 So welcome everyone today. I have the pleasure of introducing you to one of our workplace mental health specialists from the u.s Laurie van Laurie is a licensed professional counselor and supervisor of other counselors in Texas and The reason we have her with us and why we're speaking with her today is because she has a particular expertise in the area of self-injury Also known as self-harm, which we know Unfortunately is a growing issue and something that we feel really needs to be much better understood and addressed So she has written a fantastic book a care givers guide to self-injury Which shows family members and others how to support their loved one who's dealing with self-injury. So really pleased to see you again Laurie welcome Thank you. It's great to get to speak with you again Wonderful. So let's start from the very beginning What are we talking about when we say self-harm or self-injury because that's something that we get asked a lot in our training courses You know, what is it exactly? Are we talking about cutting or what is it? It is that I like to keep it simple because there are many definitions out there But the one that I've developed over the 20 years is that it's the intentional infliction of harm on one's body usually for emotional reasons and so the really Intentional aspect. It's not an accident. It's not oh oops. I goofed. I mean, it's a Conscious decision of I know I'm about to create harm on my body right, right and So another question we often get is around what's the relationship with suicide? Does it doesn't mean that the person is necessarily necessarily intending to end their life or How does that work? What's the relationship? It's a great question because that is a really important thing to differentiate So while self-injury is not a suicide attempt, there's a very strong correlation between the two To the matter of fact of at least 60 maybe even up to 70 percent of people that self-harm Do have some type of suicidal ideation and over the years. I've tracked over 530 individuals so that's one of the things I look at and I will tell you yes, at least 60% either either have the ideation or they've actually attempted But to force it the behavior itself does not mean it's intent or attempt That's where you have to ask the end in question So what was your aim in doing this so and why do people do it? I think that's something that for people that are not in that space It's it's very difficult to understand Why do people you know want to hurt themselves you said those emotional reasons Usually yes, so in a caregiver's guide to self-injury I Chronicle over 30 different reasons and since I've written that book I've come across several more So I'd say there's at least 35 different reasons. I've charted and the most common I mean by far the number one Reason is that the emotional pain is so bad. It's just so difficult to deal with It's easier to deal with the physical pain. It's it's cathartic. It's a release It's a distraction. It's a way to ground themselves But I mean we can go into my other I guess you'd say top 10s Sure, sure, but it's interesting because what we're seeing is it's a way of trying to cope with or manage Other stuff that's going on all the other emotions, whatever they may be for the person Right, so yes, it serves a purpose in a sense. Yeah It absolutely does serve the a purpose so some individuals when they get really emotional They're upset. They're just looking for some release. They might grab a bottle or they might grab Also, they might grab a joint or they might Or lose themselves on a video game The thing is is that our society Likes to pick and choose, you know, which For lack of a better way to put it, it's almost like we Normalize rationalize we're okay with the substance end of it and even the eating disorders has become more Accepted in a way that self-injury is so taboo. It's like, oh my god. It is. Yeah Like oh And that's why it's so much more prevalent than when people believe it to be It's because people are so shamed by the behavior. Why on earth? Would they ever disclose that that's what they're doing? Yeah, yeah And and more common than we think or more common than those other coping strategies It's definitely much more common than we think and one statistic that applies in America at least is and I've seen it Over the course of three years the same stat has been consistent And that's one in four girls in high school high school for Americans age 14 to 18 So one in four high school girls have self-harmed 25% right there and then I can tell you the teenage boys are doing it too Right, right and that's one of the adults I was gonna say that's one of the things we have this sort of stereotype image that it does tend to be younger people And it tends to be more female. Is that correct or you know There are other people that are using this coping strategy as well It definitely other age groups are it starts an elementary school. A lot of people are shocked by that. They're like, oh my gosh That's scary. Absolutely I would say a good number Of individuals if you find themselves harming as teenagers They probably start an elementary school in age 10 is one of the most common ages. I'm coming across Now they're not jumping right into cutting But they're doing other things the scratching and the picking and the hitting And maybe the pinching or the rubbing all those things that are easier to not catch as forms of self-harm But they actually are yeah, they really are and then it's just over the course of time That's when they move up into cutting and burning and then people are like, oh they just started to do this And it's like no they've been doing this for two or three years You just found out An adult self-harm too Right, right and are there differences in the like presentations that you would see between younger people and adults For younger people Especially once they get into the teen years, you do tend to see more of the cutting carving You can't see the scratching Burning does occur Burning is its own very interesting piece of self-injury Because if you burn, you're really looking for that pain piece, but it's also Is if they are consistently or they've done burning several times They want the radiating pain Because with the cut it's sort of a Over and done with so to speak. I mean, yeah, there still might be some throbbing bit of burn That's in the last four days and that's where oftentimes people might do it once and they go, oh Okay. Yeah, that's not going to be my method for adults I I had an individual a male and his 50s That the first time he