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This is a bit of a different review as it's not something I've written specifically for Ciao.....so here goes nothing!
As many of you know I have personal experience of self-harm (which I have written about here - http://www.ciao.co.uk/Member_Advice_on_Self_harm__Review_5614015 )
An important part of my life is being a volunteer director/trustee of Self-Injury Support in North Cumbria (SIS) which is a charity based in Carlisle (but covering all postcodes beginning with CA - there's actually another charity SAFA which covers LA postcodes) - we offer lots of services, but the main one is free counselling for people who self-harm, for as long as people want/need it. People get referred to us from GPs, mental health services, schools and other organisations, or they can refer themselves. We also deliver training, which include me talking about my personal experiences - for more info about the charity visit www.sis-cumbria.co.uk
Anyway, today (well technically yesterday as it's now after midnight) I attended a conference in Gateshead organised by the CCYP (Counselling Children and Young People) which is a subdivision of the BACP (British Association for Counselling and Psychotherapy) entitled "Self-harm - an effective response, understanding and working with children and young people who self-harm".
I'm not a counsellor myself (most people there were) but I found the day very educational and there were excellent networking opportunities. The following information is what I've spent this evening writing to share with our organisation's counsellors. I'm not sure if it'll be interesting to Ciao members unless they have experience working with young people (either in healthcare or education), but I thought I'd give it a go and put it in the Ciao Cafe.
But my main reason for posting a self-harm related review is that today - March 1st is Self-Injury Awareness Day (SIAD) - an international date for raising awareness about self-injury and self-harm.
I hope the following makes sense (for info Ruth is the SIS co-ordinator and Sue is a fellow trustee, who I attended the conference with.....bear in mind it's written specifically with our counsellors in mind....
CCYP conference – Hilton Hotel, Gateshead - 28th February 2009
Having had the pleasure of attending the CCYP Self-Harm conference on 28th February in Gateshead with Ruth and Sue at the expense of SIS I thought it only right that I should share what I learnt from the day with you.
The conference was well attended by nearly 200 delegates. This was the second of two CCYP conferences on self-harm, the first being in London in November 2008. The majority of delegates were counsellors representing various organisations (or just there for themselves), mainly from the north of England and Scotland, although some had travelled quite a distance (I struck up a conversation with counsellors from Harlow and Dagenham in Essex who had been unable to attend the London date).
As is normal at these events, there were a number of exhibition stalls – some were about various accredited training courses (so not relevant to me not being a professional), an organisation ‘Place 2 b’ which deals with emotional wellbeing in primary schools, and two book stalls. I ended up buying 3 reduced price self-harm books to add to my extensive self-harm library, 2 which I hadn’t heard of before as they’re fairly old and unknown (one of which will be really useful in developing the SIS workbook for people who self-harm) and “Who’s Hurting Who” which is a book I read back when I wrote my MSc Self-Harm dissertation in 2003 (if you fancy reading my dissertation I’ll email it to you) but hadn’t got round to buying. Welcome – Kathryn Hunt
The day was introduced by Kathryn Hunt, the Chair of CCYP. She talked about the Universal Education Foundation (UEF), and issues of the nurture and wellbeing of children. It took her a while before she even mentioned self-harm, but then talked a bit about the importance of trusting relationships between counsellors and clients who self-harm.
Keynote speaker – Dr Marcia Brophy
Marcia Brophy delivered the first keynote speech of the day,
focussing on the National Inquiry into Self-harm among young people which was now 4 ½ years ago. I have heard Marcia speak before, at a conference in Edinburgh in 2006, and am well acquainted with the National Inquiry so this was nothing new really. I imagine that most people who know about self-harm will be aware of the National Inquiry, but if not you can download the reports here - http://www.mhf.org.uk/campaigns/self-harm-inquiry/ so there’s no need for me to go into this in detail!
What was interesting was how Marcia talked about her disappointment that the recommendations from the inquiry haven’t been taken forward as far as had been hoped (for instance a lack of engagement with the NICE guidelines on self-harm), and how much work there still is to do.
There has been a website (a ‘virtual centre of excellence’) created as a result of the Inquiry - http://www.thesite.org/healthandwellbeing/mentalhealth/selfharm if you’re not already aware of that. I could talk about that as I have inside information, but I’ll save that for another day!
Morning Workshop – When Self-Harm is Sexual: A Multi-Agency Approach – Tim Woodhouse
I didn’t specifically choose this session, I just wanted to go to something different from Ruth and Sue (not because I don’t like them I hasten to add!), but I thought it sounded interesting anyway. I have read a book written by someone I met online about her personal experience of sexual self-harm (it’s called ‘Peeling back the Layers’ by JoEllen Adams – if anyone would like to read it I’m happy to lend you my copy), which basically talked about her self-harm which was a reaction to childhood sexual abuse by her Grandmother. Her self-harm mainly took the form of inserting objects into her vagina and leaving them there for periods of time, and masturbation leading to physical injuries. In addition to the general stigma of self-harm there was an additional stigma attached to hurting herself in this way.
However, I digress, as although this is what I was expecting, this isn’t really what the session was about, although there was a brief mention of a boy who inserted objects in his anus.
Tim Woodhouse is a play therapist (for the NSPCC) working with children who have been sexually abused.
Firstly Tim talked about self-injury as being a response to hyper-arousal or dissociation, and then some of the forms of self-harm (I have to say I don’t think I’d ever heard the term Dermatillomania – compulsive skin picking (see http://en.wikipedia.org/wiki/Dermatillomania) although it’s something I do myself at times of stress) and self-harm as “a continuum of behaviours from sexually reactive behaviours to involvement in the sex industry in its various guises”. Tim talked about rent boys and some research which found that the main motivating factor in becoming a rent boy wasn’t financial gain, or some sort of ‘love’, it was as a reaction to hyperactivity or dissociation, and that the sex led to a period of calm. He also talked about a boy, Dino (16) who was groomed on the Internet and a sexual experience with the groomer led to becoming HIV positive.
Much of the presentation focused on brain development (brainstem, mid brain, limbic and cortical sequences) and brain activity in emotionally healthy children and in those with attachment issues. Tim also talked about issues of traumatic response, the Six Fs (Fight, Flight, Freeze, Feed, Fart, and F*ck) Dissociation, Post Traumatic Stress Disorder (PTSD) and pre-conditions to sexual vulnerability (i.e. what makes someone vulnerable to paedophiles). He spent a lot of time talking about TSCC (Trauma System Checklist for Children), and how EDMR (Eye Movement Desensitisation and Reprocessing) therapy can help lower scores on the checklists.
We were asked to look at a case study of China, a 14 year old with a history of neglect and harm in her mother’s care. With her two younger sisters, China had been with the same Foster carers for the past 7 years, and while she had already been difficult to cope with, this had got worse as China got older – issues including theft (from foster carers and siblings), drug/alcohol abuse, non-attendance at school, poor relationships with siblings, history of threats of self-harm (there was no mention of actual self-harm), and promiscuity – including a sexual relationship with a 40 year old man (although he was convicted this was due to his abuse of another girl, as China’s testimony wouldn’t stand up in court due to her behaviours), We were split into groups and asked to think about our role as a therapist of China’s as to how we would interact with one of the following – China’s foster carers, China’s social worker, and the police. The main thing really was that a multi-agency approach was needed.
To be honest while parts of the presentation were very interesting (Tim was a good speaker) and the case study was a good chance to think from a counsellor’s perspective, I was left wondering what Tim was really talking about (it wasn’t just me as I spoke to someone else in the group later who felt similarly), was it actually sexual self-injury, or children who have been affected by sexual and other abuse? Plus the acoustics in the room were not really ideal for the session, so I don’t think that helped.Lunchtime
After a nice lunch (the sausage and mash was nicer than the usual sandwich!) it was off to our second workshop choice.
Afternoon Workshop – ‘Am I Bovered?” – Cathy Bell
I wasn’t particularly optimistic about this workshop due to the title – I have to say I’m not really a Catherine Tate fan! However, the facilitator Cathy Bell was, and she began by showing us a clip (well, when she got the laptop’s sound to work!) of Catherine Tate playing her famous character of the teenager who isn’t bovered – Lauren. There followed a discussion of this, and we all agreed that Lauren actually is bovered – she’s desperate to fit in with her peers and to feel that she belongs. She hates being made to feel stupid, and has trouble expressing how she’s feeling, instead sticking to saying “not bovered”. Although it’s comedy, it was actually quite a powerful illustration of the struggles that adolescents face in today’s society. She told us that when preparing this presentation it was young people she works with who had told her to include a clip of Lauren.
Cathy Bell is a qualified social worker and counsellor, and has worked with children and young people for most of her life. Cathy is from Northern Ireland, and is heavily involved with the Northern Ireland Children’s strategy. What I enjoyed most about her presentation was both her witty and down-to-earth delivery and how she brought personal experience into it – talking about her own nieces and their struggles during adolescence (some including self-harm and some not), touching on her own personal experience of self-harm, and other people she’s come into contact with.
