Dealing with Cutting or Self-Harming Behaviors

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I work at a hospital, often with youth. Many of our youth come in with self-harming behaviors such as cutting, head-banging, skin burning, biting, or hair pulling. These behaviors occur due to deep emotional pain. These are instant relief behaviors and are often their first go-to reactions. Many times after it only leads to worse feelings such as guilt or shame. 

March is self-harm awareness month. I wrote this blog to help my youth at the hospital, but also to help anyone else out there that might handle difficult emotional pain through self-harming behaviors.

Why do people do these things? Many times it’s just to feel something rather than nothing, distraction to other pain, to feel a sense of control, self-punishing, or expressing feelings. Many people ask, how can I deal with this in other ways? 

First, it takes practice. Unfortunately this behavior won’t just easily go away or be switched. Don’t give up. Relapse happens but it doesn’t mean it’s over or you can’t do it. You can.

Second, learn new and experiment with new coping skills. Here’s a list of many new coping skills you might not have tried before.

•        instead of cutting write on your skin with a pen, this way you can let it out without leaving a mark and it washes away later
•        snap a rubber band around your wrist
•        hold an ice cube until the feeling and urge goes away
•        take a hot shower or an ice bath
•        write out your feelings then rip it up later
•        exercise, try yoga or other relaxation exercises
•        tear apart magazines
•        feel your pulse to prove you’re alive and feeling
•        tell yourself “I don’t deserve to be hurt” until you believe it
•        create a special safe place with no knives or sharps until the urge to cut goes away
•        listen to music
•        bite a hot pepper
•        clap your hands until it stings
•        walk around in a public area
•        remember past times where you haven’t cut before and tell yourself you can do it again
•        call 1-800-DON’T CUT
•        Butterfly Project: Draw a butterfly on your arm or where you want to cut and write someone’s name in it that is special to you. Each time resist the urge to ‘cut’ that person and hurt the butterfly. Pick a new person and draw anew butterfly each time you feel the urge

Third, recognize your triggers. By learning things that trigger you, you can use those new coping skills earlier. It’s much easier to tart the process earlier than try to stop in the middle.

Fourth, possibly see a counselor or mental health therapist. They can help you through recovery as well as help process the other feelings the cutting might have been detracting from. It’s important to have ‘rapport’ or a good relationship with this counselor though otherwise it won’t help you. If you don’t feel comfortable with this therapist then please pick someone else to help. Your therapist will understand this.

Fifth, find support systems in either your friends or a group therapy situation. You’re not alone in this. Others cut too and many overcome it every day.

Control Your Olympic-Sized Anger

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Who doesn’t have anger problems once in a while? With the Olympics going on I consider it appropriate to use the term “Olympic-sized” anger. Many people, especially me and my type-A self, struggle with anger. Our first instinct is normally to bury our anger, but anger is not something to be ashamed about or even run from. Anger has a place and a purpose and has important meaning. When you’re feeling anger listen to it and explore it. Anger is meant to tell us that something is wrong and there is something that we need to address. Holding anger in can make you physically ill and lead to somatic symptoms that are for one – completely unnecessary and two – painful.

When you’re angry talk it through your mind and ask yourself what is really happening in that exact moment. Explore the root of your anger. What’s happening? What are your immediate thoughts? Are there some boundaries you should be aware of and possibly set? Also pay attention to the vulnerable and untouched emotions underneath. Anger hides our feelings of hurt, fear, worry, or sadness. When you are feeling angry - work though it and don’t shut it down. Explore it. Below are extra “gold winning tips” to learn to control your anger.

1. Learn your triggers. What sets you off the most? Also pay attention to the level of anger. We can handle ‘irritation’ or ‘mild anger’ but it’s hard to control the “Olympic-sized” ‘explosion level’ anger. By learning your triggers you can stop anger before it even starts.

2. Recognize that it is hard to stop anger when it is already out-of-control. Other anger management classes will tell you to stop in the middle and take a break and think it out, but is that really possible? Anger explosions happen all too quickly and it really is unlikely you’ll be able to stop and ‘take a break.’ That’s why it’s important to go back to number one and understand triggers to stop it before it starts.

3. Learn to make compromises between yourself and other angry parties. Then you can create a “win-win” for everyone. Compromises show that you’re willing to sacrifice something for the other person. If they see a sense of sacrifice, chances are they will do the same for you.

4. Learn assertiveness training. Learn to be more assertive rather than confrontational. Words have a lot of meaning and connotational value depending on how we use them. There’s a difference between being aggressive and argumentative rather than assertive and smart in your words.

