Lived Experience: Brittany's Story of Self-Injury & Faith (Re-Release)

In this episode, Brittany details her experience of engaging in nonsuicidal self-injury (NSSI), how it started, and how she makes sense of self-injury and her faith in God. She explains two starkly different responses she received from church leaders and shares insights about how youth pastors in particular can provide supportive responses to students who engage in self-injury and self-harm.  Purchase Brittany's new book Stories Our Scars Tell: Hope, Healing, and Honesty about the Wounds We Carry here. Follow her on Instagram at @brittanytinsleywrites and read her blog at https://brittanytinsley.com/.  Follow Dr. Westers on Instagram @DocWesters. To join ISSS, visit itriples.org and follow ISSS on Facebook and Twitter/X (@ITripleS). The Psychology of Self-Injury podcast has been rated #1 by Feedspot  in their list of "10 Best Self Harm Podcasts" and #5 in their "20 Best Clinical Psychology Podcasts." It has also been featured in Audible's "Best Mental Health Podcasts to Defy Stigma and Begin to Heal."

What is the relationship between nonsuicidal self-injury (NSSI) and pain? Are individuals who self-injure less sensitive to pain than those who don’t self-injure? What are the ethics involved in conducting research on pain? In this episode, Dr. Julian Koenig describes the research on the experience of pain among those who self-harm. Learn more about Dr. Koenig and his research lab at www.koeniglab.de. Below are links to some of the research referenced in this episode: Koenig, J., Thayer, J. F., & Kaess, M. (2016). A meta-analysis on pain sensitivity in self-injury. Psychological Medicine, 46(8), 1597-1612. Koenig, J., Klier, J., Parzer, P., Santangelo, P., Resch, F., Ebner-Priemer, U., & Kaess, M. (2021). High-frequency ecological momentary assessment of emotional and interpersonal states preceding and following self-injury in female adolescents. European Child & Adolescent Psychiatry, 30(8), 1299-1308. Kaess, M., Hooley, J. M., Klimes-Dougan, B., Koenig, J., Plener, P. L., Reichl, C., Robinson, K., Schmahl, C., Sicorello, M., Schreiner, M. W., & Cullen, K. R. (2021). Advancing a temporal framework for understanding the biology of nonsuicidal self-injury: An expert review. Neuroscience and Biobehavioral Reviews, 130, 228-239. Störkel, L. M., Karabatsiakis, A., Hepp, J., Kolassa, I.-T., Schmahl, C., & Niedtfeld, I. (2021). Salivary beta-endorphin in nonsuicidal self-injury: an ambulatory assessment study. Neuropsychopharmacology, 46(7), 1357-1363. Sigrist, C., Kaess, M., & Koenig, J. (2023). Autonomic nervous system function in nonsuicidal self-injury—A Research Domain Criteria perspective on the arousal/regulatory systems. In E. E. Lloyd-Richardson, I. Baetens, & J. Whitlock (Eds.), The Oxford handbook of nonsuicidal self-injury (pp. C18S1–C18S23). Oxford University Press. Naoum, J., Reitz, S., Krause-Utz, A., Kleindienst, N., Willis, F., Kuniss, S., Baumgärtner, U., Mancke, F., Treede, R.-D., & Schmahl, C. (2016). The role of seeing blood in non-suicidal self-injury in female patients with borderline personality disorder. Psychiatry Research, 246, 676-682. Follow Dr. Westers on Instagram @DocWesters. To join ISSS, visit itriples.org and follow ISSS on Facebook and Twitter/X (@ITripleS). The Psychology of Self-Injury podcast has been rated #1 by Feedspot  in their list of "10 Best Self Harm Podcasts" and #5 in their "20 Best Clinical Psychology Podcasts." It has also been featured in Audible's "Best Mental Health Podcasts to Defy Stigma and Begin to Heal."

