Tag: Self-Injury

Not JUST

Dr. Laura Mueller Leave a comment

How often have you heard someone say something like the following:

“I am just a bus driver.”

“Joey is just going to community college first.”

“Sarah is just going to a state school, nothing prestigious.”

“She’s not planning to get a degree, she’s just going to be a florist.”

This has been a pet peeve of mine for a very long time. Once I dove into the research around self-injury and suicide and after I had the opportunity to watch “Race to Nowhere“, I became increasingly convinced of the need to change the narrative and shift the elitist mindset around conversations about education and careers society-wide and especially in education.

On a personal note:

  1. One of my eleven children self-injured (and was sometimes suicidal) specifically around her felt need to achieve at a high level. This, despite reassurance from myself and the rest of her adoptive family that it was not at all necessary.
  2. Only two of my eleven children began their college education at other than a community college.
  3. One of my eleven children is so impacted by mental illness, historical trauma, and related drug abuse, that she is unable to function without the support of inpatient staff.
  4. Another of my children is impacted with ADHD to the point that, at the age of 26, he has not yet been able to finish his college degree despite numerous attempts.

In addition to these personal examples, much of my work is with individuals with significant disabilities whose access to a variety of job and career choices will be impacted by their disabilities. ADA requires that employers consider hiring individuals with disabilities to the point that reasonable accommodations can be made for the individual and they must be able to complete the core functions of the job. This may mean that many of the students I work with will be precluded from certain types of work.

I am sure you know personal examples or examples of other individuals you have met throughout your life and career that are similar to these scenarios. Today, I do not plan to write at great length on this topic. What I do want to do is provide one action point and pose some questions that I believe should help guide our thinking on this topic going forward.

Here is the action point:

Can you commit to removing the elitist “just from your vocabulary? I am asking that you begin to catch yourself before you say it. For example, “I am so excited! Our daughter is starting at our local community college in the Fall.” Here is another one, “Our son is attending hospitality training through Regional Center after he finishes the district’s Transition Program. It is such a great opportunity.” Or…”Yes, our daughter works for the city in the sanitation department. She drives the large trucks that pick up your trash every week. We are so proud of her!” You’ll notice…. no just.

Here are some questions I would ask you to reflect on:

  1. What percentage of a person’s value should be determined by their education and/or career?
  2. Do all people have intrinsic value, regardless of their education and/or career?
  3. If you had to rank the percentage of importance of character vs. education/career…. what would the percentages be? 50% character/50% education and career? 70/30? 30/70?
  4. In what way can you, personally, help to change the elitist narrative that devalues individuals and inappropriately overvalues specific types of education and careers?

Until next time-

Laura Mueller, Psy.D., LEP

Mindfulness Strategies

Dr. Laura Mueller Leave a comment

By Lauren Appel

“Mindfulness” has become a hot topic word and research has increased its fame.  Some benefits fall under the categories of emotional regulation, interpersonal (interactions with other people), and intrapersonal (interactions with yourself) (Davis & Hayes, 2011.)  All of these can reduce or eliminate emotional pain which can help overall functioning and remove these barriers to learning.

But what is mindfulness? The Oxford Dictionary defines it as “A mental state achieved by focusing one’s awareness on the present moment, while calmly acknowledging and accepting one’s feelings, thoughts, and bodily sensations.” Every definition that crops up highlights the same element which is focusing on the present. While traditional meditation brings us to the present, there are other more engaging ways to help our students reach this point. Below are some suggestions in guiding students to the present.

Breathing

Focusing on the breath is one of the most basic forms of mindfulness. Typically, you breathe in through your nose for 4 counts, hold for 4 counts, and breathe out through your mouth for 4 counts. The point is to slow down your breathing as much as possible. All of these strategies will take practice and may need prompts to engage in deep breathing.  Some key strategies to breathing are as follows:

Breathe in through your nose, out through your mouth- I often use the image that illustrates smelling the flower and blowing out the candle. This is especially helpful to younger students

Breathe from your belly– deep breathing can also be called belly breathing to emphasize the fact that your belly should rise and fall, not your chest. Breathing from your chest can create feelings of tension and panic. Sometimes it helps to put a hand on your stomach to feel it rise and fall. Younger children may like placing a stuffed animal on their stomachs to practice. This provides a great visual for understanding the belly breathing aspect

Five finger breathing– this serves as a visual reminder to breathe when other visual resources may not be available. You start by using your left finger to trace the line that goes up your right thumb. When you are slowly moving up a finger, you breathe in for 4 counts and when you slowly move down your finger to a “valley” between 2 fingers, you breathe out. The idea is to go through your fingers and return to the starting point for a total of 10 breaths. This can also be done subtly for self-conscious adolescents. No one has to know you are doing deep breathing exercises.

Timelines– This is just like 5 finger breathing except with a timeline labelled through 10. The student places his finger on the number one and breathes in and out for 4 counts then moves his finger to the number 2 and so on.

