How to deal with the lived experience of self-injury? Valerie and Helen face it head on: their own experience with it; how to let it go and move into recovery. They will be joined by therapist Shayna Barksdale, LCSW, for a candid episode about this painful, little understood behavior.
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Lived Experience with Self Injury
Episode 6
Helen Sneed: Welcome to Mental Health Hope and Recovery. I'm Helen Sneed.
Valerie Milburn: And I'm Valerie Milburn.
Helen Sneed: We both have fought and overcome severe chronic mental illnesses. Our podcast offers a unique approach to mental health conditions. We use practical skills and inspirational stories of recovery. Our knowledge is up close and personal.
Valerie Milburn: Helen and I are your peers. We are not a substitute for qualified counseling or other mental health resources. We're not doctors, therapists or social workers. We're not professionals. But we are experts. We are experts through our own lived experience with multiple mental health diagnoses and symptoms. Please join us on our journey.
Helen Sneed: We live in recovery, so can you welcome to episode 7 lived experience with Self Injury. Well, we have grappled and grappled with this sensitive subject and what we decided to do is to set forth some objectives to make this productive and safe for all of us. So here are our objectives for to explain and promote understanding of this little understood behavior to those who practice it and those who witness it. To investigate treatment options such as therapeutic relationships, methods and skills medication to examine how it is possible to stop self injury and to demonstrate why it's necessary to give up self injury in order to recover.
Valerie Milburn: Please remember that this podcast does not provide medical advice. The information presented is not intended to be a substitute for or relied upon as medical advice, diagnosis or treatment. The podcast is for informational purposes only. Always seek the advice of your physician or other qualified health providers with any healthcare related questions you may have. So Helen, today we have a guest.
Helen Sneed: Oh this is wonderful.
Valerie Milburn: I know. We love when we have guests. We're grateful today to have Shaina Feldman Barksdale and Shana is a licensed clinical social worker who has more than 25 years postmaster's experience working with children and adolescents families and has extensive experience working with clients who struggle with self injury. Welcome, Shana.
Shaina Feldman Barksdale: Thank you so much. I so appreciate the invitation and I'm excited to be here and I just appreciate you guys bravery in discussing this hard topic. And I think self injury is something as therapists we don't talk enough about. So I really appreciate it.
Helen Sneed: Well, we're glad to have you here today to shed much light on the subject. What we're going to start with is we figured that we all need to start on the same page. And so we're going to start with some definitions of self injury. So here's one. Self injury describes any behavior where someone causes harm to themselves, usually as a way to help cope with difficult or distressing thoughts and feelings. That's from the United Kingdom Mental Health.
Valerie Milburn: Foundation from the Mayo Clinic. Here's a definition. Self injury is the act of deliberately hurting your own body, a harmful way to deal with emotional pain. While self injury may
Valerie Milburn: bring a momentary sense of calm and a release of tension, it's usually followed by guilt and shame and the return of painful emotions.
Helen Sneed: And here's another one, our final one, any self directed repetitive behavior that causes physical injury without conscious suicidal intent. And that's Dr. Brian Daniel Smith.
Valerie Milburn: So some statistics who practices self injury, and these statistics are from Cornell University. 17% of adolescents engage in self injury, 13.4% of young adults and 5.5% of adults.
Helen Sneed: That is a lot of Americans. And so I guess our first question is what causes self injury? And you know, there are many reasons. We're going to investigate a lot of it today, but here are some. The inability to tolerate distress, isolation, loss, numbness, a desire to communicate, a symptom of a mental health condition. So what we're going to do is Valerie and I are going to relate our own stories first and then it's going to be followed by a substantive discussion with Shana. So, Valerie, what happened to you?
