Self-Harm: The Cutters (Katsion)

Self Harm: The Cutters--One Student's Thesis

UNDERSTANDING AND HELPING THOSE WHO SELF-HARM

By Julie Katsion

Distance Learning Supervisor: Lynda Doty

A thesis presented on the behavior of self-harm, beginning with defining the behavior including reasons behind it and the various profiles of typical self- harming individuals. This paper will equip counselors with some understanding of the behavior people who self-harm as well as ways to intervene with them in order to lead them to better ways to cope with their inner pain and into a trusting relationship with the Lord Jesus Christ who can bring them complete healing and deliverance.

TABLE OF CONTENTS

Chapter 1: What is Self-harm in a Nutshell?..................................................................1 Chapter 2: Portrait of Someone Who Self-harms ........................................................ 6 Chapter 3: Why Do They Do It? ................................................................................... 12 Chapter 4: Fighting Spiritual With Spiritual.................................................................17 Chapter 5: Help For the Hopeless ................................................................................. 27 Summary ............................................................................................................................. 38 Appendix A: Putting on the Whole Armor of God .................................................. 42 Appendix B : Weapons of Warfare................................................................................43 Bibliography...........................................................................46

ACKNOWLEDGMENTS

The author wishes to express sincere appreciation to her parents, Gary and Carol Shiplett, for their unwavering support and encouragement in her pursuit of this project. Their confidence in her helped her to stay the course until its completion, despite the numerous interruptions. She offers special thanks to those who shared their personal stories of self-harm which helped give her insights to add a personal touch to this project. Gratitude is also extended to Bro. Ensey and Sis. Doty of the Institute of Soteric Counseling for answering God’s call to empower people to help others the way He intended, through His Spirit and His Word wherein lies complete healing and deliverance. She especially appreciates the confidence and trust that her pastor, Bro. Brian Labat, has placed in her to counsel others. His support has helped her to persevere in her calling when her confidence was wavering. Her gratitude also goes to her husband, David, and her sons Alex, Ben and Caleb for supporting her in investing the extra time needed to complete this thesis. Most of all, she desires to give glory to God for His help in researching and writing about this extremely dark and challenging topic.

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Chapter 1

WHAT IS SELF-HARM IN A NUTSHELL

Self-harm is a very complex and often misunderstood behavior. Some counselors have never heard of it. Many do not understand it. Most hope they never have to encounter it.

Self-injury has taken various forms and is found in many different cultures. An extreme cultural tradition is found in an African New Year Festival where people will come together to resolve conflicts. As the festival escalates, some of the men will go into in a deep trance. At this time, spirits called sekes will possess them and make them stab themselves in the abdomen. Afterward, the healing of those wounds then symbolizes healing within the community.

Some organizations include self-harm as a part of their ceremonies. These acts may be rites of passage, initiation rites or may be believed to enhance spiritual experiences. For example, in the Hindu festival Thaipusum, there is a ceremony where people put themselves into a trance and painlessly drive hooks and spears threw their bodies and spikes their tongues and cheeks. Dr. Armando R Favazza1, an early contributor to studies on self-harm, collected many examples of various types of self-mutilation from many different cultures and religions in his book Bodies Under Siege.

In ancient times as well as today, there are religions that require self-injury as part of their religious experience. Shamans2 of various cultures undergo many forms

1 Dr. Armando Favazza is a Professor of Psychiatry and Neurology at the University of Missouri-Columbia’s medical school and has extensively studied self-mutilation for many year. He has been considered an early expert on the topic.

2Shamans are men or women in various cultures who dedicate themselves to helping members of their society with their problems and healing them of their sicknesses through personal contact with the spirit

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of self-mutilation in order to receive healing powers from demons and souls of deceased shamans. Others have included harming themselves as an act of piety thinking that these acts will earn them favor from their gods or will prove their love and devotion to them. They believe that the more severe the suffering, the more proof of their devotion and the more likely their gods would answer their prays. An example of this lies in the story of the prophets of Baal. When their god would not answer their prayers to consume the sacrifice on the alter after hours of prayer, they began cutting themselves with knives and lancets hoping to gain his attention (1Kings 18:27-28).

Some misguided followers of Christ even believe that by punishing their bodies, they are earning redemption. For example, in the 13th century, self-flagellation began among followers of St. Francis among catholic believers. They believed they were pleasing God by subduing the flesh and that they needed to suffer for their sins. Others have misinterpreted the bible by believing if they are sinning and cannot stop that they need to remove the offending body part based on the misunderstanding of Mark 9:43-47.

There are those who harm themselves for aesthetic purposes. In 1930, Fakir Musafar began promoting body modification and self-mutilation as an art form. He believed people could distort their bodies to make themselves more attractive. For 30 years, he found pleasure in modifying his own body privately, sewing body parts together with needle and thread, synching his waist to 19” and then he began publicly promoting body modification and self-mutilation as a ritual for making oneself more attractive. He firmly believes that mortification of the body

world. Shamanism is obtained by subjecting the body to substantial self-mutilation. A would-be shaman opens his mind to demons who bring him to death's door through a deep trance that lasts days. This trance is very real and intense, even dangerous to him. He watches demons violently torture, dismember and mutilate his body. He then spends time in hell learning secrets of healing from demons and deceased shamans and finally ascends to heaven where God consecrates him for his position. He then “resurrects” from the dead as a new person able to travel to the underworld to help the people (Favazza, 1996).

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is “not sickness but a state of grace”(Favazza, 1996). He wrote books on the subject and has performed his rituals publicly. Today, he is the certified director for a state licensed school for branding and body piercing (Ng, 1998).

One misconception about people who harm themselves is that most do it to get attention. According to some research, less than 4% harm themselves to get attention (Hollander, 2008). Most do so for coping reasons and do not want anyone to know or see what they have done. They usually go to great lengths to hide it out of embarrassment and feelings guilt or shame. This discussion will focus on this type of self-injury. These hurting souls are the ones counselors will more likely find themselves encountering.

This self-destructive destructive behavior is known by a number of different names. They include self-abuse, self-mutilation, self-injury and self-harm. For simplicity, the terms self-harm or self-injury will be used in this paper. These also seem to be the terms most commonly used in modern resources. Perhaps that is because the first two, self-abuse and self-mutilation, sound much more cold, harsh and incriminating. Our society today tends to prefer gentler terms.

Regardless of the choice of label, self-harm can be a very complicated behavior to counsel. Defining the act is a good place to start. Dr. Armando R. Favazza defines it as “the deliberate, direct, non-suicidal destruction or alteration of one’s body tissue” (Strong, 1998). According to Everything You Need to Know About: Self- Mutilation, experts define self-harm as the “act of intentionally harming one’s body for emotional relief” (Ng, 1998).

Both definitions contain important insights into the self-harming behavior. Dr. Favazza includes the point that the act is “deliberate”. It is no accident that the person harms themselves. In fact, some people go through very organized, detailed rituals when harming themselves. They may clean the area first with

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alcohol, lay their instruments out in a precise manner, and some are very conscious of where they are cutting because they usually want to hide it from others. There are those, however, who find themselves in a numb state of mind when injuring themselves and may not even realize they have done it until the numbness fades, and they find that there is blood everywhere. They have taken the injury too far. This may be especially true when the event is accompanied by alcohol or drugs. Whatever the means and whatever states in between all of those examples, the person has deliberately injured themselves.

The second key insight in Dr. Favassa’s definition is that the act is non-suicidal. This is a revelation to many people. Because injuring oneself is such a foreign concept to the general population, people assume that if a person injures themselves to the point of bleeding, then they must be trying to commit suicide. On the contrary, most of those who self-injure use this behavior as a coping mechanism, which leads to the key point in Ng’s definition. They do it for “emotional relief”.

The act of causing oneself pain or watching a wound bleed, releases emotional tension for some people. One self-injurer said that it is a cry for help and calls the act “a bright red scream”. He said he doesn’t do it because he wants to die. Instead, it is a fight for life. Another self-injurer said, “I always felt I’d die if I didn’t cut” (Strong, 1998). In fact, many who self-injure may wish they were dead due to the difficulties they face in their lives, but when they self-injure, they have no intention of killing themselves (Hollander, 2008).

