Helping Teenage Cutters

June 15, 2012

When I look around the community for good people doing good things, I need look no further that to one of my previous Interns, Kristine Newton.  She brings her maturity and competence to the counseling room to help, among other situations, teens who are cutters.   If you are one of these teenagers or if you know one, you would do well to read this article.  I asked Kristine to write something to help us understand what’s going on that drives this behavior and also what can be done to help the teen move from despair to a more mature contentment.  Need help?  Call Kristine.  She’s good.

It seemed like a normal night, their teenage daughter, Alice had come home and said good night. She seemed safe and happy; Mom and Dad were relieved and began to watch TV.  Less than ten minutes later, Alice came down the stairs, face flushed, tears in her eyes and blood gushing down her arm. While her parents were relaxing, Alice had gone to her room and slashed her arm. She had been cutting secretly for over six months, but tonight she used a box cutter and didn’t realize how sharp the blade was. The cut was so deep it required a trip to the ER and six stitches. Alice’s parents were in shock, what in the world had she done to herself and why?!!

It is estimated that one of every 200 girls between the ages of 13 and 19 in the United States engages in self-harm of some kind; of those 70% cut themselves. When families come to my office, the scene normally plays out like this.

Two very anxious parents and one scowling teenager enter the room and sit across from me. The adolescent informs me, “I will not talk to you or to them!”  They either deny the cutting is serious or state that their parents are being overly dramatic. “After all,” the teen says, “It’s not that big of a deal; cutting just makes me feel better.”

“Makes you feel better?!! That is ridiculous!” the parents exclaim.  With desperation, the parents turn and give me a look that begs me to talk some sense into their teen immediately.

The weird thing is . . . the teen is at least partially right. Cutting is a coping mechanism that “works” for some people.  Scientists have studied the issue, and believe cutting creates a temporary high, similar to the way adrenaline works.  For most of us, this does not make sense.  How in the world can hurting yourself make you feel better?  Like other unhealthy coping mechanisms such as drugs and alcohol, outsiders can easily see the dangers, but the person engaged in it cannot.  Cutting is deceptive, destructive, and can be addictive; even though for a time, it helps relieve tension, reduce numbness and/or create a distraction from stressful life events.

While cutting may appear to “work” for the person using it, like drugs and alcohol, it leaves a bitter aftertaste, and is a dangerous illusion. Cutting can lead to unplanned medical expenses, trips to the ER and, infections which sometimes cause life-long health problems. At minimum cutting leaves unattractive physical scars, and never gets to the root of the issue. Emotionally and relationally, people engaged in cutting end up isolated from others, filled with deep shame and self-hatred, and develop incredibly effective skills at hiding reality from those closest to them.

It is important to note that while cutting may look and feel like a suicide attempt, or a cry for attention most times it is not.  This surprises most of us.  Many people who engage in cutting are not attempting to kill themselves; they see cutting as a way to deal with their pain, so that they can keep on living. While cutting is not often a suicide attempt, it can be a precursor to it, and those who engage in cutting are more prone to attempt suicide in the future.  Sometimes like our teenager Alice in the first paragraph, the cutting may lead to an accidental cutting that is much more serious than intended – even accidental suicide.

To help us understand some of the reasons why a person might cut, there are several characteristics that seem common. Most cutters have experienced more than their fair share of pain.  Many have been sexually abused, grown up with family members who have drug and/or alcohol addictions, or have experienced an extraordinary trauma in their lives. When we actually begin to hear their stories, it is often a wonder to us that they are still alive, and it is understandable that they are struggling.

A second characteristic is that they often feel they have become a burden to others, they feel isolated, and thus tend to deal with their problems without outside help or advice.  They believe others are sick of listening to them, don’t understand them and can’t or won’t help them. Therefore, rather than ask others, they take on the pain themselves and engage in self harm.  One client who ended up in the emergency room said, “I didn’t want to kill myself.  But I didn’t want to burden my mom anymore by telling her I was down, again!  I thought I could cut myself and deal with it that way.  But the cut was a lot deeper than I intended. Now I am so mad at myself, I was attempting to take care of myself, but now I have created more drama and cost my parents even more money because of the hospital bill.”