What goes on at the neurobiological level that makes someone more vulnerable to self-injure or self-harm? What biological risk factors are at play? What roles do the vagus nerve, cortisol levels, and hypothalamic-pituitary-adrenal (HPA) axis have? We hope to discuss the psychology of self-injury pain in a future episode, but in this episode, Dr. Michael Kaess from the University of Bern in Switzerland explains the neurobiology of self-injury in simple terms, or what we hope can be considered simple layman's terms.  Learn more about Dr. Kaess and his research team at the Universitäre Psychiatrische Dienste (UPD) in Bern here. To participate in Dr. Kaess' research study of an online intervention for self-injury (in German), visit the STAR (Self-injury Treatment Assessment Recovery) Project at https://star-projekt.de/. Below are links to some of the research referenced in this episode: Kaess, M., Hooley, J. M., Klimes-Dougan, B., Koenig, J., Plener, P. L., Reichl, C., Robinson, K., Schmahl, C., Sicorello, M., Schreiner, M. W., & Cullen, K. R. (2021). Advancing a temporal framework for understanding the biology of nonsuicidal self-injury: An expert review. Neuroscience and Biobehavioral Reviews, 130, 228-239. Reichl, C., Heyer, A., Brunner, R., Parzer, P., Völker, J. M., Resch, R., & Kaess, M. (2016). Hypothalamic-pituitary-adrenal axis, childhood adversity and adolescent nonsuicidal self-injury. Psychoneuroendocrinology, 74, 203-211. Plener, P. L., Bubalo, N., Fladung, A. K., Ludolph, A. G., & Lulé, D. (2012). Prone to excitement: Adolescent females with non-suicidal self-injury (NSSI) show altered cortical pattern to emotional and NSS-related material. Psychiatry Research, 203(2-3), 146-152. Follow Dr. Westers on Instagram @DocWesters. To join ISSS, visit itriples.org and follow ISSS on Facebook and X/Twitter (@ITripleS). The Psychology of Self-Injury podcast has been rated #5 by Feedspot in their "Best 20 Clinical Psychology Podcasts" and by Welp Magazine in their "20 Best Injury Podcasts."

How are scars from nonsuicidal self-injury (NSSI) different than physical scars that are unintentional or result from non-self-inflicted wounds ? What psychological effects can result from daily reminders of one's own decision to self-harm? Is there an association between NSSI scars and suicidal thoughts and behaviors? In this episode, Dr. Burke discusses the mixed relationship that many people who self-injure have with the scars they bear from NSSI and how some may feel the need to hide their scars even from themselves.  Learn more about Dr. Burke and her work by clicking here or visiting the Mood & Behavior Lab (MABL) at www.moodandbehaviorlab.org. Follow her on Twitter @TaylorABurkePhD.  Below are some of her publications and papers referenced in this episode: Burke, T. A., Ammerman, B. A., Hamilton, J. L., Stange, J. P., & Piccirillo, M. (2020). Nonsuicidal self-injury scar concealment from the self and others. Journal of Psychiatric Research, 130, 313-320. Burke, T. A., Olino, T. M., & Alloy, L. B. (2017). Initial psychometric validation of the nonsuicidal self-injury scar cognition scale. Journal of Psychopathology and Behavioral Assessment, 39, 546–562. Burke, T. A., Hamilton, J. L., Cohen, J. N., Stange, J. P., & Alloy, L. B. (2016). Identifying a physical indicator of suicide risk: non-suicidal self-injury scars predict suicidal ideation and suicide attempts. Comprehensive Psychiatry, 65, 79–87. Bachtelle, S. E., & Pepper, C. M. (2015). The physical results of nonsuicidal self-injury: The meaning behind the scars. The Journal of Nervous and Mental Disease, 203(12), 927-933. Follow Dr. Westers on Instagram @DocWesters. To join ISSS, visit itriples.org and follow ISSS on Facebook and X/Twitter (@ITripleS). The Psychology of Self-Injury podcast has been rated #5 by Feedspot in their "Best 20 Clinical Psychology Podcasts" and by Welp Magazine in their "20 Best Injury Podcasts."

