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Even getting adults to commit to group therapy can be a challenge. Adults are burdened with more responsibility than adolescents and may have trouble finding the time and effort to make the commitment for their own healing, even when resources are available.
Why Aren’t There More Resources for Adult Self-Injurers?
By Renée Fabian 03/21/17
Over time, self-injury itself can become a habitual, nearly addictive behavior, and 8.7 percent of self-injurers are also addicts.
Erin Hardy, a Wisconsin-based therapist, found herself in a quandary when an uptick of people who self-injured came to her about five years ago. This was a new area to her practice, so Hardy sought consultation with her colleagues on resources, but they came up empty. An internet search left Hardy with unsatisfactory results.
“All the sudden I had this flood of individuals that were engaging in self-harm,” says Hardy. “There is really nothing [online] about self-harm other than the theme of, ‘Anybody who self-injures has borderline personality disorder,’ and … ‘there’s no cure, nobody can get better.'”
Undeterred, Hardy kept searching until she found S.A.F.E. Alternatives, an organization co-founded by Wendy Lader and Karen Conterio in the mid-1980s dedicated to self-injury recovery with the belief, “people can and do stop injuring with the right kinds of help and support.” Through their S.A.F.E. Focus program, Hardy got the training and materials she needed to lead a dedicated self-injury support group in her city.
Today, a similar internet search for self-harm resources yields information focused on adolescents. As one PsychForums member put it, “I have been online searching for several hours today regarding finding help for self-harm, and I’m 40. I have been seeing that it is mostly in young people, and feeling pretty embarrassed and ashamed that I’m an adult dealing with it. I feel like I should have grown out of this long ago.”
The pervasive idea that self-injury is a behavior relegated to emo teenagers is simply false. Self-injury affects 4 to 5.5 percent of adults, yet the stigma persists, leaving millions of self-injurers to struggle in silence and feel invisible.
Defined as intentionally harming the body without suicidal intent through behaviors such as cutting, burning or hitting oneself, self-injury serves as a maladaptive coping skill to deal with difficult emotions, experiences and feeling states.
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Those exhibiting personality traits associated with negative affect such as depression and anxiety (such as that found in BPD), non-conformity, impulsiveness, emotional instability, sensation-seeking and thrill-seeking, poor external locus of control, as well as low self-esteem, tend to be particularly susceptible to substance abuse disorders.
Personality disorders correlated with drug abuse, say researchers
Recent research suggests that drug addiction is frequently comorbid with personality disorders. According to Zimmerman and Coryell (1989), up to 43-77 percent of individuals with personality disorders qualify for a diagnosis of alcohol use disorder at some point in their lives. Likewise, Verheul and colleagues (1995, 1998) examined the co-incidence of personality disorders with substance abuse and found that 44 percent of individuals addicted to alcohol meet the criteria for a personality disorder. In addition to this, 77 percent of those who abuse opiates qualify for a diagnosis of a personality disorder. Cluster B personality disorders, such as borderline personality disorder, and antisocial personality disorder, were found to be particularly associated with substance abuse disorders.
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People with drug use disorder were much more likely to have psychiatric illnesses, the researchers reported in JAMA Psychiatry, as they were… 1.8 times as likely to have borderline personality disorder, when compared to people without drug abuse.
Ten Percent of Adults Have a Drug-Use Disorder in Their Lifetime
A survey of American adults revealed that drug-use disorder is common, co-occurs with a range of mental health disorders and often goes untreated. The study, funded by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), part of the National Institutes of Health, found that about 4% of Americans met the criteria for drug use disorder in the past year and about 10 percent have had drug use disorder at some time in their lives.
A diagnosis of drug-use disorder is based on a list of symptoms including craving, withdrawal, lack of control, and negative effects on personal and professional responsibilities. The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) no longer uses the terms abuse and dependence. Instead, DSM-5 uses a single disorder which is rated by severity (mild, moderate, and severe) depending on the number of symptoms met. Individuals must meet at least two of 11 symptoms to be diagnosed with a drug-use disorder.
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‘She suffers from this,’ you have every expert saying, ‘No, she’s not bipolar, she really has borderline personality disorder …’”
Should I Smile Back Be Categorized as an “Addiction Movie”?
By Aisha Harris
In I Smile Back, which opened this past weekend, Sarah Silverman plays very much against type: She stars as Laney, a wife and mother whose struggle to manage her mental illness threatens to upend her family and relationships. The film has been referred to casually as an “addiction movie” by many critics, as over the course of the film, Laney indulges in drugs, infidelity, and reckless behavior that put her and her loved ones at risk. But when I interviewed screenwriter and author of the novel of the same name, Amy Koppelman, and director Adam Salky (Dare) at the Toronto International Film Festival in September, they talked about not wanting the movie to be pigeonholed as such. “That’s not to say that addiction movies aren’t powerful and meaningful,” said Koppelman. “But we just always looked at the addiction, or the drinking, or the drugs, or the fucking around as symptoms of her trying to relieve herself of her fears, her having moments of being able to be numb, and in those moments not have the anxiety that’s so all-consuming for her.”
