The Journey Begins

Thanks for joining R.I.V.E.R Educational Consulting.  This ride will be a hard one, filled with rapids and ravines, but the other end of the course is one that is worthwhile.

Good company in a journey makes the way seem shorter. — Izaak Walton

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An urgent need remains unanswered for social-emotional, behavioral, and mental health instruction within our schools across the United States.  Most important, a growing number of administrators and staff members highlight the lack of training options designed specifically for educational arenas.  We, at R.I.V.E.R. Educational Consulting, seek to fill that void.

The primary goal  of R.I.V.E.R. Educational Consulting is to provide the essential training and practical knowledge to address the needs of all staff and students within an educational building.  During our sessions, staff will participate in several interactive seminars. The initial training session will assist all staff members in developing their own social-emotional, behavioral, and mental well being through reflection, highlighting the possible identification of negative thought processes,  harmful behavioral markers, and emotional escalation points.  To address these factors, our staff will provide effective, research-based strategies that will provide positive cognitive reinforcement, lessons in the avoidance of harmful engagements, and train staff in various deescalation skills.

The subsequent sessions will guide your staff members in the ways to identify students and other staff members who may suffer openly or silently from various social-emotional, behavioral, and/or mental concerns. We provide lessons on how to recognize the warning signs of self-harm, suicide, negative coping strategies, and much more.  R.I.V.E.R. Educational Consulting will guide your school community as you develop a personalized school-wide intervention plan, which may include the formation of a cohesive external web of safety within your community.

The next objective is to equip your staff members with the essential knowledge for them to feel confident and ready to contribute to the overall health and wellness of the individual school community.  We will help you and your staff to implement basic strategies within the existing curriculum and school routines that will result in significant development of student and staff social-emotional, behavioral, and mental health skills.

“Just as some teachers try to accommodate different learning styles, it’s helpful to remember there are different social styles.”  -Peter Greene

In addition, R.I.V.E.R. Educational Consulting will guide your school as you develop or review your reintegration and safety protocols for those who may be returning from outside treatment. This can include the thoughtful examination of inside factors that may possibly trigger a student or staff member in the future and the containment of school-wide contagion.

Dr. Kfoury Presents at Saint Theresa of Avila School Community Meeting

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“Addressing the Monkey on your Back: How to identify Anxiety in your child and how to actively de-escalate its effects. “

This discussion teaches parents about the nature of anxiety in children and provide tools parents can use to help their child cope with anxiety and  learn to self-regulate.  

Many children and early adolescents do not recognize their anxiety for what it actually is.  Often, they may think there is some “wrong” with them. Young Children tend to focus on physical symptoms, such a stomach aches, headaches, lethargy, etc). Young Adolescents and teenagers may feel “odd”, “weird”, out of control, or even “crazy”.  Such thoughts may create further anxiety, continuing this negative cycle.

In this brief Open Forum Discussion, Dr. Tara Kfoury will help you

  • To define what Anxiety is and what is may look like for your child
  • To identify the early onset of anxiety in your child
  • To anticipate changes and/or triggers in your child’s behaviors in the moment of an anxiety-attack (sensory, over-stimulation, prior trauma)
  • Develop a protocol for brain breaks, distractions, and other anxiety-reducing strategies
  • Engage in-the-moment de-escalation strategies (physical touch, mindfulness breathing techniques, visual & voice calming strategies, Tapping)
  • To maintain your calm as you try to calm your child
  • To speak with your child about his/her anxiety & concerns

“What should you do when you just never get to where you thought you’d be in life at this point?”

What should you do when you just never get to where you thought you’d be in life at this point? This is a question I have been asking myself frequently as of late.  I really don’t have a road map to this answer, but here are some of my thoughts at this point.

 

Let it go. What you thought you may have been is not your actuality. It simply sucks to hear, but lets face it, sometimes the truth is not pretty, nor wanted.

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So then, what do you do from here?  My advice – rebuild your dreams. Evaluate what is meant to be for your future now.  Deeply, truly, wholeheartedly ask yourself several questions: What do you want to spend your days and nights doing? What type of job will make you happy and fulfilled? Where in the world do you want to work? Who do you want to be with in life? Lastly, what is it that truly makes you happy at this stage in your life?