The term "self-harm" is an umbrella term, encompassing a broad range of behaviors, under which is included substance abuse and misuse, suicide, nonsuicidal self-injury (NSSI), and even eating disorders. In this episode, Dr. Katie Gordon, a Licensed Clinical Psychologist in Fargo, North Dakota, discusses the prevalence of self-injury among individuals with eating disorders and the prevalence of eating disorders among those who self-injure. She explains the relationship between the two behaviors, including common risk factors.  You can purchase Dr. Gordon's book The Suicidal Thoughts Workbook: CBT Skills to Reduce Emotional Pain, Increase Hope, and Prevent Suicide on Amazon here.  Below are links to some of Dr. Gordon's research as well as resources referenced in this episode: Kiekens, G., & Claes, L. (2020). Non-suicidal self-injury and eating disordered behaviors: An update on what we do and do not know. Current Psychiatry Reports, 22(68). Fox, K. R., Wang, S. B., Boccagno, C., Haynos, A. F., Kleiman, E., & Hooley, J. M. (2019). Comparing self-harming intentions underlying eating disordered behaviors and NSSI: Evidence that distinctions are less clear than assumed. International Journal of Eating Disorders, 52(5), 564-575. Smith, A. R., et al. (2013). Exercise caution: Over-exercise is associated with suicidality among individuals with disordered eating. Psychiatry Research, 206(2-3), 246-255. Gordon, K. H., Perez, M., & Joiner, T. E. (2002). The impact of racial stereotypes on eating disorder recognition. International Journal of Eating Disorders, 32(2), 219-224. Follow Dr. Westers on Instagram and Twitter (@DocWesters). To join ISSS, visit itriples.org and follow ISSS on Facebook and Twitter (@ITripleS). The Psychology of Self-Injury podcast has been rated #5 by Feedspot in their "Best 20 Clinical Psychology Podcasts" and by Welp Magazine in their "20 Best Injury Podcasts."

Emotion Regulation Individual Therapy for Adolescents (ERITA) and its internet-delivered version (IERITA) is just one of a couple of treatments developed specifically to address nonsuicidal self-injury (NSSI) among adolescents. In this episode, Dr. Johan Bjureberg from the Karolinska Institute in Stockholm, Sweden walks us through in detail each of the 11 sessions of IERITA and IERITA's 6 parallel sessions for parents. Learn more about Dr. Bjureberg's work here, and follow his research lab and their projects and publications at Emotion regulation, Self-injury, Suicide, and Intervention (ESSI) here. Below are links to his research on ERITA/IERITA referenced in this episode: Bjureberg, J., Ojala, O., Hesser, H., Häbel, H., Sahlin, H., Gratz, K. L., Tull, M. T., Knutsson, E. C., Hedman-Lagerlöf, E., Ljótsson, B., & Hellner, C. (2023). Effect of internet-delivered Emotion Regulation Individual Therapy for Adolescents with Nonsuicidal Self-Injury Disorder: A randomized clinical trial. JAMA Network Open, 6(7), e2322069. Bjureberg, J., Sahlin, H., Hedman-Lagerlof, E., Gratz, K. L., Tull, M. T., Jokinen, J., Hellner, C., & Ljotsson, B. (2018). Extending research on emotion regulation individual therapy for adolescents (ERITA) with nonsuicidal self-injury disorder: Open pilot trial and mediation analysis of a novel online version. BMC Psychiatry, 18, 326. Bjureberg, J., Sahlin, H., Hellner, C., Hedman-Lagerlof, E., Gratz, K. L., Bjarehed, J., Jokinen, J., Tull, M. T., & Ljotsson, B. (2017). Emotion regulation individual therapy for adolescents with nonsuicidal self-injury disorder: A feasibility study. BMC Psychiatry, 17, 411. Follow Dr. Westers on Instagram and Twitter (@DocWesters). To join ISSS, visit itriples.org and follow ISSS on Facebook and Twitter (@ITripleS). The Psychology of Self-Injury podcast has been rated #5 by Feedspot in their "Best 20 Clinical Psychology Podcasts" and by Welp Magazine in their "20 Best Injury Podcasts."

