Changes needed in psychological services: Look beyond the scars
The British study group that I have cited several times found major deficiencies
in professional care for the people who self-injure. I believe the situation in the US is
similar. First, our institutions provide the same services for suicide and for self-
injury, namely, medication and hospitalization or out-patient treatment. But people
who self-harm see traditional psychiatric hospital treatment as poorly understanding
their needs (often negative and dismissive) and, thus, unlikely to give good service.
Needed are specific facilities and trained staff that would provide understanding,
respectful, caring safe houses for a day or a few days; counselors specializing in
self-injury; education and counseling for children, spouses, parents or friends
involved; self-help instruction and self-help support groups; special attention to child
care while families are broken up; and so on.
Some of the available literature
The major search engines will fetch many Web sites providing information and
concrete suggestions for coping with self-injury. Note particularly PsychCentral
sites provide support groups, understanding articles, and suggestions for dealing
Two large Web sites cite many articles and review over 75 books in this area:
in print about this topic, a couple by Clinical Psychologists and therapists: Alderman
(1997) and Levenkron (1999), one by three therapists who recommend extensive
inpatient treatment (Conterio, Lader & Bloom, 1999), another by a psychiatrist
(Favazza, 1996), and two by journalists who interviewed people with this compulsion
(Hyman, 1999) and (Strong, 1999). Any of the books can help you become aware
and empathize with a self-harmer but Id suggest one of the books written by a
professional. Certainly keep in mind Dr. Linehan's (1993) book for self-help methods.
Loss of a relationship: breaking up; estranged from parent
The second most intense life stress, after death, is divorce or loss
of a love relationship. Most of us beyond 14 or 16 have felt the intense
pain and anguish of being rejected by a lover. Many writers have dealt
with marital problems and the long, distressful process of divorce.
Kessler (1975) described seven stages of divorce: