The Aspiring Psychologist Podcast - What is Indirect Self Harm and How to Reduce it - Trauma Special with Eva Perry

Episode Date: July 1, 2024

Show Notes for The Aspiring Psychologist Podcast Episode 134: What is indirect self-harm? Thank you for listening to the Aspiring Psychologist Podcast. Dr. Marianne Trent discusses the concept of indirect self-harm with guest expert Eva Perry. Indirect self-harm refers to behaviours that may cause unintended harm to oneself, such as social isolation or sleep deprivation. These behaviours are not deliberate or highly visible like direct self-harm, but they can still have negative effects on physical and mental well-being. The importance of awareness and support networks in recognising and preventing indirect self-harm is emphasised. The episode also touches on the relationship between trauma and indirect self-harm, as well as the need for mindfulness and alternative coping strategies. I’d love any feedback you might have, and I’d love to know what your offers are and to be connected with you on socials so I can help you to celebrate your wins!The Highlights: 00:00 - Introduction00:35 - Welcome to the Podcast01:24 - Guest Greeting02:11 - Introduction to Indirect Self-Harm03:07 - Defining Indirect Self-Harm04:37 - Examples of Indirect Self-Harm05:40 - Social Isolation and Sleep Deprivation07:09 - Self-Neglect and Motivation08:42 - Culturally Accepted Behaviours11:52 - Importance of Psychoeducation15:23 - Common Indirect Self-Harming Behaviours18:23 - Cultural Expectations20:27 - Mindfulness and Alternative Strategies22:27 - Screening for Indirect Self-Harm35:39 - Closing RemarksLinks:📲 Connect with Eva Perry: https://www.linkedin.com/in/dr-marianne-trent-psychology/ 🖥️ Check out my brand new short courses for aspiring psychologists and mental health professionals here: https://www.goodthinkingpsychology.co.uk/short-courses🫶 To support me by donating to help cover my costs for the free resources I provide click here: https://the-aspiring-psychologist.captivate.fm/support📚 To check out The Clinical Psychologist Collective Book: https://amzn.to/3jOplx0 📖 To check out The Aspiring Psychologist Collective Book: https://amzn.to/3CP2N97 💡 To check out or join the aspiring psychologist membership for just £30 per month head to: https://www.goodthinkingpsychology.co.uk/membership-interested✍️ Get your Supervision Shaping Tool now: https://www.goodthinkingpsychology.co.uk/supervision📱Connect socially with Marianne and check out ways to work with her, including the Aspiring Psychologist Book, Clinical Psychologist book and The Aspiring Psychologist Membership on her Link tree: https://linktr.ee/drmariannetrent💬 To join my free Facebook group and discuss your thoughts on this episode and more:

Hi there, it's Marianne here. Before we dive into today's episode, I want to quickly let you know about something exciting that's happening right now. If you've ever wondered how to create income that works for you, rather than constantly trading your time for money, then you'll love the Race to Recurring Revenue Challenge with my business mentor, Lisa Johnson. This challenge is designed to help you build sustainable income streams. And whether you're an aspiring psychologist, a mental health professional, or in a completely different field,

the principles can work for you. There are also wonderful prizes to be won directly by Lisa herself. And if you join the challenge by my link, you can be in with a chance of winning a one-to-one hours coaching with me, Dr. Marianne Trent. Do you want to know more? Of course you do. Head to my link tree, Dr. Marianne Trent, or check out my social media channels, or send me a quick DM and I'll get you all the details. Right, let's get on with today's episode. Have you ever wondered in what subtle ways we might be harming our own physical or

mental well-being? There's a concept called indirect self-harm which doesn't get a lot of press but I think it's time to turn that on its head. There are so many behaviours that can be classified as indirect self-harm. Come along, tune in and see whether you might be able to improve your well-being or that of someone that you are working with too. Hope you find it so useful. Welcome along to the Aspiring Psychologist podcast. I am Dr. Marianne Trent and I'm a qualified clinical psychologist. I am so delighted to be able to talk with you today with our guest expert for the day about a topic that you might not have considered before. I think it's especially relevant that we talk about indirect self-harm for aspiring