The person may start out with creating small wounds to bring that moment of relief, but many will find that over time they have to create more serious wounds in order to have the same level of release of stress that they had in the past. As the seriousness of the wounds increase, so can the chance of permanent damage or even death. The deeper the wound, the greater the chance of nicking a major

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artery. Some self-injurers have inadvertently died from bleeding to death. In fact, forty to sixty percent of suicides began as deliberate acts of self-harm (Hawton, K., Zahl, D. and Weatherall, R., 2003). Others, by the grace of God, have been forced to reveal their secret because they unintentionally injured themselves to a point where they could not deal with the wound themselves and needed medical help. That can lead them to getting the emotional and hopefully spiritual help that they need, too.

Some people walk through life in a state of depersonalization. For example, the difficulties of life have become so overwhelming that they find themselves unable to cope and have gradually withdrawn into a cocoon of numbness. This state of mind can be frightening and a person may cut themselves to remind themselves that they are still alive. The pain and the flow of blood provide them with a reality check; better to feel physical pain rather than to feel nothing at all. As counselors, we must show them that Christ alone brings life and even life more abundantly (John 10:10).

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Chapter 2

PORTRAIT OF SOMEONE WHO SELF-HARMS

According to Susan Bowman, EdS, LPC and author of See My Pain, approximately two million Americans self-injure (Kern, 2007). Among teens, the number of girls who self-injure may equal the number of boys. However, as they mature, women seem to internalize their anger more than men, so some say there are more women than men who self-injure (Ng, 1998). Karen Conterio, a colleague of Dr. Favazza’s, claims that two-thirds of all those who self-injure are women (Conterio, 1998). There may be a higher number of males, but men tend to express their intense emotions violently which may result in incarceration. This may be one reason there is an underreporting of self-harming behavior in men, in addition to the fact that most men have difficulty admitting emotional trauma to others more than women. For simplicity sake, this thesis will refer to the person who self-harms as a female.

Due to underreporting and misdiagnosis, the exact number of people involved in self-harm is difficult to determine. One estimate states that 1,400 out of every 100,000 have intentionally harmed themselves in some form (Conterio, 1998). A study in the Journal of Abnormal Psychology cited that from 14 to 39 percent of adolescents have abused themselves in some form mostly as a means to release emotional torment (Self-Mutilation, 2008).

A survey done in 1998 of 240 females in the US, showed that the average girl started self-injuring at the age of 14 years and usually stopped in her late 20’s, early 30’s (Ng,1998). The injuries increased in severity over those years. Gina Ng, author of Self Mutilation: A Helping Book for Teens Who Hurt Themselves, states that the typical self-injurer is middle to upper class, well educated, intelligent, and is usually a white female.

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Those who self-harm often have other major problems in their lives such as they often come from abusive homes, have an eating disorder, abuse drugs, alcohol or sex. Sometimes they have suffered neglect, abandonment, death of a parent or other loved one, or perhaps loss of a parent through divorce. They may have a parent who is an addict or there may be tense or abusive relationships in the home, especially between parents. Often there is a combination of some of these in their lives. Somehow along the way, the person has turned to self-harm as a way of coping with the intense feelings associated with stresses such as these.

Many people who harm themselves have some personality traits in common. They tend to be perfectionists and often don’t like the way their body looks. They are not able to cope with strong emotions and do not release or express their emotions with others. They usually were taught as children to keep their emotions to themselves and often their poor body image is a result of sexual or physical abuse in addition to the barrage of media that dictates what beauty is. They have a tendency to believe that all of life’s difficulties are their fault, probably because someone in their childhood told them so in some form or another. They also tend to have frequent mood swings.

It is important to find out the background of the person you are counseling, so you know what issues may arise during sessions together. It may give you insight into the reactions, behaviors and emotions the counselee exhibits with you. One critical aspect is to find out if she is taking any psychiatric medications. If so, you need to know which one so you can inform yourself about possible side effects from the medication. Dr. Peter Breggin has written an excellent resource book on the subject entitled Your Drug May Be Your Problem. He explains that psychiatric drugs often have side effects and withdrawal symptoms that can affect people’s emotions and thoughts. These may hinder the counseling process. For example, some drugs numb a person’s feelings which may explain why he is feeling

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apathetic about praying to receive the baptism of the Holy Spirit. Perhaps he has not been taking her medication regularly and suffers from a side effect of depression which can cause her to believe that she is a lost cause and that even God cannot do anything for her.

A word of caution must be mentioned. You should never ask the counselee to stop taking her medication. It could be beneficial, however, to find out if her psychiatrist or medical doctor would be willing to wean her off of it gradually with close supervision. If not, you may consider suggesting that she find one that would be willing to do so. Immediate ceasing of psychiatric medication can lead to serious repercussions and should be strongly discouraged. Withdrawal symptoms can be so serious as to lead to suicidal thoughts and desires. Since this paper will not go into depth on this subject, Breggin’s book is recommended for further study.

According to Ng, there are three types of self-injurers ranging from mild to severe. These types are seen not only in those who hurt themselves as a means of coping with emotional pain, but there are also those who harm themselves as a result of retardation or what would commonly be known as a mental condition. Ng labels them as superficial or moderate, stereotypic and major (Ng, 1998). They will be discussed here in reverse order.

First, there is the major self-injurer. Behaviors can include castration, removal of an eye or amputation of digits or limbs. These hurting souls have a variety of reasons behind their extreme behavior. They may suffer from serious mental problems, severe alcoholism or drug addiction and quite certainly they are in spiritual crisis. The reason for castration may be due to a misconception about his sexual identity, and he wants to be female. He may even misuse biblical scriptures as a basis for his choices such as believing he will more likely make it to heaven if he becomes a eunuch. Others may erroneously apply other scriptures such as

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ones the suggest to tear out the offending eye or cut off the offending hand; that it is better to enter the kingdom without it than to be sent to hell because of it (Mark 9:43-47).This type of behavior is extreme, but thankfully rare.

The stereotypic self-harmer, is the type that mostly appears in those with severe mental or emotional problems including conditions commonly known as autism, tourette syndrome or schizophrenia and usually is found in institutions. Behaviors include repetitive head banging, hitting, eyeball pressing and biting themselves among other behaviors. Usually, these acts of self-harm are for stimulation reasons rather than for coping with emotional distress. These, too, are souls in spiritual peril.

The most common type of self-injury is called superficial or moderate self-harm. The behaviors are manifested in a wide range as stated previously and they provide fast, temporary relief from anxiety, depersonalization, racing thoughts, rapid mood swings or other intense emotions. Often, these people were physically, sexually or emotionally abused as children and usually blame themselves for it. They believe they deserved the abuse and feel the need to punish themselves by hurting their own bodies.

Over time, this type of self-harm can be accompanied by an eating disorder, alcohol or drug abuse, kleptomania or other issues. While most people of this type are not trying to kill themselves, it can lead to severe depression and suicidal thoughts due to the feeling of being out of control of the self-injuring and the hopelessness of believing that no one could understand what they are going through and why they do what they do (Strong, 1998).

There are many methods used by those who self-injure. According to a study done by Karen Conterio and Dr. Favazza in 1989, the most common methods by percent of usage are as follows: cutting 72%, burning 35%, self-hitting 30%,

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interfering with the body’s healing 22%, hair pulling 10%, bone breaking 8%, and the use of multiple methods 78% (Ng, 1998). Within these categories are countless variations.

Someone who cuts herself usually chooses a sharp object that becomes the instrument of choice. She may hide it in a special place so no one will see it or it may a common object so no one will suspect its alternative use. She may either inflict a few broad, shallow cuts or one or two deep, damaging cuts. She may even insert objects into the wounds such as pins, glass or nails. Cuts are usually made on the wrists, upper or lower arms, stomach or thighs. Often cuts will be made in areas that can be hidden successfully, however, they can be inflicted anywhere on the body.

