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.Minor TranquillisersBenzodiazepines (e.g.diazepam (Valium), lorazepam, (Activan))Although these drugs reduce anxiety and thus emotionaltension there is little evidence that they reduce self-harming behaviour.In fact in some cases, self-harming behaviour was seen to increase.Common Side Effects—dizziness headache, nausea, psychological dependency, attention and memory impairments, drowsinessSerotonin related tranquillisers (e.g.buspirone) Although there has been no reported trials of this tranquilliser used with women who self-harm, it is possible that it may be more useful than other minor tranquillisers as it increases the levels of the brain chemical serotonin.It also has fewer side effects and is safer in overdoses than the benzodiazepines.Common Side Effects—rare but can be dizziness, headaches and nauseaMajor Tranquillisers(e.g.thoridazine (Meleril), chlorpromazine (Largactyl)) The major tranquillisers are often given in desperation when minor tranquillisers have proved to be ineffective.Major tranquillisers can in fact reduce self-harming behaviour in some people but the side effects have a profoundly detrimental effect on the person's quality of life.Common Side Effects—dry mouth, sedation, apathy, sensitivity to light, hypotension, mental depression3.SedativesBenzodiazepines (e.g.termazepan); other sedatives (e.g.chloral hydrate)Some women have been prescribed sedatives in the hope these would calm their tension and help them relax or sleep.Paradoxically in some cases the use of these drugshas been found to increase self-harming behaviour.This is thought to be because these drugs reduce inhibition.Common Side Effects—hangover type symptoms, over-sedation, abdominal pain4.Other medications that have been shown to be effective in some casesThe two drugs that have mostly consistently been found to be effective in reducing self-harming behaviour are lithium carbonate and carbamazine.Both these drugs are traditionally given to people who suffer from manicdepression.How these drugs affect the brain is not fully understood but both have been shown to be effective at reducing self-harming behaviour in some cases.Common Side Effects—loss of ability to co-ordinate muscles, urinary frequency, slurred speech5.Opiate Receptor BlockersSelf-harming behaviour has been shown to bring about a feeling of calm.Research has shown that this sense of calm is due to the release of endogenous opioids; opiatelike chemicals that occur naturally in the brain.Just as people can become addicted to other opioids such as heroine, opium and morphine, so they can become addicted to the release of their endogenous opioids.If addicted, the person can also suffer from a feeling of `withdrawal' which leads them to engage in behaviour that in the past has led to the release of these chemicals.Judith Herman and her colleagues carried out some trials in which people who self-harmed were given a drug (naltrexone) that reduced the need in the person for these chemicals and found that self-harming behaviour decreased significantly.Appendix IIFurther ReadingThe following is by no means a comprehensive reference list.We have included books that focus specifically on self-harm or that have particular relevance to the issue.Gloria Babiker and Lois Arnold, The Language of Injury: Comprehending Self-Mutilation, BPS Books, Leicester, 1997.This book is aimed at professionals, but offers anexcellent overview of the literature and a very compelling analysis of self-injury.Both The Basement Project and Bristol Crisis Service for Women produce publications on aspects of their work.Addresses in the resource section.Armando Favazza, Bodies Under Siege, Johns Hopkins University Press, Baltimore, 1987.This is included because it is a classic text on self-harm.Favazza also gives a comprehensive cross-cultural overview of socially-sanctioned self-mutilation by describing practices from other countries and cultures.Diane Harrison, Vicious Circles: An Exploration of Women and Self-harm in Society, Good Practices in Mental Health, London, 1995.Diane Harrison has written this book based on her own experiences as a woman who self-harms.She uses other women's experiences as well as her own.The book is divided into eight sections examining both the wider context within which self-harm occurs and the personal struggle for survival.Diane Harrison, and edited by Janet Gorman, Understanding Self Harm, Mind Publications, London, 1994.Available from MIND Mail Order, Granta House, 15-19 Broad Way, London E15 4BQ.A 10-page leaflet with sections on what self-harm is; why people do it; differences between self-harm and suicide; its relationship with sexual abuse; finding help; issues for mental health workers, for family and friends; and resources.HMSO Suicide and Self Injury in Prison: A literature review, Home Office Research Study No 115, HMSO: London, 1990.Interesting, if only in its dry approach to the topic.However, the figures on the