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

Emotion Regulation Individual Therapy for Adolescents (ERITA) Who Self-Harm (Re-Release)

nicholas.westers@childrens.com (Johan Bjureberg PhD) — Fri, 27 Mar 2026 05:00:00 +0000

Emotion Regulation Individual Therapy for Adolescents (ERITA) and its internet-delivered version (IERITA) is just one of a couple of treatments developed specifically to address nonsuicidal self-injury (NSSI) among adolescents. In this episode, Dr. Johan Bjureberg from the Karolinska Institute in Stockholm, Sweden walks us through in detail each of the 11 sessions of IERITA and IERITA's 6 parallel sessions for parents.

Learn more about Dr. Bjureberg's work here, and follow his research lab and their projects and publications at Emotion regulation, Self-injury, Suicide, and Intervention (ESSI) here. Below are links to his research on ERITA/IERITA referenced in this episode:

Bjureberg, J., Ojala, O., Hesser, H., Häbel, H., Sahlin, H., Gratz, K. L., Tull, M. T., Knutsson, E. C., Hedman-Lagerlöf, E., Ljótsson, B., & Hellner, C. (2023). Effect of internet-delivered Emotion Regulation Individual Therapy for Adolescents with Nonsuicidal Self-Injury Disorder: A randomized clinical trial. JAMA Network Open, 6(7), e2322069.
Bjureberg, J., Sahlin, H., Hedman-Lagerlof, E., Gratz, K. L., Tull, M. T., Jokinen, J., Hellner, C., & Ljotsson, B. (2018). Extending research on emotion regulation individual therapy for adolescents (ERITA) with nonsuicidal self-injury disorder: Open pilot trial and mediation analysis of a novel online version. BMC Psychiatry, 18, 326.
Bjureberg, J., Sahlin, H., Hellner, C., Hedman-Lagerlof, E., Gratz, K. L., Bjarehed, J., Jokinen, J., Tull, M. T., & Ljotsson, B. (2017). Emotion regulation individual therapy for adolescents with nonsuicidal self-injury disorder: A feasibility study. BMC Psychiatry, 17, 411.

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."

Emotion Regulation Group Therapy (ERGT) for Self-Harm (Re-Release)

nicholas.westers@childrens.com (Kim Gratz PhD, Matthew Tull PhD) — Fri, 27 Feb 2026 06:00:00 +0000

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.

You can purchase their book "Acceptance-based emotion regulation therapy: A clinician’s guide to treating emotion dysregulation and self-destructive behaviors using an evidence-based therapy drawn from ACT and DBT" on Amazon here or at New Harbinger Publications here.

Connect with Dr. Gratz on LinkedIn here and Dr. Tull here. Below are links to their research on ERGT referenced in this episode:

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.
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.
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.
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.
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."

Self-Injury in Schools (Re-Release)

nicholas.westers@childrens.com (Nancy Heath PhD) — Fri, 30 Jan 2026 06:00:00 +0000

How can schools appropriately respond to students who engage in nonsuicidal self-injury (NSSI), whether the behavior occurs at home, on school grounds, or elsewhere? What protocols exist to support schools to better respond to students who self-injure? What role does liability play? In this episode, Dr. Nancy Heath of McGill University in Montreal, Canada explains how schools can support students who engage in self-injury and self-harm.

Learn more about Dr. Heath's work here, and learn more about her work with the Development and Intrapersonal Resilience (DAIR) Research Team here. Learn more about the International Consortium on Self-Injury in Educational Settings (ICSES) at http://icsesgroup.org/.

Self-injury Outreach & Support (SiOS) offers resources for schools here and a list of do's and don'ts here. Visit SiOS at http://sioutreach.org and follow them on Facebook (www.facebook.com/sioutreach) and Twitter (https://twitter.com/sioutreach).

Below are links to some of Dr. Heath's research as well as resources referenced in this episode:

Hasking, P. A., Bloom, E., Lewis, S. P., & Baetens, I. (2020). Developing a policy, and professional development for school staff, to address and respond to nonsuicidal self-injury in schools. International Perspectives in Psychology: Research, Practice, Consultation, 9(3), 176.
Berger, E., Hasking, P., & Reupert, A. (2015). Developing a policy to address nonsuicidal self-injury in schools. Journal of School Health, 85(9), 629-647.
Lloyd-Richardson, E. E., Hasking, P., Lewis, S.P., Hamza, C., McAllister, M., Baetens, I., & Muehlenkamp, J. (2020). Addressing self-injury in schools, part 1: understanding nonsuicidal self-injury and the importance of respectful curiosity in supporting youth who engage in self-injury. NASN School Nurse, 35(2), 92-98.
Lloyd-Richardson, E. E., Hasking, P., Lewis, S.P., Hamza, C., McAllister, M., Baetens, I., & Muehlenkamp, J. (2020). Addressing self-injury in schools, part 2: how school nurses can help with supporting assessment, ongoing care, and referral for treatment. NASN School Nurse, 35(2), 99-103.
Lewis, S. P., Heath, N. L., Hasking, P. A., Hamza, C. A., Bloom, E. L., Lloyd-Richardson, E. E., & Whitlock, J. (2019). Advocacy for improved response to self-injury in schools: A call to action for school psychologists. Psychological Services, 17(S1), 86–92.
De Riggi, M. E., Moumne, S., Heath, N. L., & Lewis, S. P. (2017). Non-suicidal self-injury in our schools: a review and research-informed guidelines for school mental health professionals. Canadian Journal of School Psychology, 32(2), 122-143.
Whitlock, J. L., Baetens, I., Lloyd-Richardson, E., Hasking, P., Hamza, C., Lewis, S., Franz, P., & Robinson, K. (2018). Helping schools support caregivers of youth who self-injure: Considerations and recommendations. School Psychology International, 39(3), 312-328.
Hasking, P. A., Heath, N. L., Kaess, M., Lewis, S. P., Plener, P. L., Walsh, B. W., .Whitlock, J., & Wilson, M. S. (2016). Position paper for guiding response to non-suicidal self-injury in schools. School Psychology International, 37(6), 644-663. Open access here.
Book: Self-Injury in Youth: The Essential Guide to Assessment and Intervention (2008) by Drs. Mary Nixon & Nancy Heath

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."

What Role Does Blood Play in Self-Injury?, with Dr. Christian Schmahl

nicholas.westers@childrens.com (Christian Schmahl MD) — Thu, 25 Dec 2025 06:00:00 +0000

In this episode, Dr. Christian Schmahl from Heidelberg University and Mannheim, Germany, answers a listener's question and talks about his experimental research assessing how seeing blood affects heart rate and arousal among both those who engage in nonsuicidal self-injury (NSSI) and those who don't. He also shares insights into the role of self and blood in ritual and nonritual self-injury, including examples from different cultures about how they may interpret blood differently in the context of self-harm and even trance-like states.

To learn more about Dr. Schmahl and his work, visit here. To stay up-to-date on next year's ISSS conference in Stockholm, Sweden (Wed-Fri June 24-26, 2026), visit https://www.itriples.org/conferences. Below are a few papers referenced in today's episode:

Glenn, C. R., & Klonsky, E. D. (2010). The role of seeing blood in non-suicidal self-injury. Journal of Clinical Psychology, 66(4), 466-473.
Naoum, J., Reitz, S., Krause-Utz, A., Kleindienst, N., Willis, F., Kuniss, S., Baumgartner, Ulf, 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.
Stacy, S. E., Pepper, C. M., Clapp, J. D., & Reyna, A. H. (2022). The effects of blood in self-injurious cutting: Positive and negative affect regulation. Journal of Clinical Psychology, 78(5), 926-937.
Hornbacher, A., Sax, W., Naoum, J., & Schmahl, C. (2023). The role of self and blood in ritual and nonritual self-injury. In E.E. Lloyd-Richardson, I. Baetens, & J. Whitlock (Eds.), The Oxford handbook of nonsuicidal self-injury (pp. 468-480). Oxford University Press.

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

Media & Self-Harm: What Helps, What Harms?, with Dr. Nicholas Westers

nicholas.westers@childrens.com (Nicholas J. Westers Psy.D. ABPP) — Fri, 21 Nov 2025 06:00:00 +0000

In this episode, host and producer of The Psychology of Self-Injury podcast, Dr. Nicholas Westers, shares his own thoughts about how media portray nonsuicidal self-injury (NSSI) as well as suicide and mass shootings. He walks us through media guidelines for responsibly reporting and depicting each in the news, including the first ever NSSI media guidelines he published with ISSS colleagues. This marks the second solo episode of the podcast.

Media Guidelines:

Suicide: Read the suicide reporting guidelines published by the World Health Organization (WHO) here, learn about ethical reporting guidelines for media put forth by the American Foundation for Suicide Prevention (AFSP) here, and visit reportingonsuicide.org to review those offered by Suicide Awareness Voices of Education (SAVE).
Mass Shootings: Read about media guidelines for responsible reporting on mass shootings put forth by the Radio Television Digital News Association (RTDNA) at www.rtdna.org/mass-shootings or visit reportingonmassshootings.org (this link is not currently active but could be reactivated in the future).
Nonsuicidal Self-Injury (NSSI): Read about our International Society for the Study of Self-Injury (ISSS) media guidelines for NSSI and self-harm below. Watch Dr. Westers' interview with the British Journal of Psychiatry, the journal that published these guidelines here. See excellent resources provided by the Self-Injury & Recovery Resources (SIRR) at Cornell University at selfinjury.bctr.cornell.edu, including resources for the media here. Below are additional resources referenced in this episode.

Westers, N. J., Lewis, S. P., Whitlock, J., Schatten, H. T., Ammerman, B., Andover, M. S., & Lloyd-Richardson, E. E.(2021). Media guidelines for the responsible reporting and depicting of non-suicidal self-injury. The British Journal of Psychiatry, 219(2), 415-418.
Westers, N. J. (2024). Media representations of nonsuicidal self-injury. In E. E. Lloyd-Richardson, I. Baetens, & J. Whitlock (Eds.), The Oxford handbook of nonsuicidal self-injury (pp. 771-786). Oxford University Press.
Phillips, D. P. (1974). The influence of suggestion on suicide: Substantive and theoretical implications of the Werther effect. American Sociological Review, 39(3), 340–354.
Niederkrotenthaler, T., Voracek, M., Herberth, A., Till, B., Strauss, M., Etzersdorfer, E., Eisenwort, B., & Sonneck, G. (2010). Role of media reports in completed and prevented suicide: Werther v. Papageno effects. The British Journal of Psychiatry, 197(3), 234– 243.

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

Trauma and Self-Injury, with Dr. Rachel Zelkowitz

nicholas.westers@childrens.com (Rachel Zelkowitz PhD) — Fri, 31 Oct 2025 05:00:00 +0000

In this episode, Dr. Rachel Zelkowitz defines trauma and its prevalence among individuals who self-injure, delineates posttraumatic stress disorder (PTSD) from complex PTSD (C-PTSD), and discusses common treatments for addressing trauma, including Cognitive Processing Therapy (CPT), Eye Movement Desensitization and Reprocessing (EMDR), and Prolonged Exposure (PE). With interest in treating military veterans and active duty service members, Dr. Zelkowitz provides insights into nonsuicidal self-injury (NSSI), self-harm, and trauma among military members.

Learn more about Dr. Zelkowitz and her work here, and learn more about common treatments for trauma at the National Center for PTSD at www.ptsd.va.gov.

Below are links to some of the research referenced in today's episode:

Gromatsky, M., Halverson, T. F., Dillon, K. H., Wilson, L. C., LoSavio, S. T., Walsh, S., Mellows, C., Mann, A. J., Goodman, M., & Kimbrel, N. A. (2023). The prevalence of nonsuicidal self-injury in military personnel: A systematic review and meta-analysis. Trauma Violence Abuse, 24(5), 2936-2952.
Liu, R. T., Scopelliti, K. M., Pittman, S. K., & Zamora, A. S. (2018). Childhood maltreatment and non-suicidal self- injury: A systematic review and meta-analysis. Lancet Psychiatry, 5(1), 51–64.
Harned, M. S., Korslund, K. E., Foa, E. B., & Linehan, M. M. (2012). Treating PTSD in suicidal and self-injuring women with borderline personality disorder: Development and preliminary evaluation of a Dialectical Behavior Therapy Prolonged Exposure Protocol. Behaviour Research and Therapy, 50(6), 381-6.
Harned, M. S., Schmidt, S. C., Korslund, K. E., & Gallop, R. J.(2021). Does adding the Dialectical Behavior Therapy Prolonged Exposure (DBT PE) protocol for PTSD to DBT improve outcomes in public mental health settings? A pilot nonrandomized effectiveness trial with benchmarking. Behavior Therapy, 52(3), 639-655.

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

Parenting with Lived Experience of Self-Injury, with Dr. Janis Whitlock

nicholas.westers@childrens.com (Janis Whitlock PhD) — Fri, 26 Sep 2025 05:00:00 +0000

Two topics are covered in this episode: (1) how parents with lived experience of nonsuicidal self-injury (NSSI) can navigate conversations with their children about their own scarring and wounds, and (2) how parents (with or without lived experience) can navigate conversations about self-injury with their young adult children when they turn 18.