Valerie Milburn: Before I talk about my battle with self injury, I want to say that this part of my history is hard for me to talk about for many reasons. And just one of those reasons is that I have many loved ones who listen to this podcast and nearly every one of them is unaware that self injury is part of my past. And it may be hard for some of them to learn this about me. But because we hope that this episode will help just even one person, either not self injure or stop self injuring, I have found the courage to discuss this part of My past, my journey with self injury was one of shame and bafflement. For the longest time, I just didn't understand why I was self injuring. And I was so full of shame. And man, did I want it to stop. I had so much shame, even though no one knew about it except my psychiatrist for more than a year, maybe two. I finally told one friend only because I once thought I needed medical attention and I thought I needed her to drive me to the emergency room. We decided I didn't need to go to the er, so she was still the only one who knew for a really long time until I actually needed medical attention once as the result of self injury. And then my husband knew.
Helen Sneed: Oh, I know all about the secretive part, but I'm like you, Valerie. Before I begin, I want to say that this episode has been extremely difficult for me to handle. This is the first opportunity that I've had to discuss self injury in any kind of detail. And it's a pretty large platform to be doing this from. For the first time, I really want to provide an intimate look at the implications of my behavior. But I am worried about triggering someone in the audience. Both of us want to emphasize that self injury didn't work. It made me stay sick much longer, and I lost years of my life to the cycle of cutting. So here goes. Self injury served me for many reasons. Chiefly, the inability to tolerate the hyper or hyper arousal of toxic emotions caused me to abuse cutting. It was maladaptive and destructive, but it would bring me temporary relief. I was well aware that this action was bizarre and mysterious and, you know, just grotesque. I didn't want to act that way, but no healthy methods worked at the time. Cutting was secretive, shameful and full of rage I couldn't express elsewhere. I simply didn't know anything better to do. So we're going to look in some detail at the question of why. Why do people injure themselves? And Valerie, as usual, has done some research. Do you want to tell us what you uncovered?
Valerie Milburn: I went to several sources for possible explanations, possible reasons that a person would self injure. And I landed on some explanations that the Mayo Clinic give. Several of them make sense for me personally. And though these make sense to me now and had to in order for me to stop the behaviors. It was several years into the behaviors until I really understood why I was engaging in self injury.
Helen Sneed: Well, I was a little different. My reasons for self injury increased over the years. I understood why I did it, but that understanding didn't assuage
Helen Sneed: the mounting frequency as time went by.
Valerie Milburn: Let'S look at the first reason that the Mayo Clinic gives. One of the reasons is to manage or reduce severe distress or anxiety and provide a sense of relief. I first learned about that relief from a roommate at the trauma center where I spent five weeks and later four more weeks as she talked about the relief she got from self injury. I started self injuring after that and I would get immediate relief from the severe distress and anxiety that I was experiencing. But it was only fleeting and the shame and the fear followed soon after. And it was a desperate cycle.
Helen Sneed: I dreaded nighttime, and that's when the habit began for me because that's when the feelings and thoughts were so painful I would just lie weeping on the rug with no outlet of any kind. Marshall Linehan, who invented dialectical behavior therapy, said the mental pain is the equivalent of third degree burns. I reached a point where self injury was the only catharsis I could find. And as I got sicker, I began to cut in the daytime as well. It became a daily habit, like flossing. I should say here something very important. Cutting was never a suicidal act, nor was it intended to be. In fact, it was the opposite. It saved my life dozens of times.
Valerie Milburn: I want to emphasize here that though it may sound like self injury brought relief from intense emotional distress, that relief was fleeting and the act actually intensified the distress for me. My anxiety increased because the injurious cycle had started again and the depression worsened because I had failed again at my resolve to quit injuring. Ultimately, not only did self injury not diminish the pain, it created more.
Helen Sneed: Yeah, that's something I couldn't see for a long time. There's another reason that they cite for self injury and that is for some people, it's the need to feel something, anything, even if it's physical pain, because they feel so numb and empty inside. Now, for me, this was never an issue because I prayed to become numb. I thought it would be better for me.
