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Whitlock on self-injury and social media

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Janis Whitlock

Janis Whitlock

By Sheri Hall for the BCTR

BCTR Researcher Janis Whitlock was featured earlier this year in a PBS news story about self-injury and social media.

Whitlock, director of the BCTR’s Cornell Research Program on Self-Injury and Recovery, studies the interaction between mental health and social media. She served as an expert in a PBS story about social media tools designed to reach out to people who post about self-harm on social media.

This year, the photo-sharing platform Instagram created a new tool to reach out to people who post about injuring themselves or eating disorders. Here is how it works: Instagram allows users to report posts that they feel suggest self-harm. If an Instagram staff member flags the post, the user receives a message that suggests they talk to a friend, contact a helpline, or read tips about coping. Facebook has a similar tool for people who post about harming themselves.

“One of the things that’s abundantly clear is that people will disclose in social media and internet-based venues things that a lot of other people don’t know — maybe nobody in their life knows,” Whitlock told PBS.

“I applaud [Instagram] for making an effort to really effectively interact, to identify and capture people at the moment of their crisis. For someone who self-injures, often times if they can just pause the urge for even just 15 minutes, then the urge to injure will pass.”

Can Instagram’s new tool really help users who self-harm? - PBS Newshour

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Whitlock on teen self-injury, anxiety, and depression in Time

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time coverIn a recent Time Magazine cover story on Anxiety, Depression and the American Adolescent, the BCTR's Janis Whitlock describes the effect of current technology and social media on adolescent mental health:

"If you wanted to create an environment to churn out really angsty people, we’ve done it,” says Janis Whitlock, director of the Cornell Research Program on Self-Injury and Recovery. Sure, parental micromanaging can be a factor, as can school stress, but Whitlock doesn’t think those things are the main drivers of this epidemic. “It’s that they’re in a cauldron of stimulus they can’t get away from, or don’t want to get away from, or don’t know how to get away from,” she says.

Whitlock, director of the Cornell Research Program on Self-Injury and Recovery, goes on to describe why youth self-injure:

The academic study of this behavior is nascent, but researchers are developing a deeper understanding of how physical pain may relieve the psychological pain of some people who practice it. That knowledge may help experts better understand why it can be hard for some people to stop self-harming once they start. Whitlock, the director of the self-injury research program at Cornell, explains that studies are pretty consistent in showing that people who injure themselves do it to cope with anxiety or depression.

It’s hard to know why self-harm has surfaced at this time, and it’s possible we’re just more aware of it now because we live in a world where we’re more aware of everything. Whitlock thinks there’s a cultural element to it. Starting in the late 1990s, the body became a kind of billboard for self-expression—that’s when tattoos and piercings went mainstream. “As that was starting to happen, the idea of etching your emotional pain into your body was not a big step from the body as a canvas as an idea,” she says.

The idea that self-harm is tied to how we see the human body tracks with what many teens told me when I interviewed them. As Faith-Ann describes it, “A lot of value is put on our physical beauty now. All of our friends are Photoshopping their own photos—it’s hard to escape that need to be perfect.” Before the dawn of social media, the disorders that seemed to be the quintessential reflection of those same societal pressures were anorexia or bulimia—which are still serious concerns.

whitlock

Janis Whitlock

Whitlock says there are two common experiences that people have with selfharm. There are those who feel disconnected or numb. “They don’t feel real, and there’s something about pain and blood that brings them into their body,” she says.

On the other end of the spectrum are people who feel an overwhelming amount of emotion, says Whitlock. “If you asked them to describe those emotions on a scale of 1 to 10, they would say 10, while you or I might rate the same experience as a 6 or 7. They need to discharge those feelings somehow, and injury becomes their way,” she explains.

The research on what happens in the brain and body when someone cuts is still emerging. Scientists want to better understand how self-harm engages the endogenous opioid system—which is involved in the pain response in the brain—and what happens if and when it does.

Some of the treatments for self-harm are similar to those for addiction, particularly in the focus on identifying underlying psychological issues—what’s causing the anxiety and depression in the first place—and then teaching healthy ways to cope. Similarly, those who want to stop need a strong level of internal motivation.

