1
|
Howe E. Psychotherapeutic approaches: hopefully, globally effective. Front Psychiatry 2024; 15:1322184. [PMID: 38606404 PMCID: PMC11007125 DOI: 10.3389/fpsyt.2024.1322184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 01/23/2024] [Indexed: 04/13/2024] Open
Abstract
Many patients have lasting disorders due, for example, to excessive and chronic childhood stress. For these patients, certain psychotherapeutic approaches may be maximally effective, and this may be universally the case. This piece is intended to give providers optimal tools for reaching and helping these patients who, otherwise, may remain among those worst off. These interventions should enhance patients' trust, the quintessential precondition for enabling these patients to change. Specific interventions discussed include anticipating ambiguity and clarifying this before ambiguity occurs, therapists indicating that they will support patients' and families' wants over their own views, feeling and disclosing their emotions, validating patients' anger, laughing, going beyond usual limits, explaining why, asking before doing, discussing religion and ethics, and informing whenever this could be beneficial.
Collapse
Affiliation(s)
- Edmund Howe
- Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
| |
Collapse
|
2
|
Meheli S, Lewis SP. Support Seeking in the Context of Self-Injury Recovery: Perspectives From Individuals With Lived Experience. J Nerv Ment Dis 2022; 210:547-556. [PMID: 35044359 DOI: 10.1097/nmd.0000000000001481] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT A sample of 229 university students responded to open-ended questions for the present study, which aimed to gain a deeper understanding of lived experiences of support seeking in the context of self-injury recovery. Inductive thematic analysis of the responses indicated themes from two domains: the benefits of support seeking and the barriers to support seeking. The first domain highlighted benefits from both professional sources (such as receiving diagnosis and referrals to therapy, learning emotion regulation strategies, and developing an improved understanding of self) and informal sources (such as receiving tangible aid, having a support system, and having a compassionate space). The second domain indicated that barriers could be both intrapersonal (such as desire to continue nonsuicidal self-injury, embarrassment and shame, establishing agency without others' support, and minimizing self-injury) and interpersonal (such as fear of being stigmatized, concern for others, and unhelpful prior experiences) in nature. Implications for future research, outreach efforts, and clinical practice are discussed.
Collapse
Affiliation(s)
- Saha Meheli
- Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences (NIMHANS Hospital), Bengaluru, Karnataka, India
| | - Stephen P Lewis
- Department of Psychology, University of Guelph, Guelph, Ontario, Canada
| |
Collapse
|
3
|
Norman H, Marzano L, Oskis A, Coulson M. " My Heart and My Brain Is What's Bleeding, These Are Just Cuts." An Interpretative Phenomenological Analysis of Young Women's Experiences of Self-Harm. Front Psychiatry 2022; 13:914109. [PMID: 35911219 PMCID: PMC9330153 DOI: 10.3389/fpsyt.2022.914109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 06/23/2022] [Indexed: 11/13/2022] Open
Abstract
Engagement in self-harm, defined as intentional self-poisoning or self-injury irrespective of the apparent purpose of the act, is increasing, particularly among girls and young women. Understanding the behavior from the perspective of those who self-harm is, therefore, vital in designing effective interventions and treatments. The current brief research report presents a key theme from an Interpretative Phenomenological Analysis of the experience of self-harm among eight young women, aged between 18 and 29. The theme Is Self-Harm Bad? concerns the way in which participants both acknowledged and resisted a negative conception of self-harm that was often constructed from other people's attitudes. Three subthemes explore the reasons why participants were reluctant to endorse self-harm as bad: Self-Harm is the Symptom, Self-Harm Works (Until it Doesn't) and Self-Harm is Part of Me. The findings highlight the disparity between the characterization of self-harm as a highly risky behavior and the lived experience of self-harm as a functional means of emotion regulation. From a clinical perspective, the findings explored in this brief report suggest that highlighting the risks of self-harm may not be a sufficient deterrent. The recently revised draft National Institute for Health and Care Excellence (NICE) guidance recommends that everyone presenting to hospital following self-harm should be given a comprehensive psychosocial assessment, of which the function is, in part, to understand why the person has self-harmed. The current study underlines the importance of seeing past the behavior to the underlying causes and exploring the meaning of self-harm to the individual in order to implement effective preventative interventions.