Remember, you are not who you were even a year ago, let along 10 years ago.  Your personal rules in life have changed, and so should your goals and life aspirations. This is not to say that you don’t keep some of your original goals and dreams that you still hold dear – it simply means to build upon those, renew your goals, and add new ones as you move forward into your future.  

So, Step one: think about what makes you tick. If you close your eyes, take several deep breaths, what do you visualize doing for a career? Who are you spending your time with? What type of life are you living?  Once you answer these questions, which may not be immediate, start to make a plan.

Step Two: how are you going to move yourself toward this life that you are creating for yourself? What are the financial, social, and emotional steps you will need to fulfill to gain your life goals? Devise a budget, begin a savings plan, enumerate action steps toward your ideal job, and work at seizing that love that you want. Make a calendar, a chart, a step-by-step to-do-list with specifics to provide a constant reminder of your journey.  Watch how you grow, reward yourself when possible, and revise your list as needed. Above all, TAKE THE LEAP toward your goals, as frightening as it can be. I know the words I am saying as I write this advice. I know, because I am currently in the leap phase. I am flying in the air without the knowledge of knowing where my net is – yet, I feel so free and enthusiastic about my journey. I have waited so long for it, pined for it, refrained from it, excused it, and finally, welcomed the chaos and hard work.  

Join me, as we venture into a more fulfilling and healthy future for our present and future selves.

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“Your Demons May Have Been Ejected from the Building, but They’re Out in the Parking Lot Doing Push-Ups.”

I often ask myself, what makes people continue to make the same mistakes over and over during their lifetime? Shouldn’t the lessons learned from those mistake guide them into a future clear of those harmful situations? Clearly the old teaching is “let the baby touch the hot stove to learn never to touch a hot stove.” So, why doesn’t this apply to human behavior? Why is it that humans continue to make the same mistakes repeatedly, especially in relationships?

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Take a client of mine: a young, slender woman in her early 30s, with long brown hair, piercing brown eyes and a subtle, yet mentionable personality.  She is stuck in an endless cycle of love and hate with her boyfriend of many years. After many sessions, it appears that as soon as *Alanna becomes strong enough to break apart from this relationship, he promises to change, better himself, and begins to dote on her continuously in efforts to regain her companionship. Yet, no sooner than recommitting to the relationship, he begins to ignore her needs and slip back into his unaccommodating ways.
This pattern is quite damaging to my client, as now she feels not only used, but more so, stupid for believing that “this time “ he was really going to change and they would make it work. I find this to be more damaging than the lack of action because this tears to her core of beliefs and her impression of worthiness. Now, not only is she left beating herself up mentally for being “dumb” enough to believe her boyfriend, but now she has to begin to build up her strength to begin her fight for independence again. At times, she spends more time in our sessions tearing herself apart, referring to herself as stupid and weak, comparing herself to the Disney character Dumbo, instead of strengthening her. This can then shape her subsequent weeks fighting her way towards strengthening her damaged self-esteem and self-worth. On average, we spend 3/4 sessions attempting to pull her out of a downward depressive spiral, and the remainder 1/4 sessions building her to be more independent and self-fulfilling.

I often wonder when the last time she truly felt happy- without interruption- wholeheartedly happy. When she really felt that her life was what she chose, and not what she morphed her life into for her relationship. When I begin to address that topic, she prefers not to think to deeply- as it causes her to examine the question “Would she be happier without him?”
I press her at times to consider what she would do with her life if she had no other person to consider when making decisions. Where would she go? Where would she live? What job would she take? What would she do in her free time? Every now and then, I see a sparkle in her eyes, filled with dreams of her future. This quickly fades as she realizes that these dreams would never happen- since she chooses to continue to play the round-a-whirl relationship game. Knowing she may possibly have continued happiness, or at least more happiness than she currently has, why does she choose to stay?

