Thoughtful Therapy

  Helping women find freedom and peace



Three Myths About Self Injury

Posted on 25 November, 2014 at 22:25 Comments comments (4795)

Self injury can be a scary thing. Often, people are horrified at the thought of it. When you hear about someone hurting themselves on purpose, you may wonder how anyone could do this. Unfortunately, it is very common. In fact, you probably know someone who does it, or used to do it, whether you're aware of it or not. And you may wonder why they do it, why they don't just stop, or who caused it.

Self injury is not a new thing. It has been going on since Bible times, and probably before. It didn't just start in the last 20-30 years, although it has become more common in that time. Awareness of self injury has started growing as instances of it have increased, and as people who injure themselves start at younger and younger ages.

People hurt themselves for a variety of reasons. Some want to feel something. Anything. And so they may make cuts so that they can at least feel pain. Others want uncomfortable feelings to go away. They don't want to feel angry, anxious, depressed, afraid, or sad. By hurting themselves, they can forget the feelings for a little while. There are still other reasons, but these are a couple of the most common.

Here are a few myths about self injury

Self injury is the same as a suicide attempt. Nope. This is not true. While someone who hurts themselves could eventually make a suicide attempt, cutting or injuring is not the same thing. Suicide could also be an accidental consequence because a person hurting themselves could make a deeper cut than they realize and bleed out. Self injury is an attempt to feel something when a person feels numb, or to make uncomfortable feelings stop. It is a coping mechanism, although it is an unhealthy one. But for some people, self injury is all they can manage to do in order to feel or to make the feelings go away.

The person self injuring is trying to get back at you for something. If only it were that easy. Then, I suppose you could just apologize and the person would stop injuring. This is about them, not about you. People do not injure with the intent to hurt someone else. Think about how bad someone must feel about himself or herself to physically inflict harm on his or her body. I will repeat: This has nothing to do with you.

Someone who self injures can just stop doing it. I wish! And I'm sure the person who injures wishes it was that easy, too. Unfortunately, self injury can become an addicting type of behavior. Some people categorize it as an addiction and some do not. Either way, self injury and addiction do share characteristics. One of these is the need to increase amounts over time in order to get the same feeling or lack of feeling. For a person who self injures, it is very likely that he or she will have to make deeper cuts, more burns, etc. in order to achieve the same level of comfort as before. This can become dangerous, of course, because deeper cuts and more serious injuries require more wound care, and very possibly, professional medical care.

There are many other misconceptions or myths about self injury, as well as ways to help and ways to treat it. If you self injure or know someone who does, please hear this: there is help. You can feel better. You can get better. You can stop hurting yourself. It takes time and dedication, but you can do it. Contact a therapist who specializes in this unique area and get the support you need and deserve.

Coping Skills

Posted on 16 August, 2014 at 0:00 Comments comments (2347)

This post is by my friend and colleague, Cole Modlin.

We often see vague references to “coping skills” in self-help books or online psychology articles, but what does it mean to cope? Also, what stressors are severe enough to warrant using coping skills? I believe that all people are already coping with life events whether they are aware of it or not. For instance, turning on the TV or getting a drink with some friends are ways to cope with stress. When experiences become overwhelming and the methods of coping stop working, people tend to escalate their behaviors in negative ways or seek new alternatives. In this post I would like to describe types of coping skills and discuss how to use these skills effectively when dealing with distress or trauma.


It is helpful to separate coping skills into three basic categories:


1. Coping strategies focused on distraction

2. Coping strategies focused on grounding

3. Coping strategies focused on processing


In the category of distraction we have some of the following skills:


Counting – up to 100, down from 10, down from 100 by multiples of 7, etc.

Puzzles – Sudoku, crosswords, Lumosity, word games, cards, and anything else that occupies your mind

Exercise – walking, jogging, sports, aerobics, dancing, etc.

Sleeping – resting when we are emotionally exhausted

Music — listening or playing music of any kind

Media — playing video games, watching a funny TV show, YouTube clip, or movie


These are positive skills that provide a necessary relief to people in crisis. Our bodies simply cannot stay in a state of crisis indefinitely. Choosing healthy distractions can give us permission to experience some brief normalcy and relief when we are preparing to process events. In fact, recent studies are supporting the possibility that playing a distracting game like Tetris soon after a traumatic event can reduce the long-term negative effects of the trauma.


Of course, constantly using these distraction techniques can become a form of avoidance or denial. Moreover, one can actually build tolerance to distracting activities; thus, your favorite TV show or video game may cease being enough to keep out intrusive thoughts. If distraction efforts stop working, it is not uncommon for people to begin escalating to other more dangerous forms of escape, such as alcoholism or addiction. Hence, getting stuck on distraction may be an indication that developing skills at the next level of coping will be necessary to manage distress effectively.


Coping skills that focus on grounding the individual in the present:


Relaxation – progressive muscle relaxation, massage, diaphragmatic breathing exercises, bubble bath, yoga, prayer, meditation, etc.

Safe Place Imagery — developing a safe place in your mind connected to each of your five senses

Awareness – focus on your current environment (e.g., the feel of the floor beneath your feet, the texture of the chair you are sitting in, the smell of a candle, etc.)

Physical Senses — hold an ice-cube, pet an animal, enjoy a peppermint


There is some overlap between the distracting skills and the grounding skills. I think it is beneficial to draw the distinction between these categories because I see grounding skills as moving a person closer to dealing with the trauma or distress. These are activities that you would not typically engage in on a conscious level. Using safe place imagery or diaphragmatic breathing demonstrates awareness that support is needed and life has changed.


Finally, we come to the third category of coping, which is conducive to processing:


Journaling — putting words to your experience in private can sometimes be the first step in organizing your memories into a cohesive story

Verbalizing – talking with a support person or professional about your story

Sharing – writing a letter, giving a testimony about your experience, writing a blog, etc.

Commemorating Healing – planting a tree, getting a tattoo, writing a song or poem, creating something, etc.


This is the deepest level of coping and it usually requires the most emotional energy. With the distraction and grounding skills a person is primarily using stress management. The processing skills, in contrast, are aimed at healing from negative experiences. Activities at the processing stage are highly personal and their effectiveness for coping will often vary drastically between people, even in the same family. It is important to note that staying at this processing level for extended periods can lead to total exhaustion. We need to take care of ourselves when facing trauma. Adequate self-care requires coming up to the distracting and grounding levels at times when processing gets too overwhelming.


Many people can manage for most of their lives by using skills from the distraction category without needing to venture beyond this point. If trauma or a loss has occurred, it is much more likely that distraction will stop working. When anxious or disturbing thoughts begin invading your work and personal life despite your attempts at distraction, you could benefit from grounding yourself in those moments. However, grounding is still a temporary solution in that it places you firmly in the present but ignores the past experience.


If you do intend to begin processing your experiences, I encourage you to build a strong support system around you. Processing is hard work and you will need people to lift you up and remind you to take care of yourself. For some people it will also be essential that they talk to a mental health professional. A good therapist will help you navigate the complexities of your trauma, encouraging you to engage in distraction at times but also affirming you that you can press in to greater healing with support.