Self harm

So, this is a very delicate symptom that needs to be handled with care, affection, and non judgmental way. When i see this in the referral, I make sure to have low concerning voice, eye contact that shows kindness and my body language to show the energy that I care. Usually if i go with the intent that I care, most of the patients open up about their self harming behaviors.

Assessment of self harm

The first thing I ask them is if they are aware of the difference between self harm and suicidal ideation. I like to get history of when they start having those thoughts, when they started actually self harming themselves, how severe was it, how frequent was it, were others aware of it, how self hurt help them during those situations, what stressful even were happening at that time?

Reasons for self harm

When you start asking how did self hurt help them during those difficult situations rather than the reason behind it, they are more likely to be open about the reason. Some of the reasons I have heard from the patients I have worked with are – self punishment, feel alive and visible to others (not getting attention but get rid of feeling of being invisible), avoidance, and get rid of the emotional pain.

Self love plan

I usually like to ask them to give me a list of people who care about them. Some patients might say friends and family, others might say no body. Then I try to tease them that they are forgetting two people who is also in the room. I tell them I care because I chose to come to work because I want to show that I care to people who come in my office for help. Then I also tell them that the other person is themselves and discuss about how society, culture, family does not teach us to love ourself. And how we end up relying on self harm when we are stressed out rather that self love. And if they are willing to be open to learn new tools to replace self harm behavior, I have them come up with different ways to do things when they have those urge to self harm.

Self loving behaviors to replace self harm

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Involvement of loved ones

Since I work with children and families, I try to get families involved as much as possible, if the client is willing. I try to validate the parent’s fear, guilt and worries and give them the list below of ways that they can change their communication to help their child. I also ask the patient to come up with a list of things that they want their parents to do.

How to communicate and validate child’s emotion

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