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article imageA parent's worst nightmare: The dark side of the Internet Special

By Lisa duTrieuille     Aug 25, 2013 in Health
Fourteen year-old Hanah Smith had been threatened with a sadistic rape attack, her abuser threatened to attack Hanah with a hammer, anonymous messengers taunted Hanah about her weight, the death of an uncle and urged her to engage in self-harm.
On Friday, August 9, 2013, Hanah Smith who lived in Lutterworth, Leicestershire( which is in England), took her life after being cyberbullied on the question-and- answer site, Ask.fm. Ask.fm.. Ask.fm is basically a cyberbullying social network that has been spawning a form of self-harm. In the past year, after experiencing abuse on the site, five teenagers have killed themselves.
Scott Freeman, founder of the Cybersmile Foundation, said, "It's very easy to get carried away in this circle of online abuse when you're alone in your room. Children check it and keep checking it, and it evolves into a kind of self-harm." Freeman says," We've seen instances where people have actually lined up for abuse, posting a question like, "do you think I'am pretty?" knowing that they'll get torn apart.
Last December, 16 year-old Jessica Laney was found dead at her home in Florida after being bombarded with abusive messages online. Last autumn, Ciara Pugsley, 15, and Erin Gallagher, 13, both Irish school girls, took their own lives. And, in April, a 15 year-old from Lancashire( England), Josh Unsworth, killed himself after suffering months of abusive online messages.
Diana Lohr, a Licensed Marriage and Family Therapist, who specializes in self-harm, defines it as any intentional bodily harm to one's self. The most common forms are cutting or burning. Lohr has seen head banging, excessive hair pulling( trichotillomania), skin picking and some people argue excessive piercings can be considered a form of self-harm, punching things and breaking bones. Including one beating themselves with a hangar hundreds of times causing welts and bleeding on their bottom. Lohr has had clients say that the blood they see from engaging in self-harm represents a release of their problems and that they get some satisfaction from seeing it. In addition, she says that she has had some clients say they like the way the blood feels as well.
Lisa Marie Miller, also a Licensed Marriage and Family Therapist, who also specializes in self-harm as well, has seen kids who have cut all up their thighs, all up their stomach, their arms. Statistically, Lohr says that 1% of the population says at one time or another, have engaged in a form of self-harm. She adds that statistically what it shows is that females self-harm more than males. However, Lohr has also read conflicting things about that. Because it may be that boys may be trying to self-harm in ways that don't look like your traditional self-harm. Like really intensive sports where they're really throwing themselves or doing stunts. She adds that there could be equal rates of self-harm in both males and females but the way its being presented and reported is differently. But as of now, you definitely see according to the statistics that women have a higher rate of self-harm than men.
According to Lohr, self-harm has been around for a long time. Its something you see in animals too that are under distress such as excessive licking and pulling their hair out that you see in humans. Furthermore, Lohr adds about the time of the Plague- the Bubonic Plague. People were whipping themselves also known as self-flagellation. They were self-punishing because they felt God must be punishing them. They would just go around whipping themselves to appease God. So self-harm is really nothing new. However, Lohr says that we're gaining more awareness that self-harm is being used as a maladaptive coping skill.
In addition, Lohr says there are a lot of stereotypes and myths out there about self-harm. Some common beliefs that are untrue is that it is being used as manipulation or the self-injurer is trying to get attention. She adds that because self-harm is still very stigmatized behavior, people still tend to be a little bit secretive about it. Lohr has had a lot of clients who were very hesitant to talk about their self-harm for fear of, "Are you going to hospitalize me?" Furthermore, she adds that hospitalizing someone who self-harms, just makes things worse. However, according to Miller, an individual will be hospitalized if their self-harm is at such a lethal level that death is imminent. She says then we would be looking at the 5150 process if we cannot get them to commit to stay safe.