Valerie Milburn: I was dissociating at the time and thus I would feel as though I wasn't even in my body. And self injury allowed me to feel something. But like I said, it caused me to spiral down even further.
Helen Sneed: And here's another reason to be punished for perceived faults. Now, this just fed right into my belief system because I believed I was sick, because I was bad. And so to punish myself and my body through self injury seemed entirely appropriate. I deserved it.
Valerie Milburn: There's one more reason we want to talk about, and that is to communicate depression or distressful feelings to the outside world. And I get this because I finally told my dad. He had told me that he couldn't comprehend what I was going through. That he didn't understand why I was unable to cope with my life. He wasn't judging me, he really wasn't. He was, I think, just trying to understand. And I thought if I shared the cutting with him that he would understand the magnitude of my illness.
Helen Sneed: Well, I wanted to communicate my pain to the outside world. Language was inadequate, but physical wounds spoke volumes. It was a language written on my body. It was a reminder of how sick I was. I kept it a secret from most people, but part of me wanted to get caught. I felt more secure knowing that the truth was hidden just beneath my sleeve, just out of reach. Once a fellow patient in a program glimpsed my arm and he smiled and said, aren't you a little old for that? Well, there I was, a middle aged woman with a pretty primitive way of surviving and communicating. The problem is age didn't matter.
Valerie Milburn: No, age doesn't matter. We saw the statistics. So Helen, we've talked about how we struggled and I gotta admit that wasn't easy. So let's move into the positive. What worked to bring us into recovery. For me, it was in therapy that I came to understand these causes for my self harming behaviors. And once I understood these causes, the ones that we just talked about and others, once I understood them and learned that the self injury could be replaced with
Valerie Milburn: positive coping skills, then I was on the road to letting go. I had to learn a lot of things. One of the major things I had to learn is technically called distress tolerance. My psychiatrist would say, sit with it, it's not going to kill you. When I would have an intense emotion, and there's a Bible verse I relate it to and it's be still and know that I am God. There's another thing I learned, and that was what I call thought control. And Helen, you have a great line. When you have dark thoughts, you tell yourself, darling, don't go there. I'm not quite as eloquent. I tell myself to tell my dark thoughts, to shut the F up. My psychiatrist once told me I couldn't just stop thinking about something. He said that you can't stop thinking about something, you have to replace the thought with another one. And that has taught me that the most effective thing for me to replace something with is a gratitude list. Because no matter what, I can always find something I'm grateful for. So once I was in recovery with my drug addiction and alcoholism, the self harm Started to dwindle. And that's because the 12 steps can be worked on any area of one's life. And I worked the 12 steps on myself. Injury. And you know, working the steps is a commitment, especially with my sponsor. She gives a lot of homework. And about 18 months into sobriety, I showed my sponsor the result of my cutting. And at that point, like I said, it had dwindled and was less harmful. And she said, that's so superficial and minor. Why are you even doing it? She's very blunt.
Helen Sneed: I was gonna say, yeah.
Valerie Milburn: But then I was ready to have the ritual that she had been suggesting. And together we put what I used to self injure with in her God box. And that's the last time I self injured.
Helen Sneed: That is just a remarkable ending to it all, I think. Well, as the years went by, I became defiant. I was convinced I'd be doing it for the rest of my life. And I had no desire to quit. So how did I find the wherewithal to stop? Well, to begin with, it was very gradual. And I have to attribute it to dbt, the dialectical behavior therapy. I have borderline personality disorder. And DBT was originally designed for those of us with it. Since then, it's universally used for many, many illnesses. But through it, I learned dozens of skills to overcome the terrible emotions and thoughts. And it helped me tolerate my distress without resorting to self injury. For me, medication was also necessary. Mindfulness helped me moderate my negative thoughts and taught me how to soothe myself. A healthier life of diet and exercise. The gym was a very important agent for change. As I came to respect my body more, and that took a lot of doing, I began to take more action and to fill my days with people and activities. I had a new therapist who set very strict boundaries and ground rules for self injury. I finally began to live in the moment because for the first time in my life, I could tolerate the moment. And finally, after five years of cutting, I quit cold turkey. I've only had three slips since then. The most recent was 10 years ago.
