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On the last track, we discussed four aspects of a self-mutilator's ability to form relationships which includes: a lack of a workable medium for relationship; the factor of low self-esteem; keeping friends at a distance; and the result of shame from past abuse.
On this track, we will examine the various
methods by which self-mutilators avoid discussion in therapy: a blank slate; deflecting;
and a false self.
Method # 1 - Blank Slate
I asked her short questions to try and express to her that I understood her feelings. I said, "You look unhappy." When she looked away, I stated, "You don't want me to see your unhappiness." She then looked down at the Chinese-English dictionary in her lap. I then said, "You want the book to talk to me about you." She slammed the book down. I said, "You are mad at the book."
She finally said, "I am mad at me! My self is no good!" By breaking this silence, I had established a means of open communication. Lin soon related to me that her step-mother and father hit her hands, but she had also inflicted beatings on herself as punishment. Her eventual recovery could not have been possible had not the first moments passed in silence and overcome by brief questions and observations.
Method # 2 - Deflecting
If they don't acknowledge their problem, it won't exist
anymore. Fourteen year old Carrie was referred to me after she had been hospitalized
for making a severe cut at her elbow joint which severed her tendon.
To make Carrie be more direct about herself, I became more direct in my questioning, "You aren't aware that you are angry at yourself. You don't want to be aware of that. Cutting yourself is like screaming out that you have painful feelings and angry feelings." Carrie's next statement was, "I must be a bad person." I assured her that she was not a "bad person", but that she did have complicated feelings and I told her that I would help her to interpret these feelings. Carrie soon became more involved in the sessions and became one of my most talkative clients.
Method # 3 - The False Self
However, the emotions she was conveying never reached the root of the problem. Whenever I asked her a question, she quickly agreed with me, even when the next question contradicted the first. I soon realized that only a direct question about her injuring would help to focus Chastity. Instead of asking general questions about her emotional state, I asked, "What were your feelings at the moment you burned yourself?" For the first time, Chastity was speechless and didn't know what to say.
At last, she finally opened herself up saying, "I didn't feel anything." I than asked her, "Is that what you wanted, to feel nothing?" She replied, "Yeah. It was like I was feeling everything up to that point, but when I burned myself, and it didn't hurt, I thought everything else went away." By being direct and not allowing Chastity any way to put up a false self to distract me, I was able to help her in increasing her awareness of her feelings at the time of the burning.
Technique: Using an Authoritative Posture
In the early stages of therapy that we have discussed on this track, I find that taking a more authoritative posture allows the client to be more trusting of me. Because many clients come into therapy barely trusting themselves, the image of a strong leader to guide them is comforting and leads them to a more positive view of healing. However, the same caution must be taken that a client must become totally dependent on themselves by the time recovery has come around. Without this, the self-mutilating client is more likely to regress back into their self-destructive behavior.
On this track, we discussed three methods by which self-mutilators avoid discussion in therapy: a blank slate; deflecting; and a false self. With the blank slate or unresponsive client I used short statements. With the deflecting or evasive client and with the client exhibiting the false self, I used direct focused questions.
On the next track, we will examine five different challenges teen self-mutilators face when going through the final stages of recovery: self-blame; the fear of incomplete analysis; the danger of over-analysis; explaining scars to peers; and regret.
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