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Mental Health Certification

Miss RinRin works in the medical field and has taken additional certifications to help her kink clients with mental health. One of these courses was called ‘Talk To Me”: Improving Mental Health And Suicide Prevention In Adults. This course was taken online via course lecturer Dr. Ben Milbourn, Senior Lecturer at Curtin University. Below you will be able to read some of the notes she has taken to help you become a better you!

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If you are feeling any of the above, please think about booking a session. Not all of Miss RinRin's sessions are kink/fetish related. Several are therapeutic as well. NOT in PA? No worries, she offers phone and video visits as well.


Use the button to see her updated calendar and book her today

When you have a Therapeutic Mentoring Session with Miss RinRin, she will:

  • Recognize her reactions to what the client is telling her.

  • Be non-judgmental and empathic.

  • Show a genuine interest in what the client is telling her.

  • Try to use the language of the client she is interacting with.

  • Validate what the client is telling her and show the client she is actively listening.

  • Find out what else is happening in the client's life (stress, relationship difficulties, etc.)

Self Harm

CONTENT WARNING: The material in this section could cause distress for some people, as it explores mental health topics and includes discussions about suicide and self-harm.

 

Self-harm is defined in many ways, sometimes called deliberate self-harm or non-suicidal self-injury. Usually, self-harm refers to people intentionally hurting themselves without intent to die, often done to deal with distressing feelings. This can include behaviors resulting in direct and indirect damage (for example, drug and alcohol abuse). Socially accepted forms of body modification, such as piercings or tattoos, are not considered self-harm.

Methods

Some examples of self-harm are skin damage caused by:

  • Cutting

  • Scratching

  • Self-Battery

  • Knocking

  • Pinching

  • Biting

  • Burning

WHY PEOPLE SELF-HARM

There are countless reasons why people may self-harm. Listed below are the six main reasons.

  1. Difficulties In Emotion Regulation

  2. Invalidating Family/Environment

  3. Current Stresses

  4. Social Influences

  5. Mental Illnesses As Risk Factors

  6. Demographic Risk Factors

 

DIFFICULTIES IN EMOTION REGULATION

 

When people experience intense, distressing emotions, self-harm can be a way to cope with these feelings. Strong emotions cause high inner tension that cannot be instantly reduced but tends to stay, with only a slight decrease in intensity. Self-harm can be a method to release anxiety & stress and cope with emotions quickly.

 

For example:

  • Sam fights with his friends, and they end up rejecting him. Later, alone in his room, he deals with negative thoughts and feels too much tension, a feeling that does not lessen, so he hurts himself.

INVALIDATING FAMILY/ENVIRONMENT

If a child grows up with parents who do not validate their feelings, they cannot learn how to cope appropriately with their negative emotions (Kehrer & Linehan,1996). Then when faced with stressful times later in life, difficulties in emotion regulation increase the risk of self-harm.

Particularly serious invalidations are experiences of physical or mental abuse and mistreatment.

For example:

  • Sam tells his friends and family that his girlfriend broke up with him, and he receives comments like, 'You don't have to be sad because of her,' or 'Pull yourself together.'

CURRENT STRESSES

 

Stressors could be any situation or experience which induces intense stress.

 

Examples of this could be:

  • Partnership Conflicts,

  • The Loss Of A Job, Or

  • The Death Of A Family Member Or Friend.

SOCIAL INFLUENCES

Some people get the idea of self-harm from social influences, including from friends, traditional media, and online (Radovic & Hasking, 2013). However, while knowing someone who self-harms or seeing self-harm in films is associated with increased odds of self-harm, this is not a simple relationship (Trewavas & Hasking 2010). Depictions of self-harm online, in particular, can simultaneously be triggering for people with a history of self-harm but also offer a source of support and recovery (De Riggi et al., 2018; Lewis & Seko, 2016).

MENTAL ILLNESSES AS RISK FACTORS

Self-harm is associated with various emotional disorders (e.g., anxiety disorders, depression) but not with any particular condition (Bentley et al., 2015).

DEMOGRAPHIC RISK FACTORS

 

In community-based samples, men and women are equally likely to engage in self-harm. In clinical samples, rates are slightly higher among women. It is not clear if this reflects gender differences in rates of diagnosis, rates of treatment seeking, or an actual gender difference in prevalence (Bresin & Schoenleber, 2015). People who identify on the LGBTI+ spectrum also experience a greater risk of self-harm (Keikens et al., 2018; ).