A person who self-harms by burning herself may use fire from a candle or burning match to burn her skin. She may heat an object and then press it against her bare skin. Objects may include heated frying pans, forks, knives or other metal objects.

Self-hitting also comes in a variety of forms. Hands, arms or legs may be used to hit, punch or kick oneself until an injury occurs. Instruments such as a hammer may also be used to cause damage.

Some people may be more subtle in their self-inflicted injuries. For example, they may interfere with the healing of a wound, whether self-inflicted or not. Picking at scabs and sores prevents God’s gift of natural healing. It is a convenient method because others may not question a sore that seems to take longer than usual to heal. Other people may be "accident prone", "accidentally" cutting themselves with a knife or breaking a digit or limb from an "accidental" fall. Again, it is not likely anyone would question the injury.

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Hair-pulling for self-injury purposes can range from a few strands at a time to hundreds in one sitting. It may be that the person knowingly or unknowingly pulls her eyelashes or eyebrows out or she may pluck out other body hair. Men may pluck out their facial hair. Some people will purposefully and carefully create a pile of the hair before discarding it. Sometimes they will eat the hair after removal. One woman started pulling out her eyelashes as a young person. As she matured, she realized that it was too obvious to everyone else that she was doing that so she tried to break the habit. Over time, she found herself unknowingly pulling a few hairs at a time from the back of her head while she was reading or concentrating intensely on something. Eventually, she had to change her hairstyle to hide the bald spot in the back of her head.

Breaking bones is another form of self-harm. The person will run into hard surfaces repeatedly or bang a body part until she breaks a bone. This is a more challenging form of self-harm because of the difficulty in breaking ones own bones, but a determined person will find a way. She may even do so by appearing clumsy so no one will suspect that the injury was self-inflicted.

Sometimes self-harm begins quite unexpectedly. One preteen girl stumbled upon self-harm by accident. Her parents were divorced, her brother had sexually abused her, and she was having trouble fitting in at school. Sometimes her emotions became more than she could handle, and she would clinch her own arm, digging her nails into her skin. She found that it brought her some release. This behavior transferred to burning her skin by rubbing an eraser on it. Later, she turned to cutting herself for emotional relief. Her motto became, “If it doesn’t hurt, it doesn’t work.”

Often those who injure themselves for release of emotional pain will afterward feel guilty or stupid about it. Some even hate themselves because of the inability to stop the self-harming behavior. The temporary relief and short-term

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contentment they receive compels them to injure again even though they may realize that it is a very irrational way to deal with their problems. One woman who had been harming herself for years explains, “It becomes a vicious cycle that keeps feeding into itself”. These precious souls simply have not learned any healthy skills in how to handle their intense emotions. It becomes their "normal" to harm themselves as a way of coping with out of control emotions. Many believe they have no other alternative and no other hope.

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Chapter 3

WHY DO THEY DO IT?

There are many reasons why people would choose to harm themselves. According to Christian Hall, a counselor in Colorado Springs, the reasons behind self-injury are usually complicated. There often is not one clear reason why people practice it. What they get out of it may range from calming down from intense emotions to, if they did not self-harm, they may have chosen to kill themselves instead (Kern, 2007). However, the most common reason is that they have never learned appropriate ways to deal with strong emotions. They may stumble upon hurting themselves by accident and find that it brought some relief from emotional turmoil. It may begin as a way of dealing with problems, but it later becomes a habit and the only way they know of to cope with deep emotional pain.

Some injure themselves as a form of control or power. They feel as if life is out of their control and that harming their own bodies is a way of taking back some of that control. Many feel numb and dead to their emotions so hurting themselves is a way of feeling alive; a way to feel something. As they watch the blood ooze out of the wound, it can become the only moment that they feel alive. Many feel that physical pain is easier to bear than the emotional pain, so they use self-injury as a substitute for it. One young woman who spent years using self- harm as a way to cope with inner pain described its purpose as taking the focus off of the inside pain and bringing it on the outside. Marilee Strong, author of A Bright Red Scream: Self-Mutilation and the Language of Pain, claims that the self-injurer plays the roles of victim, perpetrator and loving caretaker (Strong, 1998). They can then tend to the injury, and find some comfort in doing so. It may even symbolize emotional healing to them even though it does not ultimately bring that to bear.

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According to therapists at the S.A.F.E. Alternatives Program3, the urge to cut can be as intense as a chain-smoker's desire for another cigarette. One of their patients related that when comparing the feelings before self-injury behavior to a friend's description of feelings before the use of intravenous drugs, the feelings were the same (Conterio, 1998). Ng points out in her book that some experts say that there is a hormone called beta-endorphin that is released when a person injures themselves. This hormone has similar qualities to addictive opiates. It stops pain so the person feels better for a little while; some even feel high from it. The act of self-injuring can, therefore, have qualities that are similar to those who bound by addictions. That may be why it is so difficult for them to stop the behavior. Some do not want to stop. They have become completely bound by their behavioral choices and have resigned to them as their only means to survive.

One reason self-harm may be on the rise is that youth tend to want to mimic the behavior of people they admire. There is the actress Roseanne and the late Princess Diana who are known to have intentionally cut themselves, and, according to a 1993 interview in the magazine “Details”, the actor Johnny Depp places cuts on his arm to mark special times in his life (Ng,1998). Someone who lacks coping skills and who is experiencing emotional trauma may read or hear about how such celebrities have turned to self-harm and decide to try it themselves.

Another reason for the rise in self-injury is due to media exposure. Movies, music and internet are talking about self-injury more today than ever before. Many portray it as a positive way of handling strong emotions. Some websites concerning self-harm have been created for informational purposes or as a

3The S.A.F.E. Alternatives inpatient program was developed by directors Karen Conterio and Wendy Lader, Ph.D. after years of clinical study of self-abuse. Their radical program places complete responsibility for self-injuring on the shoulders of the patient. While compassionate, they do not see self-abuse as an addiction but rather as a choice. Dr. Favazza, early expert in self-abuse, acclaims them as two of the few successful experts in the field.

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support to those who self-injure. While these sites may help some troubled youth open up about their self-injuring behavior, others may never have considered it as an option until they read about it on these sites. The music and movie industries have encouraged experimentation in this behavior resulting in many youth turning towards self-harm habitually as a form of emotional relief.

People who self-injure tend to have emotions that run very deep. Dr. Michael Hollander, author of Helping Teens Who Cut, explains that even if they fell numb and empty, it is because at some point they managed to turn off their overpowering emotions. He believes that it is very important to accept that many people who injure themselves for emotional relief may not be willing to give it up. It works for them and they would rather hurt themselves than to feel emotionally out of control (Hollander, 2008).

Ng suggests that there are four basic thoughts that most people have before they injure themselves. 1) Self-mutilating is ok or acceptable, 2) The human body is disgusting, and it should be punished, 3) Bad feelings can be reduced through certain actions, and 4) Only drastic measures will let others know about my feelings. These thoughts may not be conscious ones, and there may be variations on or many issues underlying any one of these reasons, but most self-injurers justify their choice to injure themselves based on some form of these erroneous ideas (Ng, 1998).

Jan Kern, author of Scars That Wound, Scars That Heal, states that there are many lies that people who self-harm tell themselves. For example, they convince themselves they do not matter or that they deserve all the bad things that happen to them. They believe they can never change or that they must be crazy and certainly that no one could possibly understand why they do it. They may even accept the lie that God does not like them or that He is mad at them; even that God hates them or that He is so disgusted with them that He does not want

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anything to do with them. They may believe that prayer does not work for them and that God is not capable of handling their problem with self-harm or that He cannot deliver them from it. Some may be angry at God for creating them or for the problems that their family is experiencing (Kern, 2007).

In order to help these individuals find freedom from self-injury, first and foremost, they must have a strong desire stop hurting themselves. Without that commitment, you will not be able to help them successfully. Secondly, they must come to terms with the knowledge that they cannot be set free from this behavior by themselves. They will need to develop their trust in God who alone can completely break the bondage. Also, they will need to find a counselor who understands self-harming behavior and the spiritual aspects of it, which will be discussed in the next chapter.

