Self harm is a pattern of behaviour that, like so many addictive patterns and dysfunctional coping mechanisms, can be hidden in plain view, even in those as young as under 10 yrs old. Here are some important early warning signs, behaviours and influences that may help you catch it sooner and in a way that is helpful to you and your child. 

There is always a danger of a child being out of their depth when they are driven by emotion, as the self-regulation function is out of register. So for example when someone is angry they will have elevated levels of adrenaline and noradrenalin in their system, which inhibits the experience of pain. So when they are e.g. cutting themselves they may well cut too deep as they simply do not feel it. Its incredibly important to accept a child’s emotional expression, even if it feels too much or out of order.  A child will earn quickly if you help them manage their experience and expression of these emotions respectfully and with boundaries.

If your child is cutting or burning, seek medical help for the wounds; if you feel out of your depth and that you cannot deal with the way your child is behaving then seek support from a child and adolescent psychotherapist (one with integrative arts training is particularly effective for less invasive intervention and assessment) or an EMDR therapist who specialises in working with children. You can also seek support for yourself from an addiction specialist. Trying to deal with it yourself and failing can generate negative emotions, making the child feel even more hopeless and the parent feel useless. Both will foster resentment, which in turn drives the urge to self-harm – a vicious circle.

Please note a child can also self harm by inviting and provoking physical assault from siblings or parents. It is a way to indirectly ventilate emotion, such as anger or hurt, by making another person responsible. If your child (or indeed any member of your family) is perpetually making you want to rage at them or hit them, then they may be using you as a conduit to express their own pain. The acting out is simply a purging of the overwhelm and will not deal with the problem. So the parent who feels ‘better’ after screaming is describing the feeling of empty before inevitably ‘filling up ‘ again. The answer is to treat the pattern as a clue to a hidden issue that if dealt with appropriately can be treated. Again EMDR is particularly effective as a brief and non-invasive trauma intervention. It works with an ‘unconscious’ part of the brain, and can bring about significant changes for a person in terms of how they manage mood and memories, in a relatively short period of time.  Highly effective for children as they don’t need to be able to talk well to get well.

I think we need to keep in mind how much pressure children are under to perform in today’s globally competitive world. They are competing physically, mentally, socially, practically…. And children are very quick to criticise and shame one another, and have access to multiple ways to put themselves up by putting another person down. (i.e. bullying, cyber bullying). The impact of negative attention can spread widely and quickly, alienating and scapegoating a child almost overnight. Children know this and are keen to remain ‘in’ with one another, placing them on high alert about what they wear, look like – weight, size, fashion sense, ability, image, spots, hair growth, etc.

Constant exams and testing places them under strain to pass but doesn’t introduce a concept of in-depth learning and consideration, so they are culturally encouraged to skim the surface – by implication, this does not teach them how to cope with deeper emotions. I often meet children who think they are ridiculous and over sensitive for having certain emotional needs or experiences, yet on further exploration I will often find they are displaying and experiencing a ‘normal’ level of affect.

I believe that many children are left to their own devices too much and do not have what I would consider to be a consistent model of a ‘good enough parent’ – providing the temporary regulation, a respectful guide, in a consistent way of a parent who is in good shape themselves. Many parents are over stretched and as a result either the child ends up taking care of the parent (not needing or wanting anything from them) or they sadly neglect the child’s core needs believing that to simply feed them, have a laugh and get them to school is enough. Children’s brains are not fully developed until the end of the teen years so until then they require guidance (decreasing as they get older) from someone they can trust and respect – pie in the sky?

I have met countless children in the middle class demographic, who when they experience profound emotion will seek ways to cope with it that are self-sufficient and appear to be short term. (ie hitting self when angry, punching self, banging head against a wall, scratching, cutting, burning, starving) and their families know they do it have not taken it seriously, often coping with it by making a joke of how sensitive the child is, perhaps in the hope that it will simply ‘go away’. But in my experience these things often graduate into eating disorders, codependence (needy giving), and alcohol and drug abuse and misuse. It is a visible part of the addictive cycle that is awash in today’s culture and it should be dealt with seriously at an early age when there is an opportunity for effective and brief intervention.

Pia Mellody and her training team with Mandy, Dita and Victoria from Charter!