Valerie Milburn: What a wonderful thing for both of us.
Helen Sneed: Yes.
Valerie Milburn: And we were both able, and we're rid of it, to be rid of it. So there's a question, Helen, you and I have asked each other and we really, really worked to come up with the answer to this question and why did it have to stop for us to begin a full life in recovery? And I thought about that a lot. And for me, the scars from the self injury were such a physical repetition presentation of my illness that I didn't feel like I was in full recovery as long as I was continuing the behavior. The self injury was still lingering after I was in recovery from substance abuse and after I was on the road to stability with bipolar disorder. And I was ready to let it go.
Helen Sneed: Yeah, it's a pivotal moment to be ready to give it, just give it up. Because I had no hope that I would ever recover. But what happened is the DBT got me going through the motions. So even though I didn't believe in any of it, I did it. And through those actions, I began to take healthier actions and I became strong and finally got my eating disorder under control.
Helen Sneed: But the hardest thing, the most God awful thing I have ever done in my life was to give up cutting. For me, it was just like an addiction. Exactly like an addiction. The urges were a central part of my life and I gave into them every time. Well, as you know, Valerie, there's no recovery unless an addiction is in remission. It was time to give it up. My decision and no one else's. And it was incredibly difficult. Sometimes to this day, I dream about it. But I am not going back. I want to live in recovery and I do.
Valerie Milburn: Yes, you do live in recovery. We both do. And we work at it every day to do so.
Valerie Milburn: I think this is a great time to bring Shayna into our conversation. Shayna, you've been a great listener as Helen and I have talked about our journeys and we now. I'd love to hear about this topic from your perspective. With your expertise. I'd love to start by giving a little more of your background. I'll first just share a bit from your bio. Shayna Feldman Barksdale is a native Austenite, something Shana and Helen have in Common. Shana is a licensed clinical social worker, certified Daring Way facilitator, and is EMDR trained. She's the owner of Austin Therapy for Girls. Shana values working with families and young adults and has been doing so since she was 23, when she graduated with her master's in social work from Our lady of the Lake University. Since then, Shana has worked in the foster care system and did the school social work thing. In 2012, Shana wanted to get back to clinical work and started Austin Therapy for Girls. Her focus at Austin Therapy for Girls is to create an environment where young girls and young women, where girls and young women feel really heard and at the same time learn some valuable tools to get through some of the most challenging years. Shaina, a fun fact about you. You have a disco ball and glitter poster of Madonna in your office.
Shaina Feldman Barksdale: Yes.
Valerie Milburn: Yes. You tell me. That represents your style of therapy of integrating both dark and light. And I think that's a great place to lead into our topic today.
Shaina Feldman Barksdale: Thank you so much.
Helen Sneed: Yeah, we just have so many questions that we're dying to ask you and have been so looking forward to this. I think the first one, you know, is you have so much experience and you have a much broader overview in your mind. What is self injury? What constitutes it?
Shaina Feldman Barksdale: Well, I think, you know, your definition from the Mayo Clinic was great, I think. And this is the hard part with self injury, I really believe it's up to the person to define what that is for them.
Helen Sneed: Well, that's interesting.
Shaina Feldman Barksdale: Yeah. I think that there's a technical definition which I think you guys have covered is causing bodily harm. But I really think for me, and again, that's kind of the focus of my work, is really hearing what that is for a client. And sometimes things that you wouldn't expect are a form of self injury. Sometimes there's a combination with some of the people I work with of picking and self injury or hair pulling and self injury. So I think that's really up to the client to decide for them. And again, I'm not a fan of putting labels on things because I think. Yeah, you guys kind of talked about this around the shame people feel, especially when it comes to self injury. Again, I'm just honored to be here and
Shaina Feldman Barksdale: honored to hear your story. And I just think that secrecy is such a powerful thing for a lot of people that some people listening to this today will probably be the first time they tell someone that this is a part of their journey.