Dr. Whitlock is emerita research faculty at Cornell University, a former Associate Director of the Bronfenbrenner Center for Translational Research, and the founder and director of the Self-Injury & Recovery Resources (SIRR) research program, which serves as one of the best and most comprehensive collations of online resources about self-injury: www.selfinjury.bctr.cornell.edu. It is a go-to resource for parents, therapists, friends, family members, schools, other caring adults, the media, and individuals with lived experience of self-injury. Dr. Whitlock is also Senior Advisor for The JED Foundation. To learn more about The JED Foundation, visit https://www.jedfoundation.org/.

Below is some of the work referenced in this episode:

Whitlock, J., & Lloyd-Richardson, E. E. (2019). Healing self-injury: A compassionate guide for parents and other loved ones. Oxford University Press.
Taliaferro, L. A., Jang, S. T., Westers, N. J., Muehlenkamp, J. J., Whitlock, J. L., & McMorris, B. J. (2020). Associations between connections to parents and friends and non-suicidal self-injury among adolescents: The mediating role of developmental assets. Clinical Child Psychology and Psychiatry, 25(2), 359-371.
Kibitov, A. A., & Mazo, G. E. (2023). Genetics and epigenetics of nonsuicidal self-injury: A narrative review. Russian Journal of Genetics, 59(12), 1265-1276.
Dawkins, J., Hasking, P., & Boyes, M. (2021). Knowledge of parental nonsuicidal self-injury in young people who self-injure: The mediating role of outcome expectancies. Journal of Family Studies, 27(4), 479–490.

Want to have a bigger role on the podcast?:

Should you or someone you know be interviewed on the podcast? We want to know! Please fill out this Google doc form, and we will be in touch with more details if it’s a good fit.
Want to hear your question and have it answered on the podcast? Please send an audio clip of your question (60 seconds or less) to @DocWesters on Instagram or Twitter/X, or email us at thepsychologyofselfinjury@gmail.com
Want to be involved in research? Send us a message at thepsychologyofselfinjury@gmail.com and we will see if we can match you to an active study.
Want to interact with us through comments and polls? You can on Spotify!

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

DSM Update: Nonsuicidal Self-Injury Disorder, or a Clinical Specifier?

Fri, 29 Aug 2025 05:00:00 +0000

In this episode, four of the top experts in researching and treating nonsuicidal self-injury (NSSI) talk about the research behind NSSI Disorder, the evolution of how they now think about NSSI within the context of the DSM, and why they now advocate for an NSSI specifier rather than an NSSI Disorder in the DSM. They also delineate their proposed criteria for self-harm as a specifier and both the positive and negative consequences of doing so.

Below are papers referenced in this episode:

Lengel, G. J., Muehlenkamp, J. J., Zetterqvist, M., Ammerman, B. A., Brausch, A. M., & Washburn, J. J. (2025). Non-suicidal self-injury: proposal to shift designation from disorder to a clinical specifier. The Lancet Psychiatry. Online advanced publication.
Shaffer, D., & Jacobson, C. (2009). Proposal to the DSM-V childhood disorder and mood disorder work groups to include non-suicidal self-injury (NSSI) as a DSM-V disorder. American Psychiatric Association, 1-21.
Muehlenkamp, J. J. (2005). Self-injurious behavior as a separate clinical syndrome. American Journal of Orthopsychiatry, 75(2), 324–333.
Brausch, A. (2019). Diagnostic classification of nonsuicidal self-injury. In J. J. Washburn (Ed.), Nonsuicidal self-injury: Advances in research and practice (pp. 71-87). Routledge.

NONSUICIDAL SELF-INJURY SPECIFIER (PROPOSED CRITERIA):

A. The specifier should be used when the nonsuicidal self-injury (NSSI) behavior is characterized by the following:

The individual intentionally engages in NSSI behavior to inflict bodily damage or pain
The individual's NSSI behavior is recent, such that it occurred at least once during the past month
The individual’s NSSI behavior is repetitive, such that it occurred on about 5 or more days in an individual’s lifetime

Note: culturally specific NSSI behavior (e.g., piercings and tattoos) and harm that is habitual (e.g., scab picking, nail biting, and hair pulling) should not be considered to be NSSI unless the behavior is explicitly for the purposes of causing damage or pain to one’s body. The NSSI specifier can still be applied if the behavior occurs under the influence of substances, as long as the behavior meets the required features.

Coding note: use code Z91.52 for individuals with a previous history of NSSI when all criteria except for recency are met (A2).

Want to have a bigger role on the podcast?:

Should you or someone you know be interviewed on the podcast? We want to know! Please fill out this Google doc form, and we will be in touch with more details if it’s a good fit.
Want to hear your question and have it answered on the podcast? Please send an audio clip of your question (60 seconds or less) to @DocWesters on Instagram or Twitter/X, or email us at thepsychologyofselfinjury@gmail.com
Want to be involved in research? Send us a message at thepsychologyofselfinjury@gmail.com and we will see if we can match you to an active study.
Want to interact with us through comments and polls? You can on Spotify!

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

Help-Seeking for Self-Injury, with Nani Kim, RN

nicholas.westers@childrens.com (Nani Kim RN) — Fri, 25 Jul 2025 05:00:00 +0000

In this episode, Nani Kim, RN from the University of Texas at Austin talks all things help-seeking for nonsuicidal self-injury (NSSI). This includes common reasons people give for choosing to seek help for self-harm, common forms of help-seeking behavior for NSSI, how often individuals who self-injure seek help for their self-injury, why they choose to seek help, what types of help they receive, and what happens when they seek help for self-injury.

Below are a few references from this episode:

Kim, N., Young, C. C., Kim, B. R., Rew, L., & Westers, N. J. (in press). Help-seeking behaviors in adolescents and young adults who engage in nonsuicidal self-injury: An integrative review. Journal of Adolescent Health. Advance online publication (free to access through August 7, 2025).
Nadler, A. (1987). Determinants of help seeking behaviour: The effects of helper’s similarity, task centrality and recipient’s self esteem. European Journal of Social Psychology, 17(1), 57-67.
Mackesy, C. (2019). The boy, the mole, the fox and the horse: Inspiring conversations on hope, love and personal growth. HarperOne.

Want to have a bigger role on the podcast?:

Should you or someone you know be interviewed on the podcast? We want to know! Please fill out this Google doc form, and we will be in touch with more details if it’s a good fit.
Want to hear your question and have it answered on the podcast? Please send an audio clip of your question (60 seconds or less) to @DocWesters on Instagram or Twitter/X, or email us at thepsychologyofselfinjury@gmail.com
Want to be involved in research? Send us a message at thepsychologyofselfinjury@gmail.com and we will see if we can match you to an active study.
Want to interact with us through comments and polls? You can on Spotify!

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

Why Do People Self-Injure? Part 2, with Dr. Kirsty Hird

nicholas.westers@childrens.com (Kirsty Hird PhD) — Fri, 27 Jun 2025 05:00:00 +0000

Dr. Kirsty Hird, a Research Officer in the Youth Mental Health team at The Kids Research Institute Australia, adds to Episode 1 of The Psychology of Self-Injury podcast by explaining in depth and in layman's terms why people self-injure according to the six most common/popular theoretical models. Connect with Dr. Hird on LinkedIn here, view her staff profile here, and follow her on ResearchGate here. Below are two of her papers related to today's interview as well as a few other resources referenced in this episode:

Hird, K., Hasking, P., & Boyes, M. (2023). A comparison of the theoretical models of NSSI. In E.E. Lloyd-Richardson, I. Baetens, & J. Whitlock (Eds.), The Oxford handbook of nonsuicidal self-injury (pp. 24-40). Oxford University Press.
Hird, K., Hasking, P., & Boyes, M. (2022). Relationships between outcome expectancies and non-suicidal self-injury: Moderating roles of emotion regulation difficulties and self-efficacy to resist self-injury. Archives of Suicide Research, 26(4), 1688-1701.
Gray, N., Uren, H., Pemberton, E., & Boyes, M. (2023). Profiling ambivalence in the context of nonsuicidal self-injury. Journal of Clinical Psychology, 79(8), 1699-1712.
Ramsey, W. A., Berlin, K. S., Del Conte, G., Lightsey, O. R., Schimmel-Bristow, A., Marks, L. R., & Strohmer, D. C. (2021). Targeting self-criticism in the treatment of nonsuicidal self-injury in dialectical behavior therapy for adolescents: a randomized clinical trial. Child and Adolescent Mental Health, 26(4), 320-330.
Gratz, K., & Tull, M. (2025). Acceptance-based emotion regulation therapy: A clinician’s guide to treating emotion dysregulation and self-destructive behaviors using an evidence-based therapy drawn from ACT and DBT. Harbinger Press.

Below are links to the original 6 theoretical models discussed in this episode:

Four Function Model - Nock, M. K., & Prinstein, M. J. (2004). A functional approach to the assessment of self-mutilative behavior. Journal of Consulting and Clinical Psychology, 72(5), 885–890.
Experiential Avoidance Model - Chapman, A. L., Gratz, K. L., & Brown, M. Z. (2006). Solving the puzzle of deliberate self-harm: The experiential avoidance model. Behaviour Research and Therapy, 44(3), 371–394.
Emotional Cascade Model - Selby, E. A., & Joiner, T. E. (2009). Cascades of emotion: The emergence of borderline personality disorder from emotional and behavioral dysregulation. Review of General Psychology, 13(3), 219–229.
Integrated Model - Nock, M. K. (2010). Self-injury. Annual Review of Clinical Psychology, 6(1), 339–363.
Cognitive-Emotional Model - Hasking, P., Whitlock, J., Voon, D., & Rose, A. (2017). A cognitive-emotional model of NSSI: Using emotion regulation and cognitive processes to explain why people self-injure. Cognition and Emotion, 31(8), 1543–1556.
Barriers and Benefits Model - Hooley, J. M., & Franklin, J. C. (2018). Why do people hurt themselves? A new conceptual model of nonsuicidal self-injury. Clinical Psychological Science, 6(3), 428–451.

Want to have a bigger role on the podcast?:

Should you or someone you know be interviewed on the podcast? We want to know! Please fill out this Google doc form, and we will be in touch with more details if it’s a good fit.
Want to hear your question and have it answered on the podcast? Please send an audio clip of your question (60 seconds or less) to @DocWesters on Instagram or Twitter/X, or email us at thepsychologyofselfinjury@gmail.com
Want to be involved in research? Send us a message at thepsychologyofselfinjury@gmail.com and we will see if we can match you to an active study.
Want to interact with us through comments and polls? You can on Spotify!

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

Self-Harm in Older Adults, with Dr. Lisa Van Hove

nicholas.westers@childrens.com (Lisa Van Hove) — Fri, 30 May 2025 05:00:00 +0000

Just how prevalent is self-injury among older adults, specifically those ages 60 and over? 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. Lisa Van Hove from Vrije Universiteit Brussel (Brussels University) is the first to reveal the prevalence of self-injury and self-harm among older adults.

To read Dr. Van Hove's info brief on NSSI in older adults through the Cornell Research Program on Self-Injury and Recovery Resources (SIRR), visit https://www.selfinjury.bctr.cornell.edu/perch/resources/older-adult-fact-sheet-1.pdf. To see Dr. Van Hove's publications, including those about self-injury among older adults, click here. Connect with Dr. Van Hove on LinkedIn here. Below is some of her research and that of others referenced in this episode:

Van Hove, L., Baetens, I., Hamza, C., Dierckx, E., Haekens, A., Fieremans, L., & Vanderstichelen, S. (2023). NSSI in older adults. In E.E. Lloyd-Richardson, I. Baetens, & J. Whitlock (Eds.), The Oxford handbook of nonsuicidal self-injury (pp. 572-592). Oxford University Press.
Van Hove, L., Baetens, I., & Vanderstichelen, S. (2025). Psychogeriatric experts’ experiences with risk factors of suicidal and non-suicidal self-injury in older adults: A qualitative study. Qualitative Research in Medicine and Healthcare, 8(1).
Van Hove, L., Baetens, I., & Vanderstichelen, S. (2024). Conceptualizing self-harm through the experiences of psychogeriatric experts. Psychopathology, 57(4), 277-285.
Van Hove, L., Nieuwenhuijs, B. M., Vanderstichelen, S., De Witte, N., Gorus, E., Stas, L., & Baetens, I. (2025). Biopsychosocial profile of community-dwelling older adults at risk for direct and indirect self-harm. Clinical Gerontologist, 1–12.
Van Hove, L., Facon M., Baetens, I., Vanderstichelen, S., Dierckx, E., Van Alphen, S.P.J., Stas, L., & Rossi, G. (2025). Development of an at-risk personality profile for (in)direct self-harm engagement in older age. Journal of Personality Disorders, 39(3), 240-262.
Murphy, E., Kapur, N., Webb, R., Purandare, N., Hawton, K., Bergen, H., Waters, K., & Cooper, J. (2012). Risk factors for repetition and suicide following self-harm in older adults: multicentre cohort study. British Journal of Psychiatry, 200(5), 399-404.
Martin, G., & Swannell, S. (2016). Non-suicidal self-injury in the over 40s: Results from a large national epidemiological survey. Epidemiology (Sunnyvale), 6(5), 266.
Choi, N. G., DiNitto, D. M., Marti, C. N., & Choi, B. Y. (2016). Nonsuicidal self-injury and suicide attempts among ED patients older than 50 years: comparison of risk factors and ED visit outcomes. The American Journal of Emergency Medicine, 34(6), 1016-1021.
Ose, S. O., Tveit, T., & Mehlum, L. (2021). Non-suicidal self-injury (NSSI) in adult psychiatric outpatients – A nationwide study. Journal of Psychiatric Research, 133, 1-9.
Wiktorsson, S., Strömsten, L., Renberg, E. S., Runeson, B., & Waern, M. (2022). Clinical characteristics in older, middle-aged and young adults who present with suicide attempts at psychiatric emergency departments: A multisite study. The American Journal of Geriatric Psychiatry, 30(3), 342-351.
Gratz, K. L., & Tull, M. T. (2025). Acceptance-based emotion regulation therapy: A clinician’s guide to treating emotion dysregulation & self-destructive behaviors using an evidence-based therapy drawn from ACT & DBT. Context Press.

