Application of mindfulness for impulse control and self harm

Self harm presents a risk in using EMDR with emotionally vulnerable clients, due to the dangers of their immediate behaviours. However, often these behaviours are in response to deep-seated memories linked to traumas, which with the help of EMDR could safely be processed once the impulsive and risky behaviours are controlled. Mindfulness has been utilised by the Author as a stabilisation method of reducing dissociation in clients, prior to trauma processing (CEP conference – Darker-Smith, 2005). More recently, the author has discovered that the application of mindfulness and imagery techniques work more effectively for clients with tendencies for self-harm, compared to alternative behavioural techniques designed to distract from or substitute for impulsive desires to self-harm (e.g.., the use of ice cubes or elastic bans, to create a distraction from the impulse). Two groups were studied in the process of treating co-morbid symptoms for alternative conditions with EMDR, ranging from eating disorders, anxiety disorders, and trauma, prior to EMDR processing. For clinical reasons, clients with depression, personality disorders and other Axis 2 disorders were not included in this study due to contraindications in current research relating to Mindfulness. Participants self-harming behaviours related to superficial cutting, punching, and burning. Group 1 consisted of six clients who were offered alternative behavioural techniques (e.g., elastic bands or ice cubes) to distract or substitute for the desire for self-harm. Group 2 consisted of eight clients who were offered mindfulness techniques, including imagery meditations to distract or substitute for the desire to self harm. The groups were distributed as evenly as possible and no major emphasis was placed on the treatment of self-harming behaviours, instead being placed on the major problems (anxiety, eating disorder or trauma).

The Group (1)[consisted of 6 persons:(3 with Anxiety, 3 with Eating Disorders, 1 with Trauma)] who were offered suitable behavioural techniques utilised them effectively when their distress levels were mild (between 1-4 on a 0-8 behavioural scale), however, reverted back t self harming behaviours (e.g., cutting, burning, pinching) when distress levels reached 5 or higher. The Group (2)[consisted of 8 persons: (3 with Anxiety, 4 with Eating Disorders, 1 with Trauma)] who were offered aspects of Mindfulness training to facilitate tolerance of distressing emotions and being aware of the active moment did not tend (on average) to revert back to self-harming behaviours, choosing instead to utilise mindfulness methods (such as 3-minute breathing space).

Conclusion: Mindfulness is more effective as impulse control for self-harming behaviours than behavioural alternative strategies and can be utilised as a form of stabilisation in combination with controlling impulsive behaviours, prior to EMDR.

Conference

English

Susan Darker-Smith

Darker-Smith, S. (2007, June). Application of mindfulness for impulse control and self harm. Poster presented at the 8th EMDR Europe Association Conference, Paris, France