Last week I was fortunate enough to attend a week of Post Induction Therapy with Pia Mellody in Arizona.  The model is focused on recovery from the relational trauma that manifests painfully later in life in self-destructive processes such as addiction, codependence and dysfunctional relationships.

As you can see from the photos I am not good at having my picture taken and closed my eyes to the experience!  I also do not have a great reputation for attention in class, with past school days littered with truancy.  (We teach best that which we most need to learn…!) But last week I was captivated.  Not all week I admit as I found the lecturing a bit tiring, but the information itself, the model, is wonderfully human and accessible.  It makes sense, and is interwoven with personal experience, crucially demanding that the therapist also is well!

The genuine integrity of the model was reinforced by the humility of the teachers. Both Pia and Sarah, who was co-facilitating, were keen to teach yet not hungry for applause. In fact Pia regularly yet subtly sidestepped the guru status that was often laid at her feet instead asserting the model as the prize and encouraging personal responsibility.

The PIT model aligns easily with the  therapeutic model at Charter, which is also borne of hard graft and personal experience and it should be relatively easy to integrate the two. This means the clients will experience more bodywork and shame reduction work, paying increased attention to relational childhood trauma and to the 5 core symptoms of codependence Pia describes in her books. We will also provide an intensive 3-day Trauma Reduction Workshop every 6 weeks which is inspired by ‘Survivors’ (The Meadows).

This is not a self-indulgent model it is an operation. It’s all about going home and getting on with your life, which is like a breath of fresh air.

Thank you too to my travel companions and co-trainees, Dita and Vic.  Getting to know you and spend last week with you was really special and enormous fun and I am privileged to have you on the Charter team.

Thus in the early stages of recovery your behaviour may have changed but the filter system remains as it was for a while, offering up ‘stinking thinking’ supported by evidence provided by your brain’s attentional bias. You need to be able to challenge this primed experience and seek out new experiences that are clean and sober, as they do exist.

It is that familiar dichotomy: listen to your feelings, don’t listen to your feelings. This means that you need to be able to have your feelings, but don’t let them dictate your behaviour. Do not believe your own press, instead stick to the plan!

So this New Year’s Eve don’t wait to be hijacked by old thoughts, make plans!

1. Find out if any of your sober friends want to go out and make arrangements to meet and go out together as a crowd
2. Go somewhere familiar – its often tempting to do something different because its NYE, but it often goes wrong
3. Don’t call anyone from your past on a whim: stay in the present with people you are with
4. If you do want to go out in a mixed crowd, make sure someone you trust in onside to help support you to stay sober, and lean on them
5. Know what you will drink – here’s a few of my and friends favourites… ginger beer, cranberry juice, lime and soda, lemonade, elderflower, appletise, Virgin Mary,
6. Remember it’s the build up of feelings (usually resentment) that fuels a relapse – be with people you can talk honestly to, and talk to them!
7. If you decide to stay in on your own make sure you have things to entertain you – DVDs or a good book, with a healthy meal and a couple of friends phone numbers to check in with because that pang of loneliness may come and it’s a powerful adversary to take on alone…channel flicking at midnight is NOT a good idea as you are likely to see the best bits of everyone else’s parties and you will feel its too late to call to chat…
8. If you run into trouble, call the AA/NA helpline – there is always someone to speak to who understands…you are truly not alone: many have gone before you and many will follow, all you have to do is the rest right thing
9. Get to a meeting on NYE and remember the gift that is recovery: share positively
10. Before you take any decision, play the tape forward and call someone

And at the end of the day, remember, its just another night.  So here’s wishing you all a very HAPPY NEW YEAR! I hope that 2013 mark the beginning of a year that you are proud of.

Being ill is always a challenge for people in recovery.  Do you take the meds or not? Should you take ones that make you drowsy or contain codeine? Not a great idea… So where is your bottom line?

Thankfully I have had the good fortune to know an amazing natural healer who has shared many secrets with me over the years, one of which I shall share with you now…

A drink that tastes FAR better than it sounds (it couldn’t taste worse!), this will boost your immune system, and protect many of your main organs including the heart and the liver (it will also get you socially rejected…don’t take it personally!).