Want to have a bigger role on the podcast?:

Should you or someone you know be interviewed on the podcast? We want to know! Please fill out this Google doc form, and we will be in touch with more details if it’s a good fit.
Want to hear your question and have it answered on the podcast? Please send an audio clip of your question (60 seconds or less) to @DocWesters on Instagram or Twitter/X, or email us at thepsychologyofselfinjury@gmail.com
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Follow Dr. Westers on Instagram and Twitter/X (@DocWesters). To join ISSS, visit itriples.org and follow ISSS on Facebook and Twitter/X (@ITripleS).

Does Conflict About One’s Gender Role Predict Self-Injury?, with Dr. Moye Xin

nicholas.westers@childrens.com (Moye Xin PhD) — Fri, 25 Apr 2025 05:00:00 +0000

In this episode, Dr. Moye Xin from Xi'an University in the Shaanxi Province of central China discusses how nonsuicidal self-injury (NSSI) is viewed in Asia and shares his thoughts about how gender role conflict may affect rates of self-harm among university students, particularly young Chinese men. Connect with Dr. Xin on ResearchGate at www.researchgate.net/profile/Moye-Xin or visit his work on SciProfiles at sciprofiles.com/profile/1469611.

Below are a few of his research studies referenced in this episode:

Xin, M., Petrovic, J., Yang, C., Zhang L., & Yang, X. (2024). Nonsuicidal self-injury among Chinese university students during the post-COVID-19 era: analysis of sex differences and the impact of gender role conflict. Frontiers in Psychology, 15, 1362762.
Xin, M., Zhang, L., Yang, C., Yang, X., and Xiang, M. (2022). Risky or protective? Online social support's impact on nssi amongst Chinese youth experiencing stressful life events. BMC Psychiatry, 22, 782.
Yang, X., & Xin, M. (2018). "Boy crisis" or "girl risk"? The gender difference in nonsuicidal self-injurious behavior among middle-school students in China and its relationship to gender role conflict and violent experiences. American Journal of Men's Health, 12(5), 1275–1285.

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Want to hear your question and have it answered on the podcast? Please send an audio clip of your question (60 seconds or less) to @DocWesters on Instagram or Twitter/X, or email us at thepsychologyofselfinjury@gmail.com
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Follow Dr. Westers on Instagram and Twitter/X (@DocWesters). To join ISSS, visit itriples.org and follow ISSS on Facebook and Twitter/X (@ITripleS).

Lived Experience: Ben's Story of Self-Injury

nicholas.westers@childrens.com (Ben Moroski) — Fri, 28 Mar 2025 05:00:00 +0000

In this episode, Ben Moroski from Los Angeles, CA, shares his story of lived experience of self-injury that began at age 17 when he and his family found themselves in a religious cult. He articulately communicates therapeutic gems he has learned throughout his journey of recovery while remaining honest with how he manages persisting urges to self-harm. Watch his autobiographical solo one man play about his struggle with self-injury at https://vimeo.com/107909913, and follow him on Instagram @bmoroski.

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Want to hear your question and have it answered on the podcast? Please send an audio clip of your question (60 seconds or less) to @DocWesters on Instagram or Twitter/X, or email us at thepsychologyofselfinjury@gmail.com
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Follow Dr. Westers on Instagram and Twitter/X (@DocWesters). To join ISSS, visit itriples.org and follow ISSS on Facebook and Twitter/X (@ITripleS).

Self-Injury Awareness Day (March 1), with Drs. Sylvanna Mirichlis & Stephen Lewis

nicholas.westers@childrens.com (Sylvanna Mirichlis PhD, Stephen P. Lewis PhD) — Fri, 28 Feb 2025 06:00:00 +0000

In this episode, Dr. Sylvanna Mirichlis from Curtin University in Perth, Australia, and ISSS Past President Dr. Stephen Lewis from the University of Guelph in Ontario, Canada share about the origins of the annual March 1st Self-Injury Awareness Day (SIAD), what people around the world are doing as part of this day, and what our ISSS Stigma, Recovery, and Lived Experience Special Interest Group is doing to boost awareness of self-injury. We also share some of our favorite clips from past episodes.

Self-Injury Resources:

International Society for the Study of Self-Injury (ISSS) (https://itriples.org/
Self-injury Outreach & Support (SiOS) (http://sioutreach.org/)
Cornell's Self-Injury & Recovery Resources (SIRR) (www.selfinjury.bctr.cornell.edu)
Shedding Light on Self-Injury (https://www.self-injury.org.au/)
Lewis, S. P., & Hasking, P. A. (2023). Understanding self-injury: A person-centered approach. Oxford University Press.
To watch Dr. Lewis' TEDx talk about his own lived experience of self-injury on YouTube, visit https://youtu.be/G17iMOw0ar8.

Timestamps for clips from past episodes:

37:37 - Lived experience: Kirsty's story of self-injury & advocacy (Season 2, Episode 30)
43:41 - Psychologists with lived experience of self-injury, with Dr. Sarah Victor (Season 1, Episode 9)
45:25 - Self-injury stigma and language, with Dr. Penelope Hasking (Season 1, Episode 4)
48:26 - Lived experience: Thomas' story of self-injury & gender dysphoria (Season 4, Episode 48)
52:48 - Self-harm across cultures, with Dr. Marc Wilson (Season 2, Episode 24)
56:39 - The psychology of self-injury scarring, with Dr. Taylor Burke (Season 2, Episode 31)
1:01:52 - A dad & daughter discuss her lived experience of self-harm (Season 3, Episode 37)
1:15:15 - Parenting youth who self-injure, with Dr. Janis Whitlock (Season 1, Episode 3)
1:23:49 - Supporting siblings of individuals who self-harm, with Dr. Amy Lucas (Season 4, Episode 46)

Want to have a bigger role on the podcast?:

Should you or someone you know be interviewed on the podcast? We want to know! Please fill out this Google doc form, and we will be in touch with more details if it’s a good fit.
Want to hear your question and have it answered on the podcast? Please send an audio clip of your question (60 seconds or less) to @DocWesters on Instagram or Twitter/X, or email us at thepsychologyofselfinjury@gmail.com
Want to be involved in research? Send us a message at thepsychologyofselfinjury@gmail.com and we will see if we can match you to an active study.
Want to interact with us through comments and polls? You can on Spotify!

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

Are Therapists Willing to Treat Self-Injury?, with Spencer Ellison & Dr. Jennifer Muehlenkamp

nicholas.westers@childrens.com (Spencer Ellison, Jennifer Muehlenkamp PhD) — Fri, 31 Jan 2025 06:00:00 +0000

In this episode, Spencer Ellison and Dr. Jennifer Muehlenkamp read a hypothetical case vignette of a client who engages in nonsuicidal self-injury (NSSI), has experienced suicidal thoughts or behaviors, or is experiencing significant depression. They then tell us how willing therapists are to treat each case (self-injury vs. suicide vs. depression), if therapists would accept them into their clinical practice, and if it depends on the therapists' (1) liability concerns, (2) comfort/skill confidence to treat self-harm, (3) attitude toward self-harm in general, and (4) attitude towards clients who self-harm.

Learn more about Dr. Muehlenkamp at her University of Wisconsin-Eau Claire faculty page here, and see her growing list of peer-reviewed publications on Google Scholar here. Learn more about Trinity Equestrian Center at www.trinity-ec.com. Below are a couple research studies referenced in this episode:

Levi-Belz, Y., Barzilay, S., Levy, D., & David, O. (2020). To treat or not to treat: The effect of hypothetical patients' suicidal severity on therapists' willingness to treat. Archives of Suicide Research, 24(3), 355-366.
Groth, T., & Boccio, D. E. (2019). Psychologists’ willingness to provide services to individuals at risk of suicide. Suicide and Life-Threatening Behavior, 49(5), 1241-1254.

Want to have a bigger role on the podcast?:

Should you or someone you know be interviewed on the podcast? We want to know! Please fill out this Google doc form, and we will be in touch with more details if it’s a good fit.
Want to hear your question and have it answered on the podcast? Please send an audio clip of your question (60 seconds or less) to @DocWesters on Instagram or Twitter/X, or email us at thepsychologyofselfinjury@gmail.com
Want to be involved in research? Send us a message at thepsychologyofselfinjury@gmail.com and we will see if we can match you to an active study.
Want to interact with us through comments and polls? You can on Spotify!

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

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Paramedical Tattooing for Self-Harm Scars, with Tattoo Artist Elena & Her Client

nicholas.westers@childrens.com (Illusions by Ink, Elena Sanchez) — Sat, 28 Dec 2024 06:00:00 +0000

What is paramedical tattooing and scar camouflage and how is it different than other treatments for self-injury scars? Not everyone with lived experience of nonsuicidal self-injury (NSSI) wants or needs to address self-harm scars, but some may choose to reduce or get rid of them as part of their recovery journey. Elena from Illusions by Ink Studio (https://illusionsbyinkstudio.com/) walks us through her approach to paramedical tattooing for self-injury. Her client "H" joins the conversation, sharing her experience as someone with lived experience of NSSI and why she chose this type of tattooing for her self-injury scars.

Connect with Elena on Instagram @illusionsbyink_studio, on Facebook here, and on YouTube @Scarcamouflagetattoo. You can reach her at elena@illusionsbyinkstudio.com. Below are a couple papers referenced in this episode:

Allroggen, M., Kleinrahm, R., Rau, T. A. D., Weninger, L., Ludolph, A. G., & Plener, P. L. (2014). Nonsuicidal self-injury and its relation to personality traits in medical students. The Journal of Nervous and Mental Disease, 202(4), 300-304.
Plener, P. L., Brunner, R., Fegert, J. M., Groschwitz, R. C., In-Albon, T., Kaess, M., Kapusta, N. D., Resch, F., & Becker, K. (2016). Treating nonsuicidal self-injury (NSSI) in adolescents: consensus based German guidelines. Child and Adolescent Psychiatry and Mental Health, 10(46).

Want to have a bigger role on the podcast?:

Should you or someone you know be interviewed on the podcast? We want to know! Please fill out this Google doc form, and we will be in touch with more details if it’s a good fit.
Want to hear your question and have it answered on the podcast? Please send an audio clip of your question (60 seconds or less) to @DocWesters on Instagram or Twitter/X, or email us at thepsychologyofselfinjury@gmail.com
Want to be involved in research? Send us a message at thepsychologyofselfinjury@gmail.com and we will see if we can match you to an active study.
Want to interact with us through comments and polls? You can on Spotify!

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

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Lived Experience: Ellie's Story of Atypical Severe Self-Harm

nicholas.westers@childrens.com (Ellie Wildbore, Shami) — Sat, 30 Nov 2024 06:00:00 +0000

In this episode, Ellie from the United Kingdom and National Health Service (NHS) shares her lived experience of atypical severe self-injury while participating in a psychiatric inpatient stay for an acute increase in severity of eating disorder symptoms. She discusses how she has used her experiences as a patient and recipient of mental healthcare in the UK to bring about systemic change, participate as a co-producer and research, and advocate for those with lived experience of nonsuicidal self-injury (NSSI) and self-harm. While participating in our interview while in inpatient care, we invite her live-in care provider (i.e., carer), Shami, to join our conversation and offer her own insights.

Connect with Ellie on LinkedIn here and on Twitter/X @EllieWildbore or @elliewildbore.bsky.social. Visit her blog at https://balancingontheborderline.home.blog/. Here are two links to Ellie being interviewed about lived experience research and her work on YouTube with the Mental Elf: https://youtu.be/HezHKYrF7zM and https://youtu.be/IA91M6fGaQo. Read the pre-print of her article referenced in this episode available for free here. Learn more about Atypical Severe Self-Injury by listening to our episode with Dr. Barry Walsh on the topic from Season 1 here.

Want to have a bigger role on the podcast?:

Should you or someone you know be interviewed on the podcast? We want to know! Please fill out this Google doc form, and we will be in touch with more details if it’s a good fit.
Want to hear your question and have it answered on the podcast? Please send an audio clip of your question (60 seconds or less) to @DocWesters on Instagram or Twitter/X, or email us at thepsychologyofselfinjury@gmail.com
Want to be involved in research? Send us a message at thepsychologyofselfinjury@gmail.com and we will see if we can match you to an active study.
Want to interact with us through comments and polls? You can on Spotify!

