstinence as the only way to recovery based on the definition of addiction and the idea that the user has lost control.  The abstinence model follows the science behind addiction.  Science has shown that some people are genetically predisposed to addiction and are more likely to get addicted  to substances or behaviors.  It is estimated that  between 40-60% of a person’s predisposition to addiction may be genetic.    Evidence also shows that with continued use, alcohol and drugs may alter the brain of the addict.  This may cause someone to start using addictively again once they’ve achieved some type of abstinence.

For some people, abstinence is seen as the only way to regain control of one’s life and effectively recover.  Alcoholic Anonymous and other 12-step fellowships follow the abstinence-based approach.  The only requirement may be a desire to stop drinking (or using) but the philosophy is rooted in this disease concept that the alcoholic has lost control over the substance and therefore treatment begins with sobriety.  AA and other fellowships are actually behavioral and psychological modification processes, seeking to instill in the minds of those who attend that if they are addicted, they are powerless over alcohol and other drugs.

Due to the nature of addiction, alcoholics and addicts usually have intricate denial and rationalization systems to convince themselves they don’t have a problem.  These psychological defenses are worked on with the First Step: admitting that they are powerless over alcohol and other drugs.  Cognitively, alcoholics and addicts need to retrain their minds that they are in fact powerless over alcohol and other drugs and therefore they cannot use them again.  Successful sobriety via the 12-step philosophy occurs when an individual can take their unhealthy attachment to substances and redirect it to a healthy attachment to the program.

Philosophy of Harm Reduction in Addiction Counseling          

The general focus of harm reduction is not whether an individual does or does not do a particular behavior, it is about reducing the potential problems associated with it.  Substance use under the harm reduction approach is not black/white, either/or; it is the gray area in between.  If a person chooses to drink or use drugs, the focus is on ways to reduce the risk from using.  An important concept that some people  do not understand is that the harm reduction approach should not be seen as condoning risky or illegal behavior.  Rather, it understands that risky behavior is inevitably going to occur, so it is more beneficial to curb the negative consequences incrementally as best as possible.

There are many types of harm reduction modalities including: drug replacement therapy such as methadone or  Suboxone, needle exchange programs, designated drivers, substituting “less harmful drugs”, testing illicit drugs for harmful additives and behavior modification to control intake.  Because harm reduction philosophy and practice resides in the gray area of the continuum, research on the topic has been muddled, largely due to the lack of a consistent definition as to what harm reduction is and how it should be measured.  This makes sense even if you only consider the expansive list provided above as types of harm reduction.

Some in addiction counseling use harm reduction as a way to motivate the client for change and incrementally work towards abstinence: a harm-reduction now,  abstinence later approach to treatment.  Others in addiction counseling implement the philosophy fully in its own capacity and  the end goal is not abstinence.

Evolving Integration of Abstinence and Harm Reduction

For people seeking help, total abstinence is an ideal goal but given their circumstances and motivation for change, that goal may be unreachable when they first seek help.  Many abstinence-based facilities are moving away from kicking out a client after one positive urine screen, which was not always the case.  Often the treatment team reassesses the situation and decides if the treatment plan is still appropriate and if the client is receiving the proper level of care.  Similarly, abstinence-based facilities are also increasingly using or allowing pharmacotherapy as an adjunct to treatment. Many treatment facilities now work with clients who are on Suboxone, Vivitrol, Naltrexone, etc.  In theory, allowing these medications is a harm-reduction approach to treatment, but in practice those modalities are becoming more acceptable across the board.

There are no hard and fast rules that apply to all people trying to get sober and/or improve their lives.  No one  is a black or white case, it is essential to individualize treatment and recognize the unique characteristics of each person.  The process should be a collaborative effort between the client and addiction counselor/treatment team.  The focus of treatment should always be  being present and being an agent for change for the person seeking help.

 

Cutting and Self Harming Behavior

People who self-harm often see it as a  way of coping with problems. It may help you express feelings you can’t put into words, distract you from your life, or release emotional pain. Afterwards, you may  feel better  for a little while.  However  the painful feelings return, and you  may feel the urge to hurt yourself again. If you want to stop but don’t know how, remember this: you deserve to feel better, and you can get there without hurting yourself.

Understanding cutting and self-harm

Self-harm is a way of expressing and dealing with deep distress and emotional pain. As strange as it may sound to those on the outside, hurting yourself can make you feel better. Injuring yourself is the only way you know how to cope with feelings like sadness, self-loathing, emptiness, guilt, and rage.

The problem is that the relief that comes from self-harming doesn’t last very long. It’s like putting on a Band-Aid when what you really need are stitches. It may temporarily stop the bleeding, but it doesn’t fix the underlying injury. It also creates its own problems.

If you’re like most people who self-injure, you probably try to keep what you’re doing secret. Maybe you feel ashamed or maybe you just think that no one would understand.  Ultimately, the secrecy and guilt affects your relationships with your friends and family members and the way you feel about yourself. It can make you feel even more lonely, worthless, and trapped.

