This is a book for clinicians who specialize in helping trauma survivors and, through the course of treatment, find themselves unexpectedly confronted with client disclosures of self-destructive behaviors, including self-mutilation and other manifestations of deliberately "hurting the body" such as bingeing, purging, starving, substance abuse and other addictive behaviors.

Arguing that standard safety contracts are not effective, the book introduces viable treatment alternatives, assessment tools, and new ways of understanding self-destructive behavior using a strengths-based approach that distinguishes between the "experimental" Non-Suicidal Self-Injury (NSSI) that some teenagers occasionally engage in, and the self-destructive behaviors that are repetitive and chronic. It also explores a cycle of behavior and uses case studies to show clinicians how to personalize the cycle with clients and form a template for treatment. In its final sections the book focuses on counter-transferential responses and the different ways in which therapists can work with self-destructive behaviors and avoid vicarious traumatization by adopting tools and strategies for self-care.

part |1 pages

Part I: It Makes Sense Given Where They’ve Come From

part |1 pages

Part II: Understanding and Working With Self-Destructive Behaviors

chapter 6|10 pages

The cycle of Self-Destructive Behaviors

chapter 8|6 pages

Unbearable Anxiety and the Frozen Loop

part |1 pages

Part III: Helping Others While Taking Care of Ourselves

chapter 15|3 pages

Focusing on Us

chapter 17|5 pages

Assessing Your Agenda

chapter 18|5 pages

Being Clear About Your Control Issues

chapter 19|8 pages

Holding Appropriate Boundaries

chapter 20|6 pages

Understanding Your Triggers

chapter 21|4 pages

Acknowledging Your Vulnerabilities

chapter 22|5 pages

Pacing the Sessions

chapter 23|4 pages

Debriefing After DiffIcult Sessions

chapter 25|5 pages

Striving for Balance in Your Life

chapter 27|5 pages

Practicing What You Preach

chapter 28|4 pages

Strengthening Your Work