ALTERNATIVE EMOTION REGULATION STRATEGIES

In cognitive-behavioral therapy (CBT), self-harm is described as an emotion regulation strategy (a method to change/control your emotions) maintained by positive and negative reinforcement. If a person wishes to cease or reduce self-harm, alternative emotion regulation strategies must be developed (Groschwitz & Plener, 2013). Given how effective self-harm is at regulating emotion, any alternative approach needs to work just as well.

 

Here is one example:

  1. Before practicing an alternative strategy, identify your current stress level on a scale from 0 to 10.

    • If you continuously experience a stress level over seven, you should train strategies that work quickly to reduce your distress. Seeing a counselor or psychologist may be helpful if a high-stress level persists.

    • Reminder: Miss RinRin offers therapy sessions that may benefit you. These sessions are not kink/fetish related and were created to help you heal, learn and focus on yourself.

2.   Use an alternative strategy to reduce the stress level. For example: reading a book, listening to music, running, calling a friend. Use this strategy for 10 minutes.

3.   Re-evaluate your stress level immediately after.

4.   Develop a list of the strategies that reduce your stress level.

MINDFULNESS EXERCISE: WATCH YOUR BREATH

Miss RinRin uses this breathing exercise to help her cope with stress in her vanilla and kink lives.

 

  1. First, take an attentive sitting posture:

    • Sit on the front edge of a chair to sit upright.

    • You may visualize a string of pearls running up your spine and holding it upright.

  2. Position your legs shoulder-width at right angles so your feet are in contact with the floor.

  3. Pull your shoulders up, and then let them drop and relax.

  4. Place your hands in your lap:

    • The right will cradle your left hand, palms up, the tips of your thumbs lightly touching.

  5. You can decide if you want to keep your eyes open or closed.

    • If your eyes are open, concentrate on a specific point on the floor before you and let your glance become unfocused and 'soft.'

  6. Close your mouth and breathe in and out through your nose.

  7. During the exercise, focus on your breath. Either notice your nose, for example, and how the air flows in a little cooler and out a little warmer. Alternatively, you may observe how your stomach rises and falls as you breathe.

 

  • You may acknowledge emerging thoughts, feelings, or body sensations but then let them move away like clouds in the sky as you return your focus to your breath.

  • Usually, you will be distracted. Practice letting the distraction go without judgment and repeatedly redirect your attention to your breath.

  • You must not judge yourself if you get distracted (I can not believe I failed), but remember the exercise in a friendly way. Be kind to yourself. It is not about making the exercise continue for as long as possible (Von Auer & Bohus, 2017). Even a few minutes can be beneficial.

  • Watch the video below to learn more examples of breathing techniques.

Watch Video Here

TIPS FOR APPROPRIATELY TALKING WITH SOMEONE WHO SELF-HARMS:

Miss RinRin uses these tips while doing therapeutic sessions with individuals while working with clients.

 

DO NOT OVERREACT:

Self-harm may bring about a range of emotions. However, reacting with much emotion (e.g., shock, being very upset) when talking to individuals about self-harm is unhelpful. These reactions can convey discomfort with the discussion, which may shut down future conversations. Other responses, such as reacting with too much concern, can also be unhelpful. In some cases, these reactions to self-harm can reinforce the behavior.

 

DO NOT INTERROGATE:

Asking questions interrogatively (for example, "Why did you…?", "Why don't you…?") can invalidate someone's experience and may convey that the person is doing something wrong. Also, avoid questions and comments implying that it is easy to stop self-harm (e.g., don't say, 'Just stop, why don't you cope this way instead?')

DON'T JUMP IN TO SOLVE THE PROBLEM:

While this often comes from a good place and desire to help, trying to 'fix' the problem could come across as not listening to or hearing what the person has to say. Further, many people are not ready to stop self-harm. This may especially be the case early on in conversations about self-harm. Many individuals may not be prepared to talk about self-harm yet.

DON'T ASK TOO MANY QUESTIONS ABOUT SELF-HARM:

Focusing too much on self-harm and paying too much attention to the details of self-harm episodes can detract from what underlies the self-harm; focusing on more information can also trigger individuals who engage in self-harm. Related to this, avoid jumping to conclusions or making assumptions about why someone self-harms.

(International Consortium on Self-Injury in Educational Settings, 2018) You can read more about it by clicking here:  https://www.icsesgroup.org/

GETTING HELP FOR SELF-HARM

Psychotherapy is Miss RinRin's method of choice to reduce the frequency or severity of self-harm.

If you or someone you know is engaging in self-harm, it is essential to seek professional help.

 

It is normal to feel reluctant to seek help for self-harm. Unfortunately, it is a topic that has been somewhat (wrongly) stigmatized. However, trained professionals will not judge anyone for opening up about self-harm. Below are a few examples of what to expect in therapy.