*Lori is a strong, intelligent wife and mother of three, who owns her own business with her friend. At times, she looks beautifully put together and other times, completely run-down when she comes to see me. It is evident that she wears her emotional battles on her face. She struggles with her decision to accept what she terms as “mediocre marital conditions” and leaving her husband of 25 years. Although our conversations are geared more toward examining why she chooses to stay in her marriage, we do have the occasional discussion of why she has not dissolved her marriage. She is self-made, independent, strong willed, and motivated in business. So, then why stay? Ironically, the question of her choice to stay in a marriage is even perplexing to her. She has stated that she is afraid of being alone for the rest of her life, but not enough to prevent her from divorce. For her, the mitigating factors are her children. Although they are maturing, and becoming more self-sufficient, Lori is afraid of missing out on her children’s lives if she has to share custody. For her, the choice doesn’t come down to nuances of child support, palimony, or finding a new place to live- it comes down to valuable time spent with her children in their family home. She considers the fleeting moments of her children’s childhood before the conditions she lives in with her husband. So, she stays.

So that then morphs into the question, if women such as the two I have spoken about entered a relationship as independent, strong, and intelligent women, how did they surrender their needs to another human being, not of their own flesh?

Although I mentioned two women in the previous paragraphs, self-sacrifice in relationships can also happen to men. Many men are culturally taught to be the provider, sometimes at the expense of their wants and desires. Some men work mundane 9-5 jobs, just to maintain a household. Over time, resentment toward the wife (at times, children) continues to build, until one day the male provider has had enough. So, let’s examine the male perspective in the same way using *Joseph’s story.

Joseph was a good looking, young teenager who had the potential to play college lacrosse. Too much partying and not enough studying led him to loose his partial scholarship. However, with the help of financial aid and loans, Joseph was able to finish college and begin to work at a financial company with great potential for growth. Although Joseph did not want to work in finance beyond his third year there, he had met his girlfriend there and liked working together. Over time, both his girlfriend and Joseph were promoted and increased their yearly salaries. They had both grown accustomed to a certain lifestyle and enjoyed the perks the company offered them. Still, Joseph disliked what he was doing and started to look for jobs elsewhere, without telling his now-fiancée. Within two weeks, Joseph had landed an interview and a job offer at a local high school in the role of athletic director. Considering his love of lacrosse, football, and other sports, Joseph thought his fiancée would support the decision for Joseph to work at a job that, he felt, gave meaning to his life. His fiancée did not agree with his desire and gave him an ultimatum to choose between their relationship and the new job. I am currently awaiting his final decision.

“When is it ok to say ‘I’ve had enough of you and your

wants. It’s my turn now!”

So, if Joseph chooses his relationship over his personal happiness, won’t that in of itself cause life-long resentment and anger- in the name of providing for his relationship? At what point in their lives should Individuals like Joseph, Lori, and Alanna choose themselves over their partners? When is it ok to say “I’ve had enough of you and your wants. It’s my time now- take it or leave it?” When is it ok to make those they love recognize that it takes two people to run a partnership/relationship/family- that is it only sacrifice by one, but compromise and equal sacrifice over the course of the relationships? I know it is human nature to want to be attached to another human, but at what cost to the self?

I find myself urging my clients to find their own voices in their relationships, yet at times, I struggle to find mine in my marriage. It is hard to be the spouse or partner that sacrifices their own needs and wants when fulfilling the role of relationship caretaker. I know, I return to that lane at times. Although I can answer the questions I have asked in this article using deep explanations of neuroscience and physical chemistry, I don’t really think those answers would help us to really “feel” the answers that we are searching for in relationships. Instead, my belief is in being mindful of all our decisions, when concerning individual decisions and partnership decisions. Weigh your options, create your pros and cons lists, and talk through the decisions, both with your partner and yourself. If it means sacrificing your dreams, hopes, and goals, for your relationship- consider how that will play out for your relationship in the long run. If contempt and hated of your partner cross your mind- well, I think you know the answer to that decision. If you are willing to go without a job, vacation, home, etc, without contention- then perhaps consider making a decision that benefits your partner more. However, the best way for each partner to make decisions is to compromise when possible. Most decisions have the possibility of compromise. It takes giving up of individual wants and putting the ego on hold at times, but often it is the most beneficial and strengthening for your relationship.