5. Use appropriate timing for possible anger-triggering conversation. Sometimes we have to have those difficult conversations that we know are just going to set either ourselves or someone else off. Pick appropriate timing. For example in couples, while someone is making dinner or right when someone gets home from work is not an appropriate setting. At work when someone has a deadline is not appropriate timing. Pick a time and setting where both parties can be focused on the matter at hand.

6. Restructure your thinking. Be more rational. It’s the end of the world” can change to “It’s frustrating but understandable.” When you are thinking things through in your mind avoid using phrases that start or end with ‘never, always, or demand.’ Logic can defeat your anger.

There are many other ways you can learn to control your anger, but these are just a few ways for you to learn how to “win gold” and control your anger before it controls you.

17 Ways to Deal with a Difficult People

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A lot of us have to deal with “difficult” people on a daily business. It could be people you work with, people you just run into or even people in your family. Here are 17 ways to deal with difficult people.

1. Understand the Problem

            Is there a specific reason that someone is being difficult? Most people have a reason and aren’t being difficult just for the fun of it. If you know this person well, people always benefit from having someone to talk to. Find out what’s going on and then try to put yourself in their perspective. If it’s not someone you can talk to, practice giving people the benefit of the doubt.

2. Take a Different Perspective

            Perspective is how we view the world, so what happens when you try to take someone else’s perspective? Put yourself in their shoes. Your understanding might become different. Is there something they have experienced in the past that makes them defensive?

3. Avoid Conflict

            Did your mother ever teach you if you don’t give someone what they want they’ll eventually get bored and leave you alone? If you think about it, did you notice you picked on your siblings or friends just because it got an entertaining reaction? Yep. I know I did. So, if people constantly pick on you, don’t give a reaction. An example might be if someone is criticizing you or giving unwanted advice, say thank you and move on with your life instead of fighting back. There’s no reason to create conflict when it’s really not needed.

4. Don’t Change Yourself

            As I mentioned in the previous section, difficult people often like to provide ‘criticisms’ or ‘suggestion’ on how you should change. Don’t doubt yourself and don’t change yourself because of a few suggestions someone made. Obviously they aren’t that important if they are the only one is saying them.

5. Pick Your Battles

            Not everything has to be a battle. Save your strength for things that are important.

6. Be Compassionate

            It’s really hard to fight with someone who is being compassionate. It may be incredibly difficult sometimes, but it will be worth it. Act the way you want to feel. Being compassionate puts you on an entirely different level and no one can disagree with compassion and kindness.

7. Know Your Own Triggers

            Know what makes you angry and how to handle your anger. Some things you might not be able to avoid, but if you prepare for it you will be able to handle it better. Most problems happen over and over again and if you know they’re already difficult, you can see it coming.

8. Define Your Boundaries

            It’s ok to set boundaries; in fact its highly recommended good practice with everyone. I was often the type of person that just let people walk over me until one day I decided against it. Turns out to be the best decision I ever made! There are a lot less ‘difficult’ people in my life because of it. Or if they are difficult they aren’t that way with me.

9. Be Polite

Once again, it’s kind of like be compassionate. You can’t fight against that. Can you even picture arguing with someone who is being polite back to you? It just doesn’t work.

10. Talk – Don’t Explode

            When you have a disagreement or something you need to address with your difficult person, talk – don’t explode. Talk nicely and calmly and don’t yell. If you don’t yell hopefully they won’t either. If they do, then stay calm and be the bigger person. Nothing is ever solved when you’re yelling at each other. Be assertive, not aggressive.

11. Be Honest!

            It’s ok to be honest! Don’t feel like you have to hide everything. If people keep attacking you and saying hurtful things confront them on it. Explain that that was rude and you feel hurt and it’s not going to be tolerated. If you’ve got something you need to say it’s ok to say it, just say it nicely and tactfully. Everyone deserves a chance to speak up for themselves.

12. Use “I Feel” Statements

            Use “I feel” statements instead of “you” or accusatory statements. If you’re having a conversation with someone and they start saying things like “it’s your fault” or “you made me do this” do you not automatically shut off and stop listening? Or maybe you do listen, but you become defensive. By using “I feel” statements there’s no blame. Everything is in your perspective and it leads to a much calmer conversations than the blame statements.

13. Look for the Good

            Everyone has a bit of good in them. Even if that good is they’ll be leaving in the next few minutes it still helps. Being positive could make all the difference. Appreciate the good and give credit for it. Try to get to know people more, it shows effort on your part and it will completely take them by surprise and they might return the favor.

