Don’t Tear Your Hair Out: We Can Manage Suicidality, Homicidality and Self-Injurious Behaviors

Presenters:

• Joan A Turkus, MD, DLFAPA
• Philip J Kinsler, PhD, ABPP
• Jan Beauregard, PhD, CSAC, CSAT

Description:

Suicidality, homicidality, and self-injurious behaviors are both common and disturbing symptoms of complex trauma and dissociative disorders as well as challenging for clinicians to manage. These chronically unsafe and challenging behaviors grind away at our patience and clinical self-confidence, often resulting in our feeling powerless and deskilled. Yet at the same time, a trauma survivor can say, “Suicide saved my life.” How do we reconcile this?

There is a body of knowledge about suicidality, homicidality, and self-injurious behaviors. This conference will discuss the assessment and the major traumagenic dynamics of suicidality, homicidality, self-injury, substance use and eating disorders, all of which are such familiar syndromes in our work. We will explore the varied meanings that arise within our clients and which drive these behaviors and look at successful therapeutic interventions within a trauma/dissociation framework for each of them to increase our clinical acumen and skill-sets.

Finally, we will address our own countertransference and vicarious traumatization. We will explore professional and personal strategies for us as clinicians.

Objectives: At the end of the presentation, a participant will be able to:

1. Describe the internal meaning systems that can lead to suicidal and/or other self-destructive behaviors.
2. Prepare interventions to aid clients in managing these behaviors.
3. Design a variety of self-care strategies to avoid vicarious traumatization and burnout.

References:

• Brand, B. (2001) Establishing Safety with Patients with Dissociative Identity Disorder, Journal of Trauma & Dissociation, 2(4), 133-155.
• Osman, A., Kopper, B., Linehan, M., Barrios, F., Gutierrez, P., Bagge, C. (1999) Validation of the Adult Suicidal Ideation Questionnaire and the Reasons for Living Inventory in an adult psychiatric inpatient sample. Psychological Assessment, 11(2), 115-123.
• Carlson, E., McDade-Montez, E., Armstrong, J., Dalenberg, C., Loewenstein, R. (2013) Development and Initial Validation of the Structured Interview for Self-Destructive Behaviors, Journal of Trauma & Dissociation, 14:3, 312-327.
• Pearlman, L. (1995). Trauma and the Therapist: Countertransference and Vicarious Traumatization in Psychotherapy with Incest Survivors. New York, NY, Norton.
• Najavits, L. (2002) Seeking Safety: A Treatment Manual for PTSD and Substance Abuse. New York, NY, Guilford.
• Shea, S. (2002) The Practical Art of Suicide Assessment: A Guide for Mental Health Professionals and Substance Abuse Counselors, Hoboken, NJ, John Wiley & Sons.
• Wallin, D. (2007) Attachment in Psychotherapy, New York, NY, Guilford Press.