Being aware of your surroundings

This strategy is especially helpful for those suffering from trauma because it helps bring them back from the flashback to the present moment.

5-4-3-2-1– This is short for 5 things you see, 4 things you hear, 3 things you can touch, 2 things you can smell, and 1 thing you can taste. For younger children, it may be enough just to name the items. For older or more advanced students, ask them to describe each item without giving away the name of the particular thing they are experiencing. The more details they can put into it, the more engaged and present they become.

Progressive Muscle Relaxation

This involves purposefully tightening certain muscle groups, holding it for several seconds, then relaxing them, or as I call it “becoming a limp noodle.”  Different muscle groups include face, neck, shoulders and chest, arm and hand, stomach, hips, thigh, calf, feet. 

Meditation

Most meditations help bring the focus to your breath or other sensations in your body.  There are guided meditations that narrate through the process and others that may have a gong or natural sounds and are more up to the meditator to make the most of it. The later should be used for advanced groups only. The length of the meditation should be based on both the age and experience of the student. Sometimes a couple minutes is more than enough. Both of these types of meditations can be found on YouTube as well as other apps like Insight Timer.

 Reference

Davis, D. M., & Hayes, J. A. (2011). What are the benefits of mindfulness? A practice review of psychotherapy-related research. Psychotherapy, 48(2), 198–208. https://doi.org/10.1037/a0022062

And….. we’re back!

Dr. Laura Mueller Leave a comment

Welcome back to the Educators and Self-Injury Blog! I hope this update finds you and yours safely making your way through this wildly challenging year. It is more important than ever to focus in on mental health and meaningful and effective social-emotional learning (SEL) and effective coping strategies for ourselves and our students. In this “welcome back” blog, I wanted to share a brief training I provided for families in my school district and introduce you to a new collaborator for this website.

Social Emotional Learning for Parents and Families

Lauren Appel, School Counselor and Behavior Specialist

When preparing for a recent presentation (on Zoom of course!) for the San Diego Office of Education, I came across a wonderful article about responding to Non-Suicidal Self Injury in schools by a school counselor from North Carolina. I was so impressed that I reached out to her and she has agreed to become a collaborator on future blog posts! I am so grateful to have met her. Here’s a short bio:

Lauren Appel attended The College of William and Mary where she received her bachelor’s in psychology and the University of Virginia where she received her master’s degree in Counselor Education. She worked three years as a school counselor in an elementary school in Martinsville, Virginia. Lauren currently works as a Behavior Specialist in a school district in Yanceyville. North Carolina.   

I am so excited to begin our collaboration together! Look for an upcoming post authored by Lauren next week.

Until then, take care and stay well!- Dr. Laura Mueller

Please read this article: Best Brightest and Saddest

Dr. Laura Mueller

A colleague of mine recently sent this article from the New York Times to all of the psychologists in my district. This article EXACTLY focuses on my soap box. By applying unrelenting pressure on students to excel and be the best one, we are creating pressure-filled lives for our children. I believe there is a balance that we as educators and parents have not achieved yet. A balance where children are encouraged to learn and grow and are provided with reasonable expectations. A balance where supports are provided for areas of need and strengths are celebrated. A balance where each individual student knows that his or her BEST is enough! We should be communicating to students that they don’t need to be THE best… they just need to be THEIR best. There is a huge difference. Whereas doing your own personal best and focusing on strengths is exhilarating,  being told that you must be THE best is exhausting, discouraging, and can even be life threatening.

Please read the attached article.

Suicide- Best Brightest and Saddest_ – NYTimes (2)

Thoughts for Parents

Dr. Laura Mueller

As a parent of two daughters who each self-injured over a period of many years, I struggled with guilt, anger, hopelessness, fear, and an array of other distressing emotions. When my oldest daughter first approached me to tell me that her friend was self-injuring in 2002, I was confused and wondered if I really understood what was happening. When she confessed that she had begun to self-injure herself the following year, I hoped that it was a temporary thing. I hoped it could be addressed by removing items that she could cut herself with and making sure she was in therapy.

Was I ever wrong.

I know now that self-injury is an insidious behavior that isn’t quickly responsive to therapy in most cases. I know now that it appears to be intrinsically reinforcing and therefore a behavior very difficult to successfully treat. I know now that  a young person determined to self-injure can find a way.

But when I first found out, I maintained the delusion that I could fix it. That I could find the right resources and all would be well. At the time, research was not yet available demonstrating the danger of treating self-injurers in groups and she participated in a homogeneous therapy group of self-injurers (do not do this). She saw a therapist that I found in LA and her father or I drove her the one and a half hours for the therapy every week. As the behavior continued and even worsened over the following years, I slowly lost my sense of control. I loved my daughter with all of my heart, but I had to let go of the idea that I could solve this problem for her. I continued to reach out to all of the resources I could find. I took her to new therapists when she felt she didn’t have rapport with the one she was seeing. We went to a psychiatrist and she began medication with a diagnosis of bipolar disorder. Still, the self-injury continued.