Sadly, there are times, like in the case of Alanna, where she had to walk away for good. It took her a few months to solidify her decision in her heart and mind, but she found herself happier for more days in a month than unhappy- which made her decision obvious to her. Today, she has re-entered the dating world, after a reasonable hiatus, with a clear picture of what she wants from her partner, but more important, what she wants from herself. She has worked at strengthening her self-esteem, self-worth, and her confidence. She has adopted a rescue dog for companionship and even joins weekly play dates at the local dog park. Her road was long, tumultuous at times, but she will tell you her story and she will shine at the thought of her future – the same future she thought wasn’t previously possible.

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*Names have been changed for client confidentiality.

 

Turnbridge Drug Treatment

On behalf of R.I.V.E.R. Educational Consulting, Dr. Kfoury was honored to have spent the day learning about Turnbridge Treatment Programs and Turnbridge Academy in New Haven, Connecticut.  Dr. Kfoury was able to visit the clinical intake center, the residential homes, as well as visit with the wonderful staff at all locations.

Dr. Kfoury could not speak more highly of a group of dedicated staff members, the carefully and comprehensibly designed multi-tiered program, and the extensive consideration given to those fighting addiction and co-occurring disorders and their families. What stood out to her the most was the carefully constructed support system for the families, especially addressing the emotional and social needs of siblings of those fighting addiction.  Too often, siblings are a forgotten link – one that Turnbridge actively sought to bring wholeheartedly into the process.

If you are or know of someone actively fighting an addiction, please do not hesitate to contact Turnbridge at 877.996.4395

Here are a few of the pictures that were taken on the visit. A big Thank you to the Turnbridge Staff and Justin Cambria, the Outreach Coordinator for hosting our Dr. Kfoury!

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The preeminent addiction treatment program for young men in Connecticut

THE PREEMINENT ADDICTION AND CO-OCCURRINGDISORDER TREATMENT PROGRAMS FORYOUNG MEN & YOUNG WOMEN

To speak with an admissions representative call 877.996.4395

Turnbridge has helped thousands of young adults and teens recover from addiction and co-occurring mental health disorders.


For nearly 15 years, Turnbridge has been positively transforming the lives of men, women, and their families through a comprehensive three-phased approach to addiction treatment that is designed to gradually reintegrate our clients back into the real world.  Learn more about their unique combination of clinical best practices, life skills development, academic & vocational support, and recreational experience by visiting their website at:

https://www.tpaddictiontreatment.com/

Turnbridge Academy

Turnbridge Academy is a comprehensive system of recovery-informed academic services designed to help our emerging adult and adolescent clients plan and pursue their educational goals. Whether you need help finishing high school or if you want to utilize our relationships with various colleges – such as SCSU, University of New Haven, Albertus Magnus College, Quinnipiac University, and Gateway Community College – Turnbridge Academy is available to help young people re-launch on their journey toward a successful future.

Turnbridge also offers a comprehensive Outpatient Care Program to help

Our outpatient program makes our exceptional clinical care available to more people close to home. If you or a loved one is struggling with substance abuse and co-occurring disorders such as anxiety and depression, Turnbridge outpatient services may be able to help.

 

Check out the Recent Outcome Study:
drug rehab success rates

What do I do now? An Introspective.

What should you do when you just never get to where you thought you’d be in life at this point? This is a question I have been asking myself frequently as of late. I really don’t have a roadmap to this answer, but here are some of my thoughts at this point.

Let it go. What you thought you may have been is not your actuality. It simply sucks to hear, but lets face it, sometimes the truth is not pretty, nor wanted.

So then, what do you do from here? My advice – rebuild your dreams. Evaluate what is meant to be for your future now. Deeply, truly, heartedly ask yourself several questions: What do you want to spend your days and nights doing? What type of job will make you happy and fulfilled? Where in the world do you want to work? Who do you want to be with in life? Lastly, what is it that truly makes you happy at this stage in your life?

Remember, you are not who you were even a year ago, let along 10 years ago. Your personal rules in life have changed, and so should your goals and life aspirations. This is not to say that you don’t keep some of your original goals and dreams that you still hold dear – it simply means to build upon those, renew your goals, and add new ones as you move forward into your future.

So, Step one: think about what makes you tick. If you close your eyes, take several deep breaths, what do you visualize doing for a career? Who are you spending your time with? What type of life are you living? Once you answer these questions, which may not be immediate, start to make a plan.