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

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Self-Injury Among Ethnically Diverse Populations, with Dr. Maryam Gholamrezaei

nicholas.westers@childrens.com (Maryam Gholamrezaei PhD) — Fri, 25 Oct 2024 05:00:00 +0000

In this episode, Maryam Gholamrezaei, PhD, C.Psych, shares about her interviews with racially and ethnically diverse individuals who self-injure, including their responses to her question, “In your culture, what is the general response to people who engage in self-harming behaviors?” She also discusses gender differences in nonsuicidal self-injury (NSSI) among different ethnic groups and offers unique insights into how the geopolitical landscape of the Middle East may influence an individual's decision to self-harm.

Learn more about Dr. Gholamrezaei on her website at https://drmaryamgholamrezaei.ca/. Below are some publications written by Dr. Gholamrezaei as well as Dr. Westers' editorial:

Gholamrezaei, M., Heath, N. L., Pereira, L., De Stefano, J., & Böke, B. N. (2023). Nonsuicidal self-injury, mental health service use, and cultural perspectives among ethnically diverse university students. Canadian Journal of Community Mental Health, 42(1), 15-40.
Gholamrezaei, M., De Stefano, J., & Heath, N. L. (2017). Nonsuicidal self-injury across cultures and ethnic and racial minorities: A review. International Journal of Psychology, 52(4), 316–326.
Gholamrezaei, M., Heath, N., & Panaghi, L. (2016). Non-suicidal self-injury in a sample of university students in Tehran, Iran: prevalence, characteristics and risk factors. International Journal of Culture and Mental Health, 10(2), 136–149.
Westers, N. J. (2024). Cultural interpretations of nonsuicidal self-injury and suicide: Insights from around the world. Clinical Child Psychology and Psychiatry, 29(4), 1231-1235.

Want to have a bigger role on the podcast?:

Should you or someone you know be interviewed on the podcast? We want to know! Please fill out this Google doc form, and we will be in touch with more details if it’s a good fit.
Want to hear your question and have it answered on the podcast? Please send an audio clip of your question (60 seconds or less) to @DocWesters on Instagram or Twitter/X, or email us at thepsychologyofselfinjury@gmail.com
Want to be involved in research? Send us a message at thepsychologyofselfinjury@gmail.com and we will see if we can match you to an active study.
Want to interact with us through comments and polls? You can on Spotify!

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

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Effects of Emotions on Self-Injury Pain Perception, with Michelle Hiner

nicholas.westers@childrens.com (Michelle Hiner) — Fri, 27 Sep 2024 05:00:00 +0000

Does the emotion someone experiences immediately preceding an episode of nonsuicidal self-injury (NSSI) influence how painful that episode of self-harm feels? In this episode, Michelle Hiner, MS, a Clinical Psychology PhD student in the Emotion and Psychopathology (EmP) Lab at Rutgers University in New Jersey talks about how individuals who self-harm after experiencing high arousal negative emotions (HANEs), like anger, experience pain differently than those who self-injure after experiencing low arousal negative emotions (LANEs), like sadness and dissociation.

Connect with Michelle on LinkedIn here, and learn more about the Emotion and Psychopathology (EmP) Lab here. Below are some papers referenced in this episode:

Drummond, P. D. (1995). Noradrenaline increases hyperalgesia to heat in skin sensitized by capsaicin. Pain, 60(3), 311-315.
Wiercioch-Kuzianik, K., & Bąbel, P. (2019). Color hurts. The effect of color on pain perception. Pain Medicine, 20(10), 1955-1962.
Paul, E., Tsypes, A., Eidlitz, L., Ernhout, C., & Whitlock, J. (2015). Frequency and functions of non-suicidal self-injury: Associations with suicidal thoughts and behaviors. Psychiatry Research, 225(3), 276–282.

Want to have a bigger role on the podcast?:

Should you or someone you know be interviewed on the podcast? We want to know! Please fill out this Google doc form, and we will be in touch with more details if it’s a good fit.
Want to hear your question and have it answered on the podcast? Please send an audio clip of your question (60 seconds or less) to @DocWesters on Instagram or Twitter/X, or email us at thepsychologyofselfinjury@gmail.com
Want to be involved in research? Send us a message at thepsychologyofselfinjury@gmail.com and we will see if we can match you to an active study.
Want to interact with us through comments and polls? You can on Spotify!

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

Goodpods Top 100 Parents Podcasts Listen now to The Psychology of Self-Injury: Exploring
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Emotion Regulation Individual Therapy for Adolescents (ERITA) Who Self-Harm, with Dr. Johan Bjureberg

nicholas.westers@childrens.com (Johan Bjureberg PhD) — Fri, 30 Aug 2024 05:00:00 +0000

Bjureberg, J., Ojala, O., Hesser, H., Häbel, H., Sahlin, H., Gratz, K. L., Tull, M. T., Knutsson, E. C., Hedman-Lagerlöf, E., Ljótsson, B., & Hellner, C. (2023). Effect of internet-delivered Emotion Regulation Individual Therapy for Adolescents with Nonsuicidal Self-Injury Disorder: A randomized clinical trial. JAMA Network Open, 6(7), e2322069.
Bjureberg, J., Sahlin, H., Hedman-Lagerlof, E., Gratz, K. L., Tull, M. T., Jokinen, J., Hellner, C., & Ljotsson, B. (2018). Extending research on emotion regulation individual therapy for adolescents (ERITA) with nonsuicidal self-injury disorder: Open pilot trial and mediation analysis of a novel online version. BMC Psychiatry, 18, 326.
Bjureberg, J., Sahlin, H., Hellner, C., Hedman-Lagerlof, E., Gratz, K. L., Bjarehed, J., Jokinen, J., Tull, M. T., & Ljotsson, B. (2017). Emotion regulation individual therapy for adolescents with nonsuicidal self-injury disorder: A feasibility study. BMC Psychiatry, 17, 411.

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

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Tips for Supporting Those Who Self-Harm, with Dr. Nicholas Westers

nicholas.westers@childrens.com (Nicholas J. Westers Psy.D. ABPP) — Fri, 26 Jul 2024 05:00:00 +0000

In this episode, host and producer of The Psychology of Self-Injury podcast, Dr. Nicholas Westers, shares his own thoughts about what we should consider when supporting friends, families, clients, and patients who engage in nonsuicidal self-injury (NSSI). This marks the first solo episode of the podcast, and Dr. Westers offers ways for listeners to have a bigger role on the podcast, including:

Should you or someone you know be interviewed on the podcast? We want to know! Please fill out this Google doc form, and we will be in touch with more details if it’s a good fit.
Want to hear your question and have it answered on the podcast? Please send an audio clip of your question (60 seconds or less) to @DocWesters on Instagram or Twitter/X, or email us at thepsychologyofselfinjury@gmail.com
Want to be involved in research? Send us a message at thepsychologyofselfinjury@gmail.com and we will see if we can match you to an active study.
Want to interact with us through comments and polls? You can on Spotify!

Below are a couple papers related to this episode with Dr. Westers:

Westers, N. J., Rehfuss, M., Olson, L., & Biron, D. (2012). The role of forgiveness in adolescents who engage in nonsuicidal self-injury. The Journal of Nervous and Mental Disease, 200(6), 535-541.
Westers, N. J., & Tinsley, B. (2023). Nonsuicidal self-injury risk assessment, intervention, and guidance for first responders and medical settings. In E. E. Lloyd-Richardson, I. Baetens, & J. Whitlock (Eds.), The Oxford handbook of nonsuicidal self-injury (pp. 873–893). Oxford University Press.

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

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Social Media, Meta, & Self-Injury, with Lotte Rubæk

nicholas.westers@childrens.com (Lotte Rubæk) — Fri, 28 Jun 2024 05:00:00 +0000

In this episode, Lotte Rubæk, MSc, who leads the Self-Injury Team in Child and Adolescent Psychiatry in the Capital Region of Denmark, talks about why interaction on image-based social media platforms like Instagram can be particularly appealing to young people who self-harm. She discusses the dynamics that can arise between users in the more closed social media networks, and she explains why she so publicly resigned from Meta's global expert panel on self-harm after serving on it for 3.5 years.

Connect with Lotte on LinkedIn here, and read The Guardian's article about her decision to resign from Meta here. Listen to her podcast, Selvskadens Psykologi, which means The Psychology of Self-Injury in Danish, here. Read about the U.S. Surgeon General's May 2023 advisory about the effects social media use has on youth mental health here, and read about his June 2024 call on Congress to require warning labels on social media platforms and their effects on young people’s lives here.

Below are Lotte's two book chapters in the new Oxford Handbook of Nonsuicidal Self-Injury and a few additional papers related to social media and self-injury:

Rubæk, L., & Møhl, B. (2023). Direct and indirect self-injury. In E. E. Lloyd-Richardson, I. Baetens, & J. Whitlock (Eds.), The Oxford handbook of nonsuicidal self-injury (pp. 41-71). Oxford University Press.
Møhl, B., & Rubæk, L. (2023). Understanding the link between direct and indirect self-injurious behavior. In E. E. Lloyd-Richardson, I. Baetens, & J. Whitlock (Eds.), The Oxford handbook of nonsuicidal self-injury (pp. 680-701). Oxford University Press.
Westers, N. J., Lewis, S. P., Whitlock, J., Schatten, H. T., Ammerman, B., Andover, M. S., & Lloyd-Richardson, E. E.(2021). Media guidelines for the responsible reporting and depicting of non-suicidal self-injury. The British Journal of Psychiatry, 219(2), 415-418.
Zhu, L., Westers, N. J.,Horton, S. E., King, J. D., Diederich, A., Stewart, S. M., & Kennard, B. D. (2016). Frequency of exposure to and engagement in nonsuicidal self-injury among inpatient adolescents. Archives of Suicide Research, 20(4), 580-590.
Bridge, J. A., Greenhouse, J. B., Ruch, D., Stevens, J., Ackerman, J., Sheftall, A. H., Horowitz, L. M., Kelleher, K. J., & Campo, J. V. (2020). Association between the release of Netflix’s 13 Reasons Why and suicide rates in the United States: An interrupted time series analysis. Journal of the American Academy of Child & Adolescent Psychiatry, 59(2), 236-243.

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

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.

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Self-Criticism as a Predictor of Self-Injury, with Christina Robillard

nicholas.westers@childrens.com (Christina Robillard) — Fri, 31 May 2024 05:00:00 +0000

In this episode, Christina Robillard talks about how self-criticism can lead to increases in self-injury urges within the next two hours as well as the relationship between self-criticism and disordered eating. She explains how she and her team use ecological momentary assessment (EMA; see Season 1, Episode 11 with Dr. Glenn Kiekens) to assess self-criticism in real time.

Connect with Christina on LinkedIn here. See Christina's academic page at the University of Victoria here and her Google Scholar page here. Below are links to some of her papers as well as one about self-criticism and pain:

Robillard, C. L., Merrin, G. J., Legg, N. K., Ames, M. E., & Turner, B. J. (2024). Different self-damaging behaviours, similar motives? Testing measurement invariance of motives for nonsuicidal self-injury, disordered eating and substance misuse. British Journal of Clinical Psychology. Advance online publication.
Robillard, C. L., Legg, N. K., Ames, M. E., & Turner, B. J. (2022). Support for a transdiagnostic motivational model of self-damaging behaviors: Comparing the salience of motives for binge drinking, disordered eating, and nonsuicidal self-injury. Behavior Therapy, 53(6), 1219-1232.
Robillard, C. L., Chapman, A. L., & Turner, B. J. (2022). Learning from experience: Within- and between-person associations of the consequences, frequency, and versatility of nonsuicidal self-injury. Suicide and Life-Threatening Behavior, 52(5), 836-847.
Robillard, C. L., Turner, B. J., Ames, M. E., & Craig, S. G. (2021). Deliberate self-harm in adolescents during COVID-19: The roles of pandemic-related stress, emotion regulation difficulties, and social distancing. Psychiatry Research, 304, 114152.
Fox, K. R., O'Sullivan, I. M., Wang, S. B., & Hooley, J. M. (2019). Self-criticism impacts emotional responses to pain. Behavior Therapy, 50(2), 410-420.

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

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.

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Lived Experience: Thomas' Story of Self-Injury & Gender Dysphoria

nicholas.westers@childrens.com (Nicholas J. Westers Psy.D. ABPP) — Fri, 26 Apr 2024 05:00:00 +0000

Approximately 47% of transgender adults and 55.7% of transgender and non-binary youth report having engaged in nonsuicidal self-injury (NSSI) at some point in their life. In this episode, Thomas details his experience of self-harm beginning at age 12, how his self-injury evolved over time, and how it related to his gender dysphoria. He also discusses dissociation as a relatively constant function (i.e., reason) of his self-injury and what happened when he fully transitioned as a man.

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

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.

Do Youth Self-Injure More Now Than 15 Years Ago?, with Dr. Jonas Bjärehed

nicholas.westers@childrens.com (Jonas Bjärehed PhD) — Fri, 29 Mar 2024 05:00:00 +0000

In this episode, Dr. Jonas Bjärehed from Lund University in Sweden walks us through his research on nonsuicidal self-injury (NSSI) that he began in 2007 as part of his dissertation project. For example, he shares high prevalence rates of NSSI in Sweden (~40%) and discusses gender differences of NSSI among adolescents in 2007 compared to 2023. He also explains the results of a 10-year longitudinal study in which he surveyed individuals as adolescents about their self-harm and then surveyed the same group as adults 10 years later.

