A Safe Place for Cutters Blog


Trying to be Perfect Makes for Imperfect

A high school girl in my Facebook group, The Safe Place for Cutters, wrote:

“i haven’t cut in a really long time…for me, i was feeling so lost in life and the pain from cutting helped center me. i’ve finally learned that you have to love yourself or else nobody will ever be able to love you. i’m such a perfectionist and it has been so hard to let go of the perfect image that i had of my self, and to accept that i am not always going to be able to live up to my ridiculous expectations of myself, but now that i have, i feel liberated. i hope that all of you are able to find that place of acceptance within yourself…we’re all here for you, because we all are going through or have gone through something similar if not exactly the same as what you’re going through.
much love to all of you!”

Sometimes the members in my group say it so much better than I could ever say myself.

To A Life Worth Living,

Foresteen Forbes, Psy. D.



Warning: Worrying About Stress is More Damaging than Stress Itself.
May 11, 2010, 10:03
Filed under: Coping Skills, Tools | Tags: , ,

In his book Ageless Body, Timeless Mind, Deepak Chopra says that worrying about stress is more damaging than stress itself. Which brings me back to something I have said previously: It is not events that shape your world. It is your thought processes.

When you learn to control your thoughts, you reduce the power that negative influences have upon your life. Remember, no matter how long a list of stress reducers you compile, your mental state will always be the most important factor when it comes to achieving peace of mind.

To A Life Worth Living,

Foresteen Forbes, Psy. D.

*If you would like to be a member of my Facebook group “The Safe Place for Cutters,” please find me on Facebook and invite me to be your friend. Click here!



9 Things You Can Do to Be Happy in the Next 30 Minutes

I came across these bits of wisdom by Gretchen Rubin who blogs about happiness, among other topics, for Real Simple’s Simply Stated. Her book, The Happiness Project (Harper Collins) is due out in 2009.

Being happier doesn’t have to be a long-term ambition. You can start right now. In the next 30 minutes, tackle as many of the following suggestions as possible. Not only will these tasks themselves increase your happiness, but the mere fact that you’ve achieved some concrete goals will boost your mood.

1. Raise your activity level to pump up your energy. If you’re on the phone, stand up and pace. Take the stairs instead of the elevator. Put more energy into your voice. Take a brisk 10-minute walk. Even better…

2. Take a walk outside. Research suggests that light stimulates brain chemicals that improve mood. For an extra boost, get your sunlight first thing in the morning.

3. Reach out. Send an e-mail to a friend you haven’t seen in a while, or reach out to someone new. Having close bonds with other people is one of the most important keys to happiness. When you act in a friendly way, not only will others feel more friendly toward you, but you’ll also strengthen your feelings of friendliness for other people.

4. Rid yourself of a nagging task. Deal with that insurance problem, purchase something you need, or make that long-postponed appointment with the dentist. Crossing an irksome chore off your to-do list will give you a big rush of elation.

5. Create a more serene environment. Outer order contributes to inner peace, so spend some time cleaning off your desk and tackling the piles in the kitchen. A large stack of little tasks can feel overwhelming, but often just a few minutes of work can make a sizable dent. Set the timer for 10 minutes and see what you can do.

6. Do a good deed. Introduce two people by e-mail, take a minute to pass along useful information, or deliver some gratifying praise. In fact, you can also…

7. Save someone’s life. Sign up to be an organ donor, and remember to tell your family about your decision. “Do good, feel good” — it really works!

8. Act happy. Fake it ’til you feel it. Research shows that even an artificially induced smile boosts your mood. And if you’re smiling, other people will perceive you as being friendlier and more approachable.

9. Learn something new. Think of a subject that you wish you knew more about and spend 15 minutes on the Internet reading about it, or go to a bookstore and buy a book about it. But be honest! Pick a topic that really interests you, not something you think you “should” or “need” to learn about.

Some people worry that wanting to be happier is a selfish goal, but in fact, research shows that happier people are more sociable, likable, healthy, and productive — and they’re more inclined to help other people. By working to boost your own happiness, you’re making other people happier, too.

To A Life Worth Living,

Foresteen Forbes, Psy. D.



Turning Darkness into Light
March 8, 2010, 10:11
Filed under: Tools | Tags:

The silver lining in the painfulness and loneliness of human plight is the awe inspiring creativity that it brings out in people.  This in turn brings hope and inspiration to others.