incidence and prevalence in prisons are very disturbing.Marsha Linehan, Cognitive Behavioural Treatment of Borderline Personality Disorder and Skills Training Manual for Treating Borderline Personality Disorder, both Guilford, New York, 1993.Linehan describes her work with women who self-harm.Michaela Swales and Barry Kiehn have written `An Overview of Dialectical Behaviour Therapy in the Treatment of Borderline Personality Disorder', 1995, in the Internet-based electronic journal `Psychiatry On-Line' http://www.cityscape.co.uk/users/ad88/psych.htmThe Mental Health Foundation also publishes material on self-harm.These include:MHF Briefing 1 Suicide and Deliberate Self Harm ISBN 0 901944 49 1 and Working With People Who Self-Injure ISBN 0953 1348 06.The latter includes nine training modules which include trainer's notes, participative exercises, handouts and overheads.The materials have been developed through the Bristol Crisis Service for Women.Available from The Mental Health Foundation, 37 Mortimer Street, London W1N 8JU.Dusty Miller, Women who Hurt Themselves: A Book of Hope and Understanding, Basic Books, New York, 1994.Dusty Miller's book provides a detailed description of her theory regarding trauma re-enactment which she feels is at the root of self-harming behaviour.The second part of the book describes her own therapeutic model of work.Louise Pembroke, Self-Harm: Perspectives from Personal Experience, Survivors Speak Out, London, 1994.As the title states this short book includes personal testimonies from both men and women who self-harm.Louise's own testimony is the longest but she provides the reader with a disturbing insight into the services provided to `help' those who self-harm as well as some useful suggestions for family and professionals.Additional publications include: L.Pembroke, Self Injury: Myths and Common Sense, National Self-Harm Network, London, 1996 and L.Pembroke and A.Smith, Minimising the Damage from Self Harm, National Self-Harm Network, London, 1996.Address for the National Self-Harm Network is in the Resources Section.B.W.Walsh and P.M.Rosen, Self Mutilation: Theory, Research and Treatment, Guilford, New York, 1988.This book gives a good overview of conventional ways of viewing and treating self-harming behaviour.Managing Self-Harm: Conference ProceedingsThe proceedings of a recent national conference on self-harm (March 1997) organised in conjunction with the Henderson Hospital have been published [ Pobierz całość w formacie PDF ]
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.Minor TranquillisersBenzodiazepines (e.g.diazepam (Valium), lorazepam, (Activan))Although these drugs reduce anxiety and thus emotionaltension there is little evidence that they reduce self-harming behaviour.In fact in some cases, self-harming behaviour was seen to increase.Common Side Effects—dizziness headache, nausea, psychological dependency, attention and memory impairments, drowsinessSerotonin related tranquillisers (e.g.buspirone) Although there has been no reported trials of this tranquilliser used with women who self-harm, it is possible that it may be more useful than other minor tranquillisers as it increases the levels of the brain chemical serotonin.It also has fewer side effects and is safer in overdoses than the benzodiazepines.Common Side Effects—rare but can be dizziness, headaches and nauseaMajor Tranquillisers(e.g.thoridazine (Meleril), chlorpromazine (Largactyl)) The major tranquillisers are often given in desperation when minor tranquillisers have proved to be ineffective.Major tranquillisers can in fact reduce self-harming behaviour in some people but the side effects have a profoundly detrimental effect on the person's quality of life.Common Side Effects—dry mouth, sedation, apathy, sensitivity to light, hypotension, mental depression3.SedativesBenzodiazepines (e.g.termazepan); other sedatives (e.g.chloral hydrate)Some women have been prescribed sedatives in the hope these would calm their tension and help them relax or sleep.Paradoxically in some cases the use of these drugshas been found to increase self-harming behaviour.This is thought to be because these drugs reduce inhibition.Common Side Effects—hangover type symptoms, over-sedation, abdominal pain4.Other medications that have been shown to be effective in some casesThe two drugs that have mostly consistently been found to be effective in reducing self-harming behaviour are lithium carbonate and carbamazine.Both these drugs are traditionally given to people who suffer from manicdepression.How these drugs affect the brain is not fully understood but both have been shown to be effective at reducing self-harming behaviour in some cases.Common Side Effects—loss of ability to co-ordinate muscles, urinary frequency, slurred speech5.Opiate Receptor BlockersSelf-harming behaviour has been shown to bring about a feeling of calm.Research has shown that this sense of calm is due to the release of endogenous opioids; opiatelike chemicals that