The Psychology of Self-Injury: Exploring Self-Harm & Mental Health

When is it appropriate for someone who engages in nonsuicidal self-injury (NSSI) to be admitted to an acute psychiatric inpatient program? And how realistic is it to expect no self-injury or self-harm to occur at all while in the hospital? How should hospital staff respond and intervene when someone engages in self-injury while on an inpatient unit? In this episode, Dr. Jason Washburn addresses these questions and discusses how hospital staff can foster empathy and compassion for individuals who self-injure while respecting their autonomy and also keeping them safe.

Learn more about Dr. Washburn and his work here. Below are links to some of his work, including his books as editor and new research. To learn more about AMITA Health and its treatment for self-injury, click here.

Washburn, J. J. (2014). Self-injury: Simple answers to complex questions. Hoffman Estates, IL: Alexian Brothers Press.

Washburn, J. J. (2019). Nonsuicidal self-injury: Advances in research and practice . New York: Routledge.

Slesinger, N. C., Hayes, N. A., & Washburn, J. J. (2021). Understanding predictors of change in a day treatment setting for non-suicidal self-injury. Psychology and Psychotherapy: Theory, Research, and Practice, 94, 517–535.

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 "Top 15 Clinical Psychology Podcasts You Must Follow in 2021" and by Welp Magazine in their "20 Best Injury Podcasts of 2021."

When we talk about nonsuicidal self-injury (NSSI) in this podcast, we are typically referring to the most common forms of NSSI. But what about rarer, more significant forms of self-harm and self-harming behaviors that do not fit neatly within the typical definition of NSSI, like ingesting foreign objects to intentionally cause internal injury? And how do these forms of “Atypical Severe Self-Injury” differ in function and severity from more common forms of self-injury? In this episode, Dr. Barry Walsh details 3 specific forms of Atypical, Severe Self-Injury, explains their unique functions, and shares clinical guidelines for treating those who engage in Atypical, Severe Self-Injury.

Learn more about Dr. Walsh and his work at Open Sky Community Services by visiting www.openskycs.org . Below are links to some of his research and publications referenced in this episode:

Walsh, B. W. (2014). Treating self-injury: A practical guide (2nd ed.). New York: Guilford.

Walsh, B. W. (2019). Atypical, severe self-injury: How to understand and treat it. In J. J. Washburn (Ed.), Nonsuicidal self-injury: Advances in research and practice . New York: Routledge.

Atypical and severe nonsuicidal self-injury as an indicator of severe psychopathology: Findings from a sample of high-risk community mental health clients (Hom et al., 2018)

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

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.

Just how prevalent is self-injury among children under age 12? Do the types and methods they use differ from those who self-injure at other ages? What about the reasons they give for self-injuring? In this episode, Dr. Imke Baetens and PhD candidate Lisa Van Hove from Vrije Universiteit Brussel (Brussels University) discuss the prevalence of self-injury and self-harm among children under age 12 and how parents can talk to their young children about the behavior.

To learn more about the International Consortium on Self-Injury in Educational Settings (ICSES), visit www.icsesgroup.org. Learn more about Dr. Baetens at www.brucc.be/en/imke-baetens. To see her publications, click here, and to learn more about her work at the Brussels University Consultation Center (BUCC), visit www.brucc.be/en. Connect with Lisa on LinkedIn here. Below are some of their research referenced in this episode:

1. Baetens, I., Decruy, C., Vatandoost, S., Vanderhaegen, B., & Kiekens, G. (2020). School-based prevention targeting non-suicidal self-injury: A pilot study. Frontiers in Psychiatry, 11, 437.
2. Van Hove, L., Baetens, I., Simundic, A., Bloom, E., & Heath, N. (in press). NSSI in elementary school children. In E. E. Lloyd-Richardson, I. Baetens & J. Whitlock (Eds.), The Oxford Handbook of Nonsuicidal Self-Injury. Oxford University Press.

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."

In this episode, Dr. Amy Lucas from Speek Health in the United Kingdom talks about supporting siblings of those who engage in nonsuicidal self-injury (NSSI). How can parents and caregivers of those who self-injure determine if they should share that information with siblings? What should parents do or say if they learn that the one self-injuring has made their siblings promise not to tell their parents about their self-injury? How might the sibling’s age influence these decisions and conversations, and what if parents are worried that a sibling will pick up the same behavior from their brother or sister who self-injures?

Connect with Dr. Lucas on LinkedIn at www.linkedin.com/in/amyhlucas, and learn more about her work at Speek Health, a resource for parents and caregivers of individuals who self-harm, at lets-speek.com. Below is one of the few (and free) research articles about siblings of those who engage in NSSI:

1. Tschan, T., Lüdtke, J., Schmid, M., & In-Albon, T. (2019). Sibling relationships of female adolescents with nonsuicidal self-injury disorder in comparison to a clinical and a nonclinical control group. Child and Adolescent Psychiatry and Mental Health, 13, 15. https://doi.org/10.1186/s13034-019-0275-2

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.