A lot of therapies address the context in which nonsuicidal self-injury (NSSI) and self-harm may occur, but only a few treatments have been designed to address NSSI specifically. In this episode, we dive into one of these treatments: Emotion Regulation Group Therapy (ERGT). Drs. Kim Gratz and Matthew Tull from the University of Toledo in Ohio walk us through in significant detail each of the 90-minute 14 sessions of ERGT. You can purchase their book "Acceptance-based emotion regulation therapy: A clinician’s guide to treating emotion dysregulation and self-destructive behaviors using an evidence-based therapy drawn from ACT and DBT" on Amazon here or at New Harbinger Publications here.  Connect with Dr. Gratz on LinkedIn here and Dr. Tull here. Below are links to their research on ERGT referenced in this episode: Gratz, K. L., & Gunderson, J. G. (2006). Preliminary data on an acceptance-based emotion regulation group intervention for deliberate self-harm among women with Borderline Personality Disorder. Behavior Therapy, 37(1), 25-35. Gratz, K. L., & Tull, M. T. (2011). Extending research on the utility of an adjunctive emotion regulation group therapy for deliberate self-harm among women with borderline personality pathology. Personality Disorders: Theory, Research, and Treatment, 2(4), 316–326. Gratz, K. L., Tull, M. T., & Levy, R. (2014). Randomized controlled trial and uncontrolled 9-month follow-up of an adjunctive emotion regulation group therapy for deliberate self-harm among women with borderline personality disorder. Psychological Medicine, 44, 2099–2112. Gratz, K. L., Bardeen, J. R., Levy, R., Dixon-Gordon, K., L., & Tull, M. T. (2015). Mechanisms of change in an emotion regulation group therapy for deliberate self-harm among women with borderline personality disorder. Behaviour Research and Therapy, 65, 29-35. Sahlin, H., Bjureberg, J., Gratz, K. L., Tull, M. T., Hedman, E., Bjarehed, J., Jokinen, J., Lundh, L., Ljotsson, B., & Hellner, C. (2017). Emotion regulation group therapy for deliberate self-harm: A multi-site evaluation in routine care using an uncontrolled open trial design. BMJ Open, 7(10), e016220. Follow Dr. Westers on Instagram and Twitter (@DocWesters). To join ISSS, visit itriples.org and follow ISSS on Facebook and Twitter (@ITripleS). The Psychology of Self-Injury podcast has been rated #5 by Feedspot in their "Best 20 Clinical Psychology Podcasts" and by Welp Magazine in their "20 Best Injury Podcasts."

