Frances Masters Manage Stress No Comments
How to Respond when Someone Self-Harms
Today I’m publishing my second e book on self harm ‘Responding to Self Harm.’ You can access the first e book ‘Understanding Self Harm here.
It’s turned into a bigger project than I anticipated, as is often the case. It’s such a big subject and the need for education and understanding is great. Schools in particular are overwhelmed and crying out for support for their students.
My hope is that the e books will help those who are caught up in a cycle of self harm, their parents and those professionals who seek to support them.
There will be a third e book coming soon which will cover the Fusion Therapeutic Coaching approach to resolving self harm.
My aim, as ever, is to be responsive to the professional landscape.
I hope it helps…
Responding to self harm
Schools in particular are struggling to cope with the rising numbers of pupils who self-harm.
The 7th edition of the Good Childhood Report, produced by UK charity The Children’s Society, says a ‘fifth of 14-year-old girls (actually 22%) in UK self-harm’ noting there has been a significant and growing difference between boys and girls in terms of happiness between 2009 and 2016. Girls’ happiness relating to their physical appearance and life as a whole has decreased over time.
Researchers suggested that social media and the internet are having more of a negative effect on girls than boys.
The report used the term ‘self-harming’ to describe a wide range of behaviours, including drug and alcohol abuse, as well as physical self-harming.
Can they stop?
It can be tough. The first step is to decide if they want to stop, then thinking about how. Keeping a list of reasons for and against might be helpful. Often people need a good support network before they can think about stopping. These days, young people in particular, are likely to seek out that support online. Advice on some websites is intended to be helpful:
Extract from a website (trigger alert)
It was the first time I cut in 6 months. I’ve been cutting for four years and this is my worst one.
‘I guess I just didn’t realize just how sharp this new knife was….I just did my usual routine of putting it up to my arm, taking a deep breath, holding it, and slicing. Only this time blood squirted everywhere…… I went into shock immediately, hyperventilating, dropping my blood pressure, and I got to the hospital in time. I did no major damage, but if I had just a little less fat on my arm, I probably would have bled to death or lost use of my right arm.
I am sending this message to cutters: Make sure you know what you’re doing if you can’t stop yourself.
But before you do something you will feel guilty about, force yourself to get out of your bedroom and talk to someone. Call someone, anyone, anytime, and even if you don’t get hold of anyone, you will have delayed your cutting for five seconds.
And that can be the difference between life and death. ‘
Extract from a website
As soon as you notice the urge to self harm, do something else until the wave of emotion subsides. Here are some suggestions:
- Pump up the volume of your favourite music and doodle on a piece of paper in time to it
- Spin yourself round on the spot until you get dizzy
- Buy a colouring book and do some mindful colouring
- Try writing poetry or a story or drawing or painting about how you feel
- Go for a walk and smile at everyone you see. If you are feeling braver, say hello to everyone too.
- Pop bubble wrap
- Plan your ideal holiday and then research it all online … destinations, prices, tickets, what there is to do when you get there… as much as you can find.
- Go through magazines and catalogues and cut out all the words and pictures that make you feel good
- Hug a soft toy
- Take your imagination on a journey to a favourite place
- Create a safe place for yourself … somewhere you can go when you are feeling bad
- Make a list of all the things that are good about yourself
- Buy yourself a cat, a hamster or even a plant and take extra special care of it
- Do something for someone else … go shopping for them, take their dog for a walk etc
- Phone a friend and have a chat
- Arrange to see or go out with a friend
- Go to a free online gaming site and try out all the games.
- When you’ve done them all go back to the first one and try and improve on the first attempt
Self harm as addiction
The Good Childhood Report did not differentiate between self-harm and other self harming behaviours such as drug and alcohol abuse. There is certainly a strong link when they are viewed as coping mechanisms, self medication or ways of self soothing.
The Diagnostic and Statistical Manual DSMV defines ‘Substance dependence’ as three or more of the following:
- using large amounts over a long period
- unsuccessful efforts to cut down
- time spent in obtaining the substance overrides social, occupational or recreational activities
- continued use despite adverse consequences
In this context the terms ‘addiction’ ‘dependence’ and ‘alcoholism’ are interchangeable and are characterized by impaired control; something that can certainly happen with self harm by cutting or other self injury.
For many, what starts out as a way of taking control of distressing thoughts, feelings or a distressing situation can soon get out of control itself. The individual can find they have developed an obsessive preoccupation with the substance or behaviour due to the neuro-chemical response of the brain and the dopamine rush of its reward centre.
Treatment with antidepressants or SSRIs should be done with caution. These medications can trigger suicidal thoughts, especially in the first 2 or 3 weeks of use and are not recommended for children and young people at all.
Effective talking therapies are generally considered the most helpful intervention in the short and long term as they address the underlying issues and help develop new skills for emotional regulation.
What schools can do
When it comes to schools, it helps for everyone to be on the same page.