Collapse
Affiliation(s)
- Hilary Norman
- Faculty of Science and Technology, Middlesex University, London, United Kingdom
| | - Lisa Marzano
- Faculty of Science and Technology, Middlesex University, London, United Kingdom
| | - Andrea Oskis
- Faculty of Science and Technology, Middlesex University, London, United Kingdom
| | - Mark Coulson
- School of Psychology, Faculty of Social Sciences, University of East Anglia, Norwich, United Kingdom
| |
Collapse
|
4
|
Simone AC, Hamza CA. A longitudinal examination of predictors of nonsuicidal self-injury disclosures among university students. J Clin Psychol 2021; 77:2860-2877. [PMID: 34773410 DOI: 10.1002/jclp.23277] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 09/08/2021] [Accepted: 10/27/2021] [Indexed: 11/09/2022]
Abstract
OBJECTIVE There is a paucity of longitudinal research on predictors of disclosures of nonsuicidal self-injury (NSSI) among emerging adults. However, understanding the factors that facilitate disclosure is critical, as disclosure may serve as a first step in accessing care. To address this gap, the present study examined predictors of prospective NSSI disclosures in a postsecondary student sample. METHODS A total of 475 university students with a history of NSSI (Mage = 17.96; 74.9% women) reported on several potential predictors of NSSI disclosure, and their disclosure history at baseline and 4- and 8-month follow-ups. RESULTS It was found that 22% of students reported disclosing NSSI during the first year of university; students who had previously disclosed, and who reported greater NSSI severity, were more likely to disclose over time. CONCLUSION Results of the present study suggest that disclosures often occur in the postsecondary context, and students who disclose NSSI may engage in more severe NSSI behaviours.
Collapse
Affiliation(s)
- Ariana C Simone
- Department of Applied Psychology and Human Development, Ontario Institute for Studies in Education, University of Toronto, Toronto, Ontario, Canada
| | - Chloe A Hamza
- Department of Applied Psychology and Human Development, Ontario Institute for Studies in Education, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
5
|
Lewis SP, Hasking PA. Self‐injury recovery: A person‐centered framework. J Clin Psychol 2020; 77:884-895. [DOI: 10.1002/jclp.23094] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 10/20/2020] [Accepted: 11/09/2020] [Indexed: 01/02/2023]
Affiliation(s)
- Stephen P. Lewis
- Department of Psychology University of Guelph Guelph Ontario Canada
| | | |
Collapse
|
6
|
Simone AC, Hamza CA. Examining the disclosure of nonsuicidal self-injury to informal and formal sources: A review of the literature. Clin Psychol Rev 2020; 82:101907. [DOI: 10.1016/j.cpr.2020.101907] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 08/07/2020] [Accepted: 08/21/2020] [Indexed: 11/27/2022]
|
7
|
Moseley RL, Druce T, Turner-Cobb JM. Autism research is 'all about the blokes and the kids': Autistic women breaking the silence on menopause. Br J Health Psychol 2020; 26:709-726. [PMID: 32996665 DOI: 10.1111/bjhp.12477] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 07/19/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The menopause is a major transition marked by considerable challenges to health and well-being. Its impact on autistic women has been almost largely ignored but is of significant concern, given the poorer physical and mental health, emotion regulation and coping skills, and the common social isolation of this group. We aimed to explore awareness and perception of the menopause; menopausal experiences and their impact across each individual's life; ways that menopause with autism might differ from a non-autistic menopause; and what optimal support might look like. DESIGN A qualitative interview study. METHODS Comprehensive interviews were conducted with 17 autistic participants (16 of whom identified as cisgender women). Inductive thematic analysis was used, guided by IPA principles and literature. RESULTS Four major themes were identified: (1) covering the long journey of our participants to recognizing autism in adulthood; (2) menopausal awareness and perceptions; (3) symptoms and their impact; and (4) ways that a neurodiverse menopause might differ from the norm. Menopausal experiences varied greatly and some participants experienced marked deterioration in daily function and coping skills, mental health, and social engagement. Menopausal awareness was often low, so too was confidence in help from health care professionals. CONCLUSIONS These findings implicate the potential for menopause to severely compromise health and well-being of autistic people and indicate an area of underserved support needs.