A final characteristic is cutters are very passionate, sensitive individuals who feel their emotions in vivid Technicolor.  God has given them a unique personality and emotional framework that has very sensitive receptors to the soft side of life.  Many times those who struggle with cutting are fun to be with, exciting to share struggles with, and often very compassionate with others. This places them on a very steep roller coaster ride. The highs are very high and the lows are almost intolerable! The downside: pain they feel at a high level and don’t know how to deal with it. They may try to tell someone they are hurting, but are blown off because others don’t experience the issue at the same intensity.

So what do you do if like the parents in the opening story, you have discovered someone you care about is cutting? Here are six suggestions.

1.  Trust.  Trust that God loves your loved one even more than you do! He loves to shine light in dark places so that He can bring restoration. Trust in His power, loving-kindness and timing to do what He has promised in your life and your loved one’s life.

2.  Don’t Panic.  My guess is that like the parents above, you would be a bit freaked out. That is normal. Don’t be shocked by your reaction.  It is very important to deal with the problem, but do so calmly and not in a panic. Remember, cutting is usually not a suicide attempt, but it is often a cry for help. Your panic could encourage more hiding, aloneness, and be a precursor to more not less cutting.

3.  Communicate love and care. Tell your loved one that you care about them, that you want to be supportive and that you want to see them get help. Do not scold, rebuke, or preach at this point, simply and clearly let them know you are in their corner and cannot be run away!

4.  Find a therapist.  I recommend finding a good therapist for your loved one. A therapist who is experienced in working with cutters is best. Therapy is often necessary not only to teach the cutter new coping skills, but also to work through the trauma that is at the root of cutting. Therapy also helps to educate the cutter of their sensitive emotional nature so they may see it as a blessing, not a curse, and to teach them to use that gift properly and well. If you are the parent, you should attend sessions as well. This is beneficial. It helps the cutter feel supported, and it will also help you. I know this may sound scary, but the therapist can not only help you know how to best deal with your situation, but also work through any doubts you may be having about your parenting skills.

5.  You find a therapist. Dealing with a cutter presents unique challenges; seek a counselor who can help you learn to react to your sensitive loved one in a new and godly way. Even if your loved one will not go to therapy, you should go! Therapy can help you deal with the situation when the person you care about does not want to change.

6.  Be a friend.  This is a time where your loved one really needs a healthy relationship. Listen when they need to talk, open the door to deeper issues, but don’t try to pound down the door. Make sure that you that you remember how to have fun with them! Don’t treat them like a project or a problem. And be patient. This behavior has usually occurred in secret for some time, a few sessions with a therapist will not make it go away. Like addictions, there may be periods of sobriety and then some relapse.

Kristine Newton, MA, LPC works with adolescents and adults at Heritage Counseling and Consulting, in the Park Cities area of Dallas. Through her earlier work at Heartlight Ministries, an inpatient rehab center for teens, and Metrocare Services, she has extensive experience working with adolescents and adults who have engaged in self harm.  To contact her, call 214.363.2345

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Transform a Community

May 30, 2012
What do you do with a community so toxic with crime, drugs and poverty that the public buses wouldn’t go into it after 10:00 PM and the police would go in only with backup? A remarkable organization, “Behind Every Door”, brings hope to the community and dignity to the people.   Every door has behind it a valuable story.   Now, groups of young boys, ages 8-13, gather on Friday mornings for their “Real Men” goup meetings to learn what it is to be a real man.   Tutoring improves school performance.   Job training helps get work.  Even planting flowers helps the place look better.  The residents say, “Life is looking up.”  This is social justice in action.
In April, WFAA-TV (ABC)  did a short story on the Village Oaks community.  Click to watch.
Check out their web site too.   Great pictures.
And great stories on their blog.
It’s only 864 homes with 2000 residents, but imagine what could happen as other communities experience the blessing of caring relationships.  It’s amazing what can happen with good people set out to do good things in the community.  Consider supporting them with finances.  I think they’re worth it.

