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When self-harm is mentioned, we usually think of physical harm. However, it's possible to hurt yourself emotionally too, and just as damaging. Those with poor mental health or trauma survivors may inflict emotional and psychological harm on themselves, and this month we will look at how hypnotherapists can help.
Why do people perform emotional self-harm?
Emotional pain and physical pain are felt in the same parts of
the brain, and people's reactions to emotional and physical pain are very
similar. Emotional self-harm may occur alongside physical self-harm or it may be used
when the sufferer subconsciously fears physical harm or doesn't want a visible
injury that might be noticed. Self-harm of any type is often connected to guilt or low self-esteem causing the person involved to feel that they somehow "deserve"
pain or punishment. It is also associated with a lack of control in life, past abuse, or trauma, or can be a way of drawing attention to one's suffering as a cry
for help. These are generalisations, of course. Every client will be different and you need to find out how things work for them.
Self-harm is a risk factor for suicide, but it's not always
connected to suicidal feelings; many report that having control over their own
bodies and minds in this way helps them stay alive. This is something to bear in mind when you talk to your client and don't be afraid to question them if you think they may be at risk.
Types of emotional self-harm
- Negative self-talk and the inner critic - constantly putting
yourself down; downplaying one's achievements; dwelling on thoughts such as
"I'm worthless" or "no one loves me"; focussing on possible
worst-case outcomes. This can also include physical self-shaming such as "I'm so fat and ugly".
- Destructive patterns: setting unrealistic goals, then
shaming yourself for not reaching them; lack of personal boundaries; repeatedly
entering abusive or destructive relationships; self-sabotage. Some authors include habits like overeating and smoking in this category since they are often triggered by emotions.
- Triggering yourself: intentionally seeking out upsetting situations
such as provoking arguments with loved ones; making hurtful comments to others;
constantly checking social media that you know will upset you; intentionally
setting off a phobia.
Helping clients who harm themselves emotionally
Once you have taken a thorough case history, consider if
your client needs a medical referral. If their emotional self-harm is severe,
it may be linked to other psychological issues that require a doctor’s intervention.
A form DASS 21 or DASS 42 can help you assess your client’s emotional state, but
remember that it’s just a form. Trust your own judgement and, if in doubt, err on the side of caution and
safeguard your client. Once you are confident that you can work with this
client, here are a few tips.
Silencing the inner critic –
- Point out that, like anxiety, the original intention of the
inner critic is often protection, however unhelpful it has become over time. It
was formed from the opinions we heard from those who were important to us as we
were growing up, to help prevent us doing things that would cause us shame or
social ostracism. As such it is a voice from the past and may not be relevant
to the present or future.
- Encourage clients to be as kind to themselves as they are to
others, and to notice the things they do well.
- Affirmations can help set new and more positive thinking
patterns.
- Ask the client in whose voice are the criticisms made. A parent,
teacher, or themselves? Sometimes changing the voice can help to change the
dialogue.
- I have a poster in my office which reads "Don't believe everything you think", and it's very relevant here. Remind clients that thoughts only have the power we give them, and just because a thought comes into your head, it doesn't mean it's true.
Reshaping destructive patterns -
- Bringing unconscious patterns into conscious awareness can
be helpful but may also lead to self-blame (“Why do I keep doing this to
myself?”) So, the awareness needs to be linked with self-forgiveness, new coping
strategies and help in making better choices.
- Encourage the development of personal boundaries, for
example, being able to say “no” and sticking to it, and factoring the
client’s own needs into their decisions as well as other people’s.
- Encourage self-care.
Responding differently to triggers
- Help with boundaries here too – for example, revising social media use by
blocking “friends” who are not really friends at all and/or putting a daily time
limit on its use.
- Teach assertive ways of communicating so the client feels they can express their needs and feelings without hurtful or argumentative speech patterns.
Overall
- No matter the kind of emotional self-harm your client is
inflicting on themselves., hypnotic suggestion and metaphor to boost self-esteem,
confidence and self-respect is likely to be helpful. Clearing metaphors may
help them release the past programming and embrace new patterns.
- Creative activities such as drawing, music or writing can act
as distraction techniques and help some clients.
- Mindfulness can be useful too; it teaches clients to be
aware of unhelpful thoughts without reacting to them emotionally.
- Sometimes it’s useful to desensitise the client to specific
triggers that set off their emotional self-harm. Reframing why friends haven’t returned
a phone call yet from, “What have I done to upset them?” to “They’re probably
busy”.
- CBT-type approaches have a good evidence base for this issue, especially for challenging negative thinking. You can also use parts work, inner child, or regression to uncover the origins of the problem if those are in your toolbox.
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Author: Debbie Waller is an experienced hypnotherapist and hypnotherapy trainer. She is the author of The Hypnotherapist's Companion, Their Worlds, Your Words, and The Metaphor Toolbox, all available from Amazon or direct from the author, and a co-writer of the Hypnotherapy Handbook.
Find out more about Debbie's services on
Yorkshire Hypnotherapy Training - multi-accredited hypnotherapy practitioner training, taster days and foundation levels.
CPD Expert - accredited CPD and other therapy training (online and workshops options), expert and qualified hypnotherapy supervision
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