Myths and facts about cutting and self-harm

 

Myth: People who cut and self-injure are trying to get attention.
Fact: The truth is that people who self-harm generally harm themselves in secret. They aren’t trying to manipulate others or draw attention to themselves.  Actually shame and fear can make it very difficult to come forward and ask for help.

Myth: People who self-injure are crazy and/or dangerous.
Fact: It is true that many people who self-harm suffer from anxiety, depression, or a previous trauma—just like millions of others in the general population, but that doesn’t make them crazy or dangerous. Self-injury is how they cope. Sticking a label like “crazy” or “dangerous” on a person is not  accurate or helpful.

Myth: People who self-injure want to die.
Fact: People who self-injure usually do not want to die. When they self-harm, they are not trying to commit suicide —they are trying to cope with their problems and pain.   They often feel that  self-injury may be a way of helping themselves go on living. However, in the long-term, people who self-injure have a much higher risk of suicide, which is why it’s important to seek help.

 

Signs and symptoms of cutting and self-harm

Self-harm includes anything you do to intentionally injure yourself. Some of the more common ways include:

• cutting or severely scratching your skin
• burning or scalding yourself
• hitting yourself or banging your head
• punching things or throwing your body against walls and hard objects
• sticking objects into your skin
• intentionally preventing wounds from healing
• swallowing poisonous substances or inappropriate objects

Self-harm can also include less obvious ways of hurting yourself or putting yourself in danger, such as driving recklessly, binge drinking, taking too many drugs, and having unsafe sex.

Warning signs that a family member or friend is cutting or self-injuring

Because clothing can hide physical injuries, and inner turmoil can be covered up by a seemingly calm disposition, self-injury can be hard to detect. However, there are warning signs you can look for :

• Unexplained wounds or scars from cuts, bruises, or burns, usually on the wrists, arms, thighs, or chest.
• Blood stains on clothing, towels, or bedding; blood-soaked tissues.
• Sharp objects or cutting instruments, such as razors, knives, needles, glass shards, or bottle caps, in the person’s belongings.
• Frequent “accidents.” Someone who self-harms may claim to be clumsy or have many mishaps, in order to explain away injuries.
• Covering up. A person who self-injures may insist on wearing long sleeves or long pants, even in hot weather.
• Needing to be alone for long periods of time, especially in the bedroom or bathroom.
• Isolation and irritability.

 

How does cutting and self-harm help?

It’s important to acknowledge that self-harm helps you—otherwise you wouldn’t do it. Some of the ways cutting and self-harming can help include:

• Expressing feelings you can’t put into words
• Releasing the pain and tension you feel inside
• Helping you feel in control
• Distracting you from overwhelming emotions or difficult life circumstances
• Relieving guilt and punishing yourself
• Making you feel alive, or simply feel something,instead of feeling numb

Once you better understand why you self-harm, you can learn ways to stop self-harming, and find resources that can support you through this struggle.

If self-harm helps, why stop?

Although self-harm and cutting can give you temporary relief,  in the long term, it causes far more problems than it solves.

• The relief is short lived, and is quickly followed by other feelings like shame and guilt.
• Keeping the secret of self-harm from friends and family members is difficult and lonely.
• You can hurt yourself badly, even if you don’t mean to. It’s easy to misjudge the depth of a cut or end up with an infected wound.
• If you don’t learn other ways to deal with emotional pain, it puts you at risk for other  problems,  including major depression, drug and alcohol addiction, and suicide.
• Self-harm can become addictive. It may start off as an impulse or something you do to feel more in control, but soon it feels like the cutting or self-harming is controlling you. It often turns into a compulsive behavior that seems impossible to stop.

Self-harm and cutting don’t help you with the issues that made you want to hurt yourself in the first place. There are  other ways that the underlying issues that are driving the self harm can be managed.

Help for cutting and self-harm

step1: Confide in someone

If you’re ready to get help for cutting or self-harm, the first step is to confide in another person. It can be scary to talk about the very thing you have worked so hard to hide, but it can also be a huge relief to finally let go of your secret and share what you’re going through.

Deciding whom you can trust with such personal information can be difficult. Ask yourself who in your life makes you feel accepted and supported. It could be a friend, teacher, religious leader, counselor, or relative

 

Tips for talking about cutting and self-harm

• Focus on your feelings. Instead of sharing detailed accounts of your self-harm behavior focus on the feelings or situations that lead to it. This can help the person you’re confiding in better understand where you’re coming from. It also helps to let the person know why you’re telling them.
• Communicate in whatever way you feel most comfortable. If you’re too nervous to talk in person, consider starting off the conversation with an email or letter Don’t feel pressured into sharing things you’re not ready to talk about. You don’t have to show the person your injuries or answer any questions you don’t feel comfortable answering.
• Give the person time to process what you tell them. As difficult as it is for you to open up, it may also be difficult for the person you tell—especially if it’s a close friend or family member. Sometimes, you may not like the way the person reacts. Try to remember that reactions such as shock, anger, and fear come out of concern for you.