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Chapter 4

FIGHTING SPIRITUAL WITH SPIRITUAL

The spiritual aspects of self-harm are deeper than meets the eye. Previous examples have only touched on the activity that goes on in the spiritual realm when people are harming themselves, especially in the cases where it is done within religious rituals. These extreme cases will not be discussed here. However, let it not be taken lightly that we have an enemy of our souls who is looking for an opportunity to infiltrate our lives; who is seeking for any opening that becomes available to him. 1 Peter 5:8 states, “Be sober, be vigilant; because your adversary the devil walks about like a roaring lion, seeking whom he may devour” (All scripture cited will be in New King James Version). Give him an inch, and, as the old saying states, he will take a mile.

Even among those who self-injure as a means of coping with emotional stress, there is activity at work in the spiritual world around them. That is not to say that they become possessed as in the example of those in the African New Year Festival mentioned earlier. However, clearly self-injury is not God's will for anyone. In fact, he speaks against any abuse of our bodies since we are the temple of God. 1 Cor. 3:16-17 states “Do you not know that you are the temple of God and that the Spirit of God dwells in you? If anyone defiles the temple of God, God will destroy him. For the temple of God is holy, which temple you are.” Even if the counselee is not yet filled with the Holy Spirit, she needs to bear in mind that her body is fearfully and wonderfully made by God, and He considers her His precious child. She must not give the enemy of her soul even an inch!

Demonic activity may begin simply as a passing thought that injuring of one's self will bring relief from the overwhelming feelings that are so difficult to

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handle. Perhaps the infiltration may come in the form of influence from a peer who has experimented with self-harm and claims that it works as a means of releasing intense emotions. The promise of release, however, is only temporary and is accompanied by unexpected surprises such as feelings of guilt, shame, embarrassment, hopelessness, unresolved problems just to name a few. The devil is a liar, and he is the father of lies (John 8:44). The counselee must be taught that if something they are told does not align with God's Word, then she should not believe it! The only way she can learn to discern truth from lies is to spend time in the Word where God shares His point of view about life. If she is not sure whether or not something is true, then she should ask someone who knows the Word well.

Evil spirits may make themselves known through voices that the distraught person hears as was the experience for Vanessa Vega, author of the book Comes the Darkness, Comes the Light. She asserts that self-harm behavior was like a war raging within her. She shares that even though she tried to resist it, there were voices pressing, taunting and accusing her. The voices demanded her to cut convincing her that she needed to cut; that she had to cut. They told her she was pitiful, hopeless and that no one cared about her pain or about her. Vanessa claims there was a darkness that called to her; first subtly, then louder and louder. She tried to avoid the darkness that awaited her by trying to find things to do to keep busy, yet the darkness lurked just waiting and calling for her... until she finally gave in. Only then would the darkness retreat; but only for a while (Vega, 2007).

At this point in her life, she had been hurting herself for emotional release for several years. The darkness and the voices she heard were unmistakingly evil. Ephesians 6:12 states "For we do not wrestle against flesh and blood, but against principalities, against powers, against the rulers of the darkness of this age,

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against spiritual hosts of wickedness in the heavenly places." These evil forces have been influencing people since the fall of Adam and Eve.

An ancient story in the bible tells of a man who lived in the tombs and had an evil spirit inside of him. He had unimaginable strength so that he could break free of any restraints placed on him, including chains. He was known for his violent behavior and no one could help him. He would cry out day and night and cut himself with stones. Ultimately, only Jesus could set him free from the unclean spirit. Once he did, the man was back to normal and had his mind restored (Mark 5:2-15).

The cases of self-harm we encounter today will not be as dramatic as the man from the tombs, but it does show how evil spirits can cause people to harm themselves. It is more likely that those who come to us that engage in self- harming behavior have been influenced by evil spirits but have not been possessed by them. Some may have even heard their voices like Vega did. Others may have simply been deceived into believing that self-harm was the answer to dealing with emotional distress. These distraught souls have never been taught healthy coping skills and have never known the deep healing and peace that Christ alone can bring into their lives.

It is important to understand that the practice of self-harm is an outward sign of an inward condition. As discussed previously, there may be multiple reasons behind the behavior. However, underlying them all is a need to allow the Holy Spirit to saturate their hurting souls. They must fight the spiritual realm by spiritual means. God has given us many weapons with which to fight spiritual battles. 2 Corinthians10:4 reminds us, "For the weapons of our warfare are not carnal but mighty in God for pulling down strongholds."

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As biblical counselors, we must help them discover those weapons and learn to use them faithfully and diligently recognizing that their healing and deliverance depends on it. These weapons include the following:

1) Get into and stay in the Word-Scripture reading and studying needs to be a top priority. She should be encouraged to use a concordance to find scriptures that encourage her heart and increase her faith. A few of the scriptures that minister to her the most can then be written down on a card and kept in a pocket at all times so she can pull them out and read them whenever she needs it. It may be necessary in the beginning to offer her a few to get her started. These may include (but not be limited to) scriptures such as Jer. 31:3, 25; Romans 5:8; 8:35, 37-39; Eph. 2:4-5; Phil. 4:6-7, 8, 13; 1 John 3:1. Encourage her to keep a journal handy when she reads the Word so she can write down verses that minister to her. Have her bring the journal to each session and ask her why she chose those particular scripture verses. This can open up some wonderful discussions.

2) Methodically put on the whole armor of God-Encourage the counselee to daily put on the armor of God (as in Eph. 6:11-17) in a very precise manner giving each piece a specific purpose. A copy of a suggested way to pray the application of the armor is included at the end of this thesis and may be copied for use by the counselee. This means of putting on the armor in prayer was given to me in the midst of a very long, six year "pit" experience. It proved very effective in keeping my faith strong that God was protecting me and fighting for me no matter how I was feeling at any given moment. It must be clearly conveyed to the counselee that in order to effectively use the armor, the person must first obey the gospel of salvation as laid out in Acts 2:38. After all, the first piece of the armor is the helmet of salvation.

3) Receive and/or refresh the Holy Spirit in your life-Help her to understand the power of the infilling of the Holy Spirit. It is through the Spirit of Christ that

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we can be overcomers. The Spirit will help her to grow in understanding and sanctification. He will help her to have strength when she is weak (2 Cor. 12:9)

4) Be faithful to church services and be actively engaged in them-

Faithfulness to services must be an agreed upon commitment. That is where she will hear the anointed preached Word of God that is able to instruct her. It is also an opportunity to be around the love of other believers and in the presence of the power of a loving God. In addition to the preaching, the opening worship service and the closing altar service are both times where the Spirit of the Lord can minister into the deepest parts of her soul where only He can touch. The counselee must be taught the importance of being actively engaged throughout the service; to give God her complete attention and heart. One new believer who had been terribly sexually abused, received the baptism of the Holy Spirit at an altar service. Prior to that service, she had been tormented by the memories, even losing sleep at night as she relived them in her mind. Afterward, she was thrilled to testify that on her way home from church, she realized that she no longer could recall the horrible details of the abuse. Only God can perform a miracle such as that, but He can only do so when people surrender completely into His loving care. Those we counsel must be encouraged to do the same.

5) Keep praise and worship on your tongue-There is tremendous power in praise and worship. Encourage the counselee to obey Ps. 34:1 "I will bless the Lord at all times; His praise shall continually be in my mouth." Explain that it will be helpful for her to get in the habit of speaking words of praise and thankfulness to the Lord throughout the day. She should engage herself in worship services by praising and worshiping the Lord wholeheartedly. Teach her that this will lift her mood and will make the enemy tremble. She needs to make sure she avoids TV programs, movies, games and websites that will hinder her new desire to grow spiritually and have emotional healing.

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6) Saturate yourself with anointed, godly music-Music can be a powerful weapon, for good or for evil. Have her clean out her music collection of all ungodly songs and replace them with spiritually uplifting music. Encourage her to listen to it regularly; in the car, in the home or on a walk wearing headphones if needed.