 

Some of the strategies used by Miss RinRin in therapeutic sessions via psychotherapy for self-harm include (Peterman & Nitkowski, 2013):

  • Clarify the focus of therapy:

    • For example, symptoms of self-harm or other mental health issues

  • Provide education about self-harm and any other mental health issues

    • also helping you educate your family if appropriate.

  • Identify why self-harm is helping and what else could help instead.

    • Might be asked to use a diary to record what occurred before the self-harm (triggers) and the consequences, then work to find alternative coping strategies. This method can create a safety plan

  • Consider the role of the Internet/social media in maintaining self-harm.

  • If self-harm is occurring in response to intense emotions, work on developing emotional skills, stress tolerance, and finding distractions, this includes:

    • Breathing Techniques

    • Relaxation Exercises

    • Talking With Others

    • Sports Activities

    • Creative forms of expression, such as writing, listening to music, or drawing

Want more strategies and information? Click the button to learn more techniques that you can use. https://www.beyondblue.org.au/mental-health/suicide-prevention/feeling-suicidal/self-harm-and-self-injury

 

Note – the same strategies do not work for everyone. These are just some examples. If some of these do not work for you or someone you know, that is okay. Miss RinRin can continuously adapt and change therapeutic sessions depending on client needs. It is all part of the process of finding what does work.

References and additional readings

American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (DSM-5®) (5 ed.). Washington, US: American Psychiatric Publishing.

 

American Psychological Association. (July/August 2015). Who self-injures? Monitor on Psychology, 46(7), 60. Retrieved from https://www.apa.org/monitor/2015/07-08/who-self-injures

 

Bateman, A., & Fonagy, P. (1999). Effectiveness of partial hospitalization in the treatment of borderline personality disorder: A randomized controlled trial. American Journal of Psychiatry, 156(10), 1563-1569.  http://dx.doi.org/10.1176/ajp.156.10.1563

 

Bateman, A., & Fonagy, P. (2009). Randomized controlled trial of outpatient mentalization-based treatment versus structured clinical management for borderline personality disorder. American Journal of Psychiatry, 166(12), 1355-1364.  http://dx.doi.org/10.1176/appi.ajp.2009.09040539

 

Bentley, K. H., Cassiello-Robbins, C. F., Vittorio, L., Sauer-Zavala, S., Barlow, D. H. (2015). The association between non-suicidal self-injury and the emotional disorders: A meta-analytic review. Clinical Psychology Review, 37, 72–88.

 

Bresin, K., Schoenleber, M. (2015). Gender differences in the prevalence of non-suicidal self-injury: A meta-analysis. Clinical Psychology Review, 38, 55–64.

 

Brown, R. C., Fischer, T., Goldwich, A. D., Keller, F., Young, R., & Plener, P. (2018). #cutting: Non-suicidal self-injury (NSSI) on Instagram. Psychological Medicine, 48(2), 337-346. http://dx.doi.org/10.1017/S0033291717001751

 

De Riggi, M. E., Lewis, S. P., & Heath, N. L. (2018). Brief report: non-suicidal self-injury in adolescence: turning to the Internet for support. Counselling Psychology Quarterly, 1-9.

 

Favazza, A., DeRosear, L., & Conterio, K. (1989). Self-mutilation and eating disorders. Suicide and Life-Threatening Behavior, 19(4), 352-361.  http://dx.doi.org/10.1111/j.1943-278X.1989.tb00566.x

 

Fischer, G., Brunner, R., Parzer, P., Resch, F., & Kaess, M. (2013). Short-term psychotherapeutic treatment in adolescents engaging in non-suicidal self-injury: A randomized controlled trial. Trials, 14(1), 294.  http://dx.doi.org/10.1186/1745-6215-14-294

 

Gandhi A., Luyckx K., Baetens I., Kiekens G., Sleuwaegen E., Berens A., Maitra S., Claes L. (2017). Age of onset of non-suicidal self-injury in Dutch-speaking adolescents and emerging adults: An event history analysis of pooled data. Comprehensive Psychiatry, 80, 170-178.

 

Hasking, P. A., Heath, N. L., Kaess, M., Lewis, S. P., Plener, P. L., Walsh, B. W., … Wilson, M. S. (2016). Position paper for guiding response to non-suicidal self-injury in schools. School Psychology International, 37(6), 644–663. https://doi.org/10.1177/0143034316678656doi: 10.1016/j.comppsych.2017.10.007

 

Hasking, P., & Boyes, M. (2018). Cutting words: A commentary on language and stigma in the context of non-suicidal self-injury. Journal of Nervous and Mental Disease, 206, 829-833

 

Herpertz, S., & Sass, H. (1994). Open self-injury behavior. Nervenarzt, 65(5), 296-306.