Having a structure, protocol and referral procedure in place will ensure a consistent response. In their 2006 report on non-suicidal self-injury in Schools, the Cornell Research Program said ‘The advantage of having a written protocol is that staff know how to respond to self-injury systematically and strategically.’
Here are some suggestions:
- Designate individuals to serve as the go-to person or people at the school for managing self-injury
- Determine under what circumstances parents should be contacted
- Decide how to manage active student self-injury with self-injurious student, peers, parents, and external referrals
- Determine when and how to issue an outside referral
- Identify external referral sources and contact information
- Educate all staff and students about self-injury, what to do and how to help
- Be aware of the conditions under which self-injury requires immediate attention, such as severe wounds that need stitches or other medical care
- Ensure all staff are aware of the designated go-to person.
- staff should be trained to comfortably respond to students who disclose self-injury with ‘respectful curiosity’ using an ‘I statement, such as:
‘I’m concerned about you and want to be sure you have the support you need. I’ve seen these scars on yours arms and I think you might be hurting yourself.
If you are, I want you to know that you can talk to me about it. If you can’t talk to me about it, I hope you will find someone else you trust to talk to’
Offering immediate support
If a child or young person confides in you, whatever your role, this is what you can do:
- Support but don’t collude: Acknowledge their feelings and set aside your reactions or judgements so you can focus on what’s really going on for the child. Be honest and realistic about what you can and can’t do in your personal or professional role.
- Do not give ultimatums: It can often make the behaviour worse by driving it underground. Confiscating tools used for self harm can simply encourage the child to find different ways of harming themselves. The self harm is a coping mechanism. Removing it without replacing it with something else can be very dangerous.
- Acknowledge the pain of the child: Accepting and acknowledging that someone is in pain doesn’t make the pain go away, but it can make it more bearable. Be hopeful about the possibilities of learning other ways of coping. If they are willing, discuss possibilities for treatment with them but don’t push them into anything, they will decide when they feel the time is right.
- Be patient; These things take time to resolve. Stay positive and focused on a good outcome.
- Acknowledge your own feelings: Be honest with yourself about how this self harm makes you feel. It is ok for you to feel frightened, uncomfortable or provoked.
- Take care of you too: You are no good to the child if you are exhausted and emotionally drained. Make sure to ask for advice and support for yourself.
Useful additional questions might include:
- Do you need treatment for the wound?
- How do you feel right now?
- How were you feeling when you did this?
- What has brought you to this point?
- What purpose do you feel the self harm is serving?
- How is it helping?
- How do you feel after hurting yourself?
- Do you want to stop?
- What could you do instead?
- Can you avoid trigger situations or deal with things in another way in the future?
Get Connected is the national helpline for young people under 25 and has been providing free, confidential help for over 10 years. They are a signposting service, supporting young people’s emotional well-being and provide a free connection to thousands of services across the UK, ensuring they get the most appropriate help. Helpline: 080 8808 4994; Twitter: getconnecteduk; Facebook: www.facebook.com/getconnecteduk
Childline provides a free and confidential telephone service for children. Helpline: 0800 1111
The Samaritans provide a 24-hour service offering confidential emotional support to anyone who is in crisis. Helpline: 08457 909090 (UK), 1850 609090 (ROI)
National Self-Harm Network Charity supports families of and people who self-harm and has an online support forum.
YoungMinds provides information and advice on child mental health issues for parents and children. Parents’ Helpline: 0808 802 5544.
Mindfull is a service for 11-17 year olds, providing support, information and advice about mental health and emotional wellbeing.
Stopping self harm, suicide prevention, the Rewind Technique, raising self esteem, Mindfulness Based Mind Management (advanced MBSR), worrying well, solution focus, guided visualisation, resolving addiction, epigenetics, mapping the connectome, polyvagal theory, the reticular activating system (RAS), secondary gain, trauma resolution, coaching for kids, treating depression, worrying well, working SMART, therapeutic stories, insight, psycho education, positive mental rehearsal, reframes, fast track learning, perception shifting, self actualisation, positive psychology, rewiring your brain, the STOP System, the SAFE SPACE happiness recipe, holistic coaching and working on the continuum of wellbeing
Frances Masters MBACP accred GHGI
Managing Director Fusion Therapeutic Coaching Ltd
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Diploma dates: Thursday 1st – Monday 5th August
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The Diploma course fee is £1,395 after deduction of a £100 early booking discount. The Trainer programme is currently only £150 per day.
On completion of the Diploma, you will have:
A nationally recognised award which will also count as 80 hours’ continuing professional development (CPD)
Access to the unique Fusion® 5 session manual; a direct replication of Frances’s own working documents
Certificated permission for use of the professional designation FCTC (Fusion Certified Therapeutic Coach)
Fusion® Therapeutic Coaching professional logos and promotional material
Alumni listing on the Integrated Coaching Academy website with links to your website and contact information
If you also complete the Master Trainer programme, you will have free ongoing access to many Fusion® products, including:
The STOP(R)System – psycho educational workshop Power Point:
The Little Book of Mind Management Power Point;
plus an easy-to-read A5 booklet featuring ‘Little Bear’
The Big Book of Mind Management Power Point:
plus an A4 workbook for training delegates, including the A-Z of mind management
Breakthrough: 1 day can change your life Power Point
: a holistic life coaching 1 or 2 day interactive work shop with work book
Mindfulness Based Mind Management Power Point
: plus hand outs for the 8 week MBMM course
3 month’s free listing in the Life Coach Directory
Do you want to take your career to the next level?