Training, Not Just Teaching

March 22, 2012

Arthur & Olga Alard

I met an interesting couple who offer practical and effective leadership training in Africa.   Americans could learn a lot from them.

What are the chances that a Russian woman with a medical degree in Epidemiology from Moscow would meet a South African man from Cape Town and get married? Yes, they met at Dallas Theological Seminary where Olga was studying World Missions and Intercultural Studies and Arthur was studying Biblical Counseling. Now they have a three-year-old son named Pavel Arturovich Alard (Russian for, Paul son of Arthur Alard). What do people do with academic master’s degrees like these?

Arthur and Olga Alard are serving with Entrust and More Than A Mile Deep (MMD) in South Africa as missionaries.  They like to say, “We’re multiplying leaders for multiplying churches.”  The name of the organization stems from a Bible passage in 2 Timothy 2:2 which says: “And ENTRUST what you heard me say in the presence of many others as witnesses to faithful people who will be competent to teach others as well.” The problem they faced with trying to train leadership in Africa loomed large from the reputation of spreading their work over a thousand miles wide but only an inch deep. But African church leaders have named their particular ministry “More Than a Mile Deep” because they have developed a program that results in deep roots that keep on multiplying.

MMD is a unique ministry because Africans have owned the development process and training and has being managing this project from the beginning. MMD learners don’t have to leave their ministry home base to receive training. Instead, MMD trainers take the training to the church leaders in their ministry contexts and facilitate the learning process with no more than 12 church leaders per group. The group is thus a co-mentoring group. They train the first generation of church leaders and the first generation church leaders become second generation trainers.  MMD’s Educational Philosophy is called Competency Development Learning. They don’t give exams, but instead assess the portfolios of each learner during and at the end of each course, tracking the progress of the ministry competencies which the church leader has developed through his/her involvement in real life ministry contexts.

Entrust and MMD offer an internationally recognized accredited, practical and quality program in partnership with the South African Theological Seminary – SATS.  What do they teach? SATS, Entrust and MMD are working on a joint project to write a new curriculum for social transformation in Africa, from a Biblical perspective. Included are courses such as Living A Practical Christian Life, Pastoral Guidance and Counseling in HIV and AIDS, Resolving Poverty and Divisive Ethnicity, Generating Sustainable Income, and Developing Business as Mission…and many more. That strikes me as very practical.

As missionaries with Entrust in South Africa Arthur and Olga are self-supported and rely on the financial support of partners. Checks can be made payable to ENTRUST with M128 on the memo line (not their names) and mailed to Entrust, PO Box 25520, Colorado Springs, CO 80936-5520.

Want to follow them on facebook?  Click here.


Don’t Forget to Remember Me

March 17, 2012

Emmanuel in Formal Attire

Emmanuel in My Office

 

 

 

 

 

 

 

 

 

This week I met a very interesting man.  He has a gift for poetry.  He thinks creatively.  He envisions wonderful plans.  He comes to the United States from Nigeria so he can study theology and Bible at Dallas Seminary.  Perhaps his most impressive impact, beyond his talent and his winsome personality, is his devotion to the Lord and his desire to spread the joys of the Gospel to young people throughout his home country of Nigeria.  He founded an organization called “GoldSpringsGold” through which he hopes to encourage others to embrace  the riches of knowing Jesus and spring forth with scattering those blessings all around.  Keep watching Emmanuel because he should be contributing to the future prosperity and dignity of Africa in the coming years.  I share one of his poems with you.