 

Teen Depression and Anxiety: Why the Kids Are Not Alright - Time Magazine (subscription required)

Photos by Lise Sarfati from the article - Time Magazine

How social media and tech impacts young minds - Morning Joe, MSNBC (video - discussion of Time cover story)

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A BCTR student on misogyny, men, and mental health treatment

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crpsir logoNarayan Reddy gives a student's perspective on working with the BCTR's Cornell Research Program on Self-Injury and Recovery in a recent Cornell Daily Sun column. Reddy, a junior in the College of Arts and Sciences, discusses the ways that misogyny also negatively affects men, specifically in the realm of seeking mental health support. The full column:

I have been a research assistant for the Cornell Research Program on Self-Injury and Recovery, now known as the Youth, Risk and Opportunity lab, for a few years now. One of the projects I worked on last year was transcribing interviews. The interviews were conducted to clarify the course of one’s relationship with NSSI throughout one’s life as it relates to the trans-theoretical model. This model reflects an individual’s readiness to act on incorporating a healthier behavior into their lives, which in the cases of these individuals would be working towards ending their engagement in NSSI [non-suicidal self-injury].

The interviews themselves were of many perspectives. Some were teenagers who faced bullying, young adults struggling with their relationships and older individuals who confided in us that self-injury had been a fixture in their life for a long time. One thing they shared in common was their gender identity. All were women, with the exception of one young man.

No, this gender distribution is not representative of the overall population. Countless demographic studies on NSSI have consistently found that its prevalence is half women and half men. However, significantly less men seek treatment for their NSSI, or rather, the underlying mental health causes maintaining the behavior. It then follows that a large amount of men experiencing mental health issues do not seek treatment for them, and another body of research can confirm that the results of this negligence can be devastating.

This is one example of how sexism is damaging to men. The movement is entitled feminism because women comprise the gender seeking equality; they are the marginalized. It is a social-justice cause that has implications for better opportunities available to women by reforming a male-dominant system to allow for the realization of ambitions, aspirations, hopes, dreams and basic fundamental rights. However, it is often neglected that men are also affected by sexism in that many feel they must live up to the expectations that a male-dominant system entails. Stereotypically masculine features are those of strength, resilience and detachedness, being minimally emotional and stereotypically feminine features are the binary opposite: weakness, delicateness and affectedness, being overtly emotional.

American Male, a short film released by MTV, effectively illustrates the toxic effects a fragile masculinity can have. American because the United States is a country horribly beset by sexism, and the setting of a fraternity grounded in ‘bro’ culture is a specific aspect of American society in which such toxicity seeps into almost every conceivable social interaction.

“Order beer not wine.” “And beef not chicken. Never light beer though. And not tofu. Never tofu. Can’t get more gay than tofu.”

The narration of how to be a man eventually makes what is implicit explicit: directly comparing the social cues that define appropriate behaviors based on gender. As he recites the laws, they begin to touch on deeper levels of personal adjustment and consequently depict stronger repressions of emotional expression and vulnerability.

“Steer clear of the arts unless you live near the coasts. That means no theatre, dancing, painting, poetry or prose. Too much reading is also risky because it makes you look soft and bookish.”

“Women move their hips when they walk, men move their shoulders.”

“Women use exclamation points when they talk, men use periods.”

“Women second guess, men go with their gut.”

“Women write in diaries, men journal.”

“Women sing, dance and perform on stage. Men play sports, watch sports and talk about sports.”

As conversations about mental health are inherently discussed through emotions, men are as a result less likely to seek help for mental health issues they are experiencing. If an adolescent is engaging in NSSI, he may fear telling his friends or even his parents because he will lose any chance of cultivating an image of toughness; the fear of not living up to his manhood.