Helen Sneed: Right?
Shaina Feldman Barksdale: Yeah. Yeah.
Helen Sneed: I'm sorry, I just keep. Tell me if I'm asking you too many questions.
Valerie Milburn: I just really love what you said about that. Each person needs to define their. What their. What self injury means to them and what their own behavior is. That's just really powerful. And.
Shaina Feldman Barksdale: Yeah. And I think, Valerie, you would agree that some, some of your addiction was probably, you know, similar to self injury and eating disorders. I mean, it's. It's hard to kind of separate.
Helen Sneed: Mm, yeah, it really, it really is with. I know it is for me with the. Well, with the eating disorders. And I don't have a drug or alcohol use problem, but. But it was definitely an addiction. I got addicted to the feeling that it engendered and made it harder to stop.
Shaina Feldman Barksdale: Can I just quickly give you something that I just learned about self injury? And I'm just so fascinated by this. So your brain, as you guys kind of alluded to, your brain does give you some relief after you have injured yourself. It's that adrenaline. And again, if you think about it, in life, we need to get medical care, so our brain takes care of us. But what I've learned recently is your brain kind of catches on. And so even though at first there is sometimes a relief, your brain catches on to it and then doesn't allow for that relief. And I think that that's kind of what you were talking about when you were talking about that shame and guilt and grief after is that becomes stronger than the relief.
Helen Sneed: Yeah. Self perpetuating. Well, it's just a horrible spiral, I guess. Can you give us more information about. Valerie gave us the statistics on how many people do it, but do you know a sort of a cross section of who does this kind of thing? I think a lot of people think of it as young girls, but it's a much wider spectrum, isn't it?
Shaina Feldman Barksdale: Right. And usually I tell people that in my population, and again, we focus on girls and young women. And I would say our age range is 5 to 25 at Austin Therapy for Girls. We also are very connected with parents. I would say 85% of our clients have some relationship with self injury. Wow. So I would say that statistics are actually pretty low according to Cornell and the Mayo Clinic. I feel like those are fairly low. Again, I can only speak from what I see on a daily basis. I think it's a very high statistic.
Helen Sneed: Have you, in your vast career, have you worked with other age groups of people that, I mean, for example, Valerie and I are quite bey, you know, the age group that you're working with now. And yet, and we were, when we were doing it, but it was just as it was just, you know, it's like the guy said, aren't you a little old for this? And I really wasn't, unfortunately.
Shaina Feldman Barksdale: I think, I think. And again, I just relate that really to anything. Is it that the perception of the gentleman who basically shamed you? I'm sorry to say that, but we don't like that. But I think maybe, maybe young girls talk more about it.
Helen Sneed: Ah, okay.
Shaina Feldman Barksdale: I think probably with TikTok and Instagram and I think there's just. Again, I think we're getting better at not living in the dark of kind of taking. Bringing some light in and talking more about it. So I do think my clients are probably talking more about it, and I think we're more educated on it. So when someone comes in and, you know, 100 degrees in Austin and they have a big, huge hoodie on that, we just, we're just more aware. So I don't, I'm sorry to say I can't really give the quotes for adults. I think it's just more prevalent that we're talking about it. I certainly don't think it's just a teenage girl thing. And it's. And I hate when people say it's attention seeking. That's just like nails on a chalkboard.
Helen Sneed: We'll talk about shaming. It's so shaming.
Shaina Feldman Barksdale: Yeah, yeah. So, so
Shaina Feldman Barksdale: I, I don't think it's. I know there's so many adults and, and, and again, it's not just gender specific either.
Helen Sneed: Yeah, I've known a number of guys.
Valerie Milburn: Who, who did it too.