Learn more about Dr. Bjärehed's research here and connect with him on LinkedIn at www.linkedin.com/in/jonasbjarehed. Below are a couple of his publications along with a couple papers on "phubbing."

Wångby-Lundh, M., Lundh L.-G., Claréus, B., Bjärehed, J.,& Daukantaitė, D. (2023). Developmental pathways of repetitive nonsuicidal self-injury: predictors in adolescence and psychological outcomes in young adulthood. Child and Adolescent Psychiatry and Mental Health, 17(1), 116.
Daukantaitė, D., Lundh, L.-G., Wångby-Lundh, M., Claréus, B., Bjärehed, J., Zhou, Y., & Liljedahl, S. I. (2021). What happens to young adults who have engaged in self-injurious behavior as adolescents? A 10-year follow-up. European Child & Adolescent Psychiatry, 30(3), 475–492.
Liu, S., Wu, P., Han, X., Wang, M., Kan, Y., Qin, K., & Lan, J. (2024). Mom, dad, put down your phone and talk to me: how parental phubbing influences problematic internet use among adolescents. BMC Psychology, 12, 125.
Lv, H., Ye, W., Chen, S., Zhang, H., & Wang, R. (2022). The effect of mother phubbing on young children’s emotional and behavioral problems: A moderated mediation model of mother–child attachment and parenting stress. International Journal of Environmental Research and Public Health, 19, 16911.

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.

Supporting Siblings of Individuals Who Self-Harm, with Dr. Amy Lucas

nicholas.westers@childrens.com (Amy Lucas PhD) — Fri, 23 Feb 2024 06:00:00 +0000

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:

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).

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.

DSM-5 & Nonsuicidal Self-Injury Disorder, with Dr. Greg Lengel

nicholas.westers@childrens.com (Greg Lengel PhD) — Fri, 26 Jan 2024 06:00:00 +0000

In 2013, the 5th edition of the Diagnostic & Statistical Manual of Mental Disorders (DSM-5) was released, and for the first time it included Nonsuicidal Self-Injury Disorder as a Condition for Further Study. It is not an actual diagnosis at this time, but there are currently six criteria listed (see below, bottom of page). In this episode, Dr. Greg Lengel from Drake University in Iowa walks us through what research says about each of the six criteria, and he discusses the pros and cons of formalizing NSSI Disorder as a diagnosis.

Listen to his interview with Dr. Brooke Ammerman from Season 3 ("How Should Self-Harm Be Defined?") here. Learn more about Dr. Lengel at his faculty profile at Drake University here and follow him on Twitter/X at @DrGregLengel. Below are links to many of the papers discussed in this episode as well as other important papers on NSSI as a disorder in the DSM-5:

Shaffer, D., & Jacobson, C. (2009). Proposal to the DSM-V childhood disorder and mood disorder work groups to include non-suicidal self-injury (NSSI) as a DSM-V disorder. American Psychiatric Association, 1-21.
Lengel, G. J., Ammerman, B. A., & Washburn, J. J. (2023). NSSI in the DSM-5. In E. E. Lloyd-Richardson, I. Baetens, & J. Whitlock (Vol. Eds.), The Oxford Handbook of Nonsuicidal Self-Injury. New York: Oxford University Press .
Lengel, G. J., Ammerman, B. A., & Washburn, J. J. (2022). Clarifying the definition of nonsuicidal self-injury: Clinician and researcher perspectives. Crisis: The Journal of Crisis Intervention and Suicide Prevention, 43, 119-126.
Lengel, G. J. & Mullins-Sweatt, S. N. (2013). Nonsuicidal self-injury disorder: Clinician and expert ratings. Psychiatry Research, 210, 940-944.
Ammerman, B. A., Jacobucci, R., Kleiman, E. M., Muehlenkamp, J. J., & McCloskey, M. S. (2017). Development and validation of empirically derived frequency criteria for NSSI disorder using exploratory data mining. Psychological Assessment, 29, 221-231.
Ammerman, B. A., Jacobucci, R., & McCloskey, M. S. (2019). Reconsidering important outcomes of the nonsuicidal self‐injury disorder diagnostic criterion A. Journal of Clinical Psychology, 75, 1084-1097.
Ammerman, B. A., Lengel, G. J, & Washburn J. J. (2021). Consideration of clinician and researcher opinions on the parameters of nonsuicidal self-injury disorder diagnostic criteria. Psychiatry Research, 296, 113642.
Ghinea, D., Edinger, A., Parzer, P., Koenig, J., Resch, F., & Kaess, M. (2020). Non-suicidal self-injury disorder as a stand-alone diagnosis in a consecutive help-seeking sample of adolescents. Journal of Affective Disorders, 274, 1122-1125.
Muehlenkamp, J. J. (2005). Self-injurious behavior as a separate clinical syndrome. American Journal of Orthopsychiatry, 75, 324–333.
Muehlenkamp, J. J., Brausch, A. M., & Washburn, J. J. (2017). How much is enough? Examining frequency criteria for NSSI disorder in adolescent inpatients. Journal of Consulting and Clinical Psychology, 85, 611619.
Washburn, J. J., Potthoff, L. M., Juzwin, K. R., & Styer, D. M. (2015). Assessing DSM-5 nonsuicidal self-injury disorder in a clinical sample. Psychological Assessment, 27, 31-41.
Zetterqvist, M. (2015). The DSM-5 diagnosis of nonsuicidal self-injury disorder: A review of the empirical literature. Child and Adolescent Psychiatry and Mental Health, 9, 31.

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NONSUICIDAL SELF-INJURY DISORDER (PROPOSED DIAGNOSIS):

A. In the last year, the individual has, on 5 or more days, engaged in intentional self-inflicted damage to the surface of his or her body of a sort likely to induce bleeding, bruising, or pain (e.g., cutting, burning, stabbing, hitting, excessive rubbing), with the expectation that the injury will lead to only minor or moderate physical harm (i.e., there is no suicidal intent). Note: The absence of suicidal intent has either been stated by the individual or can be inferred by the individual's repeated engagement in a behavior that the individual knows, or has learned, is not likely to result in death.

B. The individual engages in the self-injurious behavior with one or more of the following expectations:

To obtain relief from a negative feeling or cognitive state.
To resolve an interpersonal difficulty.
To induce a positive feeling state.

Note: The desired relief or response is experienced during or shortly after the self-injury, and the individual may display patterns of behavior suggesting a dependence on repeatedly engaging in it.

C. The intentional self-injury is associated with at least one of the following:

Interpersonal difficulties or negative feelings or thoughts, such as depression, anxiety, tension, anger, generalized distress, or self-criticism, occurring in the period immediately prior to the self-injurious act.
Prior to engaging in the act, a period of preoccupation with the intended behavior that is difficult to control.
Thinking about self-injury that occurs frequently, even when it is not acted upon.

D. The behavior is not socially sanctioned (e.g., body piercing, tattooing, part of a religious or cultural ritual) and is not restricted to picking a scab or nail biting.

E. The behavior or its consequences cause clinically significant distress or interference in interpersonal, academic, or other important areas of functioning.

F. The behavior does not occur exclusively during psychotic episodes, delirium, substance intoxication, or substance withdrawal. In individuals with a neurodevelopmental disorder, the behavior is not part of a pattern of repetitive stereotypies. The behavior is not better explained by another mental disorder or medical condition (e.g., psychotic disorder, autism spectrum disorder, intellectual disability, Lesch-Nyhan syndrome, stereotypic movement disorder with self-injury, trichotillomania [hair-pulling disorder], excoriation [skin-picking] disorder).

How Should Self-Harm Be Defined?, with Drs. Brooke Ammerman & Greg Lengel

nicholas.westers@childrens.com (Greg Lengel PhD, Brooke Ammerman PhD) — Fri, 29 Dec 2023 06:00:00 +0000

What exactly constitutes nonsuicidal self-injury (NSSI)? Dr. Brooke Ammerman from the University of Notre Dame and Dr. Greg Lengel from Drake University discuss the complexities of defining NSSI. They also describe the difference between deliberate self-harm and NSSI and share their research about what many clinicians, researchers, and people with lived experience tell them about what they think constitutes NSSI and how we should define it.

Learn more about Dr. Ammerman and her work in the Affect, Suicide, Self-Injury, and Social Triggers (ASSIST) Lab at https://assistlab.nd.edu/. Listen to her interview from Season 1 ("Disclosures of Self-Injury") here. Learn more about Dr. Lengel at his faculty profile at Drake University here. Follow them on Twitter/X at @brooke_ammerman and @DrGregLengel. Below are links to some of the papers discussed in this episode:

Lengel, G. J., Ammerman, B. A., & Washburn, J. J. (2022). Clarifying the definition of nonsuicidal self-injury: Clinician and researcher perspectives. Crisis: The Journal of Crisis Intervention and Suicide Prevention, 43(2), 119–126.
Ammerman, B. A., Lengel, G. J., & Washburn, J. J. (2021). Consideration of clinician and researcher opinions on the parameters of nonsuicidal self-injury disorder diagnostic criteria. Psychiatry Research, 296, 113642.

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

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.

Where Does Self-Injury Fit Within Self-Damaging Behaviors?, with Dr. Brianna Turner

nicholas.westers@childrens.com (Brianna Turner PhD) — Fri, 24 Nov 2023 06:00:00 +0000

The term "self-harm" is an umbrella term, encompassing a broad range of behaviors, under which is included substance abuse and misuse, eating disorders, suicide, and nonsuicidal self-injury (NSSI). In this episode, Dr. Brianna Turner from the University of Victoria in British Columbia, Canada discusses how often self-damaging behaviors, including risky sex, financial and physical recklessness, co-occur with NSSI and where NSSI fits within the umbrella of self-harming behaviors. She also simplifies research using structural models of self-damaging behaviors in a way that helps us understand the co-occurrences of potentially harmful coping behaviors.

Learn more about Dr. Turner and her work in the Risky Behaviour Lab at the University of Victoria here, and access many of her publications at https://uvic.academia.edu/BriannaTurner. Follow Dr. Turner on Twitter/X (@BriannaT_Psyc) and connect with the Risky Behaviour Lab on Instagram (@riskybehaviourlab_uvic) and Twitter/X (@RBL_UVic), especially if you are interested in participating in NSSI research. Below are the structural models of self-damaging behaviors discussed in this episode:

St. Germain, S. A., & Hooley, J. M. (2012). Direct and indirect forms of non-suicidal self-injury: Evidence for a distinction. Psychiatry Research, 197(1-2), 78-84.
Green, J. D., Hatgis, C., Kearns, J. C., Nock, M. K., & Marx, B. P. (2017). The Direct and Indirect Self-Harm Inventory (DISH): A new measure for assessing high-risk and self-harm behaviors among military veterans. Psychology of Men & Masculinity, 18(3), 208–214.
Bresin, K. (2020). Toward a unifying theory of dysregulated behaviors. Clinical Psychology Review, 80, 101885.
Kotov, R., Krueger, R. F., Watson, D., Achenbach, T. M., Althoff, R. R., Bagby, R. M., . . . Zimmerman, M. (2017). The Hierarchical Taxonomy of Psychopathology (HiTOP): A dimensional alternative to traditional nosologies. Journal of Abnormal Psychology, 126(4), 454–477.
Barlow, D. H., et al. (2017). Unified Protocol for Transdiagnostic Treatment of Emotional Disorders: Therapist Guide (2nd ed.). Oxford University.
Ehrenreich-May, J., et al. (2018). Unified Protocols for Transdiagnostic Treatment of Emotional Disorders in Children and Adolescents: Therapist Guide. Oxford University.

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

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.

Lived Experience: Allison's Story of Self-Injury & Scarring

nicholas.westers@childrens.com (Nicholas J. Westers Psy.D. ABPP) — Fri, 27 Oct 2023 05:00:00 +0000

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/.

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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.

Self-Injury in Intellectual & Developmental Disabilities (IDD), with Caroline Roberts

nicholas.westers@childrens.com (Caroline Roberts) — Fri, 29 Sep 2023 05:00:00 +0000

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:

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.
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.
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).

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.

The Psychology of Self-Injury Pain, with Dr. Julian Koenig

nicholas.westers@childrens.com (Julian Koenig PhD) — Fri, 25 Aug 2023 05:00:00 +0000

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:

Koenig, J., Thayer, J. F., & Kaess, M. (2016). A meta-analysis on pain sensitivity in self-injury. Psychological Medicine, 46(8), 1597-1612.
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.
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.
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.
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.
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).

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.

Youth Crisis, Self-Harm, & Mental Health Language, with Drs. Rachel Acheson & Maria Papadima

nicholas.westers@childrens.com (Maria Papadima PhD, Rachel Acheson PhD) — Fri, 28 Jul 2023 05:00:00 +0000

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:

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).

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.

Self-Harm OCD vs. Nonsuicidal Self-Injury, with Nathan Peterson

nicholas.westers@childrens.com (Nathan Peterson LCSW) — Fri, 30 Jun 2023 05:00:00 +0000

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:

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.
International OCD Foundation at https://iocdf.org/.
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.
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.

