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In the last section, we discussed how loathing one's body and a preoccupation with food which can lead to self-mutilation. Also we discussed the differences between male and female self-injurers due to the way in which they vent their emotions.
You probably have observed, like I, the emotional damage that can be done to a family because one of their members is a self-injurer.
In this section, we'll examine the various ways a family can be affected by self-injury: We will discuss shock and guilt; anger and resentfulness; and stronger bonds.
♦ # 1 - Shock & Guilt
Bruce, the father of 15 year old Audrey, was having a hard time coping with the syndrome. He said, "I don't bring it up unless she wishes to discuss it, and so far she has not done so. But I am mostly concerned about what was causing her to do this." Bruce's concerns are common. A deep feeling of helplessness can occur and in many cases a severe bout of self-reprimand. However, too much guilt can divert energy from the need to be helpful in the here and now.
♦ # 2 - Anger & Resentfulness
She stated, "I've tried to tell my sister she needs to find a way to stop. I've also told her I'm proud of her for seeking help, and I'll always be here for her, although I have had to set certain emotional boundaries to preserve my own mental health." When asked what she would like to tell her sister about the behavior, Jill said, "Why can't you realize everyone has ups and downs, and just deal with life?" Jill's frustration is indicative of what many families feel when confronted with a self-injuring loved one.
♦ "Conflict Agreement" Technique, 2 Steps
Jill and Christine described an incident in which both of their parents were set against the wishes of the two girls. Jill wanted to go to a public college for an art degree while the parents wanted her to attend medical school. Jill ended up obtaining the art degree. In this case, Christine was Jill's support during the conflict. However, now Jill and her parents do not talk to each other. After they had finished the exercise, Jill could now see that her restraint of her feelings was due to the fact that she did not want to lose her last tie to her family, Christine
Louisa stated, "First and foremost, I learned that Audrey can speak for herself, quite well, as a matter of fact. This is something I did for Audrey since the beginning of time. I lived her life for her, thinking I was helping her when in fact this made her feel worthless and small. I remember Audrey saying that no one listened to her or took her seriously. No wonder, when I did all the talking for her!" Audrey's self-mutilation led to her mother's revelation of her overly protective and controlling ways.
♦ Technique: "People in my Life" Paragraph
To these questions, Audrey wrote this paragraph: "My mother and I are always fighting. She never lets me speak my mind about anything. Whenever we're out with people, she won't even let me get a word in. When they ask me a question, she usually answered it for me. The best times I've had with my mother were when we didn't even have to talk at all, like when we watched a movie together. I guess I should assert myself a little more to try and let her know that I'm a big girl and can speak for myself."
Audrey had now put down on paper a summary of her relationship with Louisa, her mother, and a way to resolve the conflict between them. Would the "People in my Life" exercise be beneficial to a client of yours? If you might consider replaying this section, section 6.
In this section, we discussed the various ways families are affected by self-injury: guilt and shock; frustration and misunderstanding; and stronger bond. We also included two techniques that you might find useful with one of your clients: "Conflict Agreement" exercise and the "People in my Life" paragraph.
In the next section, we will discuss various aspects to consider when treating a self-injuring client.
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