DON’T FORGET TO REMEMBER ME.                               By – Emmanuel Olorunnisola

I AM the Creator of everything.
I know the beginning before it even began.
I see the end right from when it all began.
I have everything under my control.
I give you the will and power to choose.
Don’t forget to remember me.

I love you with all of my heart.
I AM with you even when I seem far away.
I hold the world in my hands.
And I hold you in my hands too.
In all you think and all you do,
Don’t forget to remember me.

There will be times when things will go smooth.
And all you get will make you soothe.
All you lay your hands on will bring you wealth.
And you will always be in good health.
When everything is working out well for you,
Don’t forget to remember me.

The sun rises to wake up the morning.
The sun shines to make it a day.
The moon comes up to bring down the evening,
The stars shine to make it a night.
Whether it be daytime or nighttime,
Don’t forget to remember me.

Even when it seems you are all alone:
And there’s no one to hear your voice.
Even when no one stands by you.
Even when no one believes in you.
And everybody turns his back on you,
Don’t forget to remember me.

Whether it be sunrise or sunset.
Whether it be seed time or harvest time.
Whether it be good times or bad times.
Whether it be day time or night time.
Whether it be time of birth or be it time of death.
Don’t forget to remember me.

There will be times when you will have plenty:
And your cup will surely overflow.
There will be times when you will be empty:
And there is nothing left to grow.
There will always be such times as these.
Don’t forget to remember me.

In the season when the lake is frozen.
In the season when the flowers blossom.
In the season when the storm rages
In the season when the harvest comes plenty.
In any season that comes and goes by.
Don’t forget to remember me.

When you can’t understand what is going on.
When there are more questions than the answers you get.
When you can’t find a way out of all your troubles.
When all you ask is ‘why?’ and wonder ‘why?’
When things get out of your control, and you want to give up.
Don’t forget to remember me.

I was stripped naked to give you covering.
I was crowned with thorns to make you rule your world.
I bore the cross to make you cross over.
I shod my blood to give you life.
I gave up life to make you live.
Don’t forget to remember me.

In all you do and not want to do.
In all you think and not want to think
In all you say and all you hear
In all your laurels and in all your loss
Whether in all or in nothing at all
Don’t forget to remember me.


“Understanding the Male of the Species”

March 17, 2012

Kelly G. Antwine, M.Ed., LPC

Kelly Antwine presented a verbal time-lapse picture of how the “Male of the Species” developed into what it is today.  Cultural pressures have shaped the roles in the home.  Prior to World War, 27% of the families lived on what they could produce on less than 100 acres of their homestead.   Neighbors helped each other.  Children worked along side their parents.  After the War, we clustered into the new invention called “suburbs.”
On the negative side, he explained how men have deteriorated relationally after returning from the War.

  • Men no longer worked with their sons out on the farm producing the family’s sustenance.  Instead, they worked in the factory, away from the family.
  • Men no longer worked cooperatively with one another in mutual assistance.  Instead, they competed for the ever-narrowing opportunities for advancement.
  • Men no longer valued their worth on the blessings that provided dignity.  Instead, they turned to status defined by income and material possessions for their worth.

On the positive side, he called for restored manhood by

  • sharing emotions and vulnerability with one another, implying that transparency builds intimacy.
  • taking back the responsibility of training our sons how to be persons of integrity, refusing to outsource that responsibility to “professionals” like daycare workers and teachers.
  • entering into a personal relationship with God that is genuine and authentic, resisting the temptation to just going through the motions of religious rituals that have little personal meaning.

Lots of good food for thought.  The North D/FW Chapter of the Christian Counselors of Texas organized the meeting which deserved more attendance than came.  Kelly is a Licensed Professional Counselor at Preston Place Counseling in Dallas.  He has a lot of experience with addiction recovery and can be contacted at 972-960-2222 or Kelly@PrestonPlaceCounseling.com.