psychologists as well who might be pushing themselves to the brink of exhaustion and applying all sorts of pressures to themselves too. I hope that you will find this episode to be a really thought-provoking, inspiring, helpful listen. I'll look forward to catching up with you on the other side. Just want to welcome along our guest for today Eva Perry hi hi thanks for having me on oh thank you so much for um being so um happy to talk to us so it won't surprise anybody listening to this podcast that our paths crossed on LinkedIn didn't they yes yeah I posted about um I started making some information booklets and I think they've got some attention from the community, which is nice to see. Yeah. So you are a psychology undergraduate and you're doing your psychology masters at the moment. Yeah, so I'm a postgraduate in my master's course so I've um had my undergraduate degree in psychology um and now

I'm in my master's for clinical child psychology so yeah really enjoying it. I hope that is going really well for you and your undergraduate research project was on the concept of indirect self-harm is that right? yeah that's right it was a really new uh topic when I was looking um through different ideas the idea actually came to me um I was doing I had a placement year in my degree and I did a couple level two courses just alongside that and one of them was in self-harm and suicide prevention. And they talked about indirect suicide, which led into indirect self-harm. And I thought it was so interesting. I've never heard of this kind of concept before.

So it was a perfect opportunity to do some further research while I had the opportunity. Okay. So indirect suicide is when somebody has meant to hurt themselves, but hasn't meant to end their own life. Is that right? Potentially, yeah. There's loads of different kind of ways it can happen. So whether it comes from medical neglect, for example, if someone has diabetes and they're neglecting their medication and then they end up passing away because of that. Or someone engaging in something really risky and they don't mean to end up dying from it, but they're aware of the risk or those sort of activities. Yeah. And in terms of death certificates I'm

thinking that's sometimes put down to death by misadventure as well yeah exactly yeah would that be indirect suicide would that be a cause of death that you're aware of or would it always be sort of a medical cause of death that's used you know so for example it's something to do with the brain or the head or the heart or you know what's your understanding of that yeah I'm not entirely well versed on on how that would come up on a death certificate but it would probably be put down as an accident of some kind um yeah yeah sorry to put you on the spot, but it's just the way my brain works and it's like, oh, what would happen there? OK, so tell us a little bit then about indirect self-harm, because that's a really interesting area in itself and so interesting that you did your research on it. Yeah, yeah. So basically the concept of indirect self-harm is it's there's several different definitions because it's such a new theory.

But the main one I really liked was that they it's an activity that might cause unintended harm. So it's you know, it's not deliberate seeking out harm. For example, when people self-harm they might cut themselves that's a very deliberate and highly visible form of hurting yourself which those two aspects tend to be what many professionals say makes self-harm is it being highly visible and it being deliberate so with indirect self-harm it might be things like social isolation or sleep deprivation you know just not looking after yourself so it's not necessarily uh seeking out that harm intentionally but it comes around as um a secondary effect of what you're doing

yeah really interesting so actually a lot of the stuff that we might kind of see as kind of self-neglect like not eating not taking care of yourself like sometimes not even showering not um you know not picking up your dirty socks off the floor um can potentially lead to kind of sanitation hygiene issues for yourself or issues of malnourishment that are that are about often about motivation about perhaps very low mood poor self-worth you know I think sometimes there's factors involved with how many pressures you've got going on as well so I'm thinking about I'm a mother of two young children and in the times where they used to wake like 37 times a night um to wash your hair and have a