A Dad & Daughter Discuss Her Lived Experience of Self-Harm

nicholas.westers@childrens.com (Nicholas J. Westers Psy.D. ABPP) — Fri, 26 May 2023 05:00:00 +0000

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).

Self-Injury Recovery: A Person-Centered Approach, with Drs. Stephen Lewis & Penny Hasking

nicholas.westers@childrens.com (Penelope Hasking PhD, Stephen P. Lewis PhD) — Fri, 28 Apr 2023 05:00:00 +0000

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:

Lewis, S. P., & Hasking, P. A. (2023). Understanding self-injury: A person-centered approach. Oxford University Press.
Lewis, S. P., & Hasking, P. A. (2021). Understanding self-injury: A person-centered approach. Psychiatric Services, 72(6), 721-723.
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."

The Neurobiology of Self-Injury (in Layman's Terms), with Dr. Michael Kaess

nicholas.westers@childrens.com (Michael Kaess MD) — Fri, 31 Mar 2023 05:00:00 +0000

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:

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.
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.
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."

Emotion Regulation Group Therapy (ERGT) for Self-Harm, with Drs. Kim Gratz & Matthew Tull

nicholas.westers@childrens.com (Kim Gratz PhD, Matthew Tull PhD) — Fri, 24 Feb 2023 06:00:00 +0000

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 Lyra Health and the University of Toledo in Ohio walk us through in significant detail each of the 90-minute 14 sessions of ERGT.

Connect with Dr. Gratz on LinkedIn here and Dr. Tull here. Below are links to their research on ERGT referenced in this episode:

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.
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.
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.
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.
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."

Did Self-Injury Increase During the COVID-19 Lockdown?, with Dr. Ruth Tatnell

nicholas.westers@childrens.com (Ruth Tatnell PhD) — Fri, 27 Jan 2023 06:00:00 +0000

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:

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.
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.
Read about the Harvard Happiness Study published in The Atlantic here.
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."

The Evolution of Self-Injury Treatment, with Dr. Wendy Lader

nicholas.westers@childrens.com (Wendy Lader PhD) — Fri, 30 Dec 2022 06:00:00 +0000

In 1986, the first treatment program in the United States specifically for nonsuicidal self-injury (NSSI) opened its doors. Self Abuse Finally Ends, better known as S.A.F.E. Alternatives, was a 30-day inpatient program for the treatment of self-injury and self-harm. In this episode, Dr. Wendy Lader, the Co-Founder and retired Clinical Director of S.A.F.E. Alternatives talks about what treatment looked like back then and how treatment has evolved over time.

Learn more about Dr. Lader on her website www.drlader.com, and find her book Bodily Harm: the Breakthrough Healing Program for Self-Injurers on Amazon here. To learn more about S.A.F.E. Alternatives, visit selfinjury.com or call 1-800-DONTCUT (1-800-366-8288). If you are seeking treatment options with them, let them know you heard about the program on The Psychology of Self-Injury podcast with Dr. Lader.

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."

The Psychology of Self-Injury Scarring, with Dr. Taylor Burke

nicholas.westers@childrens.com (Taylor Burke PhD) — Fri, 25 Nov 2022 06:00:00 +0000

How are scars from nonsuicidal self-injury (NSSI) different than physical scars that are unintentional or result from non-self-inflicted wounds ? What psychological effects can result from daily reminders of one's own decision to self-harm? Is there an association between NSSI scars and suicidal thoughts and behaviors? In this episode, Dr. Burke discusses the mixed relationship that many people who self-injure have with the scars they bear from NSSI and how some may feel the need to hide their scars even from themselves.

Learn more about Dr. Burke and her work by clicking here or visiting the Mood & Behavior Lab (MABL) at www.moodandbehaviorlab.org. Follow her on Twitter @TaylorABurkePhD.

Below are some of her publications and papers referenced in this episode:

Burke, T. A., Ammerman, B. A., Hamilton, J. L., Stange, J. P., & Piccirillo, M. (2020). Nonsuicidal self-injury scar concealment from the self and others. Journal of Psychiatric Research, 130, 313-320.
Burke, T. A., Olino, T. M., & Alloy, L. B. (2017). Initial psychometric validation of the nonsuicidal self-injury scar cognition scale. Journal of Psychopathology and Behavioral Assessment, 39, 546–562.
Burke, T. A., Hamilton, J. L., Cohen, J. N., Stange, J. P., & Alloy, L. B. (2016). Identifying a physical indicator of suicide risk: non-suicidal self-injury scars predict suicidal ideation and suicide attempts. Comprehensive Psychiatry, 65, 79–87.
Bachtelle, S. E., & Pepper, C. M. (2015). The physical results of nonsuicidal self-injury: The meaning behind the scars. The Journal of Nervous and Mental Disease, 203(12), 927-933.

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."

Lived Experience: Kirsty's Story of Self-Injury & Advocacy

nicholas.westers@childrens.com (Kirsty Moore) — Fri, 28 Oct 2022 05:00:00 +0000

In this episode, Kirsty Moore details her experience of engaging in nonsuicidal self-injury (NSSI) beginning at age 14 and into her 30's. She discusses her training in psychology and how she integrates research on NSSI with her lived experience of self-harm as a form of advocacy when conducting workshops on NSSI for the community. Connect with Dr. Kirsty on Instagram at @dr_kirsty_coaching.

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."

Digital Interventions for Self-Harm, with Dr. Kaylee Kruzan

nicholas.westers@childrens.com (Kaylee Kruzan PhD) — Fri, 30 Sep 2022 05:00:00 +0000

What digital interventions exist for addressing nonsuicidal self-injury (NSSI)? And do they and peer-support apps help in reducing NSSI urges and behaviors? What do individuals with lived experience of self-injury say that they look for in app-based technology to address self-injury? In this episode, Dr. Kruzan from Northwestern University Feinberg School of Medicine shares about what her research has revealed and discusses the potential utility of Virtual Reality in the treatment of self-injury and self-harm.

Learn more about Dr. Kruzan and her research at https://www.kayleekruzan.com/, and follow her on Twitter at @KayleeKruzan. Below is some of her research referenced in this episode:

Kruzan, K. P., Whitlock, J., & Bazarova, N. N. (2021). Examining the relationship between the use of a mobile peer-support app and self-Injury outcomes: Longitudinal mixed methods study. JMIR Mental Health, 8(1), e21854.
Kruzan, K. P., & Whitlock, J. (2022). Digital media, suicide, and self-injury. In J. Nesi, E. H. Telzer, & M. J. Prinstein (Eds.), Handbook of adolescent digital media use and mental health (pp. 338-362). Cambridge University Press.
Kruzan, K. P., Mohr, D., & Reddy, M. (2022). How technologies can support self-Injury self-management: Perspectives of young adults with lived experience of nonsuicidal self-injury. Frontiers in Digital Health, 4, 913599.
Kruzan, K. P., Bazarova, N. N., & Whitlock (2021). Investigating self-injury support solicitations and responses on a mobile peer support application. Proceedings of the 2020 CHI Conference on Human Factors in Computing Systems, 5, 1-14.
Kruzan, K. P., & Whitlock, J. L. (in press). Digital interventions for nonsuicidal self-injury. In E. E. Lloyd-Richardson, I. Baetens & J. Whitlock (Eds.), The 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."

Self-Injury Under Age 12, with Dr. Imke Baetens & Lisa Van Hove

nicholas.westers@childrens.com (Imke Baetens PhD, Lisa Van Hove) — Wed, 31 Aug 2022 05:00:00 +0000

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:

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.
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."

Self-Injury Over Age 40, with Dr. Sarah Swannell

nicholas.westers@childrens.com (Sarah Swannell PhD) — Fri, 29 Jul 2022 05:00:00 +0000

What is the prevalence of self-injury among adults over age 40? And what differentiates those who report having stopped self-injuring from those who continue to self-injure? How do they differ from those under age 25 who self-injure, including related to suicidal thoughts and behaviors? In this episode, psychologist Dr. Sarah Swannell from Australia discusses the prevalence of self-injury and self-harm among individuals over age 40 and stigma around the behavior.

Learn more about Dr. Swannell and her work at https://sarahswannell.com.au/. Below are links to some of her research referenced in this episode:

Martin, G., & Swannell, S. (2016). Non-suicidal self-injury in the over 40s: Results from a large national epidemiological survey. Epidemiology, 6(5), 266.
Martin, G., Swannell, S. V., Hazell, P. L., Harrison, J. E., & Taylor, A. W. (2010). Self-injury in Australia: a community survey. Medical Journal of Australia, 193(9), 506-510. (Australian National Epidemiological Study of Self-Injury [ANESSI])
Troya, M. I., Dikomitis, L., Babatunde, O. O., Bartlam, B., & Chew-Graham, C. A. (2019). Understanding self-harm in older adults: A qualitative study. EClinical Medicine, 12, 52-61.

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."

Self-Injury in Film: "PERFECTION" the Movie, with Actor & Director Christina Beck

nicholas.westers@childrens.com (Christina Beck, Dr. Barry Walsh) — Thu, 30 Jun 2022 05:00:00 +0000

Every screenwriter and film director is different and each has their own intentions and motivations, but what goes into the writing of characters who engage in self-injury and self-harm? How are such films inspired, and how do writers and directors choose to frame self-injury content? In this episode, screenwriter, director, and actress Christina Beck discusses her independent feature film "PERFECTION" and what inspired the characters and content of the film. This episode was recorded as a live virtual session held during the 17th annual ISSS Conference on June 24, 2022.

To watch PERFECTION (for free), visit perfectionthemovie.wordpress.com and click on "Watch PERFECTION NOW!" Download the movie's free companion workbook here. Please note that some content in the film could be upsetting or triggering, including depictions of self-injury, substance use, and brief flashbacks that allude to sexual abuse.

Christina is also a film professor at Loyola Marymount University in Los Angeles, CA. You can follow her on Twitter at @xtinabeck and Facebook at www.facebook.com/perfectionfilm.

To review the Media Guidelines for the Responsible Reporting and Depicting of Non-Suicidal Self-Injury published in the British Journal of Psychiatry, click here. You can also visit www.itriples.org/media-guidelines to read the original ISSS white paper and its accompanied infographic.

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."

Self-Injury Location: Visible vs Concealed, with Dr. Kathryn Gardner

nicholas.westers@childrens.com (Kathryn Gardner PhD) — Fri, 27 May 2022 05:00:00 +0000

Does it matter where on the body someone cuts, whether on typically more visible sites such as the forearm and wrist, or in typically more concealed areas, such as the upper arm and torso? Is there a relationship between where someone cuts on their body and their likelihood of continuing to engage in the behavior? In this episode, Dr. Gardner discusses her research on the psychology of self-injury location and where on the body one chooses to self-injure as well as intrapersonal (emotional) reasons and interpersonal (social) reasons for engaging in self-injury and self-harm.

Learn more about Dr. Gardner and her work at https://www.uclan.ac.uk/academics/dr-kathryn-gardner, and follow her on Twitter @KathrynJGardner. Below are links to some of her research referenced in this episode:

Gardner, K. J., Bickley, H., Turnbull, P., Kapur, N., Taylor, P., & Clements, C. (2020). The significance of site of cut in self-harm in young people. Journal of Affective Disorders, 266, 603-609.
Gardner, K. J., Paul, E., Selby, E. A., Klonsky, E. D., Mars, B. (2021). Intrapersonal and interpersonal functions as pathways to future self-harm repetition and suicide attempts. Frontiers in Psychology, 12, 688472.

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."

Self-Harm Across Cultures, with Dr. Marc Wilson

nicholas.westers@childrens.com (Marc Wilson PhD) — Fri, 29 Apr 2022 05:00:00 +0000

Are there countries, races, or ethnicities with higher or lower rates of self-injury? How prevalent is NSSI among indigenous peoples, and what role does culture play in the form, function, and meaning of self-injury? In this episode, Dr. Marc Wilson from Te Herenga Waka Victoria University of Wellington in Aotearoa New Zealand shares about cross-cultural representations of self-injury and self-harm.

Learn more about Dr. Wilson and his work at https://people.wgtn.ac.nz/Marc.Wilson. Below are links to some of the research referenced in this episode:

Sansone, R. A., Wiederman, M. W., & Sansone, L.A. (1998). The Self-Harm Inventory (SHI): development of a scale for identifying self-destructive behaviors and borderline personality disorder. Journal of Clinical Psychology, 54(7), 973–983.
Sansone, R. A., & Sansone, L. A. (2010). Measuring self-harm behavior with the Self-Harm Inventory. Psychiatry (Edgmont), 7(4), 16-20.
Gratz, K. L. (2001). Measurement of deliberate self-harm: Preliminary data on the Deliberate Self-Harm Inventory. Journal of Psychopathology and Behavioral Assessment, 23(4), 253-263.
Monto, M. A., McRee, N., & Deryck, F. S. (2018). Nonsuicidal self-injury among a representative sample of US adolescents, 2015. American Journal of Public Health, 108, 1042-1048.
Favazza, A. R. (2011). Bodies under siege: Self-mutilation, nonsuicidal self-injury, and body modification in culture and psychiatry (3rd ed.). Baltimore, MD: Johns Hopkins University Press.
Wilson, M. S. (2024). Cross-cultural representations of nonsuicidal self-injury. In E. E. Lloyd-Richardson, I. Baetens, & J. Whitlock (Eds.), The handbook of nonsuicidal self-injury (pp. 167-186). Oxford University Press.
Westers, N. J. (2024). Cultural interpretations of nonsuicidal self-injury and suicide: Insights from around the world. Clinical Child Psychology and Psychiatry, 29(4).