As this odyssey continued in my life and later included another of my daughters (read about contagion within this website), I began graduate school. Early on I decided to make self-injury a topic of all of my research projects and eventually my dissertation. Guess what? I still felt relatively hopeless at home and struggled with guilt, frustration, and anger when confronted by my daughters’ self-injury. Usually, when one of my daughters would approach me with a new injury I would greet them with the F-word and impatiently ask why they hadn’t come to me earlier? Why didn’t they use their coping strategies? Why? Why? I would worry that all of my attention, seeing to their wounds, and even taking them to the hospital would further serve to reinforce the behavior and yet, what option was there? What loving mother would do anything else?

I am sharing all of this frustration and failure with you for one main reason. I want you to give yourself a break as a parent. If a student of psychology and then doctor of psychology cannot always properly handle these difficult situations at home, don’t you think it’s understandable if you mess up now and then? I am asking you to release yourself from the guilt that you turn over in your head that this is somehow all your fault. Even if you have made mistakes, that cannot be helped by you wallowing in guilt. I am also asking you to literally give yourself a break: take time to care for yourself and your needs. As a parent of several special-needs children, I know it can be incredibly difficult to make the time for yourself. But it is so very important.

Despite all of my mistakes, I did do a few things that my daughters have reported as helpful:

– I continued to listen to them (and I always apologized for melting down).

– I spent one on one time with them every week doing something fun and with no pressure.

– I continued to seek out professional therapy for them and took them to appointments.

– One of my daughters benefited from my help in coordinating a plan for school.

I hope that parents can benefit from my experience. You can know right now that this is likely to be a long road. It is a tough road, but even as you struggle and experience personal failures and continue to see relapses of self-injury, keep providing love and warmth. Admit when you make mistakes and keep pressing on. Keep getting professional mental health assistance. Take one day at a time and make time for yourself.

 

 

Welcome to the Educators and NSSI Blog

Dr. Laura Mueller Leave a comment

Hi!

This site has now been up since 2010 and I wanted to add a piece to it that would offer ongoing, up-to-date information for educators who are interested in learning more about Nonsuicidal Self-Injury and best practices in response and prevention. I plan to write short blogs to present meaningful and useful information on an ongoing basis and may occasionally share personal stories and thoughts at other times. So- welcome to my first blog!

There are two quick resources that I want to share today that I believe are relevant to this topic. One is focused on appropriate intervention in the school environment and the other is about prevention.

Intervention: PENT

In terms of intervention, I want to make sure that you are all aware of the PENT website (Positive Environments, Network of Trainers). This website is a part of the California Department of Education and has historically focused on behavioral planning. Over the past couple of years, PENT has begun to distinguish between emotionally driven and socially mediated behavior.  They now offer a Direct Treatment Protocol for use in situations where behavior is emotionally driven and requires mental health attention.

The specific protocol for any specific mental health issue would need to be research-based and carefully selected, but the emphasis on the need for a mental health response to mental health issues is crucial. Regarding self-injury, the Treatment Plan might include the school site using an evidence based approach such as manual based Cognitive Behavioral Therapy and include a coordination of response between school, outside providers, and parents. The new form on the PENT website could be used to document the response plan. You will also find a wealth of resources regarding mental health issues under the Mental Health tab on PENT’s website.

 

Prevention: Race to Nowhere

I have a passion that I share in every presentation I give. I believe that every student deserves to know that his or her best is exactly what they need to be doing and nothing more. For some of our students, that may mean getting Cs in basic classes. I cannot possibly emphasize enough how important it is to provide a way for students to excel in their areas of strength while not forcing them into a “Harvard doctor or nothing” mold. Most students in our schools feel the pressure of honors and AP classes and the expectation that they will achieve high SAT scores and be admitted to a prestigious university. Children should be taught that professions such as trash-collectors, hair-dressers, and cashiers are honorable and not less-than. Additionally, the emphasis on extracurricular activities (which can be beneficial) can also result in a student who is busy for 12 hours almost every day. This does not promote mental health and it results in a lack of school-life balance. For some of our students, these emphases may provide that “perfect storm” where self-injury and even suicide may occur. The director of the film “Race to Nowhere” shares the following:

“Several months into the film’s development, without any warning signs, a 13-year-old girl in our community committed suicide after getting a poor grade on a math test. This local tragedy added yet more urgency to the need for change.”

Race to Nowhere helps bring focus to the fact that our children need BALANCE. They need down time. Ban Busy: Time to Thrive is another very meaningful catch phrase on the site. Please review the website and look for times to view the film locally or purchase it for your school site or district to review.

I hope you find these resources valuable and look forward to your feedback.