There was discussion about the factors impacting on a young person’s ability to cope – sexuality issues, family issues, school pressures, violence, alcohol, trauma, bullying etc. We got into groups to discuss other issues. There followed a whole group discussion, and when talking about issues of parental neglect of various sorts I joined in with my personal experience that while I had a good upbringing I felt emotionally neglected in terms of having no physical affection or the ‘I love you’ kind of affection from my family. In fact it actually hit home a bit when someone said about how heartbroken a parent was when she had realised that she had emotionally neglected her child. I wouldn’t say it’s a revelation, but I am starting to understand how my parents must have felt when they found out about my self-harm. But also that we can never really talk about all of the reasons behind it, as that would then make them feel immensely guilty, when that’s the last thing I want as it was no one’s ‘fault’, that’s just how things were, and they are otherwise excellent parents, and I love them dearly. But anyway, I digress again!
Cathy showed us the Scottish ‘See Me’ campaign’s self-harm advert which you might remember from TV (it did get across the border to Cumbria – well, I remember seeing it on TV anyway) – if you haven’t seen it or want to refresh your memory you can see it here - http://www.seemescotland.org.uk/viewourads , the video called ‘Cloud Boy TV’ – well worth a watch. It was an excellent campaign, I’ve spoken with people from See Me in the past, about what a shame it is that we haven’t had anything like that in England. Anyway, I digress!
A useful point which Cathy raised was that self-harm is a choice. At this point I again brought my own experiences to the discussion, saying how self-harm isn’t something that anyone made me do, it’s a choice that I made – I chose to cut myself to deal with my emotional pain. We talked about the role of counsellors, and all agreed that counsellors are there to help people as they find less harmful ways to cope, but that it has to be something that the client wants to change.
Research shows that friends are normally the first port of call for young people who self-harm – they are usually the first people who will become aware of self-harm. We talked about the importance of peer support, particularly in schools. We were all interested to hear from one man in our group, a secondary school teacher who was saying that in their school, form groups are not sorted according to year group – they include a range of pupils from Year 7-13. He was saying how this seems to help as the older pupils tend to look out for the younger members of their forms. I thought it was quite an interesting concept…if nothing else it’s a different way of looking how peers can support each other through school. We talked about how peer support programmes can be of enormous benefit to those who are supporting their peers (as well as those being supported) as it builds self-esteem, and a feeling of being able to help others – also, peer support can be accredited, so it can also be useful for young people for their futures.
The session ended with a song which a young person had written (and sung) basically saying thank you to their counsellor for the help they had been given – that was a nice touch really, a good way of appreciating the work which counsellors do with people who self-harm.
I thoroughly enjoyed this workshop, the highlight of the day (and it was even more enjoyable as there was a fantastic view out of the window of the bridge, and also because there were mint and jelly bean dispensers), and chatting to the people in the group – it was far more interactive than the morning’s session. Perhaps in the morning session I felt slightly out of place not being a counsellor myself, but in the afternoon I found that everyone wanted to know what I felt as a person who self-harms – all excellent preparation for the SIS training workshops. One man came and patted me on the back (literally) afterwards and said “Thank you” which was all a bit random, but nice nonetheless.
Self-Harm and Public Consequences – Dr Andrew Reeves
The final session of the day, and I’m afraid I’d started to switch off a bit despite the excitement of the big choc chip cookie in the coffee break, and chats with the Rape Crisis people from Hull as I reminisced about my University days there (in Hull, not at the Rape Crisis centre)!
Andrew started by talking about the language used to describe self-harm, and that by saying “people who self-harm” (which is actually probably the best way to describe it, rather than something like self-harmer which defines the person by their self-harm) creates a distinction between ‘them and us’ as we all self-harm to an extent. He was saying that by knowing that we all self-harm we can make connections with young people struggling with self-harm.
There was talk about school based counselling, and systems, the power of counselling and supporting young people. Far too much jargon though for me!
Unfortunately while I’m sure it was all very interesting, Andrew I don’t feel was the best keynote speaker (I feel he’d be much better suited to the smaller group of a workshop) and his monotone delivery and our tiredness at the end of the day were not conducive to listening to him! As a result it was like being back at school as I sat and continued my conversation with the lady next to me which we’d started over the chocolate chip cookie.
However, Sue spoke to Andrew afterwards and will be emailing him for more information about counselling in schools, and stuff!
All in all it was an excellent day, my only real regret (other than not taking any SIS leaflets to hand out – must remember next time – always a good icebreaker when approaching random people to network with) was that I didn’t put a load of shortbread biscuits in my bag to bring home….there’s something about free biscuits from hotels which gets me really excited!
Thanks for bearing with me, and if you can tell one person about self-harm throughout March (you could direct them to my Ciao self-harm review) then that would be absolutely fantastic!
Excellent review - I had a couple of friends at college who self-harmed, one who I was more aware of than the other. I bet these details would help a lot of people who have a friend or family member who is self-harming.
py106 11.04.2009 02:14
Thanks for sharing... a very great review. Anan
jeaniecz 28.03.2009 20:45
Not a happy subject but it's very important to talk about those things, I think you are doing a piece of great job there!