Helen Sneed: And, and, and they, again, some of them were, were, you know, older than this, the age group. So you're, you're somewhat optimistic because it's, People are more open about it, younger people are more open about it. And that makes it easier for you to treat it and to work with it.
Shaina Feldman Barksdale: Yes. I think in the last, I would say in the last two years, I feel like parents are more aware of it and the clients that I serve are more willing to talk about it again. There's still those. I have one or two clients that they had self injured, and I didn't hear about it for years, a year or two. So I still think there's that piece of shame. And again, shame is around secrecy, around judgment, that isolation piece. And I think one of the positive things about social media is that people realize that they're not alone. And some of what you guys are doing right by creating a podcast, it's like, okay, we want to talk more about it.
Helen Sneed: Well, I don't see how a person can. Well, again, it's so furtive and so secretive to begin with that I think that if you can't tell someone about it, then I just think it just becomes a bit of a trap. We've talked about some of the things that we used, methods and skills and whatnot. Are you using a number of methods or does it vary per patient? Or how do you go about using other methodologies for helping.
Valerie Milburn: Achieve recovery? Talk therapy, medication.
Shaina Feldman Barksdale: Yeah. Well, and again, I think you mentioned the gold standard for the type of. And I would just call it more addictive self injury. Certainly we have non suicidal self injury in SSI is kind of what we call it in the field. DBT is the gold standard for that. I do a lot of the work of Brene Brown, which is addressing the shame. And so that's really our focus. If I have a client that is doing self injury, I would say weekly, I refer them to some type of DBT group or a DBT therapist along with the shamework.
Helen Sneed: Okay. And I know that this. We always have a. We're always a little sensitive about talking about medication because, you know, some people are so opposed to it and some people are in between and some people. It's really worked for. But is. Are there times when you've had clients that do use medication?
Shaina Feldman Barksdale: Absolutely. I think. You know that first piece that you guys were talking about around that emotional. That intensity of emotion. Right. And I feel like that's where medications can help regulate. Right. That's chemicals in your brain. Right. That are causing that intensity. I feel like certainly talk therapy is very helpful with that. But, but the most effective treatment for I think anxiety depression is dbt, cognitive behavioral therapy along with medication management.
Helen Sneed: Okay. Okay. That's good to hear.
Valerie Milburn: Right. That's definitely what worked for me.
Shaina Feldman Barksdale: Right. And I get it. I mean medications for me as a therapist is a last resort, so. Especially for a child or an adolescent because. Yeah, we don't know what's going on in their brain. Their brain isn't fully developed till 24, 25.
Helen Sneed: Right.
Shaina Feldman Barksdale: However, it's also sometimes needed.
Valerie Milburn: Right.
Helen Sneed: I'm curious about another thing, which is when can you. I know that self injury is. I don't think it's in the DSM as an actual. It's a symptom. Right. Or a byproduct or behavior or whatever.
Shaina Feldman Barksdale: Don't get me started on the dsm.
Valerie Milburn: Okay. We don't have to talk about that, but we do have a question about does the, does treatment vary by the age of patient? I mean, that's what you wanted to ask, right?
Helen Sneed: Yeah. And also, is there a difference when you are working with someone, all of a sudden you see that it is a part of a larger illness or between just working with someone who is, we
Helen Sneed: hope, self injuring and can get over it and does not have bipolar or depression or something else? I mean, I guess I always thought that it was part of some official illness.
Shaina Feldman Barksdale: Well, and again, I think it goes to the self injury and certainly I've had, and this is a hard one, I've had eight and nine year olds who have kind of scratched themselves with their fingernails when they were upset. Normal. Yeah, it's hard. It's so hard. And so again. Right. That one is. I think that's part of it is. Okay. Were they upset about a friend arguing and they just thought, oh, I saw this on Instagram, TikTok or whatever. I heard about it at school and I just tried it. And so sometimes I think it is just that piece of, I don't want to say curiosity, but just like, oh, I don't want to feel this way anymore. Will this work? And normally those are cases that are usually a one time, two time thing. And so I don't really relate those to a mental. A diagnosis. Right. I think when there's depression and anxiety and as you mentioned, bipolar, then those definitely can be more of a symptom of that. Yeah.
