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What Are the Challenges That Face a Psychotherapist Working with Self Harm or Eating Disorders.

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What are the challenges that face a psychotherapist working with self harm or eating disorders.

“She cuts herself. Never too deep, never enough to die. But enough to feel the pain. Enough to feel the scream inside. The lines I wear around my wrist are there to prove that I exist. A broken mirror, a bleeding fist, a silver blade against a wrist, tears falling down to lips unkissed, she's not the kind you'll come to miss.” (http://xxdailydreamxx.tripod.com/id16.html)

I took this poem from an internet site that encourages people who self harm to express themselves creatively or make themselves heard. It helped me to understand the emotions and thoughts behind self harm.

Self harm is considered to be a deliberate attempt at causing …show more content…

This perhaps would be something that could be worked on in therapy.

It was also suggested that some people self harm as a way of communicating or expressing things they cannot speak. It is suggested when self abuse is used in this mannor it is considered manipulative an attempt at getting a need met or to influence another. If this is the case it is important for the therapist to listen to what that need is and to help the individual satisfy that need in a constructive and effective manner
I imagine the therapists first challenge when presented with an individual who self harms is creating a space where the client can trust the therapist. I can imagine an individual who self harms will carry a large level of guilt and shame at the behaviour and it is as always vital to move at a pace the client is comfortable with. If I am aware of marks or cuts before the client has disclosed to me I will wait until the client feels safe or I feel is ready to talk about the behaviour.
Often the client will not have appropriate support systems for whatever reason which puts them in a very vulnerable position. I would never suggest a no self harm contract as I feel that would create too much pressure. It is important to remember that the behaviour is the adapted coping strategy for this individual and on some level it provides some release or comfort and the idea of

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