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Self Harm

There is a report today saying that there is an alarming rise in the number of people self harming.
PROMIS has always treated self harm as part of the spectrum of compulsive disorders. We see the process of excitement and anticipation of harming, the release of tension and feeling of euphoria and then the subsequent crash and depression that follow as being so similar to the addictive compulsive cycle for other behaviors like bulimia or illegal drug use that even if it were a different process, the treatment method should be the same. For example, look at the way that drug addicts often become obsessed with the paraphernalia of using, self harmers can have the same relationship with their paraphernalia. Have a look at the way that bulimics have a strong sense of anticipation leading up to a binge purge process, followed by a terrible crash and depression. I think it is easy to see the parallels.
In terms of recovery, our approach for all addictive processes is to stop the behavior and to find other ways of expressing and managing feelings. Another corner stone of our treatment is to help people rebuild their self worth and value themselves again. Without this extensive rebuilding of the individual there is little hope of recovery.
My biggest concern for the treatment of self harmers in this country, is the same concern I have for addicts. The services on offer have something to say about the physical process but little to offer in the most crucial part of treatment, the gentle rebuilding of the individuals. There are wonderful medications to help people withdraw from drugs and there are clever distraction techniques taught to self harmers to divert them away from the most extreme risks of their behavior but there seems also to be a chronic lack of care and support beyond that.
I realise there is a funding dilemma and so the focus of funding is on reducing the most life threatening aspects of all of these behaviors and I applaud the good work that is being done to this effect. However I remain extremely concerned that without managing more of the underlying issues that these people are presenting with then we are simply building up a growing body of individuals who will be revolving door patients in the future passing from department to department.
We want to offer an alternative. Treat the whole individual. Of course this is a lot more expensive in the short term, but the longer term gain is that we can hope to get people out of the system and back into happy and fulfilling lives. I am sure this benefits society more than enough to warrant the extra expense in the short term.
Robin Lefever

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