The following photo was taken by one of the members of my Facebook group, “The Safe Place for Cutters.” The caption is hers.


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A blood- red sky. A delight for those who know the darkness brings worry and strife. A bother who know that the Light will be gone only for a short time. But the colors are always to remind us that life is a blend of color and picture. We are to cherish it, whether you are afraid of the impending darkness, or take joy in the Light to come.

*If you would like to be a member of my Facebook group “The Safe Place for Cutters,” please find me on Facebook and invite me to be your friend. Click here!


Is there such thing as Long Term Success for Cutters?
March 1, 2010, 10:26
Filed under: Uncategorized

I had the following conversation with a young lady on Facebook:

FB: … I wanted to ask whether you’ve had any long term success with your patients. I don’t mean those people who say they’re clean for, dunno…4 years or 18 months…I mean those, who seriously don’t even get the desire to cut anymore. And not just in stressful situations- but generally.
I was just wondering if this state even exists…

Have a nice day,

Dr. Forbes: I work w/ people w/ self harm behavior at a state hosp. Yes, I do see people get better which is why I love my job so much. Mostly it has to do with creating a validating environment.  I try to do the same with my private Facebook group and blogsite.

FB: It’s good to hear that it actually is possible to get better, or well normal again. I always thought it was about control. You know. Giving me the control – not the other way round!

In one sense, it is about control. You do have to develop internal controls to quit harming yourself and create new habits to replace the self-harm behavior.  But what really helps people to get to the place where they no longer desire to hurt themselves is to be nurtured by a validating environment. Individuals with self-harm behavior typically have grown up in invalidating environments that include; physical , sexual and emotional abuse. Deep down in your soul you feel that you are not loved or worthwhile.  A validating environment is one where you are made to feel that you really matter to someone and have a contribution to make to the world. This doesn’t give you control by itself but it is like fertilizer that gives you the strength to make it begin to happen.  You then become empowered to develop new tools such as  interpersonal skills, distress tolerance skills and emotional regulation.

*If you would like to be a member of my Facebook group “The Safe Place for Cutters,” please find me on Facebook and invite me to be your friend. Click here!



Bill of Rights for People Who Self-Harm
February 22, 2010, 10:36
Filed under: self-harm | Tags: , ,

Sometimes health professionals can stand to be more sensitive to people with self-harm behavior. I came across the following that I thought I would share.

Bill of Rights for People Who Self-Harm

Preamble:
An estimated one percent of Americans use physical self-harm as a way of coping with stress; the rate of self-injury in other industrial nations is probably similar. Still, self-injury remains a taboo subject, a behavior that is considered freakish or outlandish and is highly stigmatized by medical professionals and the lay public alike. Self-harm, also called self-injury, self-inflicted violence, or self-mutilation, can be defined as self-inflicted physical harm severe enough to cause tissue damage or leave visible marks that do not fade within a few hours. Acts done for purposes of suicide or for ritual, sexual, or ornamentation purposes are not considered self-injury. This document refers to what is commonly known as moderate or superficial self-injury, particularly repetitive SI; these guidelines do not hold for cases of major self-mutilation (i.e., castration, eye enucleation, or amputation).
Because of the stigma and lack of readily available information about self-harm, people who resort to this method of coping often receive treatment from physicians (particularly in emergency rooms) and mental-health professionals that can actually make their lives worse instead of better. Based on hundreds of negative experiences reported by people who self-harm, the following Bill of Rights is an attempt to provide information to medical and mental-health personnel. The goal of this project is to enable them to more clearly understand the emotions that underlie self-injury and to respond to self-injurious behavior in a way that protects the patient as well as the practitioner.

The Bill of Rights for Those who Self-Harm

The right to caring, humane medical treatment.
Self-injurers should receive the same level and quality of care that a person presenting with an identical but accidental injury would receive. Procedures should be done as gently as they would be for others. If stitches are required, local anesthesia should be used. Treatment of accidental injury and self-inflicted injury should be identical.

The right to participate fully in decisions about emergency psychiatric treatment (so long as no one’s life is in immediate danger).
When a person presents at the emergency room with a self-inflicted injury, his or her opinion about the need for a psychological assessment should be considered. If the person is not in obvious distress and is not suicidal, he or she should not be subjected to an arduous psych evaluation. Doctors should be trained to assess suicidality/homicidality and should realize that although referral for outpatient follow-up may be advisable, hospitalization for self-injurious behavior alone is rarely warranted.