Culture and Empathy in Cross-Cultural Counseling

March 13, 2012

When I taught a course on cross-cultural counseling, I faced the challenge of selecting the most critical issues to emphasize.  Clearly, empathy was identified as the critical condition for effective counseling.  Without empathy, people cannot connect.  With empathy, the work can begin.  I wish I had come across this article by Chung and Bemak when I was teaching.  My students would have had another paper to read.  It’s really good.  Drs. Rita Chi-Ying Chung and Fred Bemak are on the faculty at George Mason University.  (If you want to read the whole article, it’s in the Journal of Counseling & Development, Spring 2002, Vol. 80 Issue 2, 154-159.)  Here are some excerpts.

Abstract from the authors:
Empathy has been identified as a core condition for providing counseling. There are numerous articles discussing the components of empathy. However, as the U.S. becomes increasingly ethnically diverse and the world becomes more globalized, there is little discussion on how empathy will be effective with diverse populations. This article discusses the interaction of culture and empathy and suggests guidelines for establishing cultural empathy
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Various Descriptions of Empathy
  • the counselor’s ability to enter the client’s world (Rogers, 1961)
  • to feel with the client rather than feel for the client (Capuzzi & Gross, 1999)
  • to think with the client rather than for or about the client (Brammer, Abrego, & Shostrum, 1993)
  • the therapist’s ability and effort to place him- or herself symbolically in the position of the client and understand the client’s world.

But empathic understanding alone is not enough for effective therapy. The therapist must also have the ability and skill to communicate and demonstrate empathic understanding so that the client perceives it. So it’s an extremely relational ingredient.

Worldview is defined as the way individuals perceive their relationship to the world.  Worldviews not only comprise attitudes, values, beliefs, opinions, and concepts but also affect how individuals think, make decisions, behave, define, and interpret events.  The challenge for the counselor is to place oneself inside the client’s frame of reference and then have the ability to effectively communicate one’s understanding of that world.   For example, Asian students believed that the counselor displayed greater empathy when the counselor considered the students’ cultural values, such as family or societal influences, than when the counselor focused on Western values of individualistic personal attributes and needs.
The display of culturally sensitive responses and attitudes by the counselor is more important than an ethnic match.  The counselor’s ability to do this may have an impact on their credibility and subsequent ability to be culturally empathetic.  When Chinese students perceived the counselor to be empathetically involved, they also perceived the counselor to be credible. The credibility predicted their willingness to be in counseling.
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The authors list six major dimensions that significantly contribute to effective cultural empathy:
  1. Understand and accept the context of family and community for clients from different cultural backgrounds. This is especially important given the collectivistic nature of many cultures that emphasizes the social-familial context.
  2. Incorporate indigenous healing practices from the client’s culture when possible. An integration of traditional healing methods demonstrates that the counselor has a knowledge and understanding of the client’s beliefs and values. This requires an understanding of the client’s cultural conceptualization of mental health, manifestation of symptoms, and cultural expectations for treatment outcomes (Chung & Kagawa-Singer, 1995). If the counselor does not work within the cultural framework of health and mental health for each client, cultural empathy is likely to become an imposition of the counselor’s cultural value system rather than a culturally sensitive understanding of and response to the client’s problem. It is important to note that the incorporation of traditional healing methodologies does not mean that counselors must actually perform rituals such as Native American sweat lodge healing or sun dance, but rather that they work concurrently and cooperatively with traditional healers in true partnerships that entail the utmost respect for traditional healing methodologies (Bemak, Chung, & Pedersen, in press).
  3. Become knowledgeable about the historical and sociopolitical background of clients. For example, the United States has a history of discriminatory behavior toward ethnic minority populations, such as the slavery of African Americans, genocide of Native Americans, and internment of Japanese Americans. In addition, immigrants in the United States may come from countries at war or countries that have long-standing conflictual relationships between different ethnic or religious groups. These issues have important bearing on how, when, and where cultural empathy is expressed by the counselor and requires counselors to be aware of and sensitive to the importance of transgenerational trauma on clients.
  4. Be knowledgeable about the psychosocial adjustment that must be made by clients who have moved from one environment to another. This could range from relocating to another neighborhood or town; moving between urban, suburban, and rural settings; or migrating from one country to another. In all these instances, psychosocial adjustment plays a key role that would be important for a counselor to understand (Berry, 1997).
  5. Be highly sensitive to the oppression, discrimination, and racism that are encountered by many people and often on a daily basis (Bemak et al., in press; Robinson & Ginter, 1999; D. W. Sue, Bingham, Porche-Burke, & Vasquez, 1999). It is essential for counselors to understand the nature and impact of this experience in the healing process while maintaining culturally appropriate empathy with these deeply rooted issues.
  6. For those clients who feet underprivileged and devalued, it is essential for effective cultural empathy to facilitate empowerment for clients (see Bemak, 1998). This may require that counselors know about and provide information about community resources and services to clients and create supportive responses to clients so that they become confident and skilled in growing personally as well as promoting social change in their lives and communities.

