In this episode, Allison details her experience of engaging in nonsuicidal self-injury (NSSI) beginning in 9th grade and into her 20's. She explains the complex relationship she and many others have with their self-harm scars and discusses how her husband has supported her when she has self-injured. She also shares about how she makes sense of her scars in the context of her faith as a Christian. Read her To Write Love On Her Arms (TWLOHA) blog, "You are so much more than your pain," at https://twloha.com/blog/more-than-your-pain/. 

Follow Dr. Westers on Instagram and Twitter/X (@DocWesters). To join ISSS, visit itriples.org and follow ISSS on Facebook and Twitter/X (@ITripleS).

The Psychology of Self-Injury podcast has been rated as one of the "10 Best Self Harm Podcasts" and "20 Best Clinical Psychology Podcasts" by Feedspot  and one of the Top 100 Psychology Podcasts by Goodpods. It has also been featured in Audible's "Best Mental Health Podcasts to Defy Stigma and Begin to Heal."

If you or someone you know should be interviewed on the podcast, we want to know! Please fill out this form, and we will be in touch with more details if it’s a good fit.

Up to 1 in 5 (20%) individuals with intellectual and developmental disabilities (IDD) and about 3 in 7 (42%) individuals with autism spectrum disorder (ASD) engage in self-injurious behavior (SIB). Common forms of SIB include repetitive head banging, head-hitting, self-biting, self-hitting, eye-poking, skin-picking, and trichotillomania (hair pulling), among other forms of self-harm.

In this episode, Caroline Roberts from the University of Minnesota and Masonic Institute for the Developing Brain discusses the differences and similarities between SIB and nonsuicidal self-injury (NSSI) and how we can bridge the gap between NSSI research and clinical practice, and SIB among those with IDD. She also shares 4 key topics from her interviews with experts in SIB and NSSI: (1) case ascertainment, (2) perceptions of causal variables, (3) pathways to treatment, and (4) treatment goals and outcomes. 

Learn more about the Masonic Institute for the Developing Brain and their interdisciplinary approaches to understanding and improving SIB workgroup here. Follow Caroline on Twitter/X at @clrobz. Below are one of her papers and other research referenced in today's episode:

1. Roberts, C. L., Avina, A. H., & Symons, F. J. (2023). A qualitative analysis of family caregiver experiences accessing treatment for self-injurious behavior in individuals with intellectual and developmental disabilities. Journal of Mental Health Research in Intellectual Disabilities.
2. Dimian, A. F., & Symons, F. J. (2022). A systematic review of risk for the development and  persistence of self-injurious behavior in intellectual and developmental disabilities. Clinical Psychology Review, 94, 102158.
3. Steenfeldt-Kristensen, C., Jones, C. A., & Richards, C. (2020). The prevalence of self-injurious behaviour in autism: A meta-analytic study. Journal of Autism and Developmental Disorders, 50(11), 3857-3873.

Follow Dr. Westers on Instagram and Twitter/X (@DocWesters). To join ISSS, visit itriples.org and follow ISSS on Facebook and Twitter/X (@ITripleS).

The Psychology of Self-Injury podcast has been rated #1 by Feedspot  in their list of "10 Best Self Harm Podcasts" and #5 in their "20 Best Clinical Psychology Podcasts." It has also been featured in Audible's "Best Mental Health Podcasts to Defy Stigma and Begin to Heal."

If you or someone you know should be interviewed on the podcast, we want to know! Please fill out this form, and we will be in touch with more details if it’s a good fit.

What is the relationship between nonsuicidal self-injury (NSSI) and pain? Are individuals who self-injure less sensitive to pain than those who don’t self-injure? What are the ethics involved in conducting research on pain? In this episode, Dr. Julian Koenig describes the research on the experience of pain among those who self-harm. Learn more about Dr. Koenig and his research lab at www.koeniglab.de, and follow him on Twitter/X at @koeniglab.

Below are links to some of the research referenced in this episode:

1. Koenig, J., Thayer, J. F., & Kaess, M. (2016). A meta-analysis on pain sensitivity in self-injury. Psychological Medicine, 46(8), 1597-1612.
2. Koenig, J., Klier, J., Parzer, P., Santangelo, P., Resch, F., Ebner-Priemer, U., & Kaess, M. (2021). High-frequency ecological momentary assessment of emotional and interpersonal states preceding and following self-injury in female adolescents. European Child & Adolescent Psychiatry, 30(8), 1299-1308.
3. Kaess, M., Hooley, J. M., Klimes-Dougan, B., Koenig, J., Plener, P. L., Reichl, C., Robinson, K., Schmahl, C., Sicorello, M., Schreiner, M. W., & Cullen, K. R. (2021). Advancing a temporal framework for understanding the biology of nonsuicidal self-injury: An expert review. Neuroscience and Biobehavioral Reviews, 130, 228-239.
4. Störkel, L. M., Karabatsiakis, A., Hepp, J., Kolassa, I.-T., Schmahl, C., & Niedtfeld, I. (2021). Salivary beta-endorphin in nonsuicidal self-injury: an ambulatory assessment study. Neuropsychopharmacology, 46(7), 1357-1363.
5. Sigrist, C., Kaess, M., & Koenig, J. (2023). Autonomic nervous system function in nonsuicidal self-injury—A Research Domain Criteria perspective on the arousal/regulatory systems. In E. E. Lloyd-Richardson, I. Baetens, & J. Whitlock (Eds.), The Oxford handbook of nonsuicidal self-injury (pp. C18S1–C18S23). Oxford University Press.
6. Naoum, J., Reitz, S., Krause-Utz, A., Kleindienst, N., Willis, F., Kuniss, S., Baumgärtner, U., Mancke, F., Treede, R.-D., & Schmahl, C. (2016). The role of seeing blood in non-suicidal self-injury in female patients with borderline personality disorder. Psychiatry Research, 246, 676-682.

Follow Dr. Westers on Instagram and Twitter/X (@DocWesters). To join ISSS, visit itriples.org and follow ISSS on Facebook and Twitter/X (@ITripleS).

The Psychology of Self-Injury podcast has been rated #1 by Feedspot  in their list of "10 Best Self Harm Podcasts" and #5 in their "20 Best Clinical Psychology Podcasts." It has also been featured in Audible's "Best Mental Health Podcasts to Defy Stigma and Begin to Heal."

If you or someone you know should be interviewed on the podcast, we want to know! Please fill out this form, and we will be in touch with more details if it’s a good fit.

Amidst a global youth mental health crisis, is it possible that many young people are experiencing adolescent development challenges but are using mental health language to describe their distress? Even to the degree of experiencing crises that include self-harm like nonsuicidal self-injury and suicidal thoughts and behaviors? In this episode, Drs. Maria Papadima and Rachel Acheson share observations from their clinical work with youth, consider trends such as self-diagnosing through TikTok and Instagram, discuss how they walk parents and youth through these mental health crises, and offer a psychoanalytic perspective of current trends. 

Learn more about Dr. Papadima and her work at www.mariapapadima.com, and read her blog about "Self-diagnosis via TikTok" here. Below is the reference and link to their paper discussed in this episode:

1. Acheson, R., & Papadima, M. (2023). The search for identity: Working therapeutically with adolescents in crisis. Journal of Child Psychotherapy, 49(1), 95-119.

Follow Dr. Westers on Instagram and Twitter (@DocWesters). To join ISSS, visit itriples.org and follow ISSS on Facebook and Twitter (@ITripleS).

The Psychology of Self-Injury podcast has been rated #1 by Feedspot  in their list of "10 Best Self Harm Podcasts" and #5 in their "20 Best Clinical Psychology Podcasts." It has also been featured in Audible's "Best Mental Health Podcasts to Defy Stigma and Begin to Heal."

If you or someone you know should be interviewed on the podcast, we want to know! Please fill out this form, and we will be in touch with more details if it’s a good fit.

Approximately 1-4% of people throughout the world experience obsessive-compulsive disorder (OCD). Individuals with OCD are more likely than those without OCD to engage in nonsuicidal self-injury (NSSI), and recent research has shown that, among those who self-injure, having a diagnosis of OCD predicts more severe self-injury.

In this episode, licensed clinical social worker and OCD expert Nathan Peterson explains how he differentiates nonsuicidal self-injury (NSSI) from Self-Harm OCD, which is just one of many subtypes of OCD and one in which a person experiences intrusive thoughts or mental images of violence toward oneself. He then walks us through how he uses Exposure and Response Prevention (ERP) for Self-Harm OCD in therapy. 

Learn more about Nathan and his therapy practice OCD and Anxiety Counseling here. He has nearly 100k subscribers on YouTube (@ocdandanxiety) where his videos receive thousands and thousands of views. You can also follow him on Instagram (@ocdandanxietyonline), Twitter (@ocdandanxiety1), and Facebook.  Click here to take his online "Do I Have Harm OCD? Test." Below are additional resources about OCD and/or NSSI:

1. Browning, M. E., Lloyd-Richardson, E. E., Schneider, R. L., Faro, A. L., Muehlenkamp, J. J., & Claudio-Hernandez, A. (2022). Obsessive compulsive disorder and co-occurring nonsuicidal self-injury: Evidence-based treatments and future research directions. The Behavior Therapist, 45(6), 199-208.
2. International OCD Foundation at https://iocdf.org/.
3. Winston, S. M., & Seif, M. N. ( 2017). Overcoming unwanted intrusive thoughts: A CBT-based guide to getting over frightening, obsessive, or disturbing thoughts. New Harbinger.
4. Baer, L. (2012). Getting control: Overcoming your obsessions and compulsions (3rd ed.). Plume.