Helen Sneed: And I was always told that it's a real symptom of borderline personality disorder, the self injury. I don't know how you feel about that, but that was always kind of drummed into my head as someone who, you know, who is diagnosed with it. And that's what they attributed my self injury to. So yeah.
Shaina Feldman Barksdale: And again, I. If a client wants, needs a label like that, I'm happy to support them in that. But for me, I'm just not into like this is this and this is. Right. It's a behavior. And I think, I think I want to just, you know, reiterate what you guys have talked about is taking away the shame around these things. Because I think sometimes when you say borderline personality disorder, it just has this set of behaviors that people are thinking and I just don't know if that's an accurate description. Right. Of who you are as a person, Helen.
Helen Sneed: Right.
Shaina Feldman Barksdale: I mean, you're so much more than that.
Helen Sneed: Exactly. No, I love your attitude toward not labeling.
Valerie Milburn: Yes. My psychiatrist is on the same page. He says things like, so you have a Mood disorder. So what, you know, he's not into the labeling, not into the diagnoses. I mean, I know what my diagnoses are, and I know which symptoms. I know which, you know, symptoms fit me that fit. That are, you know, listed under certain disorders. But it's not about the labeling. But not I.
Shaina Feldman Barksdale: Right. And I think. And for some people, that helps them make sense of things, and that's a valid. Right. That's. Oh, gosh, I'm not. I'm not crazy. I'm putting that in air quotes. This is actually a real diagnosis, and these are my behaviors. So I think sometimes that diagnosis really gives actually people comfort that they're not alone.
Valerie Milburn: Absolutely. Yes.
Shaina Feldman Barksdale: But. But I also think we can go the other way, right. Where we're labeling everything and everything has to be a diagnosis, and. And then we're not actually treating the individual. And. And again, as my bio says, one of the things we do at Austin Therapy for Girls is we just want to hear your story. We want to listen to you. And so I think that's a big part of self injury, is finding out why. Why. And that can be. Right. An ongoing conversation.
Helen Sneed: Yeah, I'm going to do that.
Valerie Milburn: Oh, okay. I think that's really important. I know that getting a diagnosis was in some way very free for me. So talking about my relationship with my psychiatrist brings me to a question. What is the relationship? What is the impact on the therapeutic relationship when you have a client who is engaging in self harm?
Shaina Feldman Barksdale: Well, you know, it's a tricky situation, to say the least. As an adult, it's not as tricky as an adolescent child. It's very tricky because as you can imagine, a parent would definitely want to know this, and sometimes the client is wanting to keep it a secret with the therapist. And so that's kind of a gray area for therapy
Shaina Feldman Barksdale: land, is when to tell parents when to not. And so I really don't want to answer that one on the podcast because I do think that's just a professional discretion. But I do think, you know, the more people you tell, again, shame lives in secrecy. And so if you have built that trust with someone, and certainly I would encourage my clients to tell as many people as they feel that they can and people they trust.
Valerie Milburn: Well, a lot of shame is being dripped off of me through the process of this podcast, that's for sure.
Shaina Feldman Barksdale: Yeah.
Valerie Milburn: And I just want to thank you so much for being here today. And before we wrap up is, do you have any closing comments, anything you want to say that you haven't Had a chance to say yet or what we've missed? Yeah. What have we missed? What haven't we asked? Good question. Good comment, Helen. Yes.
Shaina Feldman Barksdale: I mean, I really feel like. I mean, your story just had so many different. Both of your stories just had so many different things to it. And I think one thing that I would just add is y' all both, I mean, kind of alluded to giving up the instrument and just the importance of that, that is. Can be the beginning of healing for someone, can be the final. And I think that's a really important factor if you are self injuring, to be able to give up the instrument that you're using. And there's a lot of freedom in that. So I really appreciate you both talking about that.
