Self Harm

OBJECTIVE

In this module, we will provide awareness and education on the complex-nature of issues surrounding self-harm and suicide. High School youth will be taught how to:

  • Recognize warning signs of self-harm and suicidal thoughts/attempts (for self/others)
  • Understand self-harm/suicide within a Orthodox/Biblical context.
  • Foster empathy and sensitivity surrounding the shame/guilt associated with self-harm and suicidal thoughts/attempts.

We'll also place a strong emphasis on God's love and mercy for those struggling with these issues while exploring various ways youth can develop healthy coping skills, when to seek professional help, as well as ways of engaging with others (such as friends) struggling with self-harm and suicidal ideation.

INTRODUCTION

This lesson has the potential to trigger certain individuals who have a history of self-harm or suicidal thoughts. Servants may make students aware the week prior that this particular lesson will be shared the following week to provide an opportunity for students with personal experience or sensitivity to be properly prepared. Additionally, a brief statement should be made at the beginning of the lesson (such as the sample below) to foster a safe place where students can learn, share their thoughts/feelings and as well as be edified by this dialogue.

Sample Opening Statement: "Our focus today will be on self-harm and suicide. I understand that this is a heavy and sensitive topic for some of us. Our goal here is to invite God's presence to lead our conversation and to speak with love, empathy and grace. As we do that, let's be mindful of how our words will impact those with a sensitivity towards this topic."

Warm-up Questions

Watch Trevor's Story: Trever's Story - Alive to Thrive.mp4

Additional Youtube link:

Ask the youth the following questions:

  • What do you think leads someone to a place of hopelessness/despair? What was it in Trever's case?
  • What role does social media and unrealistic societal expectations play towards feelings of depression and hopelessness?
  • What was the shift Trever experienced in his story that brought him hope?
  • In what ways can you relate to Trevor's story?

Context of discussion

  • Here servants should make an intentional effort to highlight and build on the previous "Anthropology" module. As students answer the discussion questions, integrate key points such as identity, purpose, belonging in Christ and His Church and our inherent value as children of God.

HOLY SCRIPTURE

Select a few of the following Bible Verses to show the way in which we can use Scripture to guide us in our time of need:

To cry out to God in times of struggle:

  • "Answer me, O Lord, for thy steadfast love is good; according to thy abundant mercy, turn to me;" - Psalm 68:16
  • Do not withhold Your tender mercies from me, O LORD; Let Your lovingkindness and Your truth continually preserve me. - Psalm 40:11
  • Let us therefore come boldly to the throne of grace, that we may obtain mercy and find grace to help in time of need. - Hebrews 4:16

To provide hope:

  • There is surely a future hope for you, and your hope will not be cut off." - Proverbs 23:18
  • "Have mercy on me, O God, according to thy steadfast love; according to thy abundant mercy blot out my transgressions" - Psalm 50:1
  • But God, who is rich in mercy, because of His great love with which He loved us, even when we were dead in trespasses, made us alive together with Christ (by grace you have been saved). - Ephesians 2:4-5

To highlight our value in Christ:

  • Do you not know that your bodies are temples of the Holy Spirit, who is in you, whom you have received from God? You are not your own; you were bought at a price. Therefore honor God with your bodies. - 1 Corinthians 6:19-20
  • "For you formed my inward parts; you knitted me together in my mother's womb. I praise you, for I am fearfully and wonderfully made." - Psalm 139:14

CONTENT (KEY POINTS)

(Note for servant: the following will provide a more in-depth look at the clinical aspects of self-harm and suicide, feel free to share as much or as little as your time allows... our suggestion would be to focus on warning signs as well as treatment and healthy coping as it'll be the content most beneficial for youth struggling with these issues)

What Is Self-Harm?

Self-harm or self-injury means hurting yourself on purpose. One common method is cutting with a sharp object. But any time someone deliberately hurts themself is classified as self-harm. Some people feel an impulse to cause burns, pull out hair or pick at wounds to prevent healing. Approximately 14-24% of youth or young adults have engaged in self-injury at least once. About a quarter of those have done it many times.

Why Do People Self-Harm?

Self-harm is not a mental illness, but a behavior that indicates maladaptive coping, or a need for better coping skills. Several illnesses are associated with it, including borderline personality disorder, depression, eating disorders, anxiety or PTSD. An individual may engage in self-harm behaviors for some of the following reasons:

  • Cope their negative feelings (stress, anxiety, depression)
  • Distract themselves from their negative feelings
  • Feel something physical, particularly if they are feeling numb
  • Develop a sense of control over their lives
  • Punish themselves for things they think they've done wrong

Why people cut or self-harm: In their own words:

  • "It puts a punctuation mark on what I'm feeling on the inside"
  • "It's a way to have control over my body because I can't control anything else in my life."
  • "I usually feel like I have a black hole in the pit of my stomach, at least if I feel pain it's better than feeling nothing."
  • "I feel relieved and less anxious after I cut. The emotional pain slowly slips away into the physical pain."

What are the warning signs of self-harm?

  • Many cuts/burns on the wrists, arms, legs, back, hips, or stomach
  • Wearing baggy or loose clothes (e.g., wearing hoodies or long sleeves during hot days to conceal wounds)
  • Always making excuses for having cuts, marks or wounds on the body
  • Finding razors, scissors, lighters or knives in strange places (i.e., the nightstand drawer or under the bed)
  • Spending long periods locked in a bedroom or bathroom
  • Isolation and avoiding social situations

What is suicide?