ever self-harmed was in his 50s and he did it with cigarette burns Right, right And and it sounds like you're saying there's this sort of escalation and the similar would you characterize it as an addiction? in the way that it sort of escalates over time Absolutely people need more to get that response It absolutely is the second book I wrote a practitioner's guide to the treatment of self-injury Spend one of the biggest chapters of the book is the question of is self-injury addiction And I make the case that yes, it absolutely is The neurotransmitters Are affected the brain's chemicals Are similar to what you see with substance addiction or substance misuse You look into the whole cycle of it It's very OCD in nature, which you can make the argument OCD is like an addiction itself because They're the urge and you're anticipating and maybe you're fantasizing And then you finally do the act you have relief and then it starts all over Yeah, yeah so at the WMHI at the institute obviously our focus is on workplaces and Why should a company be concerned about this when it comes to their employees? It's a great question so one Most businesses have some employees that are probably engaging in this behavior, but they just don't know And that can place a business at a risk because as we said self-injury has that correlation with suicide Now you might have an employee that tends suicide and you go, oh, well, where'd that come from? Well, it's because maybe the origins are back there Substance a substance misuse in the workplace. We know that that happens We know that there are employees that are not using substances the way they should And that there is a correlation with self-injury and substance misuse We also know eating disorders And that yeah, so when when you look at the statistics for those other behaviors that we give more attention to You have to acknowledge that self-injury is right there with it So you can't really just do the one and not the other And if nothing else I guarantee that your employees have family members that have been engaging in this Yeah, well when you're talking about those kinds of numbers, I mean we we often talk with workplaces and many will Be quite proud of the fact that you know, well, we don't have any of that here You know, everyone's happy here and and bless them. It's great that they want that so badly But just purely statistically speaking it and it's not blaming anybody. It's just as a matter of statistics There's going to be people and we don't always spot it. So What could we be looking out for what signs might we see as colleague You know or as a parent or a friend How would we know especially with so many people working from home these days? You know, we don't have that in-person contact as much as that's previously What can we do to be aware? That is the really great struggle right now with working from home or for students doing school for home online learning That has been one of the major concerns that has come up because of all the quarantine Is that people one are just more isolated. So that in itself increased risk not just for self-injury But for depression anxiety, we know that's just through the roof Yes, yeah but I think when you see some of the Changing in and clothes now right now it's winter up in our hemisphere. So long sleeves not going to be Too surprising But when it gets to be spring and summer and someone's still wearing long sleeves and they really make this conscious decision And you know, that's not typically been their fashion sense You might go well, that's interesting Not necessarily saying that's what they're doing, but that's it's one piece of it You do look for the shift in the mood. I mean just depression and or anxiety This is a unique part people don't often think about perfectionism and self-injury relation Can you talk about that because I think that's really interesting and something that as you said we often don't notice It's perfectionism is seen as a a really a good attribute to have in a lot of ways You know, we go to a job interview and what's your weakness? Oh, I'm a perfectionist It means more than that though You know It does mean more than that. That's a really dark side to perfectionism Absolutely And I'd start to actually write two books on perfectionism one that's going to be good or for students And one that's actually geared for adults because yeah, I filled out so many short-term disability claims for adults that were perfectionists and they just got the point where they could not perform any more the demands began too high They really inadvertently sabotage themselves It was self-injury and that perfectionism piece it Oftentimes you have people pleasing as the other Component So individuals that are perfectionists sometimes really struggle with people pleasing, which means foundry setting issues Those that self-harm Quite often tend to be people pleasers. They're not really good with setting boundaries So you have this group that is very worried what other people think about them and making that good impression and so For a perfectionist when they don't live up to that mark when Whether it's their standard or someone else makes a comment Oftentimes they internalize that And you can only stuff stuff stuff so long before there has got to be an outlet And that might be that they go to explode and they get drunk Or if they're the people pleasers, they're going to implode upon themselves And that can take the form of self-harm or eating disorder for that matter And that you know, you mentioned you had 30 plus reasons why people would do it that sort of Is it a punishment? Is it a guilt thing or either or or both? It sounds like every person has a very unique sort of pattern of how they do stress anxiety Perfectionism depression and then how they Try and manage those feelings and emotions as well even within the category If you like the mental health category of self-injury there's Going to be so many different Individuals with a different story so to speak. Does that be right? Yes, one of the things when I'm doing assessments and I'm training other Professionals and how to do a proper assessment of this behavior Is that I remind them every time someone self-harms could be for a completely different reason And oftentimes when they self-harm or self-injure, you might have multiple reasons It's not just I was sad or I was angry It could be I was angry and I was hurt and disappointed and I was really You know stressed out because things were going my way Took multiple things for a single episode So we have to be very careful about not