14. Clarify Misunderstandings

            This can be one of the biggest communication problems with everyone. Clarify what you don’t understand, especially if this message is being passed on to you through someone else. Talk directly to people and ask questions. Not only will this keep things clear, but they will hear your questions and see that you’re actively paying attention and listening. It never does people good to ‘pass messages along’ and have things get out of hand.

15. Use Reflective Listening

            By being a reflective listener I mean being active in using empathy. Listen, and then reflect back what you just heard in different words. It shows that you are listening and truly trying to understand what she is saying. No arguments can come about through use of reflective listening either. For more information visit a previous blog post entitled "Empathy In Action - How to be a Reflective Listener" posted through Wasatch Family Therapy. 

16. Compromise

            Make compromises with each other. Don’t always feel like you’re the person who has to “cave.” Make sure things are equal between you. This can also be part of boundaries. It’s important to realize that everyone has different expectations and it is possible to meet in the middle.

17. Most important of all…

            No matter how hard you try, you can’t change other people. You can only change yourself.

Activity: You Are In Control of Your Stress

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All of us deal with many stressors on a daily basis. Some stressors are more difficult to handle than others. On occasion, we lose control and enter a downward spiral; our stress seems to be too much to handle. For those times when your stressors are overwhelming, here is an activity that will help you see you have more control than you think.

1. Get a sheet of paper

2. Draw a line down the middle of your paper

3. On the left side write a list of your stressors. Below are some examples.

                  a.     Finances

b.     Difficult People

c.     Cooking

d.     Cleaning

e.     Work

f.      Etc…

4. Look at your list and circle the ones that you can control

Not much to circle is there? Most people find that very few stressors are really within their control. Good for you though if this isn’t true and your stressors are in your control.

5. On the right side of your paper write at least one coping skill or way you can handle each stressor you wrote on the left side.

6. Now circle what you can control.

a.     Learn to budget

b.     Set boundaries

c.     Make a plan, don’t cook things that are too complicated

d.     Take breaks, listen to music

e.     Take more breaks

f.      Etc…

All of them right? Did this turn things back in your favor? Hopefully this gives you more power over your stressors and gives you a little more hope when dealing with stressful situations. I have personally completed this activity many times and feel a little more relieved each time about my stressors. Repeat this activity as often as you need because stressors change all the time as well as coping skills.

Take control of your stress, don’t let it control you!

And p.s. You CAN do it! 

Learning to Handle Social Anxiety

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“Never let the fear of striking out keep you from playing the game.” – Babe Ruth

Whenever I hear this quote I tend to focus more on its literal meaning rather than its greater significance. I frequently keep myself from playing the game not necessarily being worried I’ll strike out, that’s inevitable, but the entire embarrassment of the situation... people watching me... waiting for me to mess up... and then laughing at me! It's just not something I look forward to doing. Not just in baseball or other sports though, but there are many situations where I do the same thing. I keep myself out because of the thought of what could go wrong. I probably gyp myself out of a lot of great activities.

Yes, I’m a therapist and even I struggle with social anxiety. Social anxiety is when you have a constant discomfort in social situations where you constantly wonder whether you are being judged by others. Here’s a few tips for those of us that do have struggles so we can work on letting our fears go and join in some most likely fun activities.

1. Learn to relax

Practicing relaxation techniques, specifically before an anxiety-provoking situation could help alleviate a lot of tension. Do deep breathing exercises or a short progressive muscle relaxation session. There are many relaxation videos that can be found on YouTube.

2. Gradual exposure

“Baby steps” anyone? Don’t feel like you have to conquer it all right now. Make a list of the least to most anxious situations and gradually practice exposing yourself to them.

3. Practice positive self-talk

A lot of us use “thinking errors.” An example is overgenalization, which is coming to a general conclusion and attaching it to everything. “Everyone is staring at me” or “Everyone thinks I’m stupid.” Really? Everyone? What about - “is anybody actually thinking that?” Probably not. Most people are actually probably thinking the exact same you are and are more focusing on themselves instead of you. Train yourself to talk yourself and your anxious thoughts down.

4. Don’t feel like you have to handle this alone

Surely there is someone who can help talk you through your gradual exposures and be your support system. Maybe you even have a friend who struggles with something similar. Utilize supports and friends! Just knowing you’re not alone can do wonders.

5. Keep practicing!

Never give if you feel like even this is too much or it isn’t working. It’s ok to involve a professional sometimes as well. And one failed chance doesn’t mean complete failure; always try again. You deserve a chance for freedom from anxiety in social situations. Just remember “never let the fear of striking out keep you from playing the game.”