Art therapy can be very effective & help clients decrease their self-harm behaviors. Please keep reading to better understand self-harm behaviors, statistics, reasons why behind self-harm & how therapy can help. This post also lists five ways that art therapy can be an effective intervention.
What is Self-Harm or Self-Injury Behavior?
Self-harm or self-injury is the act of intentionally injuring one’s self to find relief from emotional or psychological distress. Self-harm is a deliberate, controlled act and can take the form of cutting, burning, or preventing wounds from healing naturally. Self-harm behaviors are rarely based on suicidal intent. People who self harm are not trying to kill themselves.
How common is self-harm behavior?
Self-harm behaviors occur in private and so it is hard to pinpoint exact stats. Estimates vary widely from 3% to 38% in adolescents and young adults. Studies conducted with university students demonstrated a 17% lifetime prevalence rate in this population, with 13% reporting that they had engaged in self-harm more than once. Studies of high school students indicated prevalence rates of self-harm ranged from 13% to 24%.
Why do people self-harm?
There are several theories. One theory is that self-harm behaviors are an attempt to gain relief from emotional pain. The urge to hurt oneself may start with overwhelming anger, frustration or pain. When a client is not sure how to deal with emotions or learned as a child to hide emotions, self-harm may feel like a release. It can increase the body’s endorphins, which in turn raises one’s mood & leads to a feeling of pleasure. This makes self harm a difficult cycle to break. Or if a client does not feel any emotions, they might cause pain to feel something “real” to replace their emotional numbness. Another theory is that self-harm behaviors are a call for help. Usually, it is a combination of the two; an attempt to cope with distressing thoughts and feelings while asking for help.
How can therapy help? What to expect in sessions...
The first step in therapy is for the therapist to create a safe place and build therapeutic rapport. This is done by actively listening to a client without judgment. Next, the client sets goals. Does a client want to stop self harm all together or do they want to take a harm reduction approach? In addition to setting goals in the early sessions, a therapist often asks about history and current stressors.
Self-harm, in of itself, is not a diagnosis in the DSM-IV manual. It is considered a symptom and often occurs with other diagnoses, such as depression, anxiety, post-traumatic stress disorder or substance abuse. A detailed history can help establish a clear picture of what is going on, which helps the client and therapist create a treatment plan that can address the self-harm behaviors and any additional issues that are going on. Most therapists, including myself, create treatment plans with the client’s direct input. I want the goals on a client's plan to be the ones that they want to work on. I want us to establish menaingful goals together.
There are several different types of traditional talk therapies that can be helpful with self-harm behaviors. The psychodynamic model of therapy can be used to help explore past experiences and emotions. Cognitive Behavior Therapy (CBT) is useful when a client needs to learn how to recognize and challenge negative thought patterns. Dialectical behavioral therapy (DBT) skills can be useful too. DBT teaches skills related to Mindfulness, Emotion Regulation, Interpersonal Effectiveness & Distress Tolerance. Most therpaists pull from several models in order to help a client meet his or her goals.
In addition to pulling techniques from traditional talk therapies, my preferred way of addressing self-harm behaviors is through art therapy interventions. As a registered art therapist (ATR), I know art can be an amazing way to acknowledge the distressful emotions that one feels before self-harming. Creating art can provide a client with an immediate, specific tool to use when an urge to self-harm strikes. One can be productive rather than destructive. For example, a client can take a ball of clay and twist the clay into shapes until the urge has passed. Or a client can cut or tear pages out of a magazine when feeling an urge to hurt. Creating art is effective because it is active and productive and can help a client stay in the moment, which can lessen the impact of a distressing thought or feeling.
Below is five additional ways art therapy can be an effective treatment in self-harm behaviors.
Five ways art therapy can help with self-harm behaviors
1) The art-making process itself can be healing. Rather than self-harming, clients can use artwork to express and manage intense emotions that feel overwhelming. Even if a client doesn’t have words for his or her emotions, just expressing them through art can be a powerful start.
2) Cutting and self-harm can feel out of control. Creating art can be the opposite. Clients experience a sense of control while creating artwork. A client gets to decide what to create, what materials to use, how to make something and what to say about it.
3) After the artwork is created, a client can begin processing the work & actively explore the thoughts and feelings with the help of a trained art therapist The therapeutic relationship plus creating the artwork, then reflecting on it can help clients learn how to express & tolerate overwhelming feelings, which is often a treatment goal.
4) Art making is an immediate coping tool. One can make marks on a page instead of harming oneself. One can choose to be destructive and harm their artwork (tear up a page, destroy a clay vessel) rather than one’s self.
Self-harm, in of itself, is not a diagnosis in the DSM-IV manual. It is considered a symptom and often occurs with other diagnoses, such as depression, anxiety, post-traumatic stress disorder or substance abuse. A detailed history can help establish a clear picture of what is going on, which helps the client and therapist create a treatment plan that can address the self-harm behaviors and any additional issues that are going on. Most therapists, including myself, create treatment plans with the client’s direct input. I want the goals on a client's plan to be the ones that they want to work on. I want us to establish meaningful goals together.
Please reach out if you require a counselor and art therapist in the Los Angeles (Playa Vista) area or if you have any questions about self-harm treatment in a private practice setting. In addition to helping clients directly, I also enjoy working with parents who may not know the best way to support their son or daughter as they are struggling. Please email or call if I can be of help kim@kimberlygibsoncounseling.com or 310-554-8670.