This journal is a set of exercises and educational information to be used by therapists to help people who are struggling with self-destructive behaviors and thinking and want to change. This is a long process, one that many people don’t understand. Self-injury and self-destructive behaviors and thinking can become such a big part of life and relationships, that the thought of change is overwhelming. It developed out of requests from therapists for something tangible to give clients. It isn’t perfectly polished, is a bit more theory than conversation in parts, but it is a start.
Why do written work and talk about it therapy? Journaling is a part of the therapy process. And, when used to augment therapy, it can be a powerful and helpful tool. It is important to have focus on what you want to achieve when you are helping someone towards change and something that feels impossible and brand new. This journal is to give therapists working with people with deliberate self-destructive impulses, urges and behaviors a structured way to work on one important lesson at a time.
In my experience working with people who self-injure, I have learned from their struggles with self-regulation, destructive impulses and what they find helpful. A number of these journaling assignments were developed while working with people in recovery who are learning to think in differently way about a difficult set of problems, impacting their lives greatly. I tried to include these lessons in this book.
One lesson I want to emphasize is the language in this journal. It is deliberate. I get feedback that sometimes that the language is somewhat formal and the constructs are complicated. This is probably true. I think my patients are a pretty intelligent group of people, and I adjust my language to help the individual master the constructs. It is, in my opinion, my job to work through and teach the patient the language. It gives them the language to speak their minds. It is our job as clinicians to not just photocopy written exercises and tell our patients to do them. When we discuss the materials on these pages, we are teaching them:
• Language skills for communication and expression.
• How to interact, get their needs met appropriately.
• How to tolerate frustration.
• How to tolerate having to ask for help appropriately.
• How to tolerate getting helped.
• How to tolerate interaction and closeness.
• How to ask questions and think about things, and then sit with them.
• It is an opportunity to have healthy mentoring interactions which help with attachment, modeling and social skills.
• It is an opportunity to build off of their existing skills, intelligence and resources.
• It is a teaching opportunity for expression, thinking and understanding!
There are many components needing to be addressed in treatment. These include creating a working agreement, healthy limits and boundaries, structure and accountability. Much of what we clinicians do, to a great degree, is healthy parenting and helping to develop healthy attachments, age-appropriate skills development and maturity. Expecting that someone can self-manage is an important belief, and it is reasonable to believe this growth is going to be difficult. Many of our patients don’t understand that their feelings are reasonable, and serve as data that something important is going on. Feelings aren’t facts though, and it is important to think reasonably through our problems. It is our job to help them learn these lessons.