occur naturally in the brain.Just as people can become addicted to other opioids such as heroine, opium and morphine, so they can become addicted to the release of their endogenous opioids.If addicted, the person can also suffer from a feeling of `withdrawal' which leads them to engage in behaviour that in the past has led to the release of these chemicals.Judith Herman and her colleagues carried out some trials in which people who self-harmed were given a drug (naltrexone) that reduced the need in the person for these chemicals and found that self-harming behaviour decreased significantly.Appendix IIFurther ReadingThe following is by no means a comprehensive reference list.We have included books that focus specifically on self-harm or that have particular relevance to the issue.Gloria Babiker and Lois Arnold, The Language of Injury: Comprehending Self-Mutilation, BPS Books, Leicester, 1997.This book is aimed at professionals, but offers anexcellent overview of the literature and a very compelling analysis of self-injury.Both The Basement Project and Bristol Crisis Service for Women produce publications on aspects of their work.Addresses in the resource section.Armando Favazza, Bodies Under Siege, Johns Hopkins University Press, Baltimore, 1987.This is included because it is a classic text on self-harm.Favazza also gives a comprehensive cross-cultural overview of socially-sanctioned self-mutilation by describing practices from other countries and cultures.Diane Harrison, Vicious Circles: An Exploration of Women and Self-harm in Society, Good Practices in Mental Health, London, 1995.Diane Harrison has written this book based on her own experiences as a woman who self-harms.She uses other women's experiences as well as her own.The book is divided into eight sections examining both the wider context within which self-harm occurs and the personal struggle for survival.Diane Harrison, and edited by Janet Gorman, Understanding Self Harm, Mind Publications, London, 1994.Available from MIND Mail Order, Granta House, 15-19 Broad Way, London E15 4BQ.A 10-page leaflet with sections on what self-harm is; why people do it; differences between self-harm and suicide; its relationship with sexual abuse; finding help; issues for mental health workers, for family and friends; and resources.HMSO Suicide and Self Injury in Prison: A literature review, Home Office Research Study No 115, HMSO: London, 1990.Interesting, if only in its dry approach to the topic.However, the figures on the incidence and prevalence in prisons are very disturbing.Marsha Linehan, Cognitive Behavioural Treatment of Borderline Personality Disorder and Skills Training Manual for Treating Borderline Personality Disorder, both Guilford, New York, 1993.Linehan describes her work with women who self-harm.Michaela Swales and Barry Kiehn have written `An Overview of Dialectical Behaviour Therapy in the Treatment of Borderline Personality Disorder', 1995, in the Internet-based electronic journal `Psychiatry On-Line' http://www.cityscape.co.uk/users/ad88/psych.htmThe Mental Health Foundation also publishes material on self-harm.These include:MHF Briefing 1 Suicide and Deliberate Self Harm ISBN 0 901944 49 1 and Working With People Who Self-Injure ISBN 0953 1348 06.The latter includes nine training modules which include trainer's notes, participative exercises, handouts and overheads.The materials have been developed through the Bristol Crisis Service for Women.Available from The Mental Health Foundation, 37 Mortimer Street, London W1N 8JU.Dusty Miller, Women who Hurt Themselves: A Book of Hope and Understanding, Basic Books, New York, 1994.Dusty Miller's book provides a detailed description of her theory regarding trauma re-enactment which she feels is at the root of self-harming behaviour.The second part of the book describes her own therapeutic model of work.Louise Pembroke, Self-Harm: Perspectives from Personal Experience, Survivors Speak Out, London, 1994.As the title states this short book includes personal testimonies from both men and women who self-harm.Louise's own testimony is the longest but she provides the reader with a disturbing insight into the services provided to `help' those who self-harm as well as some useful suggestions for family and professionals.Additional publications include: L.Pembroke, Self Injury: Myths and Common Sense, National Self-Harm Network, London, 1996 and L.Pembroke and A.Smith, Minimising the Damage from Self Harm, National Self-Harm Network, London, 1996.Address for the National Self-Harm Network is in the Resources Section.B.W.Walsh and P.M.Rosen, Self Mutilation: Theory, Research and Treatment, Guilford, New York, 1988.This book gives a good overview of conventional ways of viewing and treating self-harming behaviour.Managing Self-Harm: Conference ProceedingsThe proceedings of a recent national conference on self-harm (March 1997) organised in conjunction with the Henderson Hospital have been published [ Pobierz całość w formacie PDF ]