Step Two: how are you going to move yourself toward this life that you are creating for yourself? What are the financial, social, and emotional steps you will need to fulfill to gain your life goals? Devise a budget, begin a savings plan, enumerate action steps toward your ideal job, and work at seizing that love that you want. Make a calendar, a chart, a step-by-step to-do-list with specifics to provide a constant reminder of your journey. Watch how you grow, reward yourself when possible, and revise your list as needed. Above all, TAKE THE LEAP toward your goals, as frightening as it can be. I know the words I am saying as I write this advice. I know, because I am currently in the leap phase. I am flying in the air without the knowledge of knowing where my net is – yet, I feel so free and enthusiastic about my journey. I have waited so long for it, pined for it, refrained from it, excused it, and finally, welcomed the chaos and hard work.

Join me, as we venture into a more fulfilling and healthy future for our present and future selves.

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Multi-Media Resources for Families & Communities

The following are great resources for Families and Communities to watch regarding various topics of Mental Health & Acceptance:

Movies: 

Not Alone (2017) – Driven by a desire to understand why her best friend killed herself at age 16, Jaqueline Monetta (18yrs), sits down with teens to talk about their struggles with mental illness and thoughts of suicide.

Inside my Mind (2015) Anxiety, a small bout of depression, or an obsessional thought, all of us can have these feelings at some time. But, what if these persist and take over our life? In this movie, the directors explore the science behind mental illness, looking at the lives of 5 patients and their road to potential help for their illnesses.

Raising Bipolar: Understanding the Disorder (2010) Directed by Eric Shotz and Ruth Rivin, this film follows four separate families struggling to raise children diagnosed with Bipolar Disorder. One storyline follows a grandmother bravely raising four bipolar children with this strange and unpredictable disorder.  Another story follows a young teen named Kelsey as she faces intensifying social pressures in school while struggling to manage her moods.

Fractured (2018) The Park Family deals with the dire consequences of untreated mental health illness in their son, Danny Park. This story is inspired by the true events of the Virginia Tech University Shooting, where Seung Hui Cho committed one of the deadliest mass shootings in American History.

Chase (2018) Based on actual events, this movie depicts the life of a young girl who is bullied through high school.  The main character unveils her story alongside a behavioral specialist, youth leaders, and a cast of film directors, helping her to explore the human behavior of bullying and its heartbreaking effects.

BIPOLARIZED (2016) This is a riveting and heart wrenching story about a young man plagued with Bipolar Disorder who challenges conventional wisdom about mental illness and drug therapy.

Shadow Voices: Finding Hope in Mental Illness  (????) This film provides an inside look at what it is like to live with a mental illness and how individuals and their families find their way through medical, governmental, societal, and spiritual issues – to hope.

Emma Wants to Live (2016) This film offers a unique, self-presented view of the deadly disease of Anorexia.  The filmmaker and star of the film is Emma, herself.  She filmed her own life as she struggled to recover from Anorexia.  Ultimately, Emma lost her battle with the disease, but taught her audience to choose life while you can.

Breaking the Silence (2017) This is a true-life documentary depicting the stories of 5 courageous women who each overcame their childhood experiences of abuse and neglect.

Unraveling the Creative Mind (2016) 10 minutes in duration. Creativity is an essential component of human progress.  From arts to technology, our world has been shaped by the visions of all those who have dared to thing differently.  Dr. Nancy Andreasen, a neuropsychiatrist, studies the creative process in the brain and its relation to mental illness.

Changing our Minds- Clear Thoughts on Depression, Drugs, and Alternative Paths to a Healthy Mind (2018 updated) This original 2010 film was updated to provide the most cutting-edge research concerning mental health and depression including all that is known about medication, medical and environmental causes, ADHD and other mental illness diagnosis; cognitive behavioral talk therapy, philosophical counseling and other natural healing methods. Interviews with leading spiritual, medical, and mental health professionals; tempered with personal stories.

A Dangerous Son (2017) This is an HBO film that focused on the lives of three separate families, each of them having a child who is living with a serious mental illness.  It unpacks their lives to portray their journeys toward finding an appropriate treatment.