A similar phenomenon occurs with other areas of mental health, with one prevalent example being the stereotype of those suffering from eating disorders being exclusively young, middle to upper-class women with body image issues. Along with women, a large amount of men also suffer from eating disorders. Their causes are as diverse as the people who deal with them. For a man who shows symptoms of an eating disorder, however, their internalization of masculinity actively prevents them from receiving treatment. It is not a stretch to say that even the way in which NSSI usually presents between genders is also gendered. Women are more taken to forms of cutting, and men, punching. Furthermore, men are barred from participating in mental health research that also requires dialogue about emotions. This can explain the lack of information regarding mental health in men and the proceeding lack of mental health treatments that could be effective for male populations. This is a particularly troubling aspect of disparity out of the entire systemic issue of stigma that mental health advocacy is fighting to address.

In accordance with de-stigmatization, we must double down on efforts to have men be open up about their emotions, or just what they are going through in general, with feminism. This sentiment is related to the fundamental importance of fighting discrimination leveraged against women because of stereotypes surrounding their emotional states. It should be noted that women are not necessarily better off than men even in this aspect.

A woman’s openness about mental health issues is not only recognized, but is often perceived as signs of being over-exaggerators attention-seekers, and has in many cases led to speculations about her sexual promiscuity. This perception deems a woman’s mental health less worthy than a man’s, who is applauded for speaking up about his mental health, whereas it becomes deceptive when a women does it. This can be seen in the discussions of celebrities’ mental health, what separates Amanda Bynes, Tila Tequila, Kehlani and Lindsay Lohan from Kanye West, Ryan Adams and most recently Kid Cudi. To take on sexism in this regard, we must empower both genders and encourage men to be more open about mental health while at the same time discouraging biased reactions when women choose to be more open about theirs.

The man who narrates the short film ends it by describing himself as a chameleon, one who must constantly alter his presentation to fit his social environment. Ultimately, he admits to sacrificing his personhood in exchange for becoming a set of social cues. In one sense, however, being a chameleon can be a good thing in that it can represent both the dark shades associated with manhood, and the bright associated with womanhood, to display the full range of colors, the emotional expressions, that paint our existence as unique human beings removed from our gender expression. Consequently, we must all learn to be dysfunctional chameleons if we truly seek to improve access to and acceptability of mental health as well as the quality of mental health treatment.

Chameleon - Cornell Daily Sun

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Online course brings self-injury to the surface

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By Olivia M. Hall from the Cornell Chronicle:

The cuts, burns and scars of nonsuicidal self-injury (NSSI) are rarely seen, as they are inflicted in private and hidden under pant legs and sleeves.

Janis Whitlock

Janis Whitlock

Janis Whitlock, Ph.D. ’03, director of the Cornell Research Program on Self-Injury and Recovery (CRPSIR) and a research scientist in the Bronfenbrenner Center for Translational Research, hopes to spotlight the issue by launching a set of web-based education and training courses. Working with eCornell, the university’s online learning subsidiary, she is showing how researchers can use the internet to broaden their reach well beyond campus.

The curriculum, aimed at individuals who interact with youths in school, community and clinical settings, as well as parents, offers research-based information paired with intervention and prevention strategies to address a phenomenon that is widespread but not yet fully understood.

“It’s a scary thing to encounter,” said Whitlock. “It’s just not your typical, run-of-the-mill risk behavior.”

Individuals practicing NSSI – upward of 15 percent of adolescents and young adults try it at least once – deliberately damage their bodies, for example by cutting, burning or carving their skin or punching objects or themselves to inflict harm. Whitlock cites 15 to 17 percent lifetime prevalence of NSSI among Cornell students, according to surveys.

Although the surface wounds may look like suicide attempts, Whitlock pointed out that NSSI is, in fact, a coping mechanism for individuals trying to deal with intense feelings or attempting to reconnect from a sense of dissociation that stems from a history of trauma or abuse.

After first hearing about NSSI among otherwise functional, nonclinical adolescents more than a decade ago, Whitlock launched epidemiological studies, founded CRPSIR and brought together colleagues to form the International Society for the Study of Self-Injury in 2006. “Now we have so much literature coming out, I can’t keep up with it,” she said. But research on techniques for intervention in schools and families is still nascent, and findings do not always reach those in need.