Talking about self-harm can bring up a lot of emotions. Don’t be discouraged if the situation feels worse for a short time right after sharing your secret. It’s uncomfortable to confront and change long-standing habits. But once you get past these initial challenges, you’ll start to feel better.

Help for cutting and self-harm

step 2: Figure out why you cut

Understanding why you cut or self-harm is a vital first step toward your recovery. If you can figure out what function your self-injury serves, you can learn other ways to get those needs met—which in turn can reduce your desire to hurt yourself.

Identify your self-harm triggers

Remember, self-harm is most often a way of dealing with emotional pain. Once you learn to recognize the feelings that trigger your need to self-injure, you can start developing healthier alternatives.

Get in touch with your feelings

If you’re having a hard time pinpointing the feelings that trigger your urge to cut, you may need to work on your emotional awareness.  Emotional awareness means the ability to identify and express what you are feeling from moment to moment and to understand the connection between your feelings and your actions. Feelings are important pieces of information that our bodies give to us, but they do not have to result in actions like cutting or other self-harming.

The idea of paying attention to your feelings—rather than numbing them or releasing them through self-harm—may sound frightening to you. You may be afraid that you’ll get overwhelmed or be stuck with the pain, however emotions quickly come and go if you let them. If you don’t try to fight, judge, or beat yourself up over the feeling, you’ll find that it soon fades, replaced by another emotion. It’s only when you obsess over the feeling that it persists.

Help for cutting and self-harm

step 3: Find new coping techniques

Self-harm is your way of dealing with feelings and difficult situations. So if you’re going to stop, you need to have alternative ways of coping in place so you can respond differently when you start to feel like cutting or hurting yourself.

If you cut to express pain and intense emotions

• Paint, draw, or scribble on a big piece of paper with red ink or paint
• Express your feelings in a journal
• Write down any negative feelings and then rip the paper up
• Listen to music that expresses what you’re feeling

If you cut to calm and soothe yourself

• Take a bath or hot shower
• Pet or cuddle with a dog or cat
• Wrap yourself in a warm blanket
• Massage your neck, hands, and feet
• Listen to calming music

If you cut because you feel disconnected and numb

• Call a friend (you don’t have to talk about self-harm)
• Take a cold shower
• Chew something with a very strong taste, like chili peppers or  peppermint

If you cut to release tension or vent anger

• Exercise —run, dance, jump rope, or hit a punching bag
• Punch a cushion or mattress or scream into your pillow
• Rip something up (sheets of paper, a magazine)
• Make some noise (play an instrument, bang on pots and pans)

Substitutes for the cutting sensation

• Use a red felt tip pen to mark where you might usually cut
• Rub ice across your skin where you might usually cut
• Put rubber bands on wrists, arms, or legs, and snap them instead of cutting or hitting

 

Professional treatment for cutting and self-harm

You will probably also need the help and support of a trained professional as you work to overcome the self-harm habit.   A therapist can help you develop new coping techniques and strategies to stop self-harming, while also helping you get to the root of why you cut or hurt yourself.

Self harm is  an outward expression of inner pain—pain that often has its roots in early life. There is often a connection between self-harm and childhood trauma.

Self-harm may be your way of coping with feelings related to past abuse, flashbacks, negative feelings about your body, or other traumatic memories. This may be the case even if you’re not consciously aware of the connection.

Helping a friend or family member who cuts or self-harms

Perhaps you’ve noticed suspicious injuries on someone close to you, or that person has admitted to you that he or she is cutting.  You may feel unsure as to what to say or how you can help.

• Deal with your own feelings. You may feel shocked, confused, or disgusted by self-harming behaviors—and guilty about admitting these feelings. Acknowledging your feelings is an important first step toward helping your loved one.
• Learn about the problem. The best way to overcome any discomfort you feel about self-harm is by learning about it. Understanding why your friend or family member is self-injuring will be very helpful.
• Don’t judge. Avoid judgmental comments and criticism—they’ll only make things worse. Remember, the self-harming person already feels ashamed and alone.
• Offer support, not ultimatums. It’s only natural to want to help, but threats, punishments, and ultimatums are counterproductive. Express your concern and let the person know that you’re available whenever he or she wants to talk or needs support.
• Encourage communication. Encourage your loved one to express whatever he or she is feeling, even if it’s something you might be uncomfortable with. If the person hasn’t told you about the self-harm, bring up the subject in a caring, non-confrontational way.

If the self-harmer is a family member, especially if it is your child, prepare yourself to address difficulties in the family. This is not about blame, but about learning ways of dealing with problems and communicating better that can help the entire  family.

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If you or someone you love is self harming, please get help as soon as possible.