7) Pray continually-Teach the counselee that prayer is simply talking to God from her heart and this can be done throughout the day. There are not any special words to be said, only a sharing of her heart with His. If she does not know where to begin, explain that it begins with being honest with God. He knows her anyway; knows her life and loves her unconditionally, and He simply wants her to talk to him...about everything. There is nothing too small or too big to talk to Him about. She should begin her day thanking Him for a new day to live for Him and asking for His strength and help her to handle anything that comes her way that day. She should also apply the armor of God for her protection at the beginning of each new day. Scriptures are also very powerful forms of prayer. Encourage her keep her journal nearby as she prays. She can refer to it during her prayer time for faith-building scriptures. She should also be encouraged to read some of the psalms as prayers. Regular prayer helps bring our flesh in submission to Christ's Spirit. It helps keep our minds attuned to Him and His will.

While not a regularly used weapon of warfare, another critical step in being an overcomer is for her to forgive those who have wronged her. This can be a very difficult step to take, however, help her to realize that it is important to her deliverance. Also, it may be helpful to teach her that forgiveness does not condone what someone has done to her, such as sexual abuse, but it does release the hold that the person has had on her. She no longer needs to live as a victim. This change in perspective can be liberating and the Holy Spirit can work a miraculous inner healing as she obeys this command to forgive others as He

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forgives us as stated in the Lord’s Prayer. If the person who harmed her never asks for forgiveness, she may never need to express forgiveness to that person face to face. This process is more for her own healing at this point.

Help her to understand that harboring bitterness towards someone is a form of self-harm in the sense that it is not punishing the other person, but it does hurt her. It keeps her from growing spiritually, it keeps her negative emotions tied to that person and events associated with that person, and it hinders her relationship with God who calls her to forgive. Unforgiveness is a stinking, festering wound that will hinder her until it is purged out. Kern suggests that it may be helpful to recite vocally in prayer the name of each person and what they did to her as she forgives each one. It can evoke intense emotions, but ultimately it is a necessary step to healing (Kern, 2007). The more she pours out her pain in prayer, the more His healing balm can cover her wounds. Those who harmed her will hold less and less power over her present or her future...if she will let Him do that beautiful work of His grace within her.

A copy of these weapons and how to use them are included in the resources at the end of this thesis. It is written for the use of the counselee and can be copied for that purpose.

These weapons are powerful, but they do take time to learn how to apply them. Spend time in your sessions discussing each one. Only practice will bring about efficiency. The most important factor to her success in overcoming self-harm or any other problem in her life is that she must never drop her weapons. They are provided by God for her protection.

Having said that, a warning must be added. It takes time to learn new behaviors. The counselee may relapse into old familiar behaviors as she learns to cope with her feelings. According to Kern, as a person turns away from self-harm, bad

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memories may begin to infiltrate her dreams. Depending on the intensity of emotion tied to those events, the counselee may resort back to self-harming behavior and may even do so with more intensity than before. (Kern, 2007)

Kerns explains that it is important to help her understand that more wounds will never be enough to handle the pain. “One more” injury will not be enough. Only Jesus’ wounds are enough to set her free from the bondage of self-injury. Help her to see that every gash, welt, bruise and piercing he took shouts out to her, “I love you!” His pain can bring her the freedom and healing she desires if she will let him. With Christ’s last breath, he said, “It is finished” (John 19:30). Within that final utterance, a person with a broken life can experience the depth of his love that can bring the wholeness she longs for. This, however, was not the end of the story. Christ came back to life! Kerns expresses the application of this pain, death and resurrection beautifully when she states, “out of the depths of pain that feels like death, life can come.” (Kerns, 2007) Therein lies a hurting soul’s hope.

It is critical to teach the counselee that even if she chooses to harm herself again, God still loves her, and He promises he will never leave her or abandon her (Heb. 13:5). He reassures us through His Word that even though we will not always do as we should, He will always be there with us. Micah 7:8 says "Do not rejoice over me, my enemy; when I fall, I will arise; when I sit in darkness, the Lord will be a light to me" (NKJ).

She can find true comfort in God's Word and in His promises. Here are a few scriptures that may minister to her.

Isaiah 61:3 promises the God will give her "beauty for ashes, the oil of joy for mourning, the garment of praise for the spirit of heaviness." She needs to come

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to know4 her loving Savior, Jesus Christ, of whom it is said in John 8:36, "Therefore if the Son makes you free, you shall be free indeed." 2 Corinthians 5:17 states, "Therefore, if anyone is in Christ, he is a new creation; old things have passed away; behold all things have become new."

The Word is one her most powerful tools. “For though we walk in the flesh, we do not war according to the flesh. For the weapons of our warfare are not carnal but mighty in God for pulling down strongholds, casting down arguments (like that nasty voice in her mind trying to convince her that she will never be set free and that she needs to hurt herself) and every high thing that exalts itself against the knowledge of God, bringing every thought into captivity to the obedience of Christ”, as stated in 2 Corinthians 10:13.

Often a new beleiver does not know how to pray. In addition to speaking her own words from her heart, she should be encouraged to personalize scriptures as her own prayers. It will become a very powerful weapon of warfare for her. A few examples are as follows.

Romans 12:1, 2 (use portions and paraphrase it to make it personal) Lord, help me to present my body as a living sacrifice, holy, acceptable to you, which is my reasonable service. I no longer want to be conformed to this world. Transform me by the renewing of my mind, that I can prove what is Your good and acceptable and perfect will.

Psalm 51:10 Create in me a clean heart, O God, and renew a right spirit within me.

4The word know does not mean simply to have knowledge of. The Hebrew word for know is yada which is a verb; an action word. It means “to know, to be known, to be deeply respected”. According to Key Word Study Bible, yada is characterized by a seeking; a faithful, long-term search. It is a quest based on true love, not selfish desire (Gresh, 2011)

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2 Timothy 2:20 Lord, make me a vessel unto honor, sanctified and good for Your use, and prepared for every good work.

These are only a few of the many powerful scriptures that can be shared. Someone that is new to studying the Word may need you to put together a few key scriptures that she can use to get her used to the idea of using God’s Word as a spiritual weapon. One pastor’s wife who struggled intensely with anxiety for awhile had a great idea that can be used in any circumstance where someone is fighting a spiritual battle. She found a few powerful scriptures that really helped her in her moments of need and wrote them down on an index card and kept them in her pocket or purse at all times. Whenever she felt anxiety begin to creep in, she found herself a quiet spot, pulled out her card and read those powerful scriptures with all the authority she could muster until the feeling had passed. It worked every time, even when she was in a public setting. She had determined in her mind that these attacks were not the will of God, and she would do whatever was needed to fight them no matter where she was at that moment!

Encourage the counselee to be tenacious! She must learn to become aware of the little thoughts that come along in her mind and be quick to deal wisely with them. 1 Peter 5:8 warns us, “Be sober, be vigilant, because your adversary, the devil, walks about like a roaring lion, seeking whom he may devour.”

Your job is to empower her with the knowledge she needs to develop her relationship with Christ. This process will take some time. There is a very good chance that her trust in authority figures has been violated in the past, and she will not easily place her trust in God. This relationship may develop slowly and will most likely begin in her ability to trust you. Therefore, it is imperative that you are consistent with your spiritual walk. She will be watching closely. 1 Timothy 4:12 exhorts spiritual leaders to, “be an example to the believers in word, in conduct, in love, in spirit, in faith, in purity.”

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It is all right to share personal experiences of your spiritual journey with her. She needs to hear that even you have some challenging days in your life and how you have overcome them by your trust in God’s promises and the comfort and direction of His Spirit through prayer. There is no need to put on heirs, for, indeed, she will eventually see right through the masquerade. Such inconsistencies will result in further damage to her ability to trust you or God.

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Chapter 5

HELP FOR THE HOPELESS

Even though self-harm has been a part of human existence for thousands of years, our society has only recently begun to see a rise in it enough to draw the attention of world of psychology. Most of the therapies developed in the last few decades have not had enough longevity to determine their effectiveness. More importantly, even with the successes some have had, they lack the most crucial component of all. There is little if any focus on the person's need for the spiritual healing that only Jesus Christ can give and, therefore, cannot be complete in their offerings.

