Self Harm Among Teens and Young Adults

Understanding Self-harm | Therapy in Fort Worth, TX

Non-suicidal self-injury or self-harm has been around for a long time. “Cutting” was a term commonly used before. This term is no longer used as self-harm and is not just about cutting yourself. The topic is incorporated into books, tv shows, movies and songs (I’m sure). A search on Google or social media can bring up a variety of information on this topic. There is information out there on how to engage in a variety of methods, support for individuals and families, dangers of the behavior and treatment options. This post is going to define non-suicidal self-injury, common misconceptions, and treatment options.

According to the International Society for the Study of Self Injury (ISSS), non-suicidal self-injury (aka self-injury) is the “deliberate destruction of body tissue without suicidal intent and for purposes not socially sanctioned.”  Socially sanctioned refers to piercing or tattoos.

Examples of self- harm include:  intentional carving of words or symbols, cutting the skin, burning, friction burning, hitting or biting self, pulling out hair, headbanging, multiple tattoos or piercings, embedding objects into the skin, or breaking bones.

Working with individuals who engage in self-harm and having to inform parents or caregivers about self-harm has confirmed some common misconceptions about self-harm. From my own practice and research, here are some of the most common misconceptions:

• Only adolescent females engage in NSSI. FALSE: Females and males engage in self-harm. Methods may vary. While it is often considered an “adolescent issue,” it can start in childhood or adulthood. While it may start in adolescence, it does continue into adulthood.

• Only people diagnosed with Borderline Personality Disorder engage in self-harm. FALSE: People who have a diagnosis of Borderline Personality Disorder may self-harm. Many individuals who do not meet criteria for this diagnosis also engage in self-harm.

• A person has been abused. FALSE: Just like the personality disorder myth, individuals who self-harm may or may not have been abused.

• There’s no help available. FALSE: There is help available. Books, trainings, support groups for individuals and caregivers and individual therapy. There are trainings for individuals, families and professionals.

• It is a failed suicide attempt. FALSE: This is a common misconception. Many of the clients I have worked with have no intention to commit suicide. Medical attention may be needed if in cases of NSSI. 

• A person is seeking attention. FALSE: I have heard this from caregivers/parents when they learn their adolescent is engaging in self harm behaviors. The way I talk to parents about it is the adolescent is crying out for help. Treatment is about replacing this unhealthy coping skill with a healthy coping skill.

• A person could stop if they wanted to. FALSE: As with any behavior associated with mental health, treatment is recommended for many individuals who self-harm.

Help is available. Individual or group therapy is recommended. Family therapy is also recommended. Involving parents or caregivers in treatment is recommended.

Involving caregivers in treatment is key. Parents may feel shocked, confused, sad, isolated or guilty. Parents may experience secondary stress as NSSI is often not visible, can be chronic and, as mentioned above, parents may feel isolated as they fear how others will react. Just like with any mental health issue, educating parents and families about NSSI is key. Having parents involved in treatment is important too especially around communication. Finding support for parents helps too.

Here are some resources:

• Healing Self- Injury – J. Whitlock, Ph.D. & Elizabeth Lloyd-Richardson, Ph.D.

• Self-Injury Recovery & Resources: Great resources for individuals, caregivers, and therapist

  Melissa K. Zawisza, LCSW-S owns Reilly Counseling PLLC. She opened her practice in August 2020 and serves teens and adults. Her specialty areas include anxiety, self-harm, grief, and trauma. At this time, all services are conducted online. Prior to private practice, Melissa worked in a variety of settings including schools, and agencies and spent thirteen years at a hospital-based clinic. Melissa is also a board-approved supervisor.

Give Life Meaning

We’re heading into the last few months of 2020 and this year feels a whole lot different! For many years we may have relied on the upcoming months to be the season of joy and full of festivities around the holidays. Instead as this holiday season approaches, I have felt the heaviness, difficulty, and uncertainty of how the next few months will unfold. I for one can say that this is completely understandable! After all we have had to experience the many changes and stress influenced by the COVID-19 pandemic. In addition, the news constantly reminds us of the additional challenges that are taking place socially, politically, and economically.

If you are struggling to stay hopeful and positive right now, then this article is dedicated to you. I’m also struggling to stay hopeful and positive right now. It’s discouraging and frustrating to dig deep to find positivity when the next challenge or problem seems to be right around the corner. Recently, I walked into my office feeling a lack of confidence and worry on how I would share hope and positivity with my clients when everything outside of my office seemed so negative. Additionally, to be more vulnerable with you guys, that moment terrified me! For the last 5 years, Reconnecting Relationships Therapy has been my home away from home. It has been an honor to serve the Dallas Fort Worth area by working with my clients. All these years my heart has been filled with gratitude and excitement as clients have shared their stories and invited me to help them create positive changes. Although most stories that are shared with me in therapy are filled with suffering and conflict, I’ve known what my purpose has been all these years. Feeling those negative emotions as I walked into my office, forced me to pause and acknowledge my current predicament.  I’m struggling with sadness, fear, frustration, and hopelessness. Since I hadn’t been diligent in processing these negative emotions outside of work, they were now making me question my purpose.

According to the CDC, about 41% of the U.S. population reported experienced mental health issues as a result of the pandemic. Common mental health issues reported included anxiety, depression, trauma-related symptoms, and substance use disorders. If you are not experiencing one of these mental health issues, perhaps you have noticed other symptoms associated with the increase of stress and anxiety.