To learn more about how medication can help address OCD (most often in tandem with ERP but not discussed in this episode), click here. 

Follow Dr. Westers on Instagram and Twitter (@DocWesters). To join ISSS, visit itriples.org and follow ISSS on Facebook and Twitter (@ITripleS).

The Psychology of Self-Injury podcast has been rated #5 by Feedspot in their "20 Best Clinical Psychology Podcasts" and also featured in Audible's "Best Mental Health Podcasts to Defy Stigma and Begin to Heal."

If you or someone you know should be interviewed on the podcast, we want to know! Please fill out this form, and we will be in touch with more details if it’s a good fit.

What is a parent's role in helping their child recover from self-injury? What might a dad say about supporting his child when he learns his child is engaging in nonsuicidal self-injury (NSSI)?  In this episode, a father and daughter sit down to discuss her lived experience of self-injury and self-harm and how parents, especially dads, can support their child. This is a shared story.

Follow Dr. Westers on Instagram and Twitter (@DocWesters). To join ISSS, visit itriples.org and follow ISSS on Facebook and Twitter (@ITripleS).

The Psychology of Self-Injury podcast has been rated #5 by Feedspot in their "20 Best Clinical Psychology Podcasts" and also featured in Audible's "Best Mental Health Podcasts to Defy Stigma and Begin to Heal."

In this episode, ISSS Past Presidents Dr. Stephen Lewis from the University of Guelph in Canada, and Dr. Penelope Hasking from Curtin University in Australia talk about a new way of understanding self-injury and self-harm, with a special focus on recovery. In their person-centered approach, they emphasize the perspective of lived experience, move away from a "why don't you just stop" mentality, normalize ongoing self-injury thoughts and urges, and discuss strengths, scarring, and disclosures. 

Follow Drs. Lewis and Hasking on Twitter at @SPLewisPhD and @PennyHasking. Keep up with Dr. Lewis' non-profit outreach organization Self-Injury Outreach & Support at @sioutreach, and follow Dr. Hasking's research in the Emotional Health and Self-Injury Research Group at @NSSI_RG. 

Below are links to their book and a couple of their articles referenced in this episode:

1. Lewis, S. P., & Hasking, P. A. (2023). Understanding self-injury: A person-centered approach. Oxford University Press.
2. Lewis, S. P., & Hasking, P. A. (2021). Understanding self-injury: A person-centered approach. Psychiatric Services, 72(6), 721-723.
3. Lewis, S. P., & Hasking, P. (2019). Putting the “self” in self-injury research: Inclusion of people with lived experience in the research process. Psychiatric Services, 70(11), 1058-1060.

To read more about person-first language and identity-first language when referencing autism, click here and also visit https://pubmed.ncbi.nlm.nih.gov/36237135/. To read about language used to discuss race and ethnicity, click here. 

Follow Dr. Westers on Instagram and Twitter (@DocWesters). To join ISSS, visit itriples.org and follow ISSS on Facebook and Twitter (@ITripleS).

The Psychology of Self-Injury podcast has been rated #5 by Feedspot in their "Best 20 Clinical Psychology Podcasts" and by Welp Magazine in their "20 Best Injury Podcasts."

What goes on at the neurobiological level that makes someone more vulnerable to self-injure or self-harm? What biological risk factors are at play? What roles do the vagus nerve, cortisol levels, and hypothalamic-pituitary-adrenal (HPA) axis have? We hope to discuss the psychology of self-injury pain in a future episode, but in this episode, Dr. Michael Kaess from the University of Bern in Switzerland explains the neurobiology of self-injury in simple terms, or what we hope can be considered simple layman's terms. 

Learn more about Dr. Kaess and his research team at the Universitäre Psychiatrische Dienste (UPD) in Bern here. To participate in Dr. Kaess' research study of an online intervention for self-injury (in German), visit the STAR (Self-injury Treatment Assessment Recovery) Project at https://star-projekt.de/.

Below are links to some of the research referenced in this episode:

1. Kaess, M., Hooley, J. M., Klimes-Dougan, B., Koenig, J., Plener, P. L., Reichl, C., Robinson, K., Schmahl, C., Sicorello, M., Schreiner, M. W., & Cullen, K. R. (2021). Advancing a temporal framework for understanding the biology of nonsuicidal self-injury: An expert review. Neuroscience and Biobehavioral Reviews, 130, 228-239.
2. Reichl, C., Heyer, A., Brunner, R., Parzer, P., Völker, J. M., Resch, R., & Kaess, M. (2016). Hypothalamic-pituitary-adrenal axis, childhood adversity and adolescent nonsuicidal self-injury. Psychoneuroendocrinology, 74, 203-211.
3. Plener, P. L., Bubalo, N., Fladung, A. K., Ludolph, A. G., & Lulé, D. (2012). Prone to excitement: Adolescent females with non-suicidal self-injury (NSSI) show altered cortical pattern to emotional and NSS-related material. Psychiatry Research, 203(2-3), 146-152.

