Philip Bird Westcast 2012 February 23, 2012

The New Teacher and Youth Self-Harm; Exploring Youth Anxiety Disorders and Self-Harm in Junior and Senior High School Settings.

1. Intro Begin with Linkin Parks Bleed it Out (about 1:54min) Can you hear the raw pain in that song? One of the reasons I think that lInkin park is so popular and so easily identifiable with youth is that they face and sing about this kind of thing in their music - Another example is Princess Diana in the last years of her marriage to Prince Charles, she cut, engaged in an eating disorder and once threw herself down the stairs. 2. First A Warning: a. This presentation discusses self-harm, self-injury and anxiety disorders. What follows may be trigger causing. 3. My Background: a. Youth Worker, Aspen Family and Community Services b. Youth Leader, Camp Chestermere c. ASIST Certified Applied Suicide Intervention Skills Training d. NVCI Certified Non-Violent Crisis Intervention 4. Why This Topic? a. Silent Epidemic this is group of symptoms and behaviors not included in the DSM IV, this is something that is new, and it is growing. b. Personal Experience (Camp and Grouphome) talk about the informal, camp stats, the 5 of 50 that speak up, and silent remainder. c. We as Teachers. Are in a unique position we may have more face time with many of these students than their parents we have the power to validate who they are as human beings, or reinforce current ongoing crises. 5. What it is : a. Nonsuicidal self-injury (NSSI) refers to the deliberate destruction of ones body tissue in the absence of conscious suicidal intent (Lewis et. al., 2011)

b. Self-injury consists of self-inflicted deliberately destructive acts resulting in tissue damage that are not intended as an act of suicide, are not widely socially acceptable, and are not due to mental retardation, autism, or other developmental disorders (Educators and Self Injury.com, 2009) 6. Statistics: a. 15% - Educators and Self Injury.com, 2009 b. 14-21% - Lewis, et. al, 2011 c. 1 in 6 (17%) Globe and Mail, 2008 d. 1 in 12 (8%) Reuters, 2011 7. Statistics 2: a. Median onset age is 15.2 years (Nixon, et.al, 2008) b. Onset between 14 and 24 years c. 56% seek help d. 77% are female 8. What it looks like a. Cutting, Burns including eraser burns, excessive hair-pulling, hitting oneself, scratching, picking excessively at scabs, head-banging (not the metal kind), punching at hard surfaces 9. Recognizing It: a. Unseasonal clothing, usually long-sleeved b. Bandages, c. Arm warmers, tights d. Change in mood or behavior usually internalization, withdrawing 10. Comorbidity: a. Links with: Eating Disorders, b. Drug and Alcohol Abuse, c. Depression or other personality disorders

d. It can become compulsive, addictive e. Suicidal Ideation 11. Causes: - please note that this is a complex issue and there are many different reasons about this set of behaviors. This is a maladaptive behavior seeking to express a great internal pain. a. Its not about suicide. And its often not considered self-mutilation. It often begins on an impulse, sometimes grounded in rejection or helplessness, loss or trauma. It is a way for self-injurers to feel alive if they are numb. b. Sexual and Physical Abuse - Educators say this link is tenuous, but may be significant when combined with the other factors c. Invalidating Environments childrens thoughts and behavior are met by erratic, insensitive, or inappropriate responses from their parents. This includes parental criticism, unrealistic expectations and a sense of alienation from parents. d. Sexuality/Sexual Identity e. Anxiety/Stress/Pain/Control This is a coping mechanism often self-harmers find that inflicting injury on themselves is often a minute pain in comparison to what is taking place inside. By cutting they find a kind of maladaptive therapeutic release. Endorphins are released by the body, etc. Often, this becomes a way the self-injurer is able to control their sense of helplessness about their situation. f. Contagion leads to next slide.

12. Contagion a. Youtube Lewis et. Al. analyzed the top 100 self-injury videos on Youtube and yes they are on Youtube and discovered that they have more than 2 million hits in total. They were generally rated as positive. 58% did not warn of the graphic content. There are other disturbing traits to this phenomenon. This online medium may reinforce the behavior, normalize it, provoke it, or foster the development of new methods to selfinjure. Other problems include the use of artistic expression in an attempt to elevate and glamorize the act b. Online Communities blogrings, forums, create a disincentive to get better c. Peers often there may be an alpha member of a group in a school or peer setting who is setting an example for others. 13. Ok. So what do I do? a. Trust your gut instincts

b. Your reaction matters c. Professionals struggle with their reaction too d. Listen. Be Calm. Be Understanding. 14. What can you Do? a. Be a listening ear, b. Be prepared to be a central person c. Refer. It cant be treated at school. Talk about the school counseling issue if there is time. Each School has a different response (within the CBE) d. Link between school counselors, offsite counselors e. Develop your resources f. Develop your understanding, research

g. Develop or investigate a school policy or protocol a. Identify and address contagion 15. Discussion/ Q&A 16. Resources 17. Works Cited

Works Cited: Lewis, S.P., Heath, N.L., St. Denis, J. M., Noble, R. (2011). The Scope of Nonsuicidal Self-Injury on YouTube. Pediatrics, 127(3). Nixon, M.K., Cloutier, P., Jansson, S.M. (2008). Nonsuicidal self-harm in youth: a population-based survey. Canadian Medical Association Journal, 178(3). Mueller, L.D. (2009). Educators & Self Injury, How to recognize, understand and respond to self injury. Educatorsandselfinjury.com. Clark, J., & Henslin, E. (2007). Inside a Cutters Mind. Colorado Springs: Navpress. Kelland, K. (2011, November 17). One in 12 teenagers self harm, study finds. Reuters. Retrieved from: http://www.reuters.com/article/2011/11/17/us-self-harm-idUSTRE7AG02520111117 Picard, A. (2008, January 29). One in six teens inflict self-harm. The Globe and Mail. Retrieved from: http://www.theglobeandmail.com/life/parenting/teens/teen-behaviour/article663414.ece