making those assumptions of well people that Injure, they must just all be depressed That's that's not the case at all or or unfortunately one of the ones that we still hear from time to time Are they seeking attention? That's I think one of the trickiest ones because they're it adds that sort of layer of judgments on top of The distress the person's already experiencing and as we said the taboo and the perhaps shame that they may have around this as well So we've got to be really careful Not to go down that path either Absolutely and In different training events I go in and explained you can't make that statement You cannot make the assumption their attention seeking So the thing that I put out there is that one are there some people that Show off their wounds and like oh look what I did this weekend and they want attention Absolutely Yeah, but I will tell you the vast majority of those that self harm Are keeping it under wraps and people don't know it's a very secretive And probably shame filled behavior for many individuals But I would also add a little bit of a compassion piece to it Because the thing is if someone has to go to that level to get attention How sad is that? I mean really what a desperate cry to help they feel like they have exhausted the other options And they have to go to this level to get someone to pay attention I don't know to me that seems worthy of like How more understanding and judgment Yeah Yeah, and that's what we say in the training if someone's going to that depth to get attention then clearly there's some attention needed Yeah So so what do we do? How do we if we do observe something amongst someone? We know we we see some of these pieces of the puzzle possible warning signs because we can't assume You know as you said just because someone's wearing long sleeves. Maybe they like the top We can't assume but if we do start to see a few things that we think oh something's not right here I've got a bit of a a concern. What can we do? What would be the best way to approach it as a first step? Being non-clinical non-professionals Well in a workplace setting it's one just start to get to know the person You don't even have to say hey, are you doing this? Yeah, I noticed that you're wearing a lot of bandages or you spend a long time in the bathroom It's No, don't be a detective But anytime you see a co-worker and it just seems like they're stressed out or they're anxious or they're sad or they're present Just go be a friend Don't ask them 20 questions. Just be present Just say you know what? I'm going to go down and get a coffee. Do you want one? It's just the simple gestures are such a great starting point If you're not responsible for solving their problems and making it all better A lot of times just having someone that gives them a smile That just says no genuinely like how are you doing? That can be the catalyst for change for them that literally small gestures like that Change the direction of going you know what? I was thinking about doing this behavior But maybe there's a little bit of hope out there Maybe someone actually Yeah So in your experience do people necessarily need to get professional help if this is something that they're struggling with or someone they know is Yes, so one thing that comes up from the parent side that I've heard and and I Think I've even heard professionals say this Is that we want to just grow out of it isn't it just a face? And they reference that a lot in regards to minors But the promise again, we have adults that do this and out of my numbers At least 10 started after the age of 18 and I have plenty of individuals that were in their 30s and above That were self-harming And at that point I don't think it's a grow out of it stage when you're in That stage of life So one you can't make that assumption Now are there some people that might try for a while and they go, you know, this isn't really my thing and they move on to something else Sure But the problem is is if you've not worked on that core issue that roots is done exactly You're just going to flip flop to most likely another unhealthy behavior Exactly, you've got to deal with whatever is the stress or underneath and now, you know, particularly in the world at the moment We've seen as you were saying mental health Levels skyrocket. There's a lot a lot of stress a lot of change a lot of challenges that people at the moment so, you know even And one of the things I say to people is if they are reaching out for a professional help they don't necessarily need to To express absolutely everything the first time they meet with a professional either, you know sometimes it's okay to Take it a little piece at a time and and look for some help with the stress that might be going on or with the perfectionism or with anxiety And no build up some trust with someone until you feel comfortable to share more of what's going on for you But do do people do you think people struggle to to reach out for professional help particularly in this area? I do I had for a while a women's non-suicidal self-injury support group and I would have women call up expressing interest in and just the shame they're like I can't believe I'm having to make this phone call. This is so embarrassing. This is something that teenagers do I'm like No, I started the group because I had enough women contacting me saying what about us And men definitely do as well, but there's barriers for men getting assistance because it's You're supposed to be able to do it all on your own and you know be tough and and truly I mean as we know in In the field that one of the bravest one of the smartest things that you can do is get help I mean, it's truly one of the strongest things and bravest things that you can do But absolutely one of the wisest decisions that you can make Because if you think about in the coaching piece if you don't know how to play golf you get a coach Well in life You're not given an instruction manual of this is how you deal with the layoff This is how you feel psychologically with the pandemic I have yet to see an instruction manual that we were all given of Yeah Well, 2020 or 2021 Yeah And I think one of the best things that I see people get is just a sense of relief when someone's able to say to them You're not the only one You won't believe it but so many people are struggling with the same thing and You're not crazy and we can start from here to improve things, you know, just that having that sense of relief that's all right Yeah, it's okay. I can start from here It absolutely is and that's one of the benefits of support groups