Perhaps you’re a counsellor looking to add advanced coaching tools to your therapeutic toolbox.
Or you may be a coach, who wants to deepen and broaden your therapeutic skills.
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Fusion®: What makes it unique?
Fusion® is a helpful and hopeful lens through which to view mental health and resilience. It is a mindfulness-based system that promotes emotional intelligence and a toolbox of mind management skills which are both easy to learn and easy to teach.
For practitioners, it is a practical, holistic, solution-focused, working model which integrates core counselling skills and advanced coaching tools, with fast track training and a helpful session by session post completion manual.
Fusion®: The Model
As we learn and grow as children, we begin to develop beliefs about the world, based on our background, culture and life experiences.
From this, we construct our personal philosophy or ‘model of reality’. It becomes the belief system from which we draw up an ‘internal map’ we then use to navigate the world in which we find ourselves. It also becomes the lens through which we ‘see’ people and events.
To be helpful, our model of reality needs to be positive, empowering and hopeful.
The Fusion®Model is based on the idea that human beings have physical and emotional needs; that our emotions, instincts and behaviours have evolved to push us towards getting those needs met; and that with mindful awareness, we will make good choices, so that we can flourish and become our ‘best selves’.
Fusion®: The System
In addition to our personal model of reality, we develop systems.
They become the habits of behaviour we repeat every day which, once learned, become ‘automatic’. Things like brushing our teeth or driving to work. Once established, we do not think about them or challenge them and they become our habitual way of ‘being’.
But often these habitual patterns are not serving us well. They are negative or based on an outdated or unhelpful model of reality. It’s like we are running the wrong software and wondering why our lives are not working well.
The mindfulness-based STOP System®
helps us make good choices and helps us respond to life’s triggers with emotional intelligence rather than react mindlessly. In this way, we are more likely to get our needs met, experience greater wellbeing and live our best lives.
Fusion®: The Toolbox
Neuroscience is providing an ever-increasing understanding about our amazing human brain.
With that knowledge, comes practical skills and tools we can all use to help regulate our emotions; to better manage our minds, our lives and our relationships.
promotes the kind of self help, mind management tips, tools and techniques that anyone can learn.
For practitioners, it provides a range of innovative and effective coaching and psychotherapeutic interventions, to accelerate client progress and improve clinical outcomes.
Fusion®: The Manual
The 5 session practitioners’ manual, integrates key counselling skills with advanced coaching tools, based on the Fusion®
Model, the system and the toolbox.
The manual has been test-bedded for over 5 years with great success in the therapeutic coaching charity I founded with a GP colleague in 2009. It is made available to all who successfully complete the NCFE accredited Fusion® Therapeutic Coaching Diploma.
Making the model fit the client
Fusion® is all about making the work ‘bespoke’ for our clients. We need to make our model fit the client, not the client fit the model. The more tools we have as practitioners, the better the chance of offering something which is ‘a good fit’ for them wherever they are on ‘the continuum of wellbeing’.
The Fusion® Diploma 2019.
Please apply if you want:
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Find out more about the FusionTherapeutic Coaching Diploma or Distance Learning Skills Certificate
or the new Fusion Trainer Programme
The Fusion® Therapeutic Coaching Model evolved from 30,000 hours of integrated coach-counselling practice, has been in use since 2006 and used by mental health charities for over 8 years with excellent and consistently positive results.
Do you want to dramatically improve your knowledge skills and client outcomes?
Many counsellors are now integrating advanced coaching and psychotherapeutic interventions into their therapeutic tool box. Counselling is changing; adapting to the modern environment and our better understanding of the human mind.
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What will you learn on the course?
- How to dramatically improve client outcomes with accelerated rapport and clinical measures
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- Advanced and essential counselling and coaching skills
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- How to format the important first session
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- Using guided imagery effectively
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- How to treat panic and anxiety attacks
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- How to deal with anger
- Utilisation of brain filters to focus attention
- A unique formula for shifting perception
- The continuum of wellbeing
- The STOP® System, a mindfulness based intervention for emotional intelligence
A full 60,000 word training manual is also provided to accompany the course and underpin theoretical knowledge.
The NCFE accredited Therapeutic Coaching Distance Learning Skills Certificate
Integrating for the first time, advanced counselling, cognitive behavioural and human givens skills in a solution focused coaching model.
At a cost of £425, this is the only distance learning integration of therapeutic coaching course in the UK. Integration of coaching and counselling is a fresh new paradigm that will change the face of mental health and mental health training.
Fusion® is at the leading edge with a fully integrated model which has been successfully used over several years and with positive outcomes for thousands of clients.