Healing Self-Injury

Lately I’ve been playing with a question I was asked after a workshop I presented on SIV. A psychologist stopped to talk after the training and was arguing the need to have the right to restrain people who self-injure. I gave him my thoughts about how retraumatizing people who already are living in a world of pain serves no one, including the staff of the institutions in which restraint and seclusion (tying people down to beds and/or locking them in padded rooms) remain prevalent He remained adamant that all SIV must be stopped, that clinicians should not have to tolerate anyone who continues to self-injure. He proposed using psychiatric drugs to achieve this as well, but did admit that there are no drugs, used appropriately, that achieve the result he was after.

It was his next statement that I found interesting. He was adamant that if a psychiatric drug could be created to take away the need to self-injure, that all the people living with SIV would be more than interested in taking it forever. I told him that I didn’t think this to be true, but that I would ask the experts, the people who live with SIV. I believe that SIV is not “all bad” as this psychologist was presenting, that SIV serves a purpose in many people’s lives that helps them cope with the aftereffects of trauma and the struggles of healing. While living with SIV certainly has its down side, it also has a purpose. And as people come to understand the trauma in their histories the need for SIV abates as healing progresses. A drug that would solve the problem so simply would likely do what so many of the other drugs used previously have done, make a person so numb that they might lose touch with their pain and struggle but also become so numbed as to not feel truly alive. I presumed that the price of permanently drugging oneself out of the need for SIV would be too high to pay. I believe that SIV fades away as we learn to understand, experience, and release the pain, rage and disconnection that it manages. We can learn a great deal about ourselves from the urges to self-injure.

But he made me think and now I am curious. Any thoughts out there?

Sometimes when you meet people who touch both your heart and your soul you carry them around in your thoughts for quite a while.  Though your time with them might have been brief, it seems that the experience changes you at a great depth.  I have been holding very warm thoughts about four people I met this past July and I want to tell you about them.

A few months ago I spent two days teaching about SIV at a state mental hospital for children and adolescents in Virginia.  The hospital had decided to make an intense effort to reduce the amount of restraint and seclusion (being locked in a small room and/or tied down to a bed) being done to the young people there.  As SIV is one of the most common reasons that people get restrained or secluded, I was hired to teach some of what I know and to work with the staff.  I had the opportunity to meet with many people, including administrators, psychologists and nurses, and direct care staff.  I met many concerned people who struggled greatly to understand what SIV is about and how to help.  Yet the people I carry around in my heart today are the four young people I had the chance to meet for an hour.  They were currently patients, living behind the locked doors of that facility.

I was led onto a unit and found four young people seated at a table.  I introduced myself, told them why I was brought to the hospital, and asked them if they would be willing to help me.  They seemed surprised to be given a choice – I had forgotten how controlled are days behind locked doors.  I asked them to listen to a short version of what I had taught the staff and tell me if they agreed with what I was saying and offer ways I could improve.  After all, it was the environment that they were living in that I was trying to change.

They could not contain their surprise and disbelief when I let them know that I had lived with SIV and was a scarred person myself.  One young woman stared at my long sleeves, so I rolled one up so that she could see the old, faded, but permanent scars.  What happened then touched the core of my heart.   She reached out and touched my scarred arm, tenderly.  What a different reaction than most, no?  These people weren’t repulsed, they recognized our kinship.

With that we talked of our lives with SIV, our histories and what had brought us such great pain, fear and rage, and our hopes for the future.  We shared a few tears, quite a few laughs, and a hug or two.  The hour flew by and it was soon time for me to go back to the meetings with the staff people.

What the staff and I talked about is for another post.  What I am thinking about as I remember those four remarkable people is how important it is to feel accepted and understood.  At one point I asked if they knew of any other slang names for people who live with SIV.  I said I thought it was most common for us to be called “cutters.”  They let me know that the current slang term has changed and that they were considered to be the “emo kids.”  The “emo” stood for “emotional hardcore.”  They were, of course, seen to be some of the most difficult patients there.

So they are the “emo kids.”  When I was about to leave our group I thanked them and said that I would remember my time with the emo kids, how much I appreciated having met them.  They said that they had also enjoyed their time with me, that it felt unusual feeling  understood by an adult.  Now that I am nearing my 50th birthday I recognized I must look really ancient to them.  So I asked them how, since the term “emo kid” would not apply to me, I should define myself.  It was decided that I am an “emo granny.”  What an honor.