How can schools appropriately respond to students who engage in nonsuicidal self-injury (NSSI), whether the behavior occurs at home, on school grounds, or elsewhere? What protocols exist to support schools to better respond to students who self-injure? What role does liability play? In this episode, Dr. Nancy Heath of McGill University in Montreal, Canada explains how schools can support students who engage in self-injury and self-harm.Learn more about Dr. Heath's work here, and learn more about her work with the Development and Intrapersonal Resilience (DAIR) Research Team here. Learn more about the International Consortium on Self-Injury in Educational Settings (ICSES) at http://icsesgroup.org/.Self-injury Outreach & Support (SiOS) offers resources for schools here and a list of do's and don'ts here. Visit SiOS at http://sioutreach.org and follow them on Facebook (www.facebook.com/sioutreach) and Twitter (https://twitter.com/sioutreach).Below are links to some of Dr. Heath's research as well as resources referenced in this episode:Hasking, P. A., Bloom, E., Lewis, S. P., & Baetens, I. (2020). Developing a policy, and professional development for school staff, to address and respond to nonsuicidal self-injury in schools. International Perspectives in Psychology: Research, Practice, Consultation, 9(3), 176.Berger, E., Hasking, P., & Reupert, A. (2015). Developing a policy to address nonsuicidal self-injury in schools. Journal of School Health, 85(9), 629-647.Lloyd-Richardson, E. E., Hasking, P., Lewis, S.P., Hamza, C., McAllister, M., Baetens, I., & Muehlenkamp, J. (2020). Addressing self-injury in schools, part 1: understanding nonsuicidal self-injury and the importance of respectful curiosity in supporting youth who engage in self-injury. NASN School Nurse, 35(2), 92-98.Lloyd-Richardson, E. E., Hasking, P., Lewis, S.P., Hamza, C., McAllister, M., Baetens, I., & Muehlenkamp, J. (2020). Addressing self-injury in schools, part 2: how school nurses can help with supporting assessment, ongoing care, and referral for treatment. NASN School Nurse, 35(2), 99-103.Lewis, S. P., Heath, N. L., Hasking, P. A., Hamza, C. A., Bloom, E. L., Lloyd-Richardson, E. E., & Whitlock, J. (2019). Advocacy for improved response to self-injury in schools: A call to action for school psychologists. Psychological Services, 17(S1), 86–92.De Riggi, M. E., Moumne, S., Heath, N. L., & Lewis, S. P. (2017). Non-suicidal self-injury in our schools: a review and research-informed guidelines for school mental health professionals. Canadian Journal of School Psychology, 32(2), 122-143.Whitlock, J. L., Baetens, I., Lloyd-Richardson, E., Hasking, P., Hamza, C., Lewis, S., Franz, P., & Robinson, K. (2018). Helping schools support caregivers of youth who self-injure: Considerations and recommendations. School Psychology International, 39(3), 312-328.Hasking, P. A., Heath, N. L., Kaess, M., Lewis, S. P., Plener, P. L., Walsh, B. W., .Whitlock, J., & Wilson, M. S. (2016). Position paper for guiding response to non-suicidal self-injury in schools. School Psychology International, 37(6), 644-663. Open access here.Book: Self-Injury in Youth: The Essential Guide to Assessment and Intervention (2008) by Drs. Mary Nixon & Nancy HeathFollow Dr. Westers on Instagram and Twitter/X (@DocWesters). To join ISSS, visit itriples.org and follow ISSS on Facebook and Twitter/X (@ITripleS).The Psychology of Self-Injury podcast has been rated as one of the "10 Best Self Harm Podcasts" and "20 Best Clinical Psychology Podcasts" by Feedspot  and one of the Top 100 Psychology Podcasts by Goodpods. It has also been featured in Audible's "Best Mental Health Podcasts to Defy Stigma and Begin to Heal."

In this episode, Dr. Christian Schmahl from Heidelberg University and Mannheim, Germany, answers a listener's question and talks about his experimental research assessing how seeing blood affects heart rate and arousal among both those who engage in nonsuicidal self-injury (NSSI) and those who don't. He also shares insights into the role of self and blood in ritual and nonritual self-injury, including examples from different cultures about how they may interpret blood differently in the context of self-harm and even trance-like states.To learn more about Dr. Schmahl and his work, visit here. To stay up-to-date on next year's ISSS conference in Stockholm, Sweden (Wed-Fri June 24-26, 2026), visit https://www.itriples.org/conferences. Below are a few papers referenced in today's episode:Glenn, C. R., & Klonsky, E. D. (2010). The role of seeing blood in non-suicidal self-injury. Journal of Clinical Psychology, 66(4), 466-473.Naoum, J., Reitz, S., Krause-Utz, A., Kleindienst, N., Willis, F., Kuniss, S., Baumgartner, Ulf, Mancke, F., Treede, R.-D., & Schmahl, C. (2016). The role of seeing blood in non-suicidal self-injury in female patients with borderline personality disorder. Psychiatry Research, 246, 676-682.Stacy, S. E., Pepper, C. M., Clapp, J. D., & Reyna, A. H. (2022). The effects of blood in self-injurious cutting: Positive and negative affect regulation. Journal of Clinical Psychology, 78(5), 926-937.Hornbacher, A., Sax, W., Naoum, J., & Schmahl, C. (2023). The role of self and blood in ritual and nonritual self-injury. In E.E. Lloyd-Richardson, I. Baetens, & J. Whitlock (Eds.), The Oxford handbook of nonsuicidal self-injury (pp. 468-480). Oxford University Press.Follow Dr. Westers on Instagram and Twitter/X (@DocWesters). To join ISSS, visit itriples.org and follow ISSS on Facebook and Twitter/X (@ITripleS).The Psychology of Self-Injury podcast has been rated as one of the "10 Best Self Harm Podcasts" and "20 Best Clinical Psychology Podcasts" by Feedspot  and one of the Top 100 Psychology Podcasts by Goodpods. It has also been featured in Audible's "Best Mental Health Podcasts to Defy Stigma and Begin to Heal."

