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November 24, 2014 | 2nd Kislev 5775

Self-Inflicted Violence: FAQs

derived from a number of sources including chapters in books by Dr. Shelley Doctors and Dr Tracey Alderman

What do we mean by self destructive behaviors?

While many different behaviors can cause harm to a young person, Resilience of the Soul speaks specifically of those self-injurious behaviors which young people choose or find themselves involved in as a way of trying to cope with or escaping difficult feelings. These include:

  • self mutilating behaviors like superficial cutting or burning of the skin where the intention is not suicide or major injury
  • binge drinking
  • binge eating
  • self starvation
  • relationship violence
  • extreme risk taking

How could these behaviors possibly help a young person to manage difficult feelings? Why do they do it?

One of the most common reasons for self destructive and self injuring behavior is to get relief from intense and unsettling emotions. Surprising as this may seem at first, it makes more sense when we realize that many people use potentially harmful means of coping to make themselves feel better temporarily when they are feeling distraught, tense or disappointed in themselves or others.

Young people and adults may use drugs, alcohol, overeating, smoking, gambling, compulsive exercise and self inflicted violence to provide relief for themselves even though the feelings that prompted the behavior return and remain unresolved. These behaviors may replace painful feelings with euphoric ones in a variety of ways. Alcohol and drugs and even food directly affect the brain and mood.

Gambling and other risk taking behavior may produce a feeling of excitement and even invulnerability. Direct self injury has a bodily effect that is the same as other physical trauma; endorphins that are released have effects similar to morphine, causing the individual not to feel the pain associated with the injury. Whenever endorphins are released there is the potential for an addictive response. Anything that provides a biochemical pathway to relief may be sought again creating habits that are potentially quite destructive and leave underlying problems untouched while offering temporary soothing.

Self destructive behaviors may serve functions beyond distraction and a temporary feeling of wellbeing. Sometimes they serve as a means of communicating distress when words are unavailable or fail. Sometimes they serve as physical expressions of an internal conflict. Paradoxically, creating a physical injury or impairing ability to function may enable the young person to provide for him/herself or get from others the nurturance and caretaking that he or she could not ask for directly.

Sometimes the young person is very self critical and self-hurt is a form of self-punishment. Young people who have been physically abused and traumatized sometimes replicate the past hurt so that they can feel in control. Many people involved in these behaviors cannot explain them, but know that they are emotionally uncomfortable and feel compelled to do what they do.

What sorts of responses occur when parents, professionals and peers discover young people involved in these behaviors?

Those who discover that a young person is purposefully cutting, bruising or burning him/herself often recoil and react with a good deal of horror and dismay. Many people often respond this way if they come upon a friend, student or loved one who is inducing vomiting after overeating.

Whenever we witness violence or its aftereffects it is natural that we experience anxiety and feelings of helplessness; it is also natural to want to do anything that we can to make the violence stop. As a result of these reactions many people express shock and disgust about the behavior and try to get the young person to promise to stop.

Those who become aware of other less direct forms of self destructive behaviors tend to react with a sense of moral outrage, seeing the behaviors as stupid, irrational, self-indulgent and hurtful to others. They may express disapproval, disappointment, anger and disdain. In all cases the young person may become more isolated, more ashamed, more distrustful and more secretive.

How common are these behaviors? Is self mutilating behavior usually associated with serious mental illness?

Are these behaviors less common among Jewish young people?Anecdotal evidence provided by teens, teachers, pediatricians, parents, camp counselors and youth workers suggest that these behaviors are far more common than anyone has previously thought and that they occur as frequently within the Jewish community as anywhere else. In fact, self mutilating behavior either is increasing or increasingly reported.

While extreme self injury does occur among hospitalized patients struggling with more serious mental illness, high functioning teens may also be secretly engaging in these behaviors as a way of coping with intense feelings. The quest for perfection and high achievement that is endemic to many of our communities inadvertently contributes to the pressures experienced by young people. Unfortunately, the same quest for perfection causes many young people and their parents to hide all signs of vulnerability and need for help.