shower and feel that there's any point in doing that you know because you're so I think about that as being bone cold tired like you just much left in the tank really you know um but also thinking about somebody who might have additional caring needs for their own partner or their children um or some you know a parent for example it's very easy to focus on meeting the needs of other people but you might do that at the detriment to yourself but actually it's a really interesting concept that technically that that is indirect self-harm yeah yeah i mean there's a massive call for for people to recognize that um those sort of behaviors you know usually they're talked about as almost a prerequisite to direct self-harm. So when it's applied in a clinical practice,

you might look at indirect self-harm as a potential warning sign. So that theory can help preventing escalation of those behaviours. What you're talking about as well with this kind of socially accepted kind of behaviours of indirect self-harm is the notion of culturally accepted self-harm acts which is something that a brilliant researcher Turp came up with which is I mean it is what it says on the tin so it's any behaviors that might be socially permissible so obviously doing this research I was a university student and in these environments, there's so many of these behaviours come up, you know, excessive alcohol consumption,

experimenting with drugs, you know, self-criticism and perfectionism. These sort of behaviours are very problematic and they definitely come under the indirect self harm bracket. But they're so acceptable, you know, in university, that's just something that everyone does. It's almost like a rite of passage. So I think there's definitely as well, very interesting looking at that, from, you know, as I was living it, to be researching that, yeah, it's interesting. It really is interesting. um I'm married and

I'm married to somebody who's currently I think he's 48 yes winding him up about almost being 49 um and one of his favorite food groups which isn't even a food group is sugar um he likes cakes he likes sweets he likes apple juice. He likes Pepsi. But he's in really good shape because actually over the last few years, he's been kind of doing some strength training and kind of doing all that jazz. And it's always been, even since I met him, he's always been heavily into sugar, but he's been long and thin like a bean. And it's like, I don't really get how you're managing that but actually it was interesting when he went to the doctor to the dentist about seven or eight months ago she was like something is not right here you know your teeth essentially are not not managing very well you know she said are you sick a lot and he was like no and I he came home and

told me and I said I think she's trying to ask gently whether you are bulimic whether you're making yourself sick because she's kind of concerned about the level of acid erosion on your teeth and when he went back again the next week you know that he explored that with her and she said and he said I think it's maybe I drink a lot of sugary drinks. You know, actually, all of the stuff I drink. So is tea, he has tea with three sugars. And, you know, he'll murder me for talking so publicly about him. He's quite private.

Sorry, babe. But it's an interesting conversation. You know, it was having an impact on his teeth. So we've now invested in a waterpik flosser. He is now drinking more sugar-free squash. He's not drinking apple juice. He's swilling his mouth out after drinking Pepsi. You know, so he's still not perfect.

But I think he just hadn't quite realised that even that constitutes indirect self-harm. Yeah, definitely. I mean, that's a brilliant example of it, where it's not the direct intention to be hurting yourself in that way. You know, these effects, they come up as an accumulation of behaviours or, you know, persistent behaviours. I do sympathise because I have a sweet tooth myself um but yeah it's it's that's a really good example of it for sure I'll let him know that it was clinically relevant and approved

okay so yeah like this is a big topic and it's it's a really broad public health conversation but is this that we need to be getting better at psychoeducation how can we have a a role for this um you know many of the people listening to this will be working in mental health services either as aspiring psychologists um or you know maybe even qualified ones too we've got some qualified listeners how can we help to think about this with the people that we work with? Yeah I think it's really a matter of awareness I mean when I was researching this for my undergraduate there was I mean I could count how many papers were on indirect self-harm on one hand it was really under-researched and so I think having that awareness can be massively helpful as I said earlier it can help with noticing early signs that may be leading to you know direct self-harming

behaviours in clinical practice to notice those signs and kind of catch it before it escalates um and obviously the example um with your partner it's um the the concern that it might be an eating disorder it's a bit contentious but um in indirect self-harm i believe that eating disorders do come under that um because it's it might not be the um the direct intention to be causing harm to your body. For example, with bulimia, you do get tooth erosion and those sort of effects. They're not doing that for that effect that they might be doing it because they have low self-esteem or they want to look a certain way so um i do think it's important to sort of catch those behaviors before they might escalate into a full-blown eating disorder for example or um you know other yeah negative uh behaviors it's really important to have that awareness

