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PASSAGE REFLECTS ON CARE AND TREATMENT OF SUICIDE AND SELF-HARM

We here at Passage are all too familiar with the pain and fear associated with suicide and self-harm, as many of our residents have experiences with suicidal thoughts and/or attempts. We wanted to take a moment to honor the spirit behind Suicide Awareness Month by talking about just what these behaviors are and how we can look at this phenomenon “In a New Light.” Join Riverside’s Clinical Director, Angela Frederickson, as she discusses this salient topic.

Suicide and self-harm behaviors can be some of the scariest expressions of mental illness that youth and families experience. They can hold family systems hostage in such a compelling way that everyone feels trapped in a cycle of misery and fear. Those who engage in suicidal behaviors and/or self injury feel equally trapped and miserable. Often the overwhelming emotional load of this topic can prevent parents and helping professionals from effectively intervening in a sustainable way. Helpers can find themselves desperately working to eliminate the problems of suicidal behavior and self-harm behavior by taking away the means to engage in such behaviors, reducing the risks leading up to such behaviors, or addressing the fallout after suicide attempts or self-harm.

Simply stated, the only resolution to the problem of suicide behaviors and self-harm behaviors is to stop engaging them. However, looking at suicide and self-harm behaviors as a solution to a problem versus the problem itself opens clients, families, and helping professionals up to a whole range of possible and effective interventions. To open our minds to consider suicide and self-harm in this way, we must try to understand and ultimately accept that to the person contemplating suicide or engaging in self-harm, these solutions are completely valid and sensible options to unbearable situations. In order to find the empathy required to help, we must acknowledge that suicide/self-harm might be a reasonable response to deep psychological pain, a reasonable effort to express that which cannot be expressed, or a reasonable punishment for an individual with tremendous self-loathing.

When we find that place of understanding and have the courage to sit with that uncomfortable acceptance of another human’s unbearable pain, we are ready to begin searching for the actual problem. If suicidal and self-harm behaviors aren’t the actual problem…then what is the problem? Perhaps the problem is a lack of skills to effectively communicate emotional intensity or needs. Often youth who have a deficit of skills in effective communication will use suicide words or self-injurious behaviors as an attempt to share with others the desperation they feel. Perhaps the problem is feelings of guilt and a desire to relieve the burden a young person feels they have placed on those around them. Suicide might seem to present a viable resolution for this situation or the use of self-harm might feel like the only adequate punishment. Perhaps the problem is the experience of crushing depressive symptoms or the torment of hallucinations, nightmares, or flashbacks. Suicide or self-harm may be the only way to alleviate the psychological pain.

While the only solution for the problem of suicidal and self-harm behaviors is to stop those behaviors, there are a myriad of sustainable solutions for a deficit of skills, a desire to discontinue feelings of guilt/self-loathing, or a need to alleviate psychological pain. The team at Northwest Passage has gathered a multitude of evidenced-based interventions to help address these problems including Dialectical Behavioral Skills group, Wellness Recovery Action Planning, and therapeutic lifestyle choices.

These interventions for youth and families from leaders in the field – Marsha Linehan, Mary Ellen Copeland, and David A. Jobes – adhere to a unifying theme that there is nothing inherently wrong or mysteriously broken about a person who presents with suicide or self-harm behaviors. Such a person is simply a human being with intense pain who also possesses the capacity to heal, change, and grow. Informed by this belief, the focus of the work is to help youth and families harness the inherent strengths of those involved in the client system to systematically work toward building mental health and more sustainable problem solving.

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