 So, what can we do? We may not be able to control many things about a pandemic. We definitely can’t bury our heads in the sand and pretend that life is not filled with various challenges right now. What we can do to gain some stability, is to find what is in our control. We can control how we use our time sheltering at home. We can control what decisions we make that care for our physical and mental health. We can decide to have a mindset and practice actions that remind us that our life still has meaning. We can choose to live a life that is meaningful and has purpose. The most valuable support we can have at this time is finding that our life still has meaning when we are attempting to cope, survive, and restructure during difficult times.

One of my favorite books is by Viktor Frankl, which I find always reminds me of man’s strength and resilience in the worst situations. In his book, Man’s Search for Meaning, he describes his experience while being held at a concentration camp during World War II. He reminds us of what helps people survive desperate circumstances, “The meaning of life is to give life meaning.” In times of uncertainty, crisis, or change we have the power to choose what will give us meaning or purpose. I may not like the changes and negative emotions that the pandemic has brought but I can choose to focus on what gives my life meaning. I’m committed to continue helping couples reduce conflict and to help my clients experience joy in their relationships! 

When Your Partner Is Going Through Anxiety

Anxiety Therapy in Fort Worth, Texas

Helping loved ones coping with anxiety

Our world is dealing with a lot of uncertainty and change right now due to COVID-19. Along with this pandemic comes so much fear, panic, anxiety, sadness, and anger. For many of us in the DFW area, we have had to face the adjustment from a fast-paced life to an “in shelter” lifestyle with all sorts of emotions, thoughts, reactions, and new realities.

For those who have coped by staying productive and are caring for your physical and emotional health, congrats! The other reality is that many people may not be ready to “sit with their feelings” or feel comfortable expressing their feelings. Some don’t even know what it is they are feeling. For a person with an anxiety disorder, the anxiety may have become worse by all the environmental changes we are currently facing.

We all experience and express our emotions differently. I want to remind you that that’s ok, we are all different and deserve to be respected and supported as we navigate and adjust to change.

The idea that we all react differently to change and how we all thrive when we receive emotional support, led me to write this article. There are many people right now struggling with anxiety, and on the other side of that many partners finding it challenging to provide emotional support during a stressful time. Here are a few tips on how to provide effective support when your partner is experiencing anxiety.

1.     Don’t Try to Fix Them

It may be your first reaction, as you’re seeing your partner get lost in their thoughts, beginning to isolate, or is displaying those symptoms you’ve seen before where you think “oh no, the anxiety is back.” Unfortunately, jumping in to solve the problem can be seen as dismissive or critical without truly listening to your partner.

When your partner is struggling with anxiety, they cannot be well for you. Anxiety can be debilitating and the last thing someone who is experiencing this disorder needs, is the feeling that they have failed you or that your love will be conditional based on their symptoms.

Instead, remind them that you want them to feel better soon because you love them and see how difficult it is for them to be experiencing anxiety.

2.     Avoid Proving to Them Why They Shouldn’t Be Afraid

Sure, anxiety is a normal body’s response to threatening situations some of which may be irrational or may not occur. For individuals struggling with anxiety, it is no longer about being afraid of something specific and weighing out the facts. Their anxiety has become too high and they are experiencing unpleasant physical, emotional, and cognitive symptoms.

Instead of challenging their fears, ask them specifics of what is upsetting to them. Allowing your partner to talk about their deep fear openly can often neutralize it, making it less threatening.

3.     Help Calm Them Down

As often as you are able to, remind your partner that they are lovable and that their anxiety will not change that. Let them know, “you’re not alone, we’re in this together.” If your partner is experiencing a panic attack, help them interrupt the attack by offering a distraction.

Helpful distractions can be as simple as breathing some fresh air outside or going for a walk. Learn more about breathing techniques specifically for anxiety, where you can practice them alongside with your partner. This will not only help alleviate your partner’s anxiety but will demonstrate your active support for your partner and your commitment to turn towards each other during difficult moments.

4.     Set Realistic Expectations

During times when your partner is struggling with their anxiety, they will not be themselves. Their energy, mood, demeanor will be different. You may be longing to share happy moments instead of evening talks about anxiety. Although it can be difficult to remain patient with your partner, remember to set realistic expectations of what your dynamic will be like during this time.

It’s ok to not be experiencing relational bliss in this moment. Consider setting the expectations that you both will practice behaviors that will provide you with rest, self-care, or professional support.

5.     Prioritize Self-care

Seeing your partner experience such dark moments can shift all the focus on their wellbeing. You may be tempted to refrain from sharing your personal stress from your partner in an attempt to not worry them further. Unfortunately, this creates a conflicting dynamic in the relationship. They may end up feeling like a fragile child, and you may end up feeling alone.

Remember the idea is to turn towards one another despite the challenges you are both facing. If your partner is unable to do this because her anxiety is interfering, practice other strategies that help you cope with your individual experience.

Practice journaling or talking to someone you trust. Allow yourself to do things that you enjoy that don’t stress you out. Dedicating time to yourself will help you cope with your individual stress as well as re-energize you for those times when your partner needs support.

It’s hard work to turn towards each other during difficult moments. My hope is that these tips will be helpful in providing you with new strategies to help someone you love and help you feel supported too!

One of my favorite quotes is by Dr. John Gottman, which I use in my work with couples. I especially believe it’s perfect for those of us wanting to be helpful to someone experiencing anxiety. Dr. Gottman says, “When you’re hurting, the world stops, and I listen.”