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."

Single-Session Intervention for Self-Harm, with Mallory Dobias

nicholas.westers@childrens.com (Mallory Dobias MA) — Thu, 31 Mar 2022 05:00:00 +0000

According to a 2020 national survey by the Substance Abuse and Mental Health Services Administration (SAMHSA), among 52.9 million adults with any mental illness in the United States, 46.2% received mental health services in the past year, which means more than half did not. Although there are known, effective treatments for mental disorders, the World Health Organization (WHO) reports that more than 75% of people in low- and middle-income countries receive no treatment.

In this episode, Mallory Dobias, MA, a Clinical Psychology PhD student at Stony Brook University in New York discusses an online, brief single-session intervention for nonsuicidal self-injury and self-harm, allowing for more accessible treatment options.

You can find Mallory's open access pre-print paper on PsyArXiv at https://psyarxiv.com/jprcg and its peer-reviewed final publication in the journal Behaviour Research and Therapy by clicking here. To find the pdf version of the intervention in Open Science Framework (OSF) visit https://osf.io/vguf4/. To find the project summary of Project SAVE (Stop Adolescent Violence Everywhere), visit www.schleiderlab.org/completed-projects.html.

Follow Mallory on Twitter at @MalloryDobias and learn more about her work with the Lab for Scalable Mental Health at www.schleiderlab.org/ and her work with the Fox Lab at Denver University at www.foxlabdu.com/.

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."

Eating Disorders & Self-Harm, with Dr. Katie Gordon

nicholas.westers@childrens.com (Kathryn Gordon PhD) — Fri, 25 Feb 2022 06:00:00 +0000

The term "self-harm" is an umbrella term, encompassing a broad range of behaviors, under which is included substance abuse and misuse, suicide, nonsuicidal self-injury (NSSI), and even eating disorders. In this episode, Dr. Katie Gordon, a Licensed Clinical Psychologist in Fargo, North Dakota, discusses the prevalence of self-injury among individuals with eating disorders and the prevalence of eating disorders among those who self-injure. She explains the relationship between the two behaviors, including common risk factors.

Learn more about Dr. Gordon and her work on her website at https://kathrynhgordon.com/. Follow her on Twitter and Instagram at @DrKathrynGordon. You can purchase her book The Suicidal Thoughts Workbook: CBT Skills to Reduce Emotional Pain, Increase Hope, and Prevent Suicide on Amazon here.

Below are links to some of Dr. Gordon's research as well as resources referenced in this episode:

Kiekens, G., & Claes, L. (2020). Non-suicidal self-injury and eating disordered behaviors: An update on what we do and do not know. Current Psychiatry Reports, 22(68).
Fox, K. R., Wang, S. B., Boccagno, C., Haynos, A. F., Kleiman, E., & Hooley, J. M. (2019). Comparing self-harming intentions underlying eating disordered behaviors and NSSI: Evidence that distinctions are less clear than assumed. International Journal of Eating Disorders, 52(5), 564-575.
Smith, A. R., et al. (2013). Exercise caution: Over-exercise is associated with suicidality among individuals with disordered eating. Psychiatry Research, 206(2-3), 246-255.
Gordon, K. H., Perez, M., & Joiner, T. E. (2002). The impact of racial stereotypes on eating disorder recognition. International Journal of Eating Disorders, 32(2), 219-224.

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."

Lived Experience: Brittany's Story of Self-Injury & Faith

nicholas.westers@childrens.com (Brittany Tinsley) — Fri, 28 Jan 2022 06:00:00 +0000

In this first episode of Season 2, Brittany details her experience of engaging in nonsuicidal self-injury (NSSI), how it started, and how she makes sense of self-injury and her faith in God. She explains two starkly different responses she received from church leaders and shares insights about how youth pastors in particular can provide supportive responses to students who engage in self-injury and self-harm.

Follow Brittany on Instagram at @brittanytinsleywrites and read her blog at https://brittanytinsley.com/.

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."

Self-Injury in Schools, with Dr. Nancy Heath

nicholas.westers@childrens.com (Nancy Heath PhD) — Fri, 3 Dec 2021 06:00:00 +0000

Below are links to some of Dr. Heath's research as well as resources referenced in this episode:

Hasking, P. A., Bloom, E., Lewis, S. P., & Baetens, I. (2020). Developing a policy, and professional development for school staff, to address and respond to nonsuicidal self-injury in schools. International Perspectives in Psychology: Research, Practice, Consultation, 9(3), 176.
Berger, E., Hasking, P., & Reupert, A. (2015). Developing a policy to address nonsuicidal self-injury in schools. Journal of School Health, 85(9), 629-647.
Lloyd-Richardson, E. E., Hasking, P., Lewis, S.P., Hamza, C., McAllister, M., Baetens, I., & Muehlenkamp, J. (2020). Addressing self-injury in schools, part 1: understanding nonsuicidal self-injury and the importance of respectful curiosity in supporting youth who engage in self-injury. NASN School Nurse, 35(2), 92-98.
Lloyd-Richardson, E. E., Hasking, P., Lewis, S.P., Hamza, C., McAllister, M., Baetens, I., & Muehlenkamp, J. (2020). Addressing self-injury in schools, part 2: how school nurses can help with supporting assessment, ongoing care, and referral for treatment. NASN School Nurse, 35(2), 99-103.
Lewis, S. P., Heath, N. L., Hasking, P. A., Hamza, C. A., Bloom, E. L., Lloyd-Richardson, E. E., & Whitlock, J. (2019). Advocacy for improved response to self-injury in schools: A call to action for school psychologists. Psychological Services, 17(S1), 86–92.
De Riggi, M. E., Moumne, S., Heath, N. L., & Lewis, S. P. (2017). Non-suicidal self-injury in our schools: a review and research-informed guidelines for school mental health professionals. Canadian Journal of School Psychology, 32(2), 122-143.
Whitlock, J. L., Baetens, I., Lloyd-Richardson, E., Hasking, P., Hamza, C., Lewis, S., Franz, P., & Robinson, K. (2018). Helping schools support caregivers of youth who self-injure: Considerations and recommendations. School Psychology International, 39(3), 312-328.
Hasking, P. A., Heath, N. L., Kaess, M., Lewis, S. P., Plener, P. L., Walsh, B. W., .Whitlock, J., & Wilson, M. S. (2016). Position paper for guiding response to non-suicidal self-injury in schools. School Psychology International, 37(6), 644-663. Open access here.
Book: Self-Injury in Youth: The Essential Guide to Assessment and Intervention (2008) by Drs. Mary Nixon & Nancy Heath

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."

Dialectical Behavior Therapy (DBT) for Self-Harm, with Dr. Jenny Hughes

nicholas.westers@childrens.com (Jennifer Hughes PhD) — Fri, 5 Nov 2021 05:00:00 +0000

Dialectical Behavior Therapy (DBT) has been lauded as an evidence-based treatment for addressing suicidal and nonsuicidal thoughts and behaviors. In this episode, Dr. Jenny Hughes explains what DBT is, describes what "dialectical" means, and walks us through how each of the four modules of DBT can be used to address nonsuicidal self-injury and self-harm: (1) Emotion Regulation, (2) Distress Tolerance, (3) Interpersonal Effectiveness, and (4) Mindfulness. She also provides an update on the science behind DBT, including what aspects of the treatment are thought to be most effective in addressing self-injury.

To learn more about DBT and opportunities for training in DBT as referenced in this episode, visit Behavioral Tech at https://behavioraltech.org/. Learn more about Dr. Hughes' work at the University of Texas Southwestern Medical Center here, and follow her on Twitter at @DrJennyHughes. Watch her 2018 TEDx talk on Resilience: Growth Through Struggle at www.youtube.com/watch?v=Nr44v2__zrU. Below are links to some of her research on DBT among youth:

Editorial: Dialectical Behavior Therapy and the Function of Self-Injury (2021)

(1) Efficacy of dialectical behavior therapy for adolescents at high risk for suicide: a randomized clinical trial (2018)

(2) Predictors and moderators of recurring self-harm in adolescents participating in a comparative treatment trial of psychological interventions (2019)

(3) Dialectical Behavior Therapy for Suicidal Self-Harming Youth: Emotion Regulation, Mechanisms, and Mediators (2021).

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Navigating Self-Injury During Routine Doctor Visits, with Brittany Tinsley

nicholas.westers@childrens.com (Brittany Tinsley) — Fri, 1 Oct 2021 05:00:00 +0000

If you’ve never engaged in self-injury or self-harm, then you may have never considered the anxieties related to something as seemingly simple as a routine doctor visit. In this episode, Brittany Tinsley explains what questions she asks herself prior to attending routine doctor visits in order to ease her anxiety about medical providers seeing her self-injury wounds and scars. We take a unique peek into what doctor visits can be like for those who self-injure or have self-injured, as well as discuss tips on navigating those visits, whether as a treatment provider or someone with lived experience.

Follow Brittany on Instagram at @brittanytinsleywrites and read her blog at https://brittanytinsley.com/.

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

Self-Injury in Japanese Manga, with Dr. Yukari Seko

nicholas.westers@childrens.com (Yukari Seko PhD) — Fri, 3 Sep 2021 05:00:00 +0000

Manga are comics or graphic novels originating from Japan. Not only do manga reveal and reinforce cultural values, beliefs, and norms, particularly in Japan, but they can also be used as a teaching tool and source of information. Manga and other comics can be used in medicine to learn and teach about illness and to build empathy. They also have the power to shape public understanding of mental health issues, even nonsuicidal self-injury (NSSI).

In this episode, Dr. Yukari Seko explains how self-injury and the characters who engage in the behavior are portrayed in Japanese manga. She also discusses the importance of manga within Japanese culture. Below is a reference (with a link) to her research paper along with a breakdown of common genres of manga and, based on her study, just how many characters within each genre engage in self-injury and self-harm:

GENRES OF MANGA (& the number of characters depicted who self-injure, based on Dr. Seko's study):

1. shōjo: comics for girls 18 and younger (written for girls, by girls) - depicted 10 characters who self-injure

2. shōnen: comics for boys 18 and younger (written for boys, by boys, about boys) - depicted 0 characters

3. seinen: comics for young males age 18-30 - depicted 6 characters, portrayed as menhera (a derivation of "mental health-er," a person with mental instability or "mentally vulnerable damsels in distress")

4. josei: comics for young females 18-30 - depicted 1 character

5. Boy's Love: a subgenre of josei manga featuring erotic relationships between male characters - depicted 1 character

6. seijen: comics for grownups - depicted 0 characters

7. redicomi: "Lady's Comic" for adult women - depicted 0 characters

8. slice-of-life: genre that features realistic depictions of everyday life.

Seko, Y., & Kikuchi, M. (2021). Self-injury in Japanese manga: A content analysis. Journal of Medical Humanities, 42(3), 355-369.

Seko, Y., & Kikuchi, M. (2022). Mentally ill and cute as hell: Menhera girls and portrayals of self-injury in Japanese popular culture. Frontiers in Communication, 7.

To learn more about Dr. Seko and her work at Ryerson University, visit https://www.ryerson.ca/procom/people/yukari-seko/.

To learn more about graphic medicine and novels referenced in this episode, see Williams, I. C. M. (2012). Graphic medicine: comics as medical narrative. Medical Humanities, 38(1), 21-27.

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If Your Child is in Therapy for Self-Injury, with Dr. Jessica Garisch

nicholas.westers@childrens.com (Jessica Garisch PhD) — Fri, 6 Aug 2021 05:00:00 +0000

Many parents understandably want their child to stop self-injuring immediately, but cessation of self-injury is often a process and recurrence of episodes of self-injury can be expected, even when in therapy. In this episode, Dr. Jessica Garisch provides insight for parents about expectations for therapy and helping their child stop engaging in self-injury and self-harm. For instance, what do you do if your child does not seem to be putting forth effort in therapy? And if you are worried that your child may not be safe enough to go to camp or on vacation, should you keep them home?

To learn more about Dr. Garisch and her work at Victoria University of Wellington, visit https://people.wgtn.ac.nz/jessica.garisch. To learn more about the Youth Wellbeing Study and its research team, visit https://youthwellbeingstudy.wordpress.com/.

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

Self-Injury Among LGBTQ Individuals, with Dr. Lindsay Taliaferro

nicholas.westers@childrens.com (Lindsay Taliaferro PhD) — Fri, 2 Jul 2021 05:00:00 +0000

Why is it important to talk about nonsuicidal self-injury among LGBTQ individuals? Just how prevalent is self-injury among those who identify as LGBTQ? And are there differences in rates of self-injury among sexual minority individuals (e.g., Lesbian, Gay, and Bisexual) compared to those that are Transgender or Gender Diverse? In this episode, Dr. Lindsay Taliaferro discusses risk and protective factors for engaging in self-injury among LGBTQ individuals. She also tackles the intersectionality of race, sexual minority status, and gender diversity among those who self-injure and self-harm. Below are links to some of her research and the resources referenced in this episode:

Rogers, M. L., & Taliaferro, L. A. (2020). Self-injurious thoughts and behaviors among sexual and gender minority youth: A systematic review of recent research. Current Sexual Health Reports, 12, 335–350.