yeah so i think often when i'm working with people with um bulimia specifically, the tooth erosion takes a while generally. But the things with kind of acid reflux and difficulty kind of keeping food down, even when you intend to, that happens a little quicker because of the way that the muscles and things work. So you can lead to lasting changes in your body because of you know bulimia is horrendous for people and it's it's a hugely distressing situation so you know there's a variety of reasons why it crops up and we know that it's a coping mechanism for you know a variety of challenging things but um you know these are not um not things that people do lightly nor are they that easy to to overcome but there are consequences for your physical health for your mental health

and um yeah i think indirect self-harm is such such an interesting area definitely and on that point as well um one of the main things that differentiates it from direct self-harm is that with indirect self-harming behaviors they usually lead on to other indirect self-harming behaviors um so for example with eating disorders you might um then you know if you're not eating you might not be sleeping well, you might be neglecting a personal hygiene because of that. So you have this sort of knock on effect that you don't see necessarily with direct self-harm. Usually there'll be one form of self-harm and then it doesn't impact so much developing another form of direct self-harm. With the research I did, we found that the average amount of indirect self-harming

behaviors we saw was 10 to 12 um in a month so it's a very big variety that that you get to see yeah what's your top 12 12 might be too many to ask you to list off but what are people most often reporting um the top three were i believe yes having self-defeating thoughts comfort eating and declining to ask for help when they were struggling um emotionally or physically oh gosh that is you know number three is especially interesting for me and i think it very much weaves in with perfectionism and that desire you know that that desire, you know, that belief that, you know, you can't ask for help or you shouldn't ask for help. And actually what I know now as a mother, you know, my youngest is now very almost eight. He's eagerly planning his

eighth birthday party and list. I wish that I'd taken the help that was offered for me, but I also wish I'd asked for more help you know when people came around to say you know cuddle the baby I wish I'd said actually can I have a nap you take baby for a walk around the block in the push chair or in the sling or actually when you're in the bathroom would you mind just staying behind for five minutes and cleaning it for me and there's not a single one of my friends that would have said no they would have been happy to help but I didn't know it was okay to ask for that help and I remember when I had my eldest who is approaching 11 he doesn't like me to say he's 10 I was in a different home to this one and he was asleep on my shoulder and because

I got so little sleep when they were asleep I was very reluctant to put them down and my babies like to wake up as soon as you put them down anyway. And I was looking at the board that was gradually getting more and more covered in dust and just thinking, I want that dusted. I'm not particularly house proud, but it got to the stage where it really needed doing like probably three months ago. And I was like, I'm not going to get a chance to do that because when I have a spare moment the last thing I'm going to want to do is to dust that skirting board but I wish I'd just said to somebody you know I probably didn't even say to my husband you dust that skirting board because I felt that pressure to be the perfect housewife the perfect mother to have a clean home we had a brand new build property at that time as well which probably didn't help because everything looked so shiny and white and so then you notice those small changes but

yeah yeah I'm just it's really interesting to to hear you say that that's the top three is not offering help that's offered to you or not asking for help that really resonates with me yeah I mean that's thank you for sharing that that's definitely an interesting uh story as well coming into that subject so um I think it comes back to what's culturally acceptable so uni students you know you're kind of expected to have those behaviors and I'm not a mother myself but um you know my sister's a mother and kind of seeing her experiences is you're kind of expected to have that that difficult time people always say oh you know my sister's a mother and kind of seeing her experiences is you're kind of expected to have that that difficult time people always say oh you know terrible tears watch out um and there's