The right to body privacy.
Visual examinations to determine the extent and frequency of self-inflicted injury should be performed only when absolutely necessary and done in a way that maintains the patient’s dignity. Many who SI have been abused; the humiliation of a strip-search is likely to increase the amount and intensity of future self-injury while making the person subject to the searches look for better ways to hide the marks.

The right to have the feelings behind the SI validated.
Self-injury doesn’t occur in a vacuum. The person who self-injures usually does so in response to distressing feelings, and those feelings should be recognized and validated. Although the care provider might not understand why a particular situation is extremely upsetting, she or he can at least understand that it *is* distressing and respect the self-injurer’s right to be upset about it.

The right to disclose to whom they choose only what they choose.
No care provider should disclose to others that injuries are self-inflicted without obtaining the permission of the person involved. Exceptions can be made in the case of team-based hospital treatment or other medical care providers when the information that the injuries were self-inflicted is essential knowledge for proper medical care. Patients should be notified when others are told about their SI and as always, gossiping about any patient is unprofessional.

The right to choose what coping mechanisms they will use.
No person should be forced to choose between self-injury and treatment. Outpatient therapists should never demand that clients sign a no-harm contract; instead, client and provider should develop a plan for dealing with self-injurious impulses and acts during the treatment. No client should feel they must lie about SI or be kicked out of outpatient therapy. Exceptions to this may be made in hospital or ER treatment, when a contract may be required by hospital legal policies.

The right to have care providers who do not allow their feelings about SI to distort the therapy.
Those who work with clients who self-injure should keep their own fear, revulsion, anger, and anxiety out of the therapeutic setting. This is crucial for basic medical care of self-inflicted wounds but holds for therapists as well. A person who is struggling with self-injury has enough baggage without taking on the prejudices and biases of their care providers.

The right to have the role SI has played as a coping mechanism validated.
No one should be shamed, admonished, or chastised for having self-injured. Self-injury works as a coping mechanism, sometimes for people who have no other way to cope. They may use SI as a last-ditch effort to avoid suicide. The self-injurer should be taught to honor the positive things that self-injury has done for him/her as well as to recognize that the negatives of SI far outweigh those positives and that it is possible to learn methods of coping that aren’t as destructive and life-interfering.

The right not to be automatically considered a dangerous person simply because of self-inflicted injury.
No one should be put in restraints or locked in a treatment room in an emergency room solely because his or her injuries are self-inflicted. No one should ever be involuntarily committed simply because of SI; physicians should make the decision to commit based on the presence of psychosis, suicidality, or homicidality.

The right to have self-injury regarded as an attempt to communicate, not manipulate.
Most people who hurt themselves are trying to express things they can say in no other way. Although sometimes these attempts to communicate seem manipulative, treating them as manipulation only makes the situation worse. Providers should respect the communicative function of SI and assume it is not manipulative behavior until there is clear evidence to the contrary.

© 1998-2001 Deb Martinson. Reprint permission granted with proper credit to author.

*If you would like to be a member of my Facebook group “The Safe Place for Cutters,” please find me on Facebook and invite me to be your friend. Click here!



No Matter What!
December 7, 2009, 11:07
Filed under: Uncategorized

Some of the individuals I work with that with self-harm behavior question if life is worth living. During such dark moments, it can be uplifting and inspiring to hear from people who have surmounted great obstacles.

This is why I highly recommend Lisa Nichols’ book, No matter What!

Lisa Nichols, is a living example of what it takes to overcome the inevitable impediments that come our way and come out the other side strong, graceful, and loving the life you’ve created for yourself. Her story is a testimony to the fact that anyone, no matter how difficult their circumstances or how challenging their setbacks, can rise above anything. How? By being determined, by developing certain skills, and by adopting useful attitudes—in short, by building what Lisa calls the “muscles” of character, which she outlines in the pages of this life-changing book.

Next: Building Your Bounce-Back Muscles.

To a Life Worth Living,

Foresteen Forbes, Psy. D.

*If you would like to be a member of my Facebook group “The Safe Place for Cutters,” please find me on Facebook and invite me to be your friend. Click here!