 

TV Shows:

The Mental Health Show (2018) This show is hosted by John Cordray, a licensed therapist who brings awareness to mental health.  John brings a seriousness mixed with entertainment and humor as he addresses the ofter misunderstood mental health issues of today.  *Available on Amazon Prime.

Science or Fiction (2018) Within the first season, there are several episodes addressing mental illness, mindfulness, anxiety, depression, hostility, seasonal affective disorder, and happiness.  *Available on Amazon Prime.

Motivational Speakers/Podcasts:

Jay Shetty can be found on http://www.jayshetty.me – Jay is an award-winning host who has quite the interesting background.  His messages are sensible, relatable, calming and soothing.  His collection of brief 1-5 minute video clips are useful from dealing with anxiety to loss of a loved one.  He addresses stress, living the best life possible, and what to really look for in another person.

Ear Buds: A Podcasting Documentary (2016-) Graham Elwood and Chris Mancini wanted to find out why podcasters had such a deep personal connection with their audiences. They went all over the country, and even to Australia and Japan, yo interview fans and podcasters.  From dealing to mental illness to battling cancer, the stories they collected in this series of podcasts are inspiring and surprising.

TedX Talks:

How Childhood Trauma Affects Across A Lifetime with Dr. Nadine Burke Harris

 

What Trauma Taught Me About Resilience with Charles Hunt

 

The Skeletons In my Closet with Stephen Lewis

 

 

The Use of Non-Suicidal Self-Injury as a Coping Strategy for Young Adolescents

For years I have examined the reasons behind why many young people have chosen to harm themselves. Yet, during this journey I have learned that it is not about understanding why they would want to harm themselves so much, but rather what they may be trying to escape, avoid, or cope with through their acts of self-harm. Contrary to suicide, self-harm is not an attempt to take one’s life. Instead, acts of self harm serve as a way to release the buildup of emotions plaguing its young captives. Non-suicidal self-injury (NSSI), is defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as the “deliberate, self-inflicted destruction of body tissue without suicidal intent and for the purposes not socially sanctioned”. NSSI includes behaviors such as cutting, biting, rubbing, and burning of skin. Its actions may also include the purposeful breaking of bones, development of eating disorders, and the addictive behaviors of alcohol, drugs, and sex.

A common misconception held about NSSI behaviors is that they are a cry for help or attention by the particular individual. Although there are a fair number of cases in which young individuals are seeking attention, NSSI is really more of a private behavior. In fact, unless the individuals reveal their scars, you will not be aware of what they are doing to their own bodies. Typically, a child who engages in NSSI behaviors will do so in a private bathroom or bedroom with no one around to observe her. Then, once she has successfully engaged in self-harm, she leaves the safety of these locations and will most likely cover the areas of harm carefully so as to not draw attention to her wounds. This is why efforts to identify adolescents who are in need of help is difficult for parents, educators, and health care professionals.

As an expert in NSSI, I am often asked by my peers how self-harm may possibly begin for many young adolescents. My answers continually evolve and vary as new research emerges, but there really is not a set answer to this question. Self-harm may begin with a simple, small cut from the razor used in the shower. Or, perhaps it began with the continual rubbing of an eraser on a student’s arm during class. Out of curiosity, the youth will initiate self-harm a second and third time to investigate the stimulus of their actions to their body. For those individuals, a trial-and-error period then occurs shortly following the initial act of self-harm. Once a preferred method of self-harm is chosen, the individual will actively seek out this form of negative behavior to alleviate her mental and emotional pain. Since she is lacking any positive coping strategies, she will continually turn to self-harm to assuage her emotional and mental pain.

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The question still remains – Why? Why would someone want to continually harm themselves? In all of my research, I still have not been able to provide an easy answer in any form. Those who self harm do not typically fit into a neat little classification. In years past, I am sure that many public health officials considered this behavior to belong to the gothic community or the Kurt Cobain grunge population who seemed completely disinterested in the common way of life. However, with updated research and a sense of urgency placed upon this medical concern, it has been revealed that NSSI affects all walks of life, socioeconomic classes, races, ethnicities, and religions. There is not a specific example of an adolescent who engages in NSSI. It can affect the high school athletic and academic over-achiever as much as the forgotten girl-next-door. It haunts the transgender adolescent as much as the straight champion hockey player with a full ride to Boston College. That’s what makes NSSI so widespread and yet, hidden in the shadows of school and home hallways.