Both Miller and Lohr agree that when working with those who self-harm, establishing safety is one of the number one things. Miller says her clients have often described engaging in self-harm similar to someone who has a drug addiction. "It's detoxing, they need "the drug"( in this case being engaged in self-harm) to feel better." In addition, Miller adds that when she is looking at self-harm, she's also looking at how lethal is it. And, how much time does she have to work with them before it might cause huge problems like a death. Furthermore, Miller says that it tends to start with a little cut but being similar to a drug addiction, or an alcohol addiction, they need more and more. She states that then it becomes deeper cuts in different areas.
When Miller has youth and/or even adults coming for the first time, she always asks about their support system, their family. She's also looking at depression and anxiety symptoms and also assessing for suicidality. Miller doesn't want to assume just because they engage in self-harm, they're not suicidal, so she always wants to check. Furthermore, she's looking for anything that's addiction type.
Lohr says other mental health issues can go along with self-harm. Especially, if the individual is using substances because they can really over do it. In addition, Lohr says that's the danger of self-harm. Sometimes people are so numb, they're so dissociated. They've been using and they're not even aware of how deep they're cutting themselves. They can lose control with it and really do some damage.
According to Lohr, she has found that some people who self-harm have been victims of child abuse, or they've grown up in an environment where expression wasn't really something that was encouraged in some cases. Furthermore she says especially if there's a lot of trauma, especially chronic child abuse, it tends to have a numbing effect and their tolerance for pain seems to increase. Some people are cutting or hurting themselves just to feel something. They just feel so numb. So, is like an attempt to reconnect with their body in the here and now.
Lohr has had clients report that they do dissociate with self-harm, not all but some. And, they're trying to get back into their bodies. Its almost like a grounding technique. She adds that self-harm has a psychological response to it. Lohr describes it like the body is reacting to being cut, releases endorphins. And, its like, "Okay, I just do this and then I get the endorphins and temporarily I get relief." But then they have to keep on doing it, because its just a little bit of relief. Its just a short term solution. You're just putting a bandage on it. Its a short term solution and it doesn't do anything for all the issues going on.
One of the things Lohr does, especially with parents, because there are so many myths out there about self-harm, she does a quiz with teens and parents. Lohr says a really good book for teens is called "Stopping the Pain." She has found that by doing the quiz with the family on some of the myths of self-harm is educating people about it which is the first step for them to have a better understanding. Lohr has had teens and adults refer to themselves as , "Yeah, I'am a cutter." "I'am mental." "I'am crazy."Lohr's response to these cognitive distortions is, "No, actually you're trying to cope with a really difficult situation. That what you're trying to do and you're not alone."
Lohr says its not just related to mental illness. It can be a divorce triggering it, a very stressful life event like losing a job. She stresses that its important to get a full assessment. Because obviously its tied to some type of emotional pain that's going on. Furthermore, Lohr adds that you really want to find out all the details of what's going on with that person.
Most commonly, Lohr says that in teens, in kids who engage in self-harm, are more likely to have a very poor body image of themselves. So eating disorders can come into play. She's seen it with people having flashbacks or traumatic experiences. Sometimes they'll resort to self-harm to interrupt the flashbacks to cope.
Working in community mental health, its not something( the self-harm) you see right away, Lohr adds. She says from what she's seen is they usually come in for depression and/or anxiety. The self-harm comes out later. A lot of people who self-harm are trying to get control. Its control of what's going on internally. Because it can be so overwhelming that its really hard to sit there with it. "I've seen kids so overwhelmed that they just cut because they don't know how to express what's going on and there may be a lot of chaos in the home. They are crying for help."
In addition, Lohr says we have access to the Internet and there is a dark side. Technology has done wonderful things. Such as bringing people suffering from similar issues together. That's the plus side. Lohr says, "I've had a client who was gravitating towards a site where people would post photographs of themselves with self-injuries. It wasn't a support group for healthy coping skills." Miller adds that there are even sites where people can google "self-harm" and it will tell one exactly how to do it.
With teens, Miller doesn't understand it but they just seem to flat out tell her what's going on. Her friends call her the "kid whisperer." She says usually after the first three sessions she knows the teen's whole story. Miller isn't sure how that happens other than teens seem to feel safe with her. Her approach is very non-judgemental and she just doesn't "tip toe" around the issues and she asks direct questions. She will say to youth and adults-"Have you ever experienced any kind of abuse? Do you know what abuse means? Has anyone ever hurt you physically, mentally or sexually?"