Having said that, there are two therapies that have components worth mentioning, even though they cannot be recommended without reservation. Let me clarify that in suggesting we glean from specific components of these two therapies, it does not mean that I endorse them in their entirety. As Spirit-filled believers, God gives us wisdom that no secular theories can give us, and yet, we must be wise and humble enough to recognize that we do not need to entirely reinvent the wheel!

I will not discuss these specific therapies in full. It is not my intention to analyze them here, but to offer portions of them that can bring skills and understanding that help us more effectively counsel this unique problem of self-injury. In the previous chapter, I conveyed the spiritual aspects of helping someone who self- harms, and, as just mentioned, no therapy is complete without such elements. Therefore, first I will explain a particular aspect of a therapy that can be beneficial. Then I will explain how it can be applied in soteric counseling, which is counseling based on the Word of God and the delivering, healing power of His

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Spirit. It is vital that we understand how we can assist these hurting souls while they are learning to trust the Lord with their pain.

The first therapy, called dialectical behavior therapy (DBT), was developed and tested by Marsh Linehan and her colleagues in the late 1980's and early 1990's. One of the helpful parts of this therapy that will assist in building trust and respect between counselor and counselee is the portion called dialectical thinking. Basically, it means that neither the counselor nor the counselee has the absolute truth. Each has their own perspective on it based on their own life experiences and motives. They must initially meet each other somewhere in between before progress can be made. The counselor needs to take the first step by validating the feelings of the counselee. Even if those feeling are illogical or unrealistic, they are very real and intense to her, and she needs to know that the counselor understands that fact. She, in turn, will learn to trust and respect the advice of the counselor.

Specifically, this idea can be applied as follows. We as counselors can become so focused on the logical steps needed to get the desired results that we neglect an extremely important quality...compassion. This element is essential to developing a trusting relationship with someone who self-harms. She has most likely convinced herself that no one really cares about her or could possibly understand the pain she suffers inside. If we are too quick to try to press for cooperation before we have heard her heart's cry, progress will be hindered if not entirely halted. Once she realizes you validate her feelings and have expressed genuine concern, she will more likely respect the advice you offer her. Bear in mind that you may be her first glimpse of the compassion of Jesus Christ. Learning to trust and respect you may be her first steps to trusting and respecting God.

If her feelings are not validated, not only might she shut out any counsel, but she may also believe that her emotions are never trustworthy and always unrealistic.

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She needs to learn that emotions are God-given, and, put in the right perspective, can be a blessing to her. They help her evaluate and respond appropriately to circumstances if she learns to rule over them instead of allowing them to rule over her. God can help her change her patterns of behavior, even those that have been engrained into her nature. 2 Corinthians 5:17 states “Therefore, if anyone is in Christ, he is a new creation; old things have passed away; behold, all things have become new.”(NKJ) The key to applying that scripture to her life is that she must choose to surrender her life to Christ completely. Dialectical thinking can become a first step in helping her in that process of submitting her life to her loving Savior.

The second component from dialectical behavioral therapy worth mentioning is in regards to dealing with the person's behavior. The idea is that behavioral choices are based on positive or negative reinforcement. For example, watching the blood flow makes her feel a release of stress. Therefore, her negative behavior has been positively reinforced by the end result of her choice to harm herself, that is momentary relief. Someone who injures herself in order to gain attention, which is less common, has her negative behavior reinforced by the positive response she gets from others. That response may be the only positive attention she receives from others in her life. Perhaps she is usually ignored or mistreated by her parents, but when they discover her self-injuries, they may show the concern and attention she craves from them. Sometimes even a negative response meets his need for attention. It is better to her than no attention at all. Ultimately, the negative behavior has been positively reinforced by others in this case. This understanding can be helpful when trying to help a person figure out what she is gaining from the self-harming behavior. Once she understands what need is being met through it, you can help her find healthier ways to meet that need.

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Dialectical behavioral therapy recognizes that those who self-harm have unrealistic and unhealthy perspectives about themselves, others, God and even about life in general. This therapy helps them correct those misconceptions. For example, a person who has tried to stop self-harming behavior and has failed repeatedly may feel hopeless and begin to believe that she is defective and weak having no will power whatsoever. One such example was given in Helping Teens Who Cut by Michael Hollander, PhD. A high school male struggled with trying to stop harming himself from self-harming and was feeling as if he did not have enough will power to quit the behavior. The counselor convinced the youth that he did have the needed will power by pointing out the fact that the young man displays a great deal of will power when he studies very hard in school and is rewarded with excellent grades (Hollander, 2008). The counselor must help the counselee see reality clearly so he can overcome his distorted perceptions about life.

One way this can be enhanced is by shedding the light of the truth of God's Word on each misconception. Each one can be counterbalanced by what God says to be true. That will help bring the lies out into the marvelous light of God's Word where they can be clearly seen and change can begin to happen. For example, according to Dr. Conterio, Dr. Lader and Jennifer Bloom there are fourteen possible justifications for self-injury (Conterio, 1998). They are as follows:

  1. 1)  It doesn't hurt anyone

  2. 2)  I don't understand why it upsets others

  3. 3)  It's my body and I can do whatever I want.

4) Givingupself-injurywillonlymakemehurtmore.

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5) 6) 7) 8) 9) 10) 11) 12) 13) 14)

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Thescarsremindmeofthebattle. IfthebestwayforotherstoseehowmuchemotionalpainI'min. No one knows that I injure, anyway.

It keeps people away. It'stheonlywaytoknowifpeoplereallycareaboutme.

Negative attention is better than none.
I need to be punished; I'm bad.
It's not my fault. It just happens.
I'm stronger than others. I can tolerate pain. If I don't self-inure, I'll end up killing myself.

These justifications are simply more lies that have infiltrated the minds of those who self-injure. Again, as counselors, we must replace these distortions of reality with truth. We must keep the counselee’s focus on the fact that God alone knows everything and is the only source of truth. The Word of God is powerful and able to penetrate deep within the mind to eradicate erroneous thinking. We must trust the ability of the living Word to do the work necessary within a soul. Deliverance and hope cannot come only through our own words. They are limited in their help. As we submit ourselves to the leading of the Holy Spirit, He can fill our mouths with the words to say that will minister deeply into the hearts of those we help. He can fully transform their minds to accurately perceive life situations.

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Dr. Conterio, Dr. Lader and Jennifer Bloom are therapists at S.A.F.E. (Self-Abuse Finally Ends) Alternative Program which is the first in-patient program focused completely on those who harm themselves. Even though the program lacks the spiritual basis that it needs for complete success, again it does have some components worthy of mentioning.

There are a few fundamentals that really set this program apart from most others. At the heart of the program is this idea that self-abuse is a choice, not part of the person's genetic make-up. Therapists have a no compromise policy; self-harming behavior must stop. Their goal is total abstinence. This no compromise policy is a great start. Our goal, however, is total deliverance. While similar, these concepts are not the same. The first suggests a voluntary choice of staying away from self- harm behavior. The second is when a person is completely set free from the behavior through the power of God.

The therapists at S.A.F.E Alternatives also state that self-harming behavior is not an addiction. However, they do admit that those who harm themselves exhibit behaviors that are similar to addicts. New England psychiatrist Bessel van der Kolk explains that when a person injures themselves, chemicals are released in the brain which are similar to addictive opiates. That is why it can be so hard for some people to stop the behavior (Conterio, 1998).

It is important to understand that while there are chemical processes going on during self-injury, there are also other factors that cause the behavior to appear addictive in nature. A person who has self-injured for any length of time has engrained habits that are very difficult to change. This behavior choice has been her means of coping with the emotional challenges in life. She has known no other means of coping. The thought of giving it up can be terrifying. Even if she wants to change her patterns, she often finds herself reverting back to what is comfortable and familiar in the time of emotional crisis. That does not mean she

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is addicted to the behavior, however. She can choose alternative patterns of behavior, especially with the Lord’s help.