Follow Dr. Westers on Instagram and Twitter (@DocWesters). To join ISSS, visit itriples.org and follow ISSS on Facebook and Twitter (@ITripleS).

The Psychology of Self-Injury podcast has been rated #5 by Feedspot in their "Best 20 Clinical Psychology Podcasts" and by Welp Magazine in their "20 Best Injury Podcasts."

A lot of therapies address the context in which nonsuicidal self-injury (NSSI) and self-harm may occur, but only a few treatments have been designed to address NSSI specifically. In this episode, we dive into one of these treatments: Emotion Regulation Group Therapy (ERGT). Drs. Kim Gratz and Matthew Tull from the University of Toledo in Ohio walk us through in significant detail each of the 90-minute 14 sessions of ERGT.

Learn more about Dr. Gratz here and reach her at [email protected]. Learn more about Dr. Tull here and follow him on Twitter @MTTull. Learn more about the Personality and Emotion Research and Treatment (PERT) Laboratory within the Department of Psychology at the University of Toledo here, and follow the PERT Lab on Twitter @LabPert. Below are links to their research on ERGT referenced in this episode:

1. Gratz, K. L., & Gunderson, J. G. (2006). Preliminary data on an acceptance-based emotion regulation group intervention for deliberate self-harm among women with Borderline Personality Disorder. Behavior Therapy, 37(1), 25-35.
2. Gratz, K. L., & Tull, M. T. (2011). Extending research on the utility of an adjunctive emotion regulation group therapy for deliberate self-harm among women with borderline personality pathology. Personality Disorders: Theory, Research, and Treatment, 2(4), 316–326.
3. Gratz, K. L., Tull, M. T., & Levy, R. (2014). Randomized controlled trial and uncontrolled 9-month follow-up of an adjunctive emotion regulation group therapy for deliberate self-harm among women with borderline personality disorder. Psychological Medicine, 44, 2099–2112.
4. Gratz, K. L., Bardeen, J. R., Levy, R., Dixon-Gordon, K., L., & Tull, M. T. (2015). Mechanisms of change in an emotion regulation group therapy for deliberate self-harm among women with borderline personality disorder. Behaviour Research and Therapy, 65, 29-35.
5. Sahlin, H., Bjureberg, J., Gratz, K. L., Tull, M. T., Hedman, E., Bjarehed, J., Jokinen, J., Lundh, L., Ljotsson, B., & Hellner, C. (2017). Emotion regulation group therapy for deliberate self-harm: A multi-site evaluation in routine care using an uncontrolled open trial design. BMJ Open, 7(10), e016220.

Follow Dr. Westers on Instagram and Twitter (@DocWesters). To join ISSS, visit itriples.org and follow ISSS on Facebook and Twitter (@ITripleS).

The Psychology of Self-Injury podcast has been rated #5 by Feedspot in their "Best 20 Clinical Psychology Podcasts" and by Welp Magazine in their "20 Best Injury Podcasts."

Early in the pandemic there was a lot of talk about how the initial lockdown and stay-at-home orders would affect people’s mental health, including risk for suicide and nonsuicidal self-injury (NSSI). In this episode, Dr. Ruth Tatnell answers questions about the pandemic's effects on rates of self-injury: Did the initial lockdown of the COVID-19 pandemic increase self-injury urges and behaviors like many people thought would happen? And do we know if self-harm has increased, decreased, or stayed the same since the first lockdown of the pandemic?

Learn more about Dr. Tatnell and her work at Deakin University here, and connect with her on LinkedIn here. Below is her publication discussed in this month's episode as well as additional articles referenced in our interview:

1. Tatnell, R., Terhaag, S., & Melvin, G. (2023). Covid-19 lockdown and non-suicidal self-injury: A Mixed methods analysis of NSSI during Australia's national lockdown. Archives of Suicide Research. Online ahead of print.
2. Tanaka, T., & Okamoto, S. (2021). Increase in suicide following an initial decline during the COVID-19 pandemic in Japan. Nature Human Behaviour, 5(2), 229–238.
3. Read about the Harvard Happiness Study published in The Atlantic here. 
4. Read about the Cigna loneliness study here and their tips for addressing loneliness here.

Follow Dr. Westers on Instagram and Twitter (@DocWesters). To join ISSS, visit itriples.org and follow ISSS on Facebook and Twitter (@ITripleS).

The Psychology of Self-Injury podcast has been rated #5 by Feedspot in their "Best 20 Clinical Psychology Podcasts" and by Welp Magazine in their "20 Best Injury Podcasts."