“When I give presentations in schools, even elementary schools, I can pack a house talking about self-injury – it’s really pretty sad,” said Whitlock. “People come up to me asking for follow-up information. Clearly we need another dissemination vehicle.”

Paul Krause ’91, CEO of eCornell and associate vice provost for online learning, agreed: “We quickly recognized that it would make sense to work together because eCornell has all the capabilities to support the development, delivery and marketing of an online NSSI course.”

Best known for its professional development courses in such areas as marketing, finance and hospitality, eCornell also applies its experience and best practices to specialized curricula such as Whitlock’s to extend research-based education to learners beyond Ithaca.

Some 40 participants have enrolled since the first, self-paced version of the NSSI 101 course launched in February. This month, Whitlock is facilitating co-experts on NSSI by teaching the first iteration of a three-week version that offers eight to 10 hours of interactive instruction and continuing education credits. Shorter, abridged courses are also in development for medical professionals and parents of children who self-injure.

“This is an exciting opportunity for us,” said Krause, under whose leadership eCornell doubled the number of faculty members it works with to more than 100 over the past year. “We have faculty who are leading experts in their fields. eCornell’s mission is to help them use online learning to reach people all over the world.” (Whitlock’s first registrant was from South Korea.)

“The audiences with whom we seek to engage – be they parents, educators or others – need information that is high-quality, based in sound research, is compelling and that they can access on their own schedule,” added Rachel Dunifon, associate dean for research and outreach in the College of Human Ecology. “Working with eCornell to deliver research-based programming allows us to take a cutting-edge approach to our public engagement mission, broadening our reach and enhancing our impact as we seek to fulfill our college mission of improving lives.”

Olivia M. Hall, Ph.D. '12, is a freelance writer and anthropologist.

Online course brings self-injury to the surface - Cornell Chronicle

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View videos from fall BCTR talks

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Videos from our fall events are now online, in case you missed them or want to revisit the events. Videos are embedded below (when possible) and all are permanently archived in our media library.

 

2015 Iscol Lecture:
Workforce of the Future

October 7, 2015
Reshma Saujani, Founder and CEO, Girls Who Code

 

 

2015 Bronfenbrenner Lecture:
The Obama Evidence-Based Revolution: Will It Last?

September 16, 2015
Ron Haskins, Center on Children and Families; Budgeting for National Priorities; Economic Studies, Brookings Institution

 

View video

 

Talk at Twelve:
Helping Parents Help Their Teens: Lessons Learned about Parent Stress and Support from Research on Self-injury and Families

November 12, 2015
Janis Whitlock, BCTR, Cornell University

 

 

Talk at Twelve:
Trauma-informed Hospice and Palliative Care: Unique Vulnerabilities Call for Unique Strategies

September 10, 2015
Barbara Ganzel, BCTR, Cornell University

 

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Talks at Twelve: Janis Whitlock

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Helping Parents Help Their Teens: Lessons Learned about Parent Stress and Support from Research on Self-injury and Families
Thursday, November 12, 2015

Janis Whitlock
BCTR, Cornell University

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Addressing scars as lingering reminders of the pain of self-injury

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Janis Whitlock

Janis Whitlock

Even after doing the emotional work to heal from self-injury, scars can remain as a reminder of a painful time for many who self-injure. Tattooing has emerged as a potentially helpful tool for people with a history of self injury to cover, and reinterpret, their scars.

Janis Whitlock, director of the BCTR's Cornell Research Program on Self-Injury and Recovery, is quoted in a Vice.com post about coping with self-injury scars. There is a biochemical payoff to self harm, notes Whitlock, "You are basically relying on your body's own chemical-producing capacity to generate a set of drugs that change your consciousness."

Whitlock also responded to the idea of warning youth about the visibility and stigma of future scarring as a deterrent to self-injurious behavior. She noted that, due to the developmental stage of the teenage brain, it is nearly impossible for youth to absorb that kind of message about the future when they're flooded with emotion.