In summary, to be effective with culturally diverse clients, it is critical that the counselor displays and demonstrates cultural empathy. Without the counselor’s culturally responsive empathy, there is a high probability of clients’ premature termination of counseling and the danger that the counselor will be ineffective with clients. Simply stated, the contribution of culturally responsive empathy is that it has the potential to greatly contribute to the healing process when working across cultures.


Help Children of Divorce

January 17, 2012

Kids suffer from divorce.  My heart goes out to these boys and girls who often demonstrate more common sense about getting along than their parents.  They face an enormous adjustment for which no kid is equipped without some help.   Now, KidWorks provides that help.  Here’s a note from Rob Pine, the Executive Director, ChristianWorks for Children, highlighting a strong leader, Monica Epperson, and a ten-year-old boy of divorced parents, Cody.   Watch the video, read their story, let your heart respond with some kind of support.   They need facilitators as well as financial support.  Are children important?  Jesus thought so: “Let the little children come to me, and do not hinder them, for the kingdom of heaven belongs to such as these.”  (Matthew 19:14)

Rob writes:

God directed Monica Epperson our way to serve Him and join us as a National Representative for KidWorks, to develop and distribute materials, and to train others across the country.  She has a powerful story of her own as a child of divorce, and she has a passion to help children defeat the fears and worries that accompany that experience.  The author of two children’s books, Bounce and A Heart with Two Homes, Monica provides personal and heart-rendering insight into the issues that children of divorce face and into how KidWorks effectively addresses those issues.   She writes about this in a posting on the ChristianWorks.

It was a typical night at KidWorks, and all the groups had been in session for awhile.  The topic for the evening was Fears and Worries. One of the Middles’ facilitators suddenly appeared with a little boy named Cody who had asked to leave the group. Cody was obviously having a hard time that evening and began to cry. Our KidWorks Coordinator listened as he explained he wanted to leave because he didn’t want to cry in front of the other kids. In Cody’s own words, he expressed that “Fourth graders are too big to cry, but I know it’s alright to cry.” This exceptional ten year old boy must have felt very torn. As the conversation continued, he eventually shared what was behind the tears. His divorced parents continued to fight in front of him even while talking on the phone. The public display of his parent’s inability to get along was a big worry for him. After a bit of conversation, and composure on Cody’s part, he was ready to go back into the group. He felt better!

Cody was really brave to share as he did. He was brave enough to cry, even though it was not in front of the other kids. As is often the case with children of divorce, his pain and hurt were deeply rooted. Being able to release the pain and hurt is a step in the healing process.  KidWorks is a safe place where kids can share their deepest hurts along with their fears and
worries. Group facilitators help kids like Cody learn to address issues of divorce as well as help them learn coping skills to deal with those issues.

You can contact the KidWorks Coordinator, Beverly Ritz at britz@christian-works.org, for more information.