Stabilizing Unsafe Behavior: Suicide and Self-Injury – Janina Fisher

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Childhood trauma and neglect leave survivors with a legacy of overwhelming memories and emotions but also a compromised nervous system that impairs their capacity to tolerate the normal ups and downs of life. Unaware that their intense reactions are driven by implicit traumatic memories lodged in the body, these clients resort to desperate measures: addictive behavior and self-harm to numb the body or increase hypervigilance, suicidal ideation to restore a sense of control over their lives and painful emotions, dissociative and borderline responses of fight and flight when hurt, threatened, or rejected. Rather than offering a context for healing the effects of childhood trauma, therapy becomes a crisis center whose goal it is simply to ensure the client’s safety.

Recent developments in neuroscience research and the evolution of new treatment techniques offer some hopeful answers to these puzzling and frustrating challenges. Ironically, the survival responses that preserve sanity under threat do not diminish once the danger is past. Instead, they continue to drive the symptoms for decades after the events are over, interfering with functioning, relationships, and therapeutic treatment.

This presentation will use a neurobiological lens for looking at traumatized individuals carrying a range of diagnoses troubled by addiction, self-destructive and suicidal behavior. We will explore the implications of a neuroscientifically-informed perspective on treatment and present the latest advances in effective interventions. When the trauma symptoms are “decoded” in this way, stuck, self-destructive, and therapy-destructive presentations become more understandable and manageable.

• Describe the implications of the neuroscience research for understanding and treating traumatized individuals
• Identify the neurobiological causes of self-destructive behavior
• Integrate mindfulness-based therapy techniques into the treatment
• Select appropriate interventions for stabilizing addictive and self-destructive symptoms and behavior

• Unsafe behavior and the neurobiology of trauma
• Changing the client’s relationship to impulsive suicidal and self-destructive behavior
• Somatic and cognitive-behavioral interventions for stabilization