Whizz: 3 peeled garlic cloves, 2 unpeeled carrots I stick of celery with leaves, I medium tomato, 1scrubbed sweet potato, unpeeled, & cut into sticks, ½ deseeded Jalepeno pepper, a thumb length of white radish and add water for texture.

Drink twice a day for 3 days!

Good health and happy Christmas!

We are not talking about alcoholic drinking or binge drinking either. Fetal Alcohol Syndrome is a well-documented, permanent severe mental and physical consequence for the child of heavy drinking by mother during pregnancy. But this is not where this research is aimed.  No, this research relates to a couple of glasses of wine a week!

When pregnant, women often report feeling different and separate from the group, as well as stressed, uncertain, out of sorts and under pressure.  It may feel hard enough without also not being able to drink a glass of wine ‘to relax’.  But this research suggests that the price you may pay ‘to relax or feel part of’ may actually be too high. IQ is not just intelligence, it represents the ability to interact and understand; a powerful influence in self-esteem. Your child may pay with his or her quality of life for your need to use alcohol for 9 months. Not a balanced equation no matter what your mathematic ability!

So we need to support women – and maybe even more ambitiously our society – to find other ways to relax so that alcohol steps down from top slot of how to clock off.  It is a depressant, it causes accidents, is fundamental in many severe health problems, causes long term and debilitating mental health issues, and now we can see that it impacts on our future generation’s IQ before it is even born.

With such compelling evidence around negative impact of alcohol on the unborn child we must invest in other strategies. We need to learn how to stop, pause, take a breath so that all that we strive for and invite into our lives doesn’t drown us in its administration and relentless rhythm. In pregnancy we lay the foundations for the child’s profile as well as for our relationship with him or her, and those 9 months should not be overlooked nor taken for granted. In fact they are an opportunity for investment!  Mindfulness Meditation is a powerful method that focuses on the breath and helps to alleviate anxiety, pressure and even craving by letting go of thoughts and feelings without banishing them or trying to control them. It can help make mental and emotional space to forge a connection between the unborn baby and its mother as well as to gain essential perspective. Similarly pregnancy yoga provides a proactive engagement with the changing body and mind, and has proven positive health benefits, pregnant or not. Laughing, singing, dancing, exercise have also all been widely researched and promoted in their positive effect on well-being.

Be in the solution…

Read more here:  http://www.guardian.co.uk/society/2012/nov/14/iq-study-drinking-alcohol-pregnancy

Read the full article:  http://www.nta.nhs.uk/Club%20drugs%20report%202012.aspx

Last weeks press commented on a middle class population drinking themselves into ill health and I believe these are the very same ‘functional alcoholics’. The commuters, workers, mums in the school yard – these are today’s problem drinkers it seems ‘responsible for 10 times the costs of young drinkers’ according to Alcohol Concern, ‘unwitting[ly] …taking serious risks with their health’ and drinking their stresses and exhaustion away. Only it doesn’t go away, it sits there ignited into its own need for more alcohol. To drink alcohol to compensate for emotional need is to make a monster.

And this functional behaviour, is this to appear civilized, all the while arguing and stressing behind the scenes?

I meet children of functional alcoholics who are often scapegoated into addictive behaviour themselves. Mutinous they sit in my rooms, often with a parent wringing their hands, bemoaning their loss of potential. And when these children start talking they are angry. They have often been given money to fix emotional need, as it is the currency that enables the parent to feel functional. They have been placed second to the drinking. The lies and secrets that they have been silently asked to keep so that the alcoholic status quo can rule has left them no alternative but to act out, or act in. Welcome to ACOA – the adult child of an alcoholic: self sufficient yet insecure, these children also often feel guilty about their feelings of anger and sense of neglect as they can see their parent is working ‘so hard’ or is ‘so damaged’ or that the child is ‘given everything’ so wherefore this sense of loss, of anger?

But sadly it does not surprise me. The denial in our society is supreme. Drinking is endorsed, celebrated as a badge of strength – caner’s pride – or brushed under the carpet (again) with bullish denial that shames the concerned into silence: ‘it wasn’t that bad’, ‘everybody does it’, ‘lighten up’, or  ‘do you want me to stop drinking and stay at home every night?’ Or some such variation on a theme that employs tactics that minimize, exaggerate, universalise, generalise – whatever they do they ameliorate the fact and park the issue one more time.