In this episode, host and producer of The Psychology of Self-Injury podcast, Dr. Nicholas Westers, shares his own thoughts about how media portray nonsuicidal self-injury (NSSI) as well as suicide and mass shootings. He walks us through media guidelines for responsibly reporting and depicting each in the news, including the first ever NSSI media guidelines he published with ISSS colleagues. This marks the second solo episode of the podcast.Media Guidelines:Suicide: Read the suicide reporting guidelines published by the World Health Organization (WHO) here, learn about ethical reporting guidelines for media put forth by the American Foundation for Suicide Prevention (AFSP) here, and visit reportingonsuicide.org to review those offered by Suicide Awareness Voices of Education (SAVE).Mass Shootings: Read about media guidelines for responsible reporting on mass shootings put forth by the Radio Television Digital News Association (RTDNA) at www.rtdna.org/mass-shootings or visit reportingonmassshootings.org (this link is not currently active but could be reactivated in the future).Nonsuicidal Self-Injury (NSSI): Read about our International Society for the Study of Self-Injury (ISSS) media guidelines for NSSI and self-harm below. Watch Dr. Westers' interview with the British Journal of Psychiatry, the journal that published these guidelines here. See excellent resources provided by the Self-Injury & Recovery Resources (SIRR) at Cornell University at selfinjury.bctr.cornell.edu, including resources for the media here. Below are additional resources referenced in this episode.Westers, N. J., Lewis, S. P., Whitlock, J., Schatten, H. T., Ammerman, B., Andover, M. S., & Lloyd-Richardson, E. E.(2021). Media guidelines for the responsible reporting and depicting of non-suicidal self-injury. The British Journal of Psychiatry, 219(2), 415-418.Westers, N. J. (2024). Media representations of nonsuicidal self-injury. In E. E. Lloyd-Richardson, I. Baetens, & J. Whitlock (Eds.), The Oxford handbook of nonsuicidal self-injury (pp. 771-786). Oxford University Press.Phillips, D. P. (1974). The influence of suggestion on suicide: Substantive and theoretical implications of the Werther effect. American Sociological Review, 39(3), 340–354.Niederkrotenthaler, T., Voracek, M., Herberth, A., Till, B., Strauss, M., Etzersdorfer, E., Eisenwort, B., & Sonneck, G. (2010). Role of media reports in completed and prevented suicide: Werther v. Papageno effects. The British Journal of Psychiatry, 197(3), 234– 243.Follow Dr. Westers on Instagram and Twitter/X (@DocWesters). To join ISSS, visit itriples.org and follow ISSS on Facebook and Twitter/X (@ITripleS).The Psychology of Self-Injury podcast has been rated as one of the "10 Best Self Harm Podcasts" and "20 Best Clinical Psychology Podcasts" by Feedspot  and one of the Top 100 Psychology Podcasts by Goodpods. It has also been featured in Audible's "Best Mental Health Podcasts to Defy Stigma and Begin to Heal."