Maladaptive Strategies and Self-Harming
Submitted by Heather Rhodes, APRN-BC
Tags: bounderies maladaptive strategies self harming behaviors self-harming strategy stress
As people have social distanced and quarantined during the pandemic, the use of social media has increased as a means to stay connected. Being connected has not been an entirely healthy endeavor for everyone, though, as this platform has also allowed a milieu for unrestrained bullying behaviors and socio-cultural sources of stress that are unprecedented in history (Papathanasiou, Tsaras, Neroliatsiou, & Roupa, 2015). Information technology has become an ocean of opportunity for people of all ages to engage and influence how others feel about themselves and what they are doing. Not understanding appropriate boundaries and how to set them along with unhealthy coping mechanisms have left many people incapable of adequately dealing with a tsunami of criticisms. Unhealthy coping strategies increase the risks for self-harming behaviors. Levels of "perceived stress tend to be higher among those with mental illness" (Lavoie, 2013, p. 185) and at-risk populations will be driven to find ways to mitigate the increased stress levels. Some of those coping mechanisms employed include cutting, burning, skin picking or hair pulling.
People with mental health disorders (including depression, schizophrenia, anxiety, and autism) often lack the coping mechanism to manage the stressors that come with everyday living (Taylor & Stanton, 2007). Once the threshold of adaptation to an individual stressor is reached, maladaptive coping strategies are "initiated to help the individual to deal effectively with the stressful event" (Papathanasiou, Tsaras, Neroliatsiou, & Roupa, 2015, p. 47). Research suggests that "people who self-harm repeatedly are more likely to report using avoidance and emotion-focused coping rather than rational or detached coping" mechanisms (Borrill, Fox, Flynn & Roger, 2009, p. 362). Cutting, burning, skin picking and hair pulling all redirect the feeling of stress towards the feeling of pain and provide a level of relief from stress that otherwise cannot be achieved in the moment.
Understanding some of the reasons for self-harm helps drive therapy. Some of those reasons include distraction, self-punishment, anger expression, and escape (Moorey, 2010). Helping patients identify the root cause of self-harm and then giving them the skills to express their emotions in a healthy manner is paramount to healing. "People who self-harm have deficits in problem-solving abilities" (Linehan, Camper, Chiles, Strohsal, & Sherin, 1987, p. 3). Methods in managing the maladaptive strategy of self-harm include cognitive-behavioral therapy (CBT) and Beck's cognitive therapy (Moorey, 2010). Intervening at various points (safe milieu, helping the patient map emotions before and during the stressor, teaching emotion regulation strategies, etc.) can help the patient develop coping strategies to decrease the need to self-harm and develop ways to cope in more healthy ways going forward.
Clients should be encouraged to practice new coping strategies outside of stressful events. This pre-emptive training will help prepare the client for when the wave of stress crashes over them. Instead of panicking, the client will immediately let the new coping strategy take over to decrease the immediate stress reaction and handle the problem in a healthy manner. Learning triggers, recognizing when stress levels are increasing and implementing new coping strategies are all effective management strategies to handle the emotion of anxiety and decreasing self-harming behaviors.
Reference
- Borrill, J., Fox, P., Flynn, M., & Roger, D. (2009). Students who self-harm: Coping style, rumination and alexithymia. Counseling Psychology Quarterly, 22(4), 361-372.
- Connolly, S. D., & Bernstein, G. A. (2006). Practice parameter for the assessment and treatment of children and adolescents with anxiety disorders [PDF]. Journal of the American Academy of Child and Adolescent Psychiatry, 46(2), pp. 267-283.
- Lavoie, J. A. (2013). Eye of the beholder: Perceived stress, coping style, and coping effectiveness among discharged psychiatric patients. Archives of Psychiatric Nursing, 27(4), pp.185-190.