Suicide is the voluntary and intentional act of taking one's life. Suicidal thoughts (or suicide ideation) refers to thinking about or planning suicide. Thoughts can range from creating a detailed plan to having a fleeting consideration. It does not include the final act of suicide.

Many people experience suicidal thoughts, especially during times of stress or when they are facing mental or physical health challenges. Suicidal thoughts are a symptom of an underlying problem.

The Warning Signs of Suicide:

While some suicides may occur without any warning signs, most people who are suicidal do give warnings, such as:

  • Increasing their alcohol and/or other drug use
  • Talking about wanting to die or to kill oneself; referring to death via poetry, writings and drawings
  • Fascinating over or preoccupying oneself with death
  • Talking about being a burden to others, feeling hopeless or having no reason to live
  • Acting anxious or agitated; behaving recklessly/taking unnecessary risks and impulsivity
  • Isolating or withdrawing oneself
  • Displaying dramatic changes in mood, personality or appearance
  • Giving things away, such as prized possessions/Setting one's affairs in order

Treatment And Coping

For our purposes, we'll combine treatment and coping to deal with both self-harm and suicidal thoughts/attempts. Firstly, Self-injury is not a life-sentence. youth CAN and DO STOP self-injuring. However, the longer an individual self-injures, the more difficult it can be to stop. It is important to remember that stopping a behavior that has become a frequently used maladaptive coping strategy will take time, effort and new healthy coping strategies. Stopping self-injury is not something that occurs over night, or with threats. In fact, this approach may increase negative emotions for the student and may increase self-injury.

Take time with your youth to discuss God promises to His children, to provide a future and a hope. A teen in crisis may not understand how God is working in their lives. However, as we lean into God's word, we're reminded that we're called to trust God even when we do not understand our circumstances. (Psalm 46:1, Psalm 27:14, Hebrews 12:1-3; Proverbs 23:18). Because God's unfailing love towards, He promises to never leave or forsake us. Take time to discuss with your teens how His love is everlasting; it will never stop, disappear or grow cold. Nothing can separate us from His love. God can and will provide mercy and grace (Hebrews 4:16; 13:5; Ephesians 2:4-5; Romans 8:35-39).

Additionally, it's important to note that there are effective treatments for self-harm that can allow a person to feel in control again. Psychotherapy is important to any treatment plan. Self-harm may feel necessary to manage emotions, so a person will need to learn new coping mechanisms.

DISCUSSION/ ACTIVITY

All of us experience negative emotions (albeit to various degrees). Now that we know that self-harm is mal-adaptive coping (an unhealthy way of coping with negative emotions), let's brainstorm healthy distractions and coping skills when we feel anxious or stressed If you have access to a white board (or a large poster board), write all the various suggestions youth come up with for healthy coping skills. Remind youth our first line of defense is strengthening our spiritual walk. Praying, Bible reading, attending Liturgy/Tasbeha if possible, listening to a favorite hymn/spiritual song are all powerful ways to draw on God's strength and not rely on ours alone. Additionally, activities such as journaling, talking to a friend, going for a walk/run, listening to music, creating art (and countless other activities referenced in the 99 coping skills handout) are very helpful in creating healthy habits and coping strategies.

Activity Suggestions

As a personal exercise, (or for those willing to share) have teens write down negative statements they tell themselves on a regular basis that include the words never or always, such as, "Things are never going to get better" or "I always do the wrong thing." Have your teens rewrite those statements in flexible terms such as, "Things could get better with hard work" or "Sometimes I make good decisions." The idea is to recognize we rarely live life in the absolutes of "never" or "always," and a good outcome is as likely as a bad outcome. Have them say the positive, flexible statements out loud whenever thinking the negative thoughts.

APPLICATION (Action)

Action Steps (when dealing with self-harm/suicidal thoughts)

  • Define the problem
    • Come to terms with the issue at hand
    • Be open and honest, with yourself and before God
  • Monitor safety
    • Regularly assess the overall safety of self-harm behaviors or suicidal thoughts/attempts
  • Lean on your faith
    • Seek spiritual support (confession, communion, relying on God's Word, active prayer life)
    • Connect with spiritual mentors or servants who will walk this journey with you
  • Seek help
    • Seek help from a trained professional, school counselor etc.
    • Communicate honestly with parents, family and loved ones about the issue at hand
    • Enlist the help of a trusted adult
  • Do the work
    • Get to work learning healthy coping and alternatives to destructive thoughts/harmful behavior
    • Remove temptations that lead to self-harm behavior

CONCLUSION

It's impossible to go through life without experiencing negative emotions. However, we need to help our youth recognize the ways in which we choose to deal with our stressors and negative emotions. When it comes to self-harm and suicide, it's important to remember that our God is for us While our thoughts and feelings can sometimes take us away from this indispensable truth, it's important that we develop the spiritual strength to fall back on God's love and mercy, which are new every day. We do this by engaging with the word of God through meditating on His promises, partaking of the sacraments, especially communion and confession. Additionally, seeking help from a trusted friend/adult, spiritual mentor or a Mental Health Professional (if the need arises) is a sign of healthy coping and growth in dealing with difficult circumstances and negative emotions.