The program also discourages hyper-nurturing which is very wise. It places the responsibility for recovery completely on the shoulders of the person who self- injures. The therapists never ask the person to give them the objects used to self- injure and never encourages anyone to “babysit” the person in order to keep them from self-injuring. Such choices would send the message that only an outside person can keep her safe from harming herself. It is important for her to know that she is the only one who can keep herself safe (Conterio, 1998). We must add to that concept by reminding her that she is not alone in the struggle to resist the temptation to harm herself. Remind her that Christ will give her the strength she needs to resist that temptation. He will always make another healthier choice available to her. She must learn to look for it.

Spiritual aspects must always be kept in mind. People who harm themselves have an enemy of their souls who does not want them to learn to lean on Christ Jesus. There are evil spiritual forces at work to attempt to distract people from turning to God for help. It may be in the form of negative thoughts such as fear of letting go of the self-harming behavior since it is the only thing that has worked for them. The thought of hopelessness may nudge them to believe that they will never be able to change or that they must harm themselves in order to make it through the crisis.

As counselors, we must help the counselee to identify the lies that her flesh or the enemy of her soul has told her and replace them with truth; scriptures that counteract the lies. For example, “I can do all things through Christ who strengthens me” I Peter 4:13 (NKJ). Another concept in scripture that would be helpful to teach her is from 2 Corinthians 10:3-5. It will help her understand how the Word of God can be used to fight spiritual warfare. When negative thoughts

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come to mind, she can quote 2 Corinthians 10:3-5, “For though we walk in the flesh, we do not war according to the flesh. For the weapons of our warfare are not carnal but mighty in God for pulling down strongholds, casting down arguments and every high thing that exalts itself against the knowledge of God, bringing every thought into captivity to the obedience of Christ.She must learn that she indeed can choose not to harm herself.

There is a simple, humorous analogy that can be taught to counselees. They can be told that they may not be able to stop a bird from flying by their head, but they can stop it from making in nest in their hair. That is to say, they may not be able to control what thoughts come into their heads, but they can control how long they stay there. They can learn to replace the thoughts with something good, like scripture, a song that lifts their faith or they can immediately rebuke that thought in the name of Jesus Christ if it persists and then follow it up with the Word or a spiritual song.

Like the S.A.F.E. Alternative Program, counselors should not teach their counselees substitution methods for dealing with intense emotions. Some therapists would encourage people to place a rubber band on their wrist and snap it whenever they want to hurt themselves. Another substitution offered would be to put their hand in ice. These alternatives keep them focused on releasing emotions through actions rather than dealing the underlying issues. It sends the false message that every strong emotion must be followed by either a destructive action or at least one that mimics self-harming behavior. They need to learn that they can handle their emotions. They have to ride them out. They must learn to set with their painful feelings”, to choose to control themselves and to express their feelings in a healthy way (Conterio, 1998). More importantly, it is imperative that they be taught to turn to Christ for help in learning these skills. We, as

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counselors, empower them with the knowledge they need; the Holy Spirit empowers them with the ability to apply that knowledge successfully.

As with any ingrained habit, it takes time for someone to learn better ways to handle their emotional pain. Relapses should not be seen as failures. The only time a counselor may consider calling for additional help, such as an ambulance or a pastor, is when the person who self-harms has injured themselves to the point of needing medical intervention or if the person is either on drugs or drinking alcohol when abusing their bodies and the counselor knows it is happening at a given moment.

Such was the case for one counselor. A woman, who had been sober for some time, called the counselor saying she had cut herself and could not stop the bleeding. The counselor called their pastor, not wanting to go into such a situation alone, which was very wise. The two of them tried to help the woman, but it was clear to both of them that the alcohol was causing her deep depression, and she wanted to kill herself. They even found her in the bathroom trying to place a razor blade into the wound after she learned that they wanted to take her to the hospital. When they couldn't stop the bleeding, they called an ambulance. The original wound may or may not have been accidental, but the placing of the blade into the wound and the voiced desire to die was clearly intentional.

No amount of praying was going to help in that moment. She needed immediate assistance that the two of them could not offer. Even Jesus said, “Be wise as serpents and harmless as doves,” in Matthew 10:16 (NKJ). We are often good about the “harmless” part, but not so good with the “wise” part sometimes. Bear in mind when you are uncertain about making that tough decision, sometimes the best teacher is the consequences that must be endured due to decisions made. For example, this particular woman spent about four days in the mental ward and

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failed two college classes due to missed finals. She lost financial aide due to the failed classes. Consequences can be awful, but lessons learned can be priceless. Do not protect counselees from them. God can use it for His glory in their lives. Do not let the enemy of your soul make you think you are being heartless and cruel. That is a lie, too!

One thing I make clear to my counselees is that I love them too much to not be honest with them. That is especially important for them to know when I have to tell them difficult truths; things they simply do not want to hear. They need to be told that I am honest with them because I do not want them to remain in the state they are in. I tell them if I did not love them, I would not say anything difficult to them at all. I love them enough to risk them being upset with me for telling them difficult truths. That applies also to making those difficult decisions such as needing to call an ambulance when deemed necessary. You may even need to remind yourself that it is an act of love to look out for their safety when it is against their will.

Another difficult decision to make is the one regarding ending your sessions with them before they are set free from their bondage of self-harm. If you have kept this person in prayer while counseling them, the Holy Spirit will lead you as to when to stop sessions with them. As difficult as it is, there are some people that simply do not want to or are not yet ready to stop injuring themselves. It comes to a place where nothing you say is making a difference. You cannot force the person to change. They must want to change. They must fully surrender. Trust that God will never lose sight of them, and when you are not there to work with them, God is still at work. You planted seeds and God alone brings the increase. He does not need you to finalize the work. He may lead them back to you at some time in the future or you may never counsel them again, but trust that they are in His care even when they are not in yours.

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Helping people who self-harm means much more than simply bringing them to the point where they are willing to stop hurting themselves. They will usually have other problems that accompany the self-harming behavior such as substance abuse, depression, eating disorders or any number of other issues. All of these, however, will most likely stem from other issues from their past or present. Such issues may include unhealthy family relationships, dysfunction in the family, stress at school or work, or sexual abuse to name a few.

There are a few underlying factors that are common among self-harming individuals. They lack the skills of how to handle intense emotions in a healthy way. They have many misconceptions about themselves, others, life and God. They have difficulty expressing their feelings to others for various reasons such as fear that no one will understand them or perhaps that others will reject them or will not take them seriously.

It is imperative to recognize that while dealing with the various issues that these hurting souls carry, their spiritual needs must also be addressed. Each individual has a unique personality and different set of circumstances surrounding the self- harming behavior. However, every person needs to know that there is hope in Christ for complete inner healing, peace and deliverance. They will develop their relationship with God by first developing a trusting relationship with you.

While many of the details may vary from one person to another that you counsel, there are some basic steps that you can follow as a guideline for counseling those who harm themselves due to intense emotional pain.

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1) Do they want to stop their self-harming behavior?-If not, there is not much you can do for them. You should consider postponing counsel until they are ready to stop hurting themselves.

2) Discuss some basic background information-Are they on any psychiatric medications? Who knows about their self-harming behavior? Is their family supportive of them getting counseling? How much are they willing to cooperate? Where are they at in their relationship with the Lord? Are they willing to commit to a minimum of six sessions (so you can develop some trust between you and begin guiding them without them quitting if it gets too challenging for them)? Will they commit to being faithful to church during your sessions together so they can hear the preached Word of God, have the opportunity to be in His presence during the worship service and at the altar, and begin developing healthy relationships with others in the church for emotional support? These issues can be addressed over a couple of sessions depending on their openness and willingness.

3) Validate their feelings; earn their respect-Most people who harm themselves have difficulty relating to authority figures, which you may very well represent to them. It is critical to the development on your relationship with them that you begin by validating their feelings when they do begin to express themselves to you. As you do so, they will begin trusting you enough to respect your advice.

4) Teach them ways to handle their emotions, not ignore or neglect them- Help them understand that their emotions are God-given and can be beneficial if handled properly. Encourage them to find a friend they can talk to whenever emotions begin to intensify. Teach them how read their own body signals so they can become more self-aware, which will help them

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handle their emotions before they get out of control. Have them keep a journal and encourage them to share with you what they have written.