How can those who care help?

First and foremost those who care can help by keeping lines of communication open, by acknowledging the emotional distress that is part of their lives and that of the youth in our communities and by admitting that many people do become involved in self destructive behavior. Anything we do that diminishes isolation, denial, shame and hopelessness will be a step toward building hope and connection.

Much as we wish these behaviors would cease, we are most effective when we convey our awareness that someone may not be able to stop these maladaptive behaviors until they find better ways to manage their feelings. Making certain that we know where to refer youth and their families for psychotherapy and medical help is essential.

Creating families and Jewish communities in which vulnerabilities and emotional pain can be acknowledged together is a first step towards beginning to find solutions.


What does Judaism have to say about self destructive behavior?

Our Jewish tradition urges us to always choose life, to believe that choices are placed before us and that we have within us the capacity to take the life affirming, positive path. Each of us is made in the image of God, each of us is of infinite value and therefore each of us is worthy of care and protection

This same tradition reminds us that we need one another and that we are most likely to make healthy, ethical choices when we feel ourselves to be fully integrated members of families and communities that are truly Sanctuaries for our souls.

At the same time, aspects of our Jewish tradition and culture may inadvertently serve to encourage excessive guilt and perfectionism by encouraging us to acknowledge only the most noble of feelings.

Perfectionism, then, may be the inadvertent result of our seeking always to try to improve ourselves, our families and our world to try to reach an ideal state. Other aspects of our tradition which offer self-denial and self-affliction as means of achieving forgiveness and closeness to God may be misapplied by the person who is in despair.

Our Jewish tradition suggests, however, that the greatest relief and healing can be achieved when one person’s despair is recognized and helped by another. When King Saul was melancholy, David’s presence, music of his harp and song offered solace; from this we know that companionship, prayer and song can be powerful sources of transformation and help for the person who is suffering.


What can my congregation do?

Think about becoming involved in this sort of transformative education by starting a Resilience of the Soul (formerly Kedushat HaGuf) program. Additonal resources are available on the Resilience of the Soul website.


What could Judaism and Jewish community offer that might help?

Judaism and Jewish community can offer a sense of belonging and of hope.

Our communities can become sacred places where all kinds of feelings are acknowledged; the painful experiences of envy, rage, despair and loneliness along with the joyous experiences of companionship, celebration, accomplishment and cooperation.

Our communities, from our early childhood programs through confirmation and beyond, can be places where together we seek within our traditions and our wisdom for better ways of manage the trials that are part of every life.

Families can find understanding and respect instead of stigma and criticism even when one member or another has become overwhelmed by life.

Seeking within our sacred texts, we can learn from the experiences of Biblical and Talmudic figures, that grappling with loss, disappointment, failure, jealousy and hurt have been the challenge to those who came before us and that together we can find ways of coping that are not destructive to ourselves or others.


What kinds of rituals and worship services might be developed?

Encouraging words are as honey, sweet to the soul and health to the being.” Proverbs 16:24 A few words spoken during Shabbat or festival services acknowledging the struggles teens and families may be experiencing can be a simple and profound way of letting people know that the deepest concerns of their lives are understood in the synagogue.

Ancient prayers can be adapted to offer a link to contemporary concerns, thereby offering people words with which to express what is in their hearts, offering alternatives to destructive action and giving voice the longing for the help of God and community.


How do we know that our young people and families want their synagogues to address these issues?

The staff of the Department of Jewish Family Concerns has visited a number of synagogues, and camp settings where we have learned from clergy, staff, parents and young people how prevalent these behaviors are and how much they would like their synagogue communities to serve as places where open conversation can take place.

The Department of Jewish Family Concerns held a one day think tank involving fifty professionals from all avenues of Reform Jewish life and from allied professions. At this meeting, we heard reiterated the degree to which self destructive behavior is an urgent issue of concern and we were given a mandate to produce programs and materials as a resource to our families and professionals who are seeking to prevent and respond to these behaviors and the painful feelings that generate them.

 

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