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Assess & respond to individuals at risk of self harm or suicide

Understanding self harm / injury

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Self injury vs Suicide

Handout : Differentiating Suicide attempts from Self injurious behaviour

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Self injury: A definition

A pervasive pattern of deliberate mutilation of one`s own body with the intent to cause injury or damage, but without suicidal intent, in order to provide relief from an intolerable emotional state, usually beginning in adolescence, and marked by the following:

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How do you handle your emotions ? Group Activity E.g When you are angry with someone do you

tell him/her ? Or do you keep your feelings to yourself ? Or do you snap or lash out at others ?

Intense emotions: Do you prefer to be alone or with others ?

Do you try to find ways to escape rather than deal with feelings or problems directly ?

How do you communicate your feelings to others ?

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Defining Self injury Recurrent impulses to physically harm

oneself Intrusive, obsessional thoughts about

self injuring. Intolerable emotional states of emotional

numbing & dissociation Feeling of both physical & psychological

relief after the act of S.I. Multiple episodes of S.I.

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Defining Self injury continued Low lethality Impulsivity in other areas that are

potentially self destructive (e.g. AOD, eating disorders, high risk or dangerous behaviours such as: reckless driving or becoming involved in abusive interpersonal relationships.

A general pervasive mood of depression or anxiety

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Statistics of Self injury

Underreported Secretive behaviour Prevalence rate of 1000 / 100,000

(1%) Other sources: 1400 / 100,000 Violent & anti-social youth- 40%

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Characteristics of Self injury Done to oneself Performed by oneself Physically violent: hitting, cutting or

burning Not suicidal Intentional, purposeful not accidental Typically, first appears during

adolescence Tends to peak in early to mid twenties

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Characteristics of S.I. cont`d

Often begins to decline in 30`s Repetitive episodes with patterns

of increasing frequency & severity as time goes on

Loses its effectiveness over time: occurrence decreases with age; regardless of any intervention

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Characteristics of Self injurers: Poor impulse control History of childhood illness or severe

illness or disability in family member Difficulty in forming stable relationships

– leading to “social exclusion” Fear of change Poor self care Low self worth

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Characteristics of self injurers cont`d Childhood history of trauma Rigid all or nothing thinking (catastrophic

thinking) Perfectionism & workoholism Constant fear, anxiety or heightened

alertness S.I. creates experience of pain &

increased tension / arousal When S.I. stops : emptiness, dullness etc

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Hidden Scars, Silent Wounds

Show video & handout question sheet

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Self injury & mixed messages

Self destruction vs Survival

Group Activity : T- shirt Front “ What I am really feeling “ Back “ What others see “

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Helping someone who self injures Recognising the symptoms & Assess

the risk of self harm or suicide Listening non-judgementally Provide support & information Encouraging the person to seek

professional help Encourage the person to use self

help strategies