The kinds of therapies that Miller uses are more strength based therapies. So, its finding the strengths of the individual, acknowledging them and building them up. One of the therapies that Miller uses which is a specialty of hers is expressive art therapy. Basically its using the creative arts as a therapeutic tool.
For instance, she's done an art directive with youth called, "My Shoes, My Story," in which she has youth take a pair of shoes and put their life story on them. Miller says that what came out of the project was a lot of abusive experiences, a lot of current domestic violence in their relationships, a lot of gang violence and seeing people die. First she wants to stabilize them so they are feeling a little bit better and a little bit more stronger. And, also a little bit more confident that they can talk about it. And when they're ready to and want to, Miller and the client will go back and talk about what had gotten them to self-harm.
According to Miller its not unusual for children and adults to have little or big relapses as with any addiction which is a part of the process. It takes time to learn new skills. She says so letting them know that if they relapse, its okay to tell her they've relapsed. Miller says, "I don't want them to feel they have to hide anything from me. Because self-harm is about hiding. I don't want anymore hiding." When Miller works with a client who has been self-harming she always asks if there has been a past history of mental illness and she also keeps an eye out if there are some genetic factors.
Furthermore, Miller says self-harm goes across all groups of people at different socioeconomic levels. Lohr adds that its really important to get help as soon as possible. And, that self-harm needs to be taken seriously. In addition, she says that one has to be able to learn how to identify and sit with them and find alternative skills to express themselves in a healthy way.
Lohr says helping the client find something that can help them channel the self-harm in a healthy way that's not going to lead to self-harm. Such as punching a speed bag or punching bag which can be helpful. Doing some physical exercise can release the same endorphins that they were getting from cutting. Sports such as track, choir, band, karate, getting involved in team sports such as soccer, football or even just getting up and going for a walk can be helpful too.
Being verbally abused can cause a child to engage in self-harm. Verbal abuse is more painful than physical abuse. Because you're having this caregiver whose supposed to protect you, keep you safe and they're telling you, "You're worthless." "You're never going to amount to anything." "Nobody loves you." You're disgusting." "You're an accident." Or, having a black male parent tell their 8 year-old black girl, justifying that they are helping their child about how white people will look at them in the world by saying, "Renee, you're nothing but a nigger." Its one thing to have a stranger tell you that but when a parent tells you basically that you're not worth shit, you're dirt, you're no good. That can take some time to get over, sometimes many years. So of course the child will internalize it much like those youth who got mentally beat up by anonymous messenger's on the site, Ask.fm. "Well, if my own parent thinks this of me, then it must be true because this is my own parent." Its not some stranger off the street. Absolutely it can be devastating and feed into a lot of negative self-talk and self-hatred that can definitely lead to self-injury. Ask kids or adults who have been mentally or verbally abused and they will tell you that they would have rather have been hit instead because they would know when the physical abuse was over and would stop at some point. Lohr says emotional abuse is really hard to prove. Its definitely in the category of abuse but Lohr has seen people struggle to make a case to actually remove the child from a home. She's seen more action taken in much younger children with special needs. They're more apt to be pulled out of the home.
Lohr can't emphasize enough how important it is to dispel all the myths around self-harm, especially the myths that block people from getting the help they need. Some of them can be stigmatized and it can prevent people from getting help and support. Lohr has noticed that people will think, "They're doing it for attention." So pretty much what Lohr hopes is for someone who self-harms is that you're not alone. And, this is something that you can get a lot of support and help with. And not to be afraid to come forward in terms of getting help. And really breaking those myths, reaching out and educating the public on it.
Miller's advice is, "Just if you know of someone whose engaging in self-harm behavior, try to stay calm, non-judgemental and compassionate. Do your best to help them seek out support from mental health professionals, medical professionals and if they're your family friend or member do your part by initiating the process. And, obviously if it's a minor initiate the process for them."
More about Cyberbullying, Selfharm, selfmutilation, Cutting, Burning
 
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