Adolescents struggle with life’s occurrences daily, yet many of them have very little positive, heathy coping strategies. Their emotional and mental pain calls to them night and day. For these adolescents, there is no silencing of the mind. It can be likened to a subway train that operates 24 hours a day. This emotional and mental “train” has little to no stopping, is inclusive of flashes of life’s pressure continually felt on your mind, heart, and chest, and is accompanied by continual thoughts that race through your brain with only seconds in between “stops”. Many of these adolescents endure this “train ride” daily as part of their norm. Each day they force themselves to wake up, struggle to put on a brave face, appear “normal”, well-adjusted, and functional, and yet they feel like a train with no stops. To these adolescents, NSSI allows them to “get off the train” by engaging in acts of cutting or burning of their skin, starvation or engorgement, drugs, alcohol, and unprotected sex.

Another image that often accompanies NSSI is that of a balloon. Many adolescents describe a buildup of daily feelings- unpleasant looks and statements from classmates and teachers alike, disgruntled friends, family members, personal trauma, and the everyday anxiety to be perfect.- to be comparative to that of filling up of a balloon. Once the balloon is so large, there is no where for the air to go, so it just explodes. To the adolescents who engage in NSSI, the actual physical action of cutting ones flesh open, even if a tiny line, is like releasing the air in the balloon. That rush of release is how they feel once they engage in an act of self-harm. For them, the balloon they have felt being blown up each day, filled with anxiety, tension, self-loathing, and further emotional pain, releases its air, deflates, ready to begin the week again, once the physical injury occurs.

So then what? Honestly, it begins all over again. Without the knowledge of how to process emotions in a socially-acceptable, healthy way, the adolescent will continue to self-harm, possibly even increasing the range of self-harm to a more severe state. Imagine, again, the balloon. Once the emotional release occurred, the balloon went back to its resting state, deflated and empty. However, the following week, more of the same negative interactions with those around the adolescents occurred, self-loathing thoughts were established, and more social disapproval was demonstrated, thereby re-inflating the balloon. The feeling of being overwhelmed will occur, and the child will engage in self-harm again. Such behavior becomes cyclical. It may only be interrupted by discovery by a friend, teacher, or family member or when the self-harming individual seeks help herself.

Acts of NSSI can remain at the level of small destructions of skin or may escalate to greater acts of self-harm, some requiring intensive medical care. Again, it is important to remember that since NSSI occurs in private, many do not see the evolution and escalation of self-harming behaviors in their home, classroom, or community. In fact, detection of self-harm is often through the word of a sibling or a classmate, but usually is discovered after quite a bit of time and several acts of self-harm have occurred.

So how can educators, families, and friends help break the cycle? At the societal level, we must first start by shining a light on this ever-growing epidemic. We must open our doors to welcome in the discussions of mental and behavioral health within everyday educational settings. As a society, we must acknowledge that we serve as caretakers, parents, and guardians of all of our young people. We must educate ourselves to recognize children who are in need of social-emotional, behavioral, and mental health help. Then dive deeper – learn the signs of NSSI and the triggers that encourage self-harm, simultaneously promoting open dialogue centered around mental health with our youth. Learn to model healthy coping strategies that will allow our children to positively deal with negative emotions while enduring life’s hardships. Current research pinpoints a lack of positive and healthy coping strategies among our youth as a catalyst for the increasing number of self-harm in adolescents. In an age of increasing social media and a decline in meaningful face-to face discussions, our children lack the essential know-how to communicate their feelings in positive, effective, and meaningful ways. More so, children do not feel free to be themselves and express their genuine emotions. To the contrary, our children hide their feelings inside themselves or anonymously put them online into chatrooms for all to see. Yet, everyday their internal tension builds until they are ready to burst. This is when children look towards negative methods like cutting to seek an emotional release. Still, the question remains: how does one make the leap from negative feelings to taking an eternal object and hurting herself? Where does she gain that, so to speak, courage, to alleviate her emotional and mental pain through physical pain? Again, unless you are a self-harmer, the answer alludes you.