 

How tattoos can ease the emotional pain of self-harm scars - Vice

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Schools learning to address rising student self-injury

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"Schools around the country have begun offering new classes and mental-health programs to help stem a sharp rise in the number of adolescents found to be engaging in self injury, especially cutting," begins a recent Wall Street Journal article. The piece goes on to outline the use of dialectical behavior therapy (DBT) in schools across the country to offer kids other tools to deal with overwhelming emotions.

Whitlock-inpost

Janis Whitlock

Janis Whitlock, director of the Cornell Research Program on Self-Injury and Recovery, was a resource for the "Teen Cutting: Myths & Facts" sidebar on the article:

Myth: Cutting is a kind of suicide attempt.
Fact: Cutting usually isn’t intended to be life-ending. It is a coping mechanism used by young people who are stressed, overwhelmed or in emotional pain. It helps them manage their emotions and feel temporary relief.

Myth: Self-injury is something girls do, not boys.
Fact: Therapists and school officials often see more self-injuring girls than boys, but it may be that girls are more willing to ask for help. In many research samples of self-injuring people, there is a small, or no, difference in the proportion of males versus females. Girls are more likely to cut; boys are more likely to hit or burn.

Myth: Self-harm is a problem among teens but not younger children.
Fact: In a sample of 665 youth surveyed for a 2012 paper in Pediatrics, 7.6% of third graders, 4% of sixth graders, and 12.7% of ninth graders reported engaging in non-suicidal self-injury. Self-harming behaviors included cutting, hitting and scratching.

Myth: Self-injury is a problem among social misfits and struggling students.
Fact: People who self-harm include excellent students and those who struggle; youth who have a hard time fitting in, as well as leaders with a wide circle of friends; and those from advantaged and disadvantaged backgrounds.

Myth: People who cut are looking for attention.
Fact: Most people who do it say cutting, while painful, makes them feel relief temporarily. Young people often do it secretly: In one study, nearly a quarter of adolescents who reported self-injuring said they were sure nobody knew or suspected. Some say the physical pain distracts them from emotional pain, or that it makes them feel more alive.

 

Schools face the teen cutting problem - Wall Street Journal

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CRPSIR cited in NPR story on self-injury

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In his late teens David Fitzpatrick began to cut himself with razor blades. He was not intending to commit suicide, but was using self-injury as a way to cope with overwhelming emotions. This type of is self-wounding is called Nonsuicidal self-injury (NSSI), which the Cornell Research Program on Self-Injury and Recovery (CRPSIR) defines as the deliberate, self-inflicted destruction of body tissue resulting in immediate damage, without suicidal intent, and for purposes not culturally sanctioned.

David told his story to local NPR station WNPR in Connecticut, describing his shame and confusion around NSSI,

For me, it was just a growing depression, and shame, and self-rage, and loathing...I got so overwhelmed. I felt like I can’t tell anyone about this, because it’s so bizarre.

The piece references information from the CRPSIR web site, an excellent source of information on NSSI, including resources for those who self-injure, parents and caregivers, friends, therapists, and other professionals who serve youth.

 

Self-injury and mental illness: A story of recovery - WNPR

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Whitlock quoted on self-injury in US News & World Report

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Misconceptions and misinformation about self-injury can keep sufferers from getting care and effect how they are treated by others. A recent US News & World Report article addresses some common myths about self-injury, including that self-injurers are suicidal, that self-injury is uncommon, and that the behavior is untreatable.

0089_12_140.jpgJanis Whitlock, director of the BCTR's Cornell Research Program on Self-Injury and Recovery, was quoted in the section dispelling the misconception about self-injurers necessarily being suicidal:

If someone becomes suicidal, then the act of having engaged in self-injury does psychologically prepare them to damage their body. That piece, for somebody who's never hurt their body before, is not easy. We have a lot of inner safeguards, psychologically, from taking our own lives. Somebody who really wants to commit suicide is going to have to overcome that. And somebody with self-injury has already practiced hurting themselves that way.

The article includes nine myths about self-injury in all.

Myths and facts about self-injury - US News & World Report

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