It is so very very hard for a family member to bring a concern about a loved one’s drinking – so hard that most people miss the opportunity for early intervention, coming to someone like me when they are on their knees – can you save my marriage / my job / have I ruined my children? But I need to say that the shame, fear and regret does not have to be such a burden if you get help sooner!

Charter is predominantly designed as a day programme where people can get well in the context of their lives. This is a deliberate design as those addicts I want to work with are not at the critical end of the continuum (though they may feel it) but somewhere in between, where denial still reigns and trouble usually follows. These people, these addicts, are living amongst us, on the tube, at work; they are serving you, picking up the kids, functioning at some level. These are my clients. I work where intervention happens in time for a full and happy life to be possible.

I believe that abstinence is not the goal, but the means, and thus at Charter we work with each client on the core characteristics of addiction rather than necessarily the drug of choice, reducing the risk of devastating relapse and cross addiction.

Addiction is a human condition, it’s relational and it operates on a continuum. Where you are on that continuum plays a huge part in what sort of treatment you will respond best to. The work we do here is extraordinary, consistently turning out sustainable recovery, as evidenced by our thriving aftercare community. It is possible not only to get clean, but also to live a happy and fulfilling life. Aim for the stars…(and don’t stop flapping your wings ‘til you get there!)

One of the reasons I was interested in hosting this event with Montrose was because we need challenging dialogue amongst the thinkers and decision makers who are interested in this incredibly difficult human condition so that addiction is not marginalised to the confines of the extreme cases, but seen in a broader light, often where an opportunity of early intervention lies. (Is this where I mention being able to spot an addict at age 7…?)

So here I am looking back at all my friends families that helped define who I am today and I realise that those comfy old rooms aren’t quite as comfy as I recall – the wallpaper is definitely peeling off!  It strikes me that there is no such thing as a functioning family.  Addiction captures every household in some shape or form.  For some it is nothing more than an eccentricity, a foible but for others it is entirely consuming.  We all approach it from a different angle, some of us will choose to ignore what’s happening – perhaps they’ll grow out of it, or they might need to just “get a grip or get out!”  Some of us will want to skirt around the issue and others will want to attack it head on.

But we all have one thing in common – we want change but without change!  We look at the person we love and the addiction we hate, we want to keep the person we love and lose the addiction we hate.  We are united in the terror that in losing the addiction we are also going to lose the person.  And so as they head off toward the first step of change we find ourselves siding with addiction. We become overwhelmingly fearful of change.  We’re so busy looking at who our loved one is going to become in the ensuing weeks, months or even years that we lose sight of who they are in the here and now. We’re terrified that this person who we love and know is going to become a happy-clappy-daisy-chasing-Moonie! Perhaps the drinking isn’t that bad, maybe this relationship will turn them around, possibly a little more time – after all doesn’t time heal? And let’s not hide from the financial aspects of curing addiction, that’s definitely on the list!

Several years ago my younger sister came to me to talk, I had long suspected that her world was spiralling out of control and so was relieved when she told me that she needed my help.  We sat at our kitchen table and she told me that she had regularly been using drugs, she had a serious eating disorder and that she could no longer hide the scars of her self-harming.   Over the next hour or so my relief that she was finally sharing gave way to horror (which I tried desperately to conceal from her).  When she was done telling me her life at that moment she asked “Can you help me?”   I panicked, I had suspected that she might have food issues and I thought she occasionally cut herself but I had always envisaged that when this day came I’d be able to help her out with a cup of tea, a little chat and maybe a visit to the doctor.  This was unbelievably out of my league!  I said the only thing that I could – “No, but I have a good friend who can!”

So in answer to all of the above – yes, my sister changed.  She became an incredible, amazing and beautiful being.  She is still vulnerable yet stronger with it, she still relies on friends and family yet she is independent, she’s accepted what she needs to change in herself and what she can’t change in others.  And she can still party without becoming someone she doesn’t like!

And as ugly as it is, I’m closing with the financial aspect.  The phrase “it never rains but it pours” comes to mind, if any of the above is relevant then let me tell you – right now it’s chucking it down and this is the rainy day you’ve been saving for, so get your feet wet!