Mental Health Connect

Nick Allen talked about clinical experience and psychological research which suggests that self-injury is often about managing emotions, either to reduce or elicit emotions. Self-harm and the use of pain may be more normal or normative that we are prepared to admit and we need to stop labelling self-injury as “attention-seeking” behaviour. For example, experiments have shown that imagining self harm can help calm strong emotions, or feel less angry. Another experiment found that pain induced by holding one’s arm in iced water helped people feel less guilty about unethical behaviour.

So self-injury appears to be about coping with overwhelming emotional arousal: deliberate self-harm may help people reduce their level of emotional arousal and thereby learn that self-harm can be a solution to emotional problems. Nick suggests that there are different groups among people who self-injure, and that people may have different reasons for using self injury. In addition, self-injury is most common during adolescence, along with many other dangerous behaviours.

Young people take risks and make changes in their lives during adolescence which are important developmentally, yet these same behaviours and changes put them at risk for mental health problems and other health problems. Adolescents are facing increasingly difficult decisions and challenges to self-control, including the way they are targeted as consumers. There have also been historical shifts to parenting practices which promote autonomy and involve less parental control. Adolescence is a time of rapid change and extremes in emotions, and although non-suicidal self injury is common, it is important to remember that most adolescents don’t intentionally injure themselves. Some risk factors have been identified in previous research. First, an invalidating family environment involving emotional neglect and emotional abuse increases the risk of self-injury. Difficulties with managing or regulating emotions also increase the risk of self-harm. Another problem associated with self harm is lack of sleep – and sleep improvement programs can be used in both clinical and public health settings. Finally, girls going through puberty earlier than their peers are more likely to self-harm, so appropriate and sensitive intervention may help girls adjust better to puberty.

Nick suggests that acceptance and commitment-based therapies are especially useful in helping people deal with overwhelming emotions. Instead of “trying” to change, positive change is promoted by acceptance. Accepting where you are now allows you to change, even when where you are now seems intolerable.

During the question and answer session there was further discussion about how to better prepare young people, especially girls, for the changes that occur during puberty. Although the education system is preparing children well for understanding the physical changes involved in puberty, we may not be doing as well at preparing them for emotional and social changes. It was suggested that school-based education programs could involve more education about things like getting unwanted sexual attention and the development of more intense emotional experiences.

You can learn more about Nick’s work and the Orygen Youth Health centre here:

http://oyh.org.au/