 

International Consortium on Self-Injury in Educational Settings (2018). Talking to individuals about self-injury. available from http://dairheathresearchteam.mcgill.ca/international-consortium-self-injury-educational-settings-icses/

 

Kiekens, G., Hasking, P., Claes, L., Mortier, P., Auerbach, R., Boyes, M., Cuijpers, P., Demyttenaere, K., Green, J., Kessler, R., Nock, M., Bruffaerts, R. (2018). The DSM-5 non-suicidal self-injury disorder among college freshman: Prevalence and associations with mental illnesses and suicidal thoughts and behaviors. Depression and Anxiety, 35, 629-637.

 

Kiekens, G., Hasking, P., Claes, L., Boyes, M., Mortier, P., Auerbach, R.P., Cuijpers, P., Demyttenaere, K., Green, J.G., Kessler, R.C., Nock, M.K., & Bruffaerts, R. (2018). The associations between non-suicidal self-injury and first onset suicidal thoughts and behaviors. Journal of Affective Disorders, 239, 171-179.

 

König, E., & Plener, P. (2015). Fortbildungsangebote für Ärzte und Therapeuten zum leitliniengerechten Umgang mit nicht-suizidalem selbstverletzendem Verhalten (NSSV). Retrieved from https://www.uniklinik-ulm.de/kinder-und-jugendpsychiatriepsychotherapie/forschung-und-arbeitsgruppen/arbeitsgruppe-wissenstransfer-dissemination-e-learning/star-train.html

 

Laukanen, E., Rissanen, M. J., Tolmunen, T., Kylmä, J., & Hintikka, J. (2013). Adolescent self-cutting elsewhere than on the arms reveals more serious psychiatric symptoms. European Child and Adolescent Psychiatry, 22(8), 501-510.  http://dx.doi.org/10.1007/s00787-013-0390-1

 

Lewis, S.P. & Seko, Y. (2016). A double-edged sword: A review of the potential benefits and risks of online non-suicidal self-injury activities. Journal of Clinical Psychology, 72(3), 249-262.

 

 

Kehrer, C & Linehan, M. (1996). Interpersonal and Emotional Problem-Solving Skills and Parasuicide among Women with Borderline Personality Disorder. Journal of Personality Disorders: Vol. 10, No. 2, pp. 153-163.

 

International Society for the Study of Self-injury. (2018, May). What is self-injury? Retrieved from: https://itriples.org/about-self-injury/what-is-self-injury

 

Lloyd-Richardson, E. E., Perrine, N., Dierker, L., & Kelley, M. L. (2007). Characteristics and functions of non-suicidal self-injury in a community sample of adolescents. Psychological Medicine, 37(8), 1183-1192.  http://dx.doi.org/10.1017/S003329170700027X

 

Madge; et al. (2008). "Deliberate self-harm within an international community sample of young people: comparative findings from the Child & Adolescent Self-harm in Europe (CASE) Study." Journal of Child Psychology and Psychiatry. 49(6): 667–677. doi:10.1111/j.1469-7610.2008.01879.x.

Nixon, M., Cloutier, P. F., & Aggarwal, S. (2002). Affect regulation and addictive aspects of repetitive self-injury in hospitalized adolescents. Journal of the American Academy of Child & Adolescent Psychiatry, 41(11), 1333-1341.  http://dx.doi.org/10.1097/00004583-200211000-00015

 

Nock, M., & Prinstein, M. (2005). Contextual features and behavioral functions of self-mutilation among adolescents. Journal of Abnormal Psychology 114(1), 140-146.  http://dx.doi.org/10.1037/0021-843X.114.1.140

 

Plener, P. (2015). Suizidales Verhalten und nichtsuizidale Selbstverletzungen: Springer Verlag.

Plener, P., Kaess, M., Schmahl, C., Pollak, S., Fegert, J. M., & Brown, R. C. (2018). Non-suicidal self-injury in adolescents. Deutsches Ärzteblatt International, 115(3), 23-30.  http://dx.doi.org/10.3238/arztebl.2018.0023

Plener, P., Libal, G., Keller, F., Fegert, J. M., & Muehlenkamp, J. J. (2009). An international comparison of adolescent non-suicidal self-injury (NSSI) and suicide attempts: Germany and the USA. Psychological Medicine, 39(9), 1549-1558.  http://dx.doi.org/10.1017/S0033291708005114

 

Von Auer, A. K., & Bohus, M. (2017). Skillstraining für Jugendliche mit Problemen der Gefühlsregulation - Das Therapeutenmanual - Inklusive Keycard zur Programmfreischa

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