Taliaferro, L. A., McMorris, B. J., Rider, G. N., & Eisenberg, M. E. (2019). Risk and protective factors for self-harm in a population-based sample of transgender youth. Archives of Suicide Research, 23(2), 203-221.

Taliaferro, L. A., McMorris, B. J., & Eisenberg, M. E. (2018). Connections that moderate risk of non-suicidal self-injury among transgender and gender non-conforming youth. Psychiatry Research, 268, 65-67.

GLSEN's National School Climate Survey (2019).

Hatch Youth - the Montrose Center in Houston: https://www.montrosecenter.org/hatch-youth/

The Trevor Project: https://www.thetrevorproject.org/

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

Managing Self-Injury in Inpatient Settings, with Dr. Jason Washburn

nicholas.westers@childrens.com (Jason J. Washburn PhD ABPP) — Fri, 4 Jun 2021 05:00:00 +0000

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).

Lived Experience of Self-Injury & Stigma: Lexy's Story

nicholas.westers@childrens.com (Lexy Staniland) — Fri, 21 May 2021 05:00:00 +0000

In this episode, Lexy details her experience of engaging in nonsuicidal self-injury (NSSI) and the stigma she has encountered as a result of self-injury and self-harm. Lexy is the current Student Representative of the International Society for the Study of Self-Injury (ISSS) and a PhD candidate working in the area of self-injury stigma. She is currently working on multiple projects looking at how self-injury stigma is experienced and how it is portrayed in the media. She has recently published a paper outlining how researchers can better understand self-injury stigma: Stigma and nonsuicidal self-injury: Application of a conceptual framework (Staniland, Hasking, Boyes, & Lewis, 2021)

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

BIG NEWS! The Psychology of Self-Injury podcast has been rated #5 by Feedspot in their "Top 15 Clinical Psychology Podcasts You Must Follow in 2021." Click here to see the full Top 15 list.

Atypical Severe Self-Injury, with Dr. Barry Walsh

nicholas.westers@childrens.com (Barent Walsh PhD, Dr. Barry Walsh) — Fri, 7 May 2021 05:00:00 +0000

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).

Monitoring Self-Injury in Real Time, with Dr. Glenn Kiekens

nicholas.westers@childrens.com (Glenn Kiekens PhD) — Fri, 23 Apr 2021 05:00:00 +0000

How do we assess self-injury differently than 20-30 years ago? Rather than asking someone to remember how they were thinking and feeling when they last self-injured days, weeks, and even months ago, advances in technology allow researchers and clinicians to monitor self-injury and self-harm in real time, as it occurs. In this episode, Dr. Glenn Kiekens discusses the advantages of adapting real-time monitoring (also known as experience sampling or ecological momentary assessment [EMA]) in researching nonsuicidal self-injury as well as the ethical concerns to consider when doing research in real time.

Learn more about Dr. Kiekens and his work in the Center for Contextual Psychiatry at KU Leuven by clicking here. Follow Dr. Kiekens on Twitter @GKiekens. Below are links to some of his research and the resources referenced in this episode:

Opening the black box of daily life in non-suicidal self-injury research: With great opportunity comes great responsibility (preprint available at https://psyarxiv.com/yp86x)

Fluctuations in affective states and self-efficacy to resist non-suicidal self-injury as real-time predictors of non-suicidal self-injurious thoughts and behaviors (2020)

Consensus statement on ethical & safety practices for conducting digital monitoring studies with people at risk of suicide and related behaviors (Nock et al., 2020)

Revealing the form and function of self-injurious thoughts and behaviors: A real-time ecological assessment study among adolescents and young adults (Nock, Prinstein, & Sterba, 2009)

Changes in ecological momentary assessment reported affect associated with episodes of nonsuicidal self-Injury (Armey, Crowther, & Miller, 2011)

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

Treatment for Self-Injurious Behaviors (T-SIB), with Dr. Peggy Andover

nicholas.westers@childrens.com (Margaret S. Andover PhD, Peggy Andover PhD) — Fri, 9 Apr 2021 05:00:00 +0000

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: Treatment for Self-Injurious Behaviors (T-SIB). Dr. Peggy Andover, its lead developer, walks us through the 9 sessions of T-SIB, including the personalized modules of sessions 7 & 8.

Learn more about Dr. Andover and her work in the Mood and Behaviors Lab at https://www.fordham.edu/info/23638/mood_and_behaviors_lab and reach her at andover@fordham.edu. Follow her on Twitter @DrPeggyAndover. Below are links to some of her research and the resources referenced in this episode:

Moderators of treatment response to an intervention for nonsuicidal self-injury in young adults (2020)

An intervention for nonsuicidal self-injury in young adults: A pilot randomized controlled trial (2017)

Development of an intervention for nonsuicidal self-injury in young adults: An open pilot trial (2015)

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

Psychologists with Lived Experience of Self-Injury, with Dr. Sarah Victor

nicholas.westers@childrens.com (Sarah Victor PhD) — Fri, 26 Mar 2021 05:00:00 +0000

How many psychologists have lived experience of nonsuicidal self-injury (NSSI)? What biases should mental health professionals with and without a history of self-injury keep in mind when treating or supervising someone who has lived experience? In this episode, Dr. Victor shares preliminary data that she has just begun analyzing regarding the prevalence rates of mental health difficulties and self-injury among psychologists and psychology graduate students. She provides guidance about how mental health professionals can provide appropriate care to therapy clients and supervision to trainees who have lived experience of self-injury and self-harm. She also discusses how individuals with lived experience can be involved in research and teaching.

Learn more about Dr. Victor and her work in the Tracking Risk Over Time Lab (TRTL) at https://www.depts.ttu.edu/psy/people/svictor/ and her website at https://www.sarahevictor.com/. Follow her on Twitter @sarahevictor. Below are links to some of her research and the resources referenced in this episode:

Psychologists with lived experience of non-suicidal self-injury: Priorities, obstacles, and recommendations for inclusion (click here for the free version of the author's manuscript)

LiveThroughThis.org

Strategy for Patient-Oriented Research (Canadian Institutes of Health Research)

Patient-Centered Outcomes Research Institute (PCORI)

ClinicalTrials.gov

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

Lived Experience of Self-Injury: Malika's Story

nicholas.westers@childrens.com (Malika) — Fri, 12 Mar 2021 06:00:00 +0000

In this episode, Malika details her experience of disclosing her self-injury to her parents as a teenager, seeking treatment, and how she decided to start Selfharmerproblems Instagram and YouTube pages.

Follow her on Instagram and YouTube, and visit her new website at www.selfharmerproblems.org. To watch all her YouTube videos about her lived experience of self-harm, click here.

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

Disclosures of Self-Injury, with Dr. Brooke Ammerman

nicholas.westers@childrens.com (Brooke Ammerman PhD) — Fri, 26 Feb 2021 06:00:00 +0000

What are some common reasons people give for choosing to disclose their self-injury? How do positive and negative reactions affect someone’s willingness to disclose their self-injury or self-harm in the future and their likelihood of discontinuing their self-injury? In this episode, Dr. Ammerman shares findings from her research in which individuals who self-injure share their answers to these questions. She also explains why only providing "tangible aid" such as offering to help someone who self-injures get medical help or referring them to a mental health professional may not always be all that helpful.

Learn more about Dr. Ammerman and her work in the Affect, Suicide, Self-Injury, and Social Triggers (ASSIST) Lab at https://assistlab.nd.edu/. Below are links to some of her research referenced in this episode:

The development of a measure to assess social reactions to self-injury disclosure

How should we respond to non-suicidal self-injury disclosures?: An examination of perceived reactions to disclosure, depression, and suicide risk

Characterizing the choice to disclose nonsuicidal self‐injury

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

A Mother's Perspective of Her Daughter's Self-Injury

nicholas.westers@childrens.com (Nicholas J. Westers, Psy.D., ABPP) — Fri, 12 Feb 2021 06:00:00 +0000

Imagine receiving a phone call from your child's school expressing concern that your child might be suicidal. This is Dee's story. In this episode she shares about how she was able to differentiate between self-harm of suicide and nonsuicidal self-injury (NSSI), support her daughter through the process, connect her to therapy, and what advice she has for parents in similar circumstances.

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

Self-Injury and the Internet, with Dr. Stephen Lewis

nicholas.westers@childrens.com (Stephen P. Lewis PhD) — Fri, 29 Jan 2021 06:00:00 +0000

What is the quality of online health information related to self-injury and self-harm? What are some of the risks and benefits related to seeking self-injury content on the internet? In this episode, Dr. Lewis details 3 overarching risks and 4 overarching benefits of accessing self-injury content online. He also discusses his research related to the effects of hopeless vs. hopeful comments on YouTube videos about self-injury.

To watch Dr. Lewis' TEDx talk about his own lived experience of self-injury on YouTube, visit https://youtu.be/G17iMOw0ar8. Learn more about self-injury and Dr. Lewis' work at Self-injury Outreach & Support (SiOS) (http://sioutreach.org/). Follow SiOS on Facebook (https://www.facebook.com/sioutreach) and Twitter (https://twitter.com/sioutreach). Below are links to his research and resources referenced in this episode:

Non-suicidal self-injury, youth, and the Internet: What mental health professionals need to know

Googling self-injury: The state of health Information obtained through online searches for self-injury

The Scope of Nonsuicidal Self-Injury on YouTube

Self-Injury Resources:

Self-injury Outreach & Support (SiOS) (http://sioutreach.org/)
Shedding Light on Self-Injury (https://www.self-injury.org.au/)
Self-Injury & Recovery Resources (SIRR) (www.selfinjury.bctr.cornell.edu)
The International Society for the Study of Self-Injury (ISSS) (https://itriples.org/)

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

Self-Injury Stigma and Language, with Dr. Penelope Hasking

nicholas.westers@childrens.com (Penelope Hasking PhD) — Fri, 15 Jan 2021 06:00:00 +0000

What are common ways we talk about self-injury or self-harm that may inadvertently perpetuate stigma about the behavior and those who engage in it? In this episode, Dr. Hasking offers a unique way of thinking about words like "contagious" and "recovery." She also provides insights into the pros and cons of including a Nonsuicidal Self-Injury Disorder as a potential formal diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM). Learn more about self-injury and Dr. Hasking's work at Shedding Light on Self-Injury (https://www.self-injury.org.au/). Below are links to some of her research referenced in this episode:

Cutting words: A commentary on language and stigma in the context of nonsuicidal self-injury

Self-injury recovery: A person-centered framework

Stigma and nonsuicidal self-injury: Application of a conceptual framework

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

Parenting Youth Who Self-Injure, with Dr. Janis Whitlock

nicholas.westers@childrens.com (Janis Whitlock PhD) — Fri, 1 Jan 2021 06:20:00 +0000

If you suspect that your child might be engaging in self-injury, how do you start the conversation and how often should you check in with your child so that you are not being too invasive? How can parents safely set rules if they fear their child might self-injure in response to these rules? In this episode, we answer these questions and more as we talk about how parents and loved ones can foster healing for their children who self-injure or self-harm as well as for themselves.

Dr. Whitlock’s book “Healing Self-Injury: A Compassionate Guide for Parents and Other Loved Ones” is available on Amazon (www.amazon.com/Healing-Self-Injury-Compassionate-Guide-Parents/dp/0199391602). Dr. Whitlock is a Research Scientist in the Bronfenbrenner Center for Translational Research at Cornell University and the founder and director of the Self-Injury & Recovery Resources (SIRR) research program, which serves as one of the best and most comprehensive collations of online resources about self-injury: www.selfinjury.bctr.cornell.edu. It is a go-to resource for parents, therapists, friends, family members, schools, other caring adults, the media, and individuals with lived experience of self-injury. Follow them on Instagram @cornell_crpsir.

Dr. Whitlock is also Senior Advisor for The JED Foundation. To learn more about The JED Foundation, visit https://www.jedfoundation.org/.

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

Nonsuicidal Self-Injury vs. Suicide, with Dr. Jennifer Muehlenkamp

nicholas.westers@childrens.com (Jennifer Muehlenkamp PhD) — Fri, 1 Jan 2021 06:10:00 +0000

Today there is still confusion among a lot people about the differences between suicide and nonsuicidal self-injury. Although nonsuicidal self-injury (NSSI) is a form of self-harm and a risk factor for attempting suicide, the two behaviors should not be confused and those who self-injure should not be assumed to be “suicidal.” In this episode, we discuss how the onset, frequency, method, and function of self-injury are related to risk for suicide attempt.

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

Why Do People Self-Injure?

Fri, 1 Jan 2021 06:00:00 +0000

Self-injury does not reflect typical behavior, but it is also not uncommon. One in five adolescents across the globe reports having self-injured, and one in twenty adolescents in the United States reports having self-injured 6 or more times in the past 12 months. Self-injury isn’t limited to adolescents: 13% of young adults and 6% of adults also report having engaged in self-injury.

But why? According to research, there are two primary categories: emotional reasons and social reasons. In this inaugural episode of The Psychology of Self-Injury, Dr. Nicholas Westers delves into these two categories and asks leading experts, an individual with lived experience of self-injury, and a parent of a teen who self-injures: "Why do people self-injure or self-harm?"

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