5) Help them understand the spiritual aspects of their situation; give them the tools they need to fight the spiritual battles-Get them into the Word for strength, hope and guidance. Give them a few powerful scriptures to start out with to keep on a card in their pocket to quote as needed for the building up of their faith and the strengthening of their resolve to no longer harm themselves. Encourage daily prayer, regular church attendance and note- taking during sermons as they hear helpful information. Encourage them to keep a journal handy as they read the Word and write down scriptures that minister to them and their thoughts about it. Have them bring the journal to sessions and share what they wrote. Help them purge their music collections and internet usage of anything ungodly for their own protection. If they have not obeyed the gospel, lead them to do so. They need the baptism of the Holy Spirit to empower them as they learn to handle life’s challenges in a healthy way.

6) Deal with misconceptions about themselves, others and God as they arise-Use the Word of God to shine the light of truth on lies they have believed whenever possible. Help them to recognize the truth about circumstances and people in their lives. Develop healthy perceptions about who God really is and how He works in their lives.

7) Teach them healthy interpersonal relationship skills-Instruct them how to set appropriate boundaries with others, to express their feelings respectfully, to mirror back what they hear others saying and other healthy communication skills. Guide them how to choose their friends wisely; ones that are healthy for them and build them up.

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8) Be a good example for them to follow; be faithful, open, loving and real with them-They can detect masquerades and will reject your instruction if your actions do not support your words. Share your own struggles and how you have handled them both from the past as well as in the present.

9) Encourage them to never give up-Express to them the need for tenacity. Explain that there will be times when things will not go right or times when they will fail, but they must determine themselves that they will never give up pursuing their healing and deliverance.

10) Keep yourself right with God-You must make certain that your spiritual life is healthy. God knows the hearts and lives of those you counsel better than anyone else, and He can help them through you if you keep yourself attuned to Him. It is important for your own spiritual and emotional health to keep a strong prayer life. Otherwise, you will start trying to carry their burdens yourself. Also, you may begin relying on your own wisdom and knowledge when counseling which cannot bring the full healing and deliverance that God has for them. Trust in His abilities to help them, not your own.

While following these basic steps, keep yourself open to the leading of the Holy Spirit. God created the hurting souls you are counsel. He knows the innermost parts of the mind and heart. He alone can make them whole.

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APPENDIX A: Applying the Full Armor of God

One of the weapons of your warfare is the armor of God. It should be applied every morning before you start your day and before you go to sleep at night. It will help protect you from spiritual attack and will give you strength and faith to fight those spiritual battles as well as the battles with your own flesh. Application of the armor is based on Ephesians 6:10-17 where verse 10 states its purpose, “...be strong in the Lord and in the power of His might.” Each piece of armor should be applied with a specific purpose. Below is an example of how you can apply each piece of armor.

I put on the helmet of salvation* to cover my mind. Help me think like You think and remember who I am in you, Lord. Bring into captivity every thought to the obedience of the Lord Jesus Christ (2 Corinthians 10:5).

I put on the breastplate of righteousness. Create in me a pure heart with pure motives. I hide Your Word in my heart that I will not sin against You (Psalm 199:11).

I put in my hand the sword of the Spirit to fight the enemy with the power of the Word of God. I submit myself to God, therefore, I resist the Devil and he will flee from me (James 4:7)!

I put in my hand the shield of faith to quench the fiery darts of the enemy. Let every attack of the enemy come to nothing today, Lord!

I put on my waist the belt of truth. I stand on Your Word and on Your promises!

I put on my feet the preparation of the gospel of peace that everywhere I go and everything I do, I will walk in Your name and in Your will.

Thank You, Lord, for protecting me and fighting for me today! In Jesus’ name, amen.

*Reminderin order to use these pieces most effectively, you must already have the contents of them “in your arsenal” so to speak. For example, in order to use the helmet of salvation to its fullest potential, you need to have obeyed the plan of salvation as stated in Acts 2:38; repentance, baptism in Jesus’ name by emersion and receiving of the infilling of the Holy Spirit which will be evidenced by speaking in tongues like believers did in the early church as stated in the book of Acts. Once you obey the gospel of Christ, you can then fully claim the protection of His armor.

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Appendix B: Weapons of Warfare

2 Corinthians 10:4 “For the weapons of our warfare are not carnal but mighty in God for pulling down strongholds.”

NEVER DROP YOUR WEAPONS!

1) Get into and stay in the Word-Scripture reading and studying needs to be a top priority. Use a concordance to find scriptures that encourage your heart and increase your faith. Write a few scriptures that minister to you the most on a card and keep it in a pocket at all times so you can pull them out and read them whenever you need to. Here are few good ones to consider: Jer. 31:3, 25; Romans 5:8; 8:35, 37-39; Eph. 2:4-5; Phil. 4:6-7, 8, 13; 1 John 3:1. Keep a journal handy when you read the Word so you can write down verses that minister to you. Bring your journal to each session and talk about why she chose those particular scripture verses.

2) Methodically put on the whole armor of God-Daily put on the armor of God (as in Eph. 6:11-17) in a very precise manner giving each piece a specific purpose. A copy of a suggested way to pray the application of the armor is attached. This means of putting on the armor in prayer was given to me in the midst of a very long, six year "pit" experience. It proved very effective in keeping my faith strong that God was protecting me no matter how I was feeling at any given moment. In order to most effectively use the armor, you must first obey the gospel of salvation as laid out in Acts 2:38. After all, the first piece of the armor is the helmet of salvation.

3) Receive and/or refresh the Holy Spirit in your life- It is through the Spirit of Christ that we can be overcomers. The Spirit will help you to grow in understanding and sanctification. He will help you to have strength when you are weak (2 Cor. 12:9).

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4) Be faithful to church services-Faithfulness to services is a requirement during counseling. That is where you will hear the anointed preached Word of God that is able to instruct you. It is also an opportunity to be around the love of other believers and in the presence of the power of a loving God. In addition to the preaching, the opening worship service and the closing altar service are both times where the Spirit of the Lord can minister into the deepest parts of your soul where only He can touch. One new believer who had been terribly sexually abused, received the baptism of the Holy Spirit at an altar service. Prior to that service, she had been tormented by the memories, even losing sleep at night as she relived them in her mind. Afterward, she was thrilled to testify that on her way home from church, she realized that she no longer could recall the horrible memories of the abuse. Only God can perform a miracle such as that, but He can only do so when people surrender completely into His loving care. When you attend services, be completely present there by giving your full attention and response to His presence. Come expectant of what He wants to do in your life.

5) Keep praise and worship on your tongue-There is tremendous power in praise and worship. Obey Ps. 34:1 "I will bless the Lord at all times; His praise shall continually be in my mouth." It will be helpful to get in the habit of speaking words of praise and thankfulness to the Lord throughout the day. In your prayer time and at church, praise God with all your heart. It will lift your mood and will make the enemy tremble! Avoid TV programs, movies, games and websites that hinder your new desire to grow spiritually and have emotionally healing.

6) Saturate yourself with anointed, godly music-Music can be a powerful weapon, for good or for evil. Clean out your music collection of all ungodly songs and replace them with spiritually uplifting music. Listen to it regularly; in the car, turn it on in the home, on a walk; wear headphones if needed.

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7) Pray continually-Prayer is simply talking to God from your heart and this can be done throughout the day. There are not any special words to be said, only a sharing of your heart with His .Begin by being honest with God. He knows you anyway; knows your life and loves you unconditionally, and He simply wants you to talk to him...about everything. There is nothing too small or too big to talk to Him about. Begin your day thanking Him for a new day to live for Him and asking for His strength and help to handle anything that comes your way that day. Apply the armor of God for your protection at the beginning of each new day. Scriptures are also very powerful forms of prayer. Keep your journal nearby as you pray. Refer to it during your prayer time for faith-building scriptures. Read some of the psalms as prayers. Regular prayer helps bring our flesh in submission to Christ's Spirit. It helps keep our minds attuned to Him and His will.

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