And it’s true that it doesn’t fully make sense to brand I Smile Back with that simplistic genre tag. Whereas many addiction movies like Requiem for a Dream or Drugstore Cowboy are memorable primarily for their uncomfortably bleak, unrelentingly graphic depictions of substance abuse, I Smile Back doesn’t lean so heavily on disturbing drug-fueled moments. In scenes with her husband, played by Josh Charles, Laney confesses her bleary outlook on life: She doesn’t want to get a dog for the family because she “doesn’t want the kids to be hurt by its eventual death,” she says at one point. She finds it difficult to find meaning in life—though she tries hard, and clearly loves her children and family, as shown in one particular scene in which they bond in the middle of the night during a power outage. The story is just as concerned with Laney’s depression and unhappiness as it is with watching her succumb to her addictions. In fact, it’s probably more accurate to call it a movie about mental illness—onscreen, Laney gives in to addiction over and over again, but her addiction feels much more character-driven than drug-driven.
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The young woman — and her family — were exhausted and confused by the barrage of treatments and medications. How were they supposed to cope with her nightmarish outbursts, her self-mutilation and suicide attempts, her destructive behavior?
Her brain tormented her, and doctors could not understand why
By Aleszu Bajak September 14 at 2:38 PM
“I hate myself, and my brain,” Pam Tusiani wrote in her journal while under 24-hour watch on the fourth-floor psychiatric ward of Baltimore’s Johns Hopkins Hospital. “Nothing is worse than this disease.”
When Tusiani wrote those words in 1998, doctors had little understanding of the disorder that was troubling her, and all these years later they have little more.
Trying to understand how the illness works — in hopes of finding a cure — strikes at the heart of psychiatry, indeed medicine in general. How does one replicate at the basic research level what one sees in a patient? How do you find the chemical root of a disease, especially one as complex and multifaceted as borderline personality disorder, or BPD?
Just as a smile takes dozens of facial muscles to execute, a particular emotional response to a stimulus requires a web of brain activity. The brain isn’t a series of one-way streets. It’s a hive of superhighways, and we can barely make out the cars, much less figure out where they came from, where they’re headed, what they’re carrying and why they’re on the road. We barely understand a healthy brain, so how are we to understand one haunted by psychoses?
Some days Tusiani, a New Yorker who was attending Loyola University in Baltimore when she was hospitalized, would cut herself, usually on the arms and hands, not so much to inflict pain but rather to relieve inner turmoil. “Bleeding enough that I felt good,” she wrote. One day she’d be curled up in the fetal position, unable to eat or speak; the next, she’d be pacing her house, berating anyone within reach and seeking drugs and alcohol — or a razor — for relief.
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It’s all too easy to glamourise suicide once it’s happened. To pack out a funeral ceremony, dripping platitudes, telling everyone you “wish you’d known”. But if the potential suicide victim “fails”?
What I learnt when I tried to kill myself
What do you do when everyone knows what you did?
By Charlotte Dingle
A few weeks ago I joined the same exclusive club as Drew Barrymore, Eminem, Britney Spears and a host of other celebs. Like your average A-list party, there was plenty of booze and a few pills involved. There was a trip to casualty, too – again, not atypical. But this was a party of one. Mired in sadness, devoid of hope, and brooding on a stupid fight with my partner, I sat in my bedroom and necked anti-depressants (oh the irony) like Smarties, all washed down with a tidal wave of whisky. I barely remember what followed immediately afterwards. All I know is that I survived, thanks to the swift actions of said partner.
My friend G (full name withheld as her family still refuses to accept that she committed suicide) did the same thing seven years ago, at exactly the same age I am now. She was smart, vivacious, funny, bloody gorgeous – the last person you’d expect to ever feel unhappy. We’d been giggling over fancy dress plans just the day before it happened. But G died, drunk and emotional after storming out of the pub following an argument with her boyfriend. Later on, he tried to kill himself by starting a fire in his flat. He ended up in a prison psychiatric hospital. It was so, so sad.
Every year in the UK, 5,000 people succeed in committing suicide. As many as 100,000 are estimated to have attempted it. They shoot themselves, they overdose, they slash veins and they inhale gas. Most of the time, the people around them have no idea that this drastic final gesture is on the cards. Because part of the reason that so many take their own lives is the tremendous taboo surrounding depression and suicide. I first broke my silence over mental health issues when I came clean about my diagnosis of Borderline Personality Disorder on this very website. A lot of people warned me against it. “It will affect your whole career,” they said. “Your name will be out there, attached to that.” I won’t lie: I was terrified. But something inside me screamed that I had to write it regardless. That maybe that was the kind of thing my career should actually be about, above all else.
As it turned out, that article has now been shared almost 16,000 times and counting. For something born of such pain, such feelings of inadequacy and shame, reactions to it have made me feel pretty good about myself. But the day after I made my attempt, I was nevertheless terrified when I awoke to a barrage of Facebook message notifications. “Are you OK?” seemed to be the running theme. Filled with creeping dread, I checked out my last status update. Oh fuck. Turns out I’d drunkenly told the world exactly what had happened. As people often do when they + social media with booze and despair.
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