sort of that expectation that it's going to be horrible so you might not feel uh perhaps that you you should be asking for help because you know this is just how it's supposed to be I think that definitely plays into a lot of the papers that we see yeah I think it's one of the beautiful things about this podcast and also lovely nourishing books is that it helps you think oh I didn't realize that I've never thought about that or actually you know I might use that or do that differently in future so I wish that when I'd visited my friends with new babies that I'd said so i brought my mini vac with me i'm just gonna he's okay i'm just gonna i'm just gonna just gonna whip it around for you because actually you think that and like there's no shame in that is it we're not trying to shame people

we're trying to say actually when i come around i really want to be as useful to you as i can you know and actually if you don't need me to bring three brand new baby grows from next, you know, can I bring you some home cooked meals that you put in the freezer that are going to really nourish you. And actually, when my friend was pregnant with her third child, she had her first baby, sadly, her second was stillborn, she was really thinking about the birth of her third baby. And rather than baby things, she said, could you cook me your favourite meals, put them in some freezable containers. And then when I met up with her, I bought her a really lovely cool bag, I'd put some like little kind of cold freeze things in there. And that's what she, you know, existed on when her baby was little.

You know, all of this made with love, really nutritious. She knows I like vegetables. So she knew that that would be, you know, food with love. And to know that actually a time when you're going to be struggling, for example, I lost my dad and that was a really challenging time for probably the two years after that and when he was unwell I wish I'd asked for more help and accepted more help at that time but it's only really when we de-shame ourselves and when we go through adversity and then learn compassion that we know it's okay to ask for help it's not it doesn't say anything

bad about you to do that yeah I 100% agree it's so important to surround yourself with those positive people I think a lot of times people you surround yourself with can facilitate those sort of behaviors so you know as a uni student if you're surrounding yourself with people who are experimenting a lot with drugs or you know promiscuity alcoholism that those sort of behavior so you know as a uni student if you're surrounding yourself with people who are experimenting a lot with drugs or you know promiscuity alcoholism that those sort of behaviors it's easy to get drawn into that so it's so important to have that supportive network it sounds like you were absolutely brilliant to your friend it's i'm just definitely you know grateful to have you for that um yeah it's it's a really important thing the thing with indirect self-harm is because it's so under research there's not many um kind of interventions for it

um as such out there so um yeah we've kind of got to think about those sort of um you know preventative and protective factors in in terms of reducing those behaviors i think support networks is a massive one yeah yeah and because it is so new are there any outcome measures that yet screen for indirect self-harm yes so um there's one that i used for my undergraduate research, which is the direct and indirect self-harm inventory. And actually, interestingly, the first self-harm measure that you're probably familiar with, the self-harm inventory actually had quite a few indirect self-harming behaviors on it anyway, which I think is good. good so for my undergraduate um project I merged those two together to get a list of um indirect self-harming behaviors that people could you know rate how often they engage in those so it'd be items like um you know driving recklessly or exercising when you're injured or um yeah those sort of behaviors is it's uh it's very limited measures but we do have a couple

really good ones yeah and that's another interesting one isn't it one of my besties um has got into marathons and half marathons and um all sorts of fitness in the last couple of years and every time she runs she ends up with like runs for a distance she runs up she ends up with a problem with her knee and i'm like baby girl i think your body is saying i really want you to run and she's like no it's telling me it wants me to run more and i'm like i'm not so sure about that my love but it's really difficult things we want to do our body doesn't necessarily like and it's interesting to think about that as self-harm yeah 100 it's being mindful of um you know what your body's telling you i think it's mindfulness with i mean it's in most different therapies and counseling it's and that's for a

reason it's so important to be in tune with your um you know the physical sensations and and um you know for example certain indirect self-harm behaviors can be uh just picking your nails um my partner has this habit where he'll pick his cuticles and it'll it's oh i feel it looks so painful um and it counts as indirect self-harm because you're causing harm to yourself but it's not the direct intention of it and so those sort of behaviours it's important to be mindful of when you're doing that and to kind of catch yourself from doing that

to kind of stop