advice please?

Question

a good friend of mine has been self harming for years and has recently plucked up the courage to go to a nhs psychologist for support and conselling. However my friend was told there are no appointments for 2 months and the psychologist is 'happy with him doing it as he uses sterile blades' and came out more depressed than he came in! is there any advice you can give me that might help him....going private is not an option....thanks guys!

Answer 1

Many people self-harm at some point in their lives, normally as a result of depression or mental trauma. This is a way of "letting the pain out" nothing like a suicide attempt. So the psychologist is kind of right, your friend's life is not currently threatened.

I worked in an NHS adult psychology department, and we were told to tell new referrals that the first appointment would be in 2 months, when normally they would be seen in a month or six weeks.

Don't let your friend miss his appointments, as he won't get any more if he does. Just be supportive, let him know that you care and will help him through this hard patch that won't last forever (even though it may feel like it right now) and don't worry too much about the self-harming. Unless a wound gets infected it isn't life-threatening and will probably inhibit a suicide attempt.

Answer 2

Self harm is a coping strategy to deal with intense emotional pain. It's a way of managing without completly self destructing. Self harmers do not usually do themselves serious long term damage by their injuries (the damage was done much earlier by someone else). It works by distracting from the deeper hurt, and because endorphins are released in the brain by pain, which gives a numbing effect similar to opiates. When working with self harmers, who are not ready to stop advice on safer ways of harming is often given, this may have been what the psych was trying to do (although it dosen't sound like he handled it well).

Your friend sounds like he is beginning to think about stoping, it can be an addictive behaviour so it will take time. Encorage him to keep working on it and don't judge him if he still harms occasionally. Some things that can help are putting an elastic band on your wrist and flicking it hard. It hurts, and produces the same reaction but without damage. I don't know what your friends living arrangements are but if he can remove anything he might harm with, and either give it to someone he trusts, or put it somewhere where he will have to put some effort into getting at it, it might help. This gives him time to think before he harms, if he gives it to you, you must be prepared to give it back if he really needs it, otherwise he has no outlet and may do something worse, but it gives you and him the opportunity to talk about it before he does it, and often talking to someone else will reduce the urge. Alternatively agree with him that he will always call you, or someone else (The Samaritans are good at this), before he harms, don't agree to this unless you are wiling to stick with it.

MIND do a very good booklet on self harm, you can download it from their website in PDF format, or buy it for a £1. Type self harm into YAHOO (or any other) search engine and you will find lots of information.

He is lucky to have you, many people freak out completly when faced with this issue. It's difficult to understand, and harder to respond to, good luck to both of you.

Answer 3

I don't know what nhs stands for, but I would obtain the name and, if possible, practicing id number and contact your local health department and explain your concerns. It is VERY common for their to be long waits for the initial appt, and I would encourage your friend to make that appt. However if things get desperate in the meantime I would get him to the local ER. There are often free or reduced psychiatric treatment at public health agencies (again talk to your local health department or contact the crisis line).

I can see how one would think the statement that he was pleased the indiivudal was at least using stereile blades, however it does not seem appropriate to encourage the behavior-which it sounds like your friend interpreted it as.

Good luck.

Answer 4

Typically self harming is a sign of severe abuse or witnessing Domestic violence as a child. The cutters I have known use the pain to dull their psychological pain. It is sad. Your friend is lucky to have you. It is important to assure them that they are a good person and they don't deserve to hurt all the time. The suggestion about going to the ER is great. You might want to search which local hospitals have a Psych floor which would be good if your friend would want to be admitted for a day or two to get some meds.

Answer 5

Your friend could ask to be referred to someone else if he is not comfortable with this psychologist. He could also try clenching some ice in the palm of his hand when he feels the urge to cut himself. Self harming is often used as a release from the pain we are suffering inside. Maybe a counsellor could help.

Answer 6

Coming from a mother who is a Mental Health Professional my enter life. I feel for your friend. i know many mental health centers that have a thing called a "sliding scale". I know I used to make 7.00 an hour and I only had to pay like 5.00 per session. Maybe call around for your friend and see if there is any mental health facilities that have sliding scales. Also, you could call United Way I used them once too. Isn't it funny that I was raised by a mental health pro and I have been to more therapist than gotten hair cuts in my life.

I will pray for your friend.

Answer 7

What a load of bollox!
I don't believe that drivel about "OK so long as it's with sterile blades".
No NHS employee would say that to a patient especially a nutter!
Tell your friend to stop confabulating get a proper life!!!

Answer 8

Is this Psychologist real ,?and telling your friend he pleased with him when he uses clean blades ,you need to get help from some where else for your friend and quickly. Good luck

Answer 9

take the shrink to a tribunal for misconduct and then private will be a possibility cos the nhs will have to pay plenty of compensation if you have the evidence to back it up eg a tape recording of meeting or some sort of written opinion then sue his *** from under him
serious misconduct

Answer 10

Several different theories have been proposed to explain self-mutilation:


self-mutilation is an outlet for strong negative emotions, especially anger or shame, that the person is afraid to express in words or discuss with others.


self-mutilation represents anger at someone else directed against the self.


self-mutilation relieves unbearable tension or anxiety Many self-mutilators do report feeling relief after an episode of self-cutting or other injury.


self-mutilation is a technique for triggering the body's biochemical responses to pain. Stress and trauma release endorphins, which are the body's natural pain-killing substances


self-mutilation is a way of stopping a dissociative episode. Dissociation is a process in which the mind splits off, or dissociates, certain memories and thoughts that are too painful to keep in conscious awareness. Some people report that they feel "numb" or "dead" when they dissociate, and self-injury allows them to feel "alive."


self-mutilation is a symbolic acting-out of the larger culture's mistreatment of women. This theory is sometimes offered to explain why the great majority (about 75%) of self-mutilators are girls and women

The symptoms of self-mutilation typically include wearing long-sleeved or baggy clothing, even in hot weather; and an unusual need for privacy. Self-mutilators are often hesitant to change their clothes or undress around others. In most cases the person has also shown signs of depression.

Although there are no medications specifically for self-mutilation, antidepressants are often given, particularly if the patient meets the diagnostic criteria for a depressive disorder........Mindfulness training, which is a form of meditation, has been used to teach self-mutilators to observe and identify their feelings in order to have some control over them.
The prognosis depends on the presence and severity of other emotional disorders, and a history of sexual abuse and/or suicide attempts. In general, teenagers without a history of abuse or other disorders have a good prognosis. Patients diagnosed with borderline personality disorder and/or a history of attempted suicide are considered to have the worst prognosis.
Some society-wide factors that influence self-mutilation, such as the high rate of sexual abuse of children and media stereotypes of women, are difficult to change. In general, however, young people who have learned to express themselves in words or through art and other creative activities are less likely to deal with painful feelings by injuring their bodies.........Key Terms


Borderline personality disorder (BPD)
A pattern of behavior characterized by impulsive acts, intense but chaotic relationships with others, identity problems, and emotional instability.


Dissociation
The splitting off of certain mental processes from conscious awareness.


Dissociative disorders
A group of mental disorders in which dissociation is a prominent symptom. Patients with dissociative disorders have a high rate of self-mutilation.


Endorphins
Pain-killing substances produced in the human body and released by stress or trauma. Some researchers think that people who mutilate themselves are trying to trigger the release of endorphins.