Over the last couple of decades there has been a steady increase in the number of young people who are harming themselves.
This seems to be a worldwide phenomenon, at least in westernised countries.
The act of self harm, which usually involves deliberately cutting, burning or otherwise harming the body, is not a diagnosis in itself, but is a symptom of psychological distress.
“I became what I am today at the age of twelve, on a frigid overcast day in the winter of 1975. I remember the precise moment, crouching behind a crumbling mud wall, peeking into the alley near the frozen creek. That was a long time ago, but it’s wrong what they say about the past, I’ve learned, about how you can bury it. Because the past claws its way out. Looking back now, I realize I have been peeking into that deserted alley for the last twenty-six years.” ― Khaled Hosseini, The Kite Runner
In my day-to-day working life I see many young people. Many of them have been given various mental illness diagnoses. While many of these are correct according to our “diagnostic” manuals, they add little to helping a young person find workable solutions to their dilemma.
As a Child and Adolescent Psychiatrist, I feel that my remit should lie in working to improve mental health and not just in treating mental “illness”. This is supported by the organisation for which I work.
The Recovery Model lies at the heart of its philosophy of care and is one of its guiding principles. This means that we should focus on helping young people, and their families, to enable the young person to lead the best possible life, no matter the nature, or degree of illness, or what sort of difficulties that they have.
People today are in danger of drowning in information; but, because they have been taught that information is useful, they are more willing to drown than they need be.
If they could handle information, they would not have to drown at all.”
― Idries Shah, Reflections
Information is one thing that is plentiful in the twenty first century. It is said that one week of the New York Times contains more information than the average person, alive just fifty years ago, would have been exposed to in their entire lives. As well as the ever increasing availablity of information, the volume of data available seems to be expanding exponentially, and most of this is unfiltered. This knowledge revolution, while having many benefits, does come with a significant price.
Attention Deficit Trait (ADT) is a term that describes the effects of a persistent state of information overload that can be generated by the digital world. It was first used by psychiatrist, Edward Hallowell, in an article in the Harvard Business Review. He described a state “Marked by distractability, inner frenzy, and impatience…” occuring in business managers that turned “otherwise talented performers into harried underachievers.”
This condition although similar to ADHD, is caused by the environment in which we live and work. In other words it is something that we are doing to ourselves.
I find hope in the darkest of days, and focus in the brightest. I do not judge the universe.
Dalai lama.
The term Mindfulness seems to be on everyone’s lips at the moment. A great deal of research has already been undertaken into its benefits, and these cover many of the domains of our daily lives .
Although much of this research has been carried out on adults, there is increasing evidence that there are also benefits for young people. Indeed, even the British government has started to advocate that it should be taught in schools.
Mindfulness is simply being aware of what is happening right now without wishing it were different, enjoying the pleasant without holding on when it changes (which it will); being with the unpleasant without fearing it will always be this way (which it won’t) James Baraz
The benefits of mindfulness in adults are being well researched, and the available evidence about this practice shows many positive benefits across several domains of human functioning. Research into the benefits for young people has lagged behind the work in adults but is starting to demonstrate very similar effects.
Several studies which have used brain scans and other neuroscientific assessments, have demonstrated both structural and functional changes in the brain following mindfulness practice. These changes are directly related to improvements in both the clarity of our thinking as well as our awareness and control over our feelings.
This means that we can act out of what is happening in the present moment rather than allowing past events and scripts to dictate our current choices and behaviours.
Begin challenging your own assumptions. Your assumptions are your windows on the world. Scrub them off every once in a while, or the light won’t come in.
It has been said that one of the reasons that teenagers in the western world struggle, is because there are no clear rites of passage to mark their transition from childhood to adult responsibilities. No cattle jumping ceremonies, no circumcision rituals, no going walkabout.
Instead, there seems to have been the almost random selection of a particular birthday to mark the start of adulthood. The age at which this happens has changed over the years, from celebrating the twenty-first birthday in my parents’ day when we were given the key to the door, to the eighteenth birthday in my youth – where I was among the first group of 18 year olds able to vote in Britain. At the moment there is talk of reducing this age of transition even further to sixteen.
One of the reasons for this long period of transition is the long period of education and training necessary for young people to learn all the knowledge, and skills, required to function in the modern world. This has become necessary because of the move away from a traditional, predominantly rural, hand-made world – one where there were clear boundaries between child and adult – to the modern industrial and digital age, where adolescence has become a long, drawn out affair, stuck in a twilight zone between the two.
In a world where many of the old certainties have gone, young people are struggling to develop a strong sense of identity and to grow to maturity in a world of rapid change. A world where technologies become obsolete almost as soon as they are introduced.
Most seem to cope well with this period of adolescent development, but a sizeable minority struggle, threatening to drown in this stormy sea of change and uncertainty. It is this group of young people who are at the highest risk of developing a depressive syndrome, with all the problems that this can bring to their future emotional, social, and personal development.
It is this group who would benefit from extra support and help in negotiating the transitional process.
As members of the human species we are, by our very nature, social animals. We evolved living in groups, our hunter gatherer lifestyle meant that we were seldom, if ever, alone. Because of this we tend to go into a physical and mental decline if we are denied contact with our fellow humans. A strong, supportive social network of family and friends is one of the main protectors against stress.
It should therefore come as no surprise, that research has demonstrated strong emotional responses to both being excluded from the group, or being forced to exclude others from the group. This could be something as simple as being briefly involved in a game with strangers in the park, only for them to suddenly just carry on as if you were not there, to the deliberate ostracism that occurs when bullies get to work in schools, or whole societies make artificial divisions among people. These emotional responses can also come into play where groups are socially excluded or isolated as part of a deliberate policy, or unintentionally, when forces such as institutional racism come into play.
There are very good reasons why solitary confinement has been used as a punishment or form of torture for thousands of years.
“On the parable of the Good Samaritan: “I imagine that the first question the priest and Levite asked was: ‘If I stop to help this man, what will happen to me?’ But by the very nature of his concern, the good Samaritan reversed the question: ‘If I do not stop to help this man, what will happen to him?” Martin Luther King.
The parable of the Good Samaritan is a teaching from the Christian faith about kindness. More importantly, it is about everyone being a part of the same world, and how, as social creatures, we cannot afford to be indifferent to our fellow human beings. Status, rules, or any other artificial barriers that we place between ourselves and others, are often the excuses that we give to ourselves for not getting involved.
It is their choice, someone else will stop to help, I don’t know what to do, I am going to be late. Similar justifications may come to us as reasons to explain our choice not to become involved.
When the immediate risk of suicide is high, getting involved saves lives.
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