Self-Injury: Psychotherapy with People Who Engage in Self-Inflicted Violence

People who directly injure their bodies are increasingly seeking help from psychotherapists. Coming out of the closet of shame, they are turning to professionals for understanding, compassion, and healing. Because of the potent nature of self-injury and the variety of issues it touches, clinical responses to it have often been only moderately beneficial and, in too many cases, distinctly harmful. In this perceptive work, Dr. Robin Connors offers helpful guidelines to clinicians that will improve their capacity to respond in a direct, effective, and respectful way to people who self-injure. Key to this work is understanding the function of self-inflicted violence and its relationship to unresolved traumas and losses, including the role of trauma in disrupting the formation of the self-boundary. Dr. Connors identifies fundamental therapeutic tasks, gives clear examples of interventions, and offers concrete recommendations for interacting with patients about their self-injury. A range of related issues are addressed as well, from repairing inadequate self-boundaries to using adjunct therapies. Finally, the task of determining right action in light of strong countertransferential responses is explored, including situations where self-injury occurs in the therapist's presence. In this exceptional book, Dr. Connors gives us the words to describe the pain beneath self-injuring behavior, and a blueprint for providing the compassionate understanding that is a prerequisite for healing.

Table of Contents:
Part 1 Preface Part 2 I. Understanding Self-Injury as the Tip of the Iceberg Chapter 3 1. What is Self-Injury? Chapter 4 2. Understanding Self-Injury Chapter 5 3. Trauma, Wounding, and Healing Chapter 6 4. The Incomplete Self-Boundary Part 7 II. Responding to People Who Self-Injure Chapter 8 5. Therapeutic Goals and the Role of Compassionate Presence Chapter 9 6. A Therapeutic Posture to Support the Healing Process Chapter 10 7. Helping Clients Address Their Self-Injury Chapter 11 8. Repairing and Completing the Self-Boundary Chapter 12 9. Working with Core Issues and Other Interventions Part 13 III. Managing Our Own Responses to Self-Injury Chapter 14 10. What Happens to Good Clinicians? Chapter 15 11. Finding the Right Action Chapter 16 12. Nourishing and Sustaining the Self of the Therapist

About the Author :
Robin E. Connors, Ph.D., a clinician and consultant in private practice in Pittsburgh, Pennsylvania, is the co-author of Understanding Self-Injury: A Workbook for Adults. She has published extensively in professional journals, including her articles on self-injury in trauma survivors in the American Journal of Orthopsychiatry. She was clinical supervisor at Pittsburgh Action Against Rape, consultant to Lakewood Hospital Psychiatric Hospital, teacher at Arsenal Family and Children's Center, and research assistant at Western Psychiatric Institute and Clinic. Dr. Connors has taught many training courses to therapists in diverse settings, practiced as a divorce mediator, edited a newsletter offering legal information to mental health professionals, and worked as a freelance writer. She currently specializes in work with women experiencing life transitions, trauma survivors, and couples.

Review :
No longer need the topic of self-inflicted violence be approached with confusion and trepidation. The arrival of Self-Injury: Psychotherapy with People Who Engage in Self-Inflicted Violence offers a sigh of relief and a cry of celebration. With gentle wisdom and intellectual mastery, Dr. Connors transcends previous work on this subject. Her dignified presentation and simple genius will impact all who are fortunate enough to read this book. At last-an alternative to giving up before we start! When we are confronted with a self-mutilating patient, we are on the high seas without a compass. That is, until now. In this book, Dr. Connors has gathered and presented valuable data on every aspect of treating those who self-injure. Instead of diagnosing 'borderline' and looking for a brave soul to refer such patients to, we may have a handle on the problem ourselves. Every psychotherapist must read this book. Robin Connors provides a frank and compassionate discussion of one of the most challenging issues trauma survivor clients and their therapists face. She presents much of the accumulated wisdom about relational therapy for those who self-injure in language that is accessible to lay readers and clinicians alike. Dr. Connors speaks from a place of honesty, humility, and significant clinical experience in providing practical guidelines for understanding and responding constructively to self-injury. This book is an excellent resource for clinicians and those who self-injure. In this courageous, beautifully written book, Dr. Robin Connors has dared to address, with much compassion and understanding, the issue of patients who engage in behaviors that many of us find incomprehensible if not downright offensive. She views self-inflicted violence as a fundamentally adaptive and life-preserving coping mechanism-a desperate effort to preserve self-integrity in the face of impending fragmentation. These behaviors are enactments, to communicate something deeply important about the patient's internal experience. The therapeutic goal then is to help these patients speak the unspeakable, tolerate the intolerable, and manage the unmanageable. Connors's book is at once life-affirming, heartwarming, and inspiring-a must-read for any of us working with patients who inflict injury upon themselves as a frantic call for help.