Nonetheless, there are steps that we, as a society, can take to combat NSSI and it’s co-occurring coping strategies. First, we must learn the signs to identify a child who may be engaging in self-harm (see chart below). Become educated on the ways NSSI can occur, how NSSI can be hidden, when and where self-harm can occur, how it can begin, the reasons why children may self-harm, and finally how children may try to deny engaging in NSSI. Do some investigation work. Identify the most common triggers that cause adolescents to harm themselves. Determine if the student has any of these triggers in her life. Then, continue investigating. Check to see if the particular student may have a pre-existing or undiagnosed condition such as ADHD, anxiety, depression, or another that may increase her risk of self-harm. Take a day or two to fully examine the adolescent’s daily routines – does she have friends, does she socialize frequently with others during the day, does she tend to rush out of school as soon as she can? Talk to her teachers and coaches. Ask if the student in question exhibits a frequency of perfectionism with her work, has suddenly become passive in the classroom, or has begun to demonstrate obsessive behavior when completing academic tasks? Does she have a tendency to take risks, is she impulsive in class or on sports teams, or does she have frequent conflicts with friends and teammates? The answers may reveal a child in need of help.

Second, really educate yourself about the various positive coping strategies for adolescents. Knowing these strategies and modeling such strategies will help you to talk with children about working through their emotions in healthy ways. By providing solid, concrete ways to process human emotions, adolescents will be armed with the know-how to help them cope positively with their emotions while effectively communicating their social and emotional needs to the adults and peers around them.

Third, highlight who in the school, in the community, and at home could serve as a soundboard for children in need. Create a positive group name for the fellow staff members- something that encourages open dialogue between the adults in the building and the student population. By identifying these staff members, students may be more willing to seek help, especially from adults who are not typically in the traditional role of guidance counselor or school psychologist. However, it must be noted that it is essential for schools to provide fundamental training to those staff members before any such action can take place. Once training is complete, and the identification to the school is given, staff will be able to provide social-emotional, behavioral, and mental health help, de-escalation skills, as well as the critical connections to professionals both in the school and within the community who may be able to help them further. With a team in place, children will be comforted to know they have people around them willing and able to support them.

Most important, DO NOT AVOID the conversations around self-harm, self-esteem, and self-loathing. These three conversations of “self”s are real, and they are hitting our youth particularly hard – especially with the overuse of social media. As educators, community caretakers, and parents, we must not avoid difficult conversations. Fooling ourselves to think it does not occur with “my child” or “within our school” will not help to break the cycle of self-harm. Again, self-harm, self-loathing, and self-esteem concerns are not isolated to a particular region, school, or person. All children, whether young or old, are susceptible. If we don’t think we have the have the answers or know of possible solutions, tell those children that you will need time to discover the answers and get back to them. Then, do your research. Be vigilant to find answers, models, anecdotes, videos, everything and anything that can help a child with her social emotional, behavioral and mental health needs. Then, share what you discovered with those children who are asking life-sculpting questions.

Through identification, conversation, and continual support, trained or self-educated adults can and will be able to help our struggling youth. Make sure you learn the signs of non-suicidal self-injury and its co-occurring negative coping strategies today.

Signs of Possible Self-Injury:

* Unexplained cuts, bruises, burns, or breaks (often on wrists, upper & lower arms, inner thighs, and chest area)
* Refusal to change clothing in front of others, including peers and family members
* Prefer to wear concealing clothing, despite hot weather and/or uniform requirements.
*Loss of hair (resulting from having been pulled out by the child)
*Avoidance of situations where less clothing may be expected (parties, swim events, other sport activities)
*Change in eating habits (Over-eating or under-eating, skipping meals, dieting)
*Sudden increase or decrease in exercise. (at times excessive)
*Change in relationships with friends, romantic relationships
*Unpredictable, impulsive behaviors and outbursts, moodswings
*Decrease in the desire to socialize with peers or family members
*Sudden increase / decrease in sleeping
*Increase in anxiety
*Keeping sharp objects on hand or hidden in bedroom