and I have the one for teenage girls And I I put under a coaching guide so that way it's not limited to just yeah The counseling license it's literally anyone in the world could join that group that the support factor is so big Of in a group you go. I'm really not alone. Like there are other people with this And it puts things in perspective and there's so many benefits to groups And it's not that people have to share their life story in a group Most if you're run correctly are very respectful of that there are group rules confidentiality that Yeah, if you're not feel if you're not comfortable talking then you know what it's okay You don't have to you can just sit and be present and listen to others until you feel that comfort level Then counseling or coaching either way It's not to go back to your point. You don't have to give your entire life story in that first visit One of the things I do at the intake is say hey, I know this is awkward. You're coming to a complete stranger You know nothing about me other than what you saw on my website And so if there's anything that we start to talk about today that you're not comfortable with it's okay Just let me know and you know what we'll get back to it later Perfect It's not as intimidating of a process is what people think it is one of the things that's really stood out to me from what you've said is that that 10 year old piece and I'm just wondering like from a preventative perspective. What can we do as a as parents perhaps teachers? In workplaces, what what can we do given that in many times it starts young but not always How can we prevent people from getting to this space where they see this As a as an option for them if there's anything we can do in our environments There's uh, there's probably several things on the parenting side It's quality time together. It's being present It's putting down the technology. It's turning off The videos and have actual quality engagement with your child Because jobs are always going to be there It you know in some form or another there's always going to be some kind of job But your child is only in your house for a certain period of time And you can't ever get that back. So quality engagement making eye contact with them And just even within adults We've we got so used to looking down on our screen and we're having these conversations And one that's disrespectful, you know, frankly, but And we connect when you actually make eye contact with someone you touch them at a deeper level It's more meaningful. There's a respect. There's a level of care There's I actually care enough to hear what you're saying and to give you that undivided attention The one of the big reasons that people do fall into self-harm or I could say, you know, eating disorders too and and other things The emotional abuse and bullying falls under that category Very cruel society. We've become very Detached in a lot of ways and again It's going back to technology because it's so easy to be a troll on social media and say something hateful Because you're not in the room with that person to see and feel their reaction So bullying is a big part And if we have more policies that better monitor that that say, you know what in our business We will not have this culture and that has to come from the top all the way down. Absolutely. Yeah And and there's probably a lot of education needs to be done on that Obviously parents need to be monitoring their children's social media accounts and they need to be having these conversations of What's okay? And what's not okay? But parents have to be very aware of what they are role modeling as well And how they're talking about other people because kids are listening Yeah, absolutely the sponges And so what I'm hearing there is it's very relational Very I mean we we're social creatures and and we interact with others as part of our life. We need that and Strengthening those social bonds and those relationships can go such a long way For not just for self-injury, but we know for all sorts of mental health issues. It's just so critical Yes, it's a big focus at the moment So it's fantastic work that you're doing Laurie And I'm so glad we're able to meet and talk about this and and bring some understanding to this topic That so often is in the shadows. I want to ask you is there like one sort of most important Thing that you wished everybody knew when it came to self-injury One key sort of message that you want to get out there into the world I Guess the overall thing is that there is help out there. There is help that You do need to do your due diligence and find out who has true experience and of course But you should do that whenever you seek help of any type yes And that it's This is something we can turn the tide on it doesn't have to be the epidemic that it is and if we will just start having these conversations Things that we consider taboo, but if we just start to have conversations about our Health and it's not really just a mental health because mental health is physical health Our brain is physical health but And that's one of the things I do hope if there's any possible good that come from That can come from all of this pandemic mess is We have more of an appreciation of the moment And not taking things for granted and that includes our relationships with people But it also is the realization of just how important Our mental and physical health is no longer separating them out Absolutely. I love it Thank you so much for your insights. I think there's a lot of people that are going to get a lot of real benefit out of this To everyone watching if you do want to know more about this particular topic, there's Many things you can do, but I'll give you a couple number one Make sure you get a copy of lorry's book and we'll post the link to that in the comments if you're interested to really delve into it and Upskill yourself in this area if you're looking for training in that reach out to us and we'll give you all sorts of Details of what some of the options are But again, thank you so much for your time lorry and I look forward to talking more Thank you for this wonderful opportunity Hi, I'm emi gulding director of psychology for the workplace mental health institute We hope you liked the video if you did make sure to give it a thumbs up We have more and more videos being released each week So when you subscribe you'll get a notification letting you know when a new one's just been published So make sure to hit that subscribe button and don't miss out on this vital information for yourself your colleagues and your loved ones