working in mental health

[duloxetine_queen]

anyone else work in mental health and have any tips for supporting clients who SH when you yourself are an active SHer with no desire to stop?

[onlypurples]

I have worked in mental health before while I was active with SI. It was ackward and uncomfortable. I felt like I was living a lie. In mental health, it isn't about you - it is about them - but I could just feel that some of the patients/ clients could see straight through me... they just knew... and it bothered me, just like I could see straight through to some of them and identify what we had in common. I just kept my distance and focused on the job at hand in the office, classroom, etc... and didn't address the issue of SI directly - I left it up to other people in the office.

Boundaries were vital, but dealing with SI so intimately has skewed my perception of boundaries with myself.

Your clients will more than likely be able to see straight through you, unless you are a fabulous liar.

Honest question though: Why would you want to advise your clients to do something you aren't willing to do yourself? Personally, I wouldn't be able to do this... and I wouldn't feel comfortable knowing that my therapist or social worker or person trying to help me wasn't willing to follow their own advice.

[duloxetine_queen]

i wouldn't advise a client to do something i wouldn't do myself.
if they want to stop, good for them and i'm there to support them.
if they don't, it's all about harm reduction.
unless a client is sectionable, it's about working with their choices, however much one may disagree with these personally. i find it hard at times not to self-disclose, particularly with clients i particularly empathise with or who have more issues around pushing boundaries, but as you say i'm there for them, not me.
though obviously i and have my professional hat on so might recommend that they investigate things i know haven't worked for me but might for them. i don't see this as lying so much as giving them an informed choice. everyone is different. it's terrifying when you meet people who have no idea of what their diagnosis means, how their meds work, etc after years of psychiatric involvement. i've also worked (as a client) with professionals i've known had MH issues and didn't see them as lying or think i could 'see through' their professionalism (after all, everyone is human) but appreciated their empathetic perspective.
i meant really i find it hard as it triggers me to want to SH.

[onlypurples]

There is a fine line in dealing with those who self-injure, as we both know... and if a therapist doesn't take "enough action", it can make the situation worse. Counselors are not there to encourage the behavior, they are they there to reduce and eventually help eliminate the behavior all together --- not replace or reduce, totally eliminate (long term goal).

Clients see straight through their care workers. If they say something that doesn't line up, they won't trust them anymore. Practicing what you preach is important --- and it doesn't make sense how you could encourage even harm reduction if you aren't practicing harm reduction or plan to ever totally stop hurting yourself. For me, I wouldn't see my therapist or care worker as credible if I could tell they were doing this... I would just laugh in their face and walk away.

In terms of triggers, that is where having a solid support system outside of work is vital. Work is work and boundaries must be adhered to... including the emotional ones, even though those are often the hardest.
- if you know being around those who self-injure will trigger you, work in a team with those who self-injure or limit your direct interactions with those who are actively self-injuring... or limit your types of conversation/ interaction in which triggers might be increased
- know when to step away and take a breath for yourself or call for backup
- slowly increase your "tolerance" to your triggers, ease into it
- develop a routine for "decompressing" after a trigger at work such as going to the bathroom and washing your face, listening to a certain song on your iPod, walking around the building, going out for a cig, fix yourself a cup of tea or coffee and sit down at a table by yourself, etc...

[syn]

It's tough, my grad level year, I had my work relapse of SI I've ever had in my life, and thankfully have since stopped. It was hard too because I was working in addictions.

I however, frame my treatment as we are all people and we are all in recovery, that the goal of treatment is for the client to decide and begin to discuss what that recovery means to them.

I actually doubt they saw through me, not even sure if my field instructor new about the SI, though she new I was dealing with depression and on medication. Some clients inquired about my medication, as I at times looked a bit drugged.

It is so important in mental health, especially when providing counseling to have a supportive supervisor with whom you can at least indirectly address your issues of transference with.

Thing is, it's tough for everyone in the field. In some ways I have had a head's up, can do some pretty deep clinical work, as I don't really have a sense of stigma, or distance from the issues.

However, because of that work I tend to need a lot of clinical support, as it weights heavily on me. On good teams where we could discuss our transference openly, it was ok. Actually it was therapeutic, and I was able to reach out to co-workers without even bringing up my own mental health history. As that isn't what makes me. The feelings that bring on my transference are feelings everyone has.

I'd love to talk to people who are going through this.

While currently not SIing recently had a very bad job placement, where the clinic really brought on some heavy guilt issues, and I was very isolated and never have been able to discuss my transference. While I no longer SI, I am still in recovery, and it has been a feat to get out of here without feeling completely crushed in every possible way.