Helen Sneed: Yeah, it was a tough trip to the trash can when I threw the stuff away.
Shaina Feldman Barksdale: Yeah. And again, people don't really honor that part of the story and honor that there's a reason why people do this. There's a way to heal it for sure, but not to shame people for self injuring.
Valerie Milburn: Thank you. Thank you so much for being here. Brought a lot to the conversation and I really appreciate it. I learned a lot. So I just love it that you were here.
Helen Sneed: Yeah. Thank you. I feel much smarter, which is always a good thing. And I'm sure that people in the audience do too. So this does bring our topic to a close and we hope to have fostered some understanding of this complex, often misunderstood behavior. I think what we most want to do is to validate the pain that causes it and invalidate the usefulness of the habit.
Valerie Milburn: Great.
Helen Sneed: We have named some significant treatment methods. We've told our own stories of self injury and how we overcame it. And for both of us, full recovery wasn't possible until we could stop hurting ourselves. It wasn't easy, but it has brought such amazing, lasting, positive changes to our lives. And now we're going to. Valerie is going to lead us in a much needed mindfulness exercise.
Valerie Milburn: Yes, we always close with the mindfulness exercise. And I always give a definition. What is mindfulness? Mindfulness is 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. Today's mindfulness information and exercise is adapted from Mindful Magazine. Here's an interesting fact. It's estimated that 95% of our behavior runs on autopilot, something Mindful Magazine calls fast brain. This autopilot, this fast brain is caused by neuro networks, neural networks that reduce our millions of sensory inputs per second. Into manageable shortcuts. These default brain signals are like signaling superhighways. They're so efficient that they often cause us to relapse into old behaviors before we even remember what we were meant to do instead. Mindfulness is the exact opposite of these processes. Mindfulness is slow brain. It's executive control rather than autopilot mindfulness. Slow brain enables intentional actions. But that takes some practice. The more we activate the slow brain, the stronger it gets. But here's the problem. While my slow brain knows what's best for me, my fast brain is causing me
Valerie Milburn: me to shortcut my way through life. So how can we trigger ourselves to be mindful when we need it most? There are ways to put your slow brain in the driver's seat. And here's one way we can create new patterns. You could try this. Try a series of if this, then that messages. If this, then that messages. These messages can create easy reminders to shift into slow brain. Here's an example. You might come up with this. If, then this, if this, then that message. Here we go. If opening my computer, then make a three item gratitude list. This could shift into mindfulness. As you are about to start your workday, here's another if this, then that. Here we go. If the phone rings, then take a breath before answering. Here's another one. If turning out the bedside light, then do a progressive relaxation exercise. Each intentional action to shift into mindfulness will strengthen your slow brain. So now take a minute. Take a minute to think of a new pattern you can create. Can you think of one or do you identify with an example I just gave? What is something you do every day that can prompt a mindful action? Maybe something you do many times a day. Have you thought of something? Visualize it, commit to it. Really commit to doing it. Okay, I'm going to check back with you next episode and see how you're doing with your if this, then that message.
Helen Sneed: Thank you, Valerie. I'm going to work on mine all week because I'll need to. So this is it for now. In our next episode, we'll address the somber, intimidating, grave subject of suicidal ideation. Our knowledge is firsthand and the methods to save lives are stronger than ever. The therapist will join our conversation. We really hope you can be with us too. There is so much to learn.
Valerie Milburn: I want to thank you, Shana, again for being with us and thank our audience. Thank you, listeners. We always appreciate the time you spend.
Helen Sneed: With us and please get in touch with us. We would love to hear from you and get some feedback and we will get back to you, I swear. The email address is mental healthhopeandrecoverygmail.com so again, let us hear from you. And until we meet again, I leave you with the most positive word I know. Onward.