Collapse
Affiliation(s)
| | - Tanya Druce
- Department of Psychology, Bournemouth University, Poole, UK
| | | |
Collapse
|
8
|
Abstract
A growing body of research has focused on understanding what may contribute to cessation of self-injury. Although these efforts are of value, cessation represents just one component of self-injury recovery. Exclusive or primary focus on cessation may foster unrealistic expectations for those with lived experience of non-suicidal self-injury (NSSI). Accordingly, this commentary discusses the importance of expanding the concept of NSSI recovery beyond cessation in both research and clinical domains. We conclude by presenting a person-centred and non-stigmatising conceptual reframing of recovery.
Collapse
|
9
|
Hambleton AL, Hanstock TL, Halpin S, Dempsey C. Initiation, meaning and cessation of self-harm: Australian adults’ retrospective reflections and advice to adolescents who currently self-harm. COUNSELLING PSYCHOLOGY QUARTERLY 2020. [DOI: 10.1080/09515070.2020.1737509] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Ashlea L. Hambleton
- School of Psychology, The University of Newcastle, Callaghan, NSW, Australia
| | - Tanya L. Hanstock
- School of Psychology, The University of Newcastle, Callaghan, NSW, Australia
| | - Sean Halpin
- School of Psychology, The University of Newcastle, Callaghan, NSW, Australia
| | - Caitlin Dempsey
- School of Psychology, The University of Newcastle, Callaghan, NSW, Australia
| |
Collapse
|
10
|
Pain perception, distress tolerance and self-compassion in Turkish young adults with and without a history of non-suicidal self-injury. CURRENT PSYCHOLOGY 2020. [DOI: 10.1007/s12144-020-00634-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
|
11
|
Lewis SP, Kenny TE, Whitfield K, Gomez J. Understanding self‐injury recovery: Views from individuals with lived experience. J Clin Psychol 2019; 75:2119-2139. [DOI: 10.1002/jclp.22834] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Stephen P. Lewis
- Department of PsychologyUniversity of GuelphGuelph Ontario Canada
| | - Therese E. Kenny
- Department of PsychologyUniversity of GuelphGuelph Ontario Canada
| | | | - Jennifer Gomez
- Department of PsychologyUniversity of GuelphGuelph Ontario Canada
| |
Collapse
|
12
|
Cleare S, Gumley A, O'Connor RC. Self-compassion, self-forgiveness, suicidal ideation, and self-harm: A systematic review. Clin Psychol Psychother 2019; 26:511-530. [PMID: 31046164 DOI: 10.1002/cpp.2372] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 04/18/2019] [Accepted: 04/25/2019] [Indexed: 12/18/2022]
Abstract
Self-compassion has been implicated in the aetiology and course of mental health with evidence suggesting an association between greater self-compassion and lower emotional distress. However, our understanding of the nature and extent of the relationship between self-compassion and self-harm (self-injury regardless of suicidal intent) or suicidal ideation remains unclear. This review, therefore, aimed to critically evaluate the extant literature investigating this relationship. To do so, a systematic search, including terms synonymous with self-compassion, was conducted on three main psychological and medical databases (Web of Science, PsycINFO, and Medline). Only studies investigating self-compassion or self-forgiveness and self-harm or suicidal ideation were found to be relevant to the review. Eighteen studies were included in the final narrative synthesis. Heterogeneity of studies was high, and the majority of studies were quantitative and cross-sectional (n = 16) in design. All studies reported significant associations between higher levels of self-forgiveness or self-compassion and lower levels of self-harm or suicidal ideation. Several studies suggested that self-compassion or self-forgiveness may weaken the relationship between negative life events and self-harm. In conclusion, this review highlights the potential importance of self-compassion in the aetiology of suicidal thoughts and self-harm. We discuss the clinical and research implications.
Collapse
Affiliation(s)
- Seonaid Cleare
- Suicidal Behaviour Research Laboratory, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Andrew Gumley
- Suicidal Behaviour Research Laboratory, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Rory C O'Connor
- Suicidal Behaviour Research Laboratory, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| |
Collapse
|
13
|
Gregory WE, Glazer JV, Berenson KR. Self-Compassion, Self-Injury, and Pain. COGNITIVE THERAPY AND RESEARCH 2017. [DOI: 10.1007/s10608-017-9846-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
14
|
Buffering the effects of peer victimization on adolescent non-suicidal self-injury: The role of self-compassion and family cohesion. J Adolesc 2016; 53:107-115. [PMID: 27710776 DOI: 10.1016/j.adolescence.2016.09.005] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Revised: 08/22/2016] [Accepted: 09/16/2016] [Indexed: 11/22/2022]
Abstract
Non-suicidal self-injury (NSSI) is a significant behavioral problem among adolescents all over the world. This study examined the longitudinal relationship between peer victimization and NSSI, as well as the buffering effects of self-compassion and family cohesion on this relationship. Data were collected at two time points from 525 secondary school students (226 girls; Mage = 12.97, SD = 1.02) in China. Results showed that peer victimization (marginally) significantly predicted NSSI over time even after controlling for Wave 1 NSSI. This association was weakened under the condition of high levels of self-compassion. Findings of this study emphasize the buffering effect of self-compassion in the relationship between peer victimization and NSSI, and are informative for prevention and intervention of this behavioral problem.
Collapse
|
15
|
Rayner G, Warne T. Interpersonal processes and self-injury: a qualitative study using Bricolage. J Psychiatr Ment Health Nurs 2016; 23:54-65. [PMID: 26686549 DOI: 10.1111/jpm.12277] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/14/2015] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Literature on self-injury has recognized the impact on the relationship between clients and staff. RATIONALE There is an absence of a detailed account of interpersonal processes surrounding self-injury. AIM A Bricolage qualitative research approach was carried out in the United Kingdom that explored the interpersonal processes surrounding self-injury. METHOD Three pairs of clients and staff were interviewed about an incident of self-injury. The interviews were thematically analysed and then synthesized producing a deeper exploration of the relationship between the client and staff. FINDINGS An interpersonal trigger followed by anger and shame, resulted in self-injury to 'numb' these experiences. DISCUSSION Self-injury is conceptualized as a safety behaviour to avoid shame and anger and then as a maintenance cycle that traps the client in a reinforcing and rejecting relationship. Staff interviewed were able to reflect with the clients and help them reframe these experiences. IMPLICATIONS FOR PRACTICE Mental Health Nurses can work with clients to understand their own interpersonal cycles of self-injury. They can then reflect on their own roles in this process and avoid reinforcing the clients' negative beliefs. WHAT THE STUDY ADDS TO INTERNATIONAL EVIDENCE: This is the first international paper to explore the interconnection between the client and a professional helper in their lived experiences of self-injury.
Collapse
Affiliation(s)
- G Rayner
- Nursing, Midwifery, Social Work & Social Care, University of Salford, Salford, UK
| | - T Warne
- Nursing, Midwifery, Social Work & Social Care, University of Salford, Salford, UK
| |
Collapse
|
16
|
Lewis SP, Mehrabkhani S. Every scar tells a story: Insight into people’s self-injury scar experiences. COUNSELLING PSYCHOLOGY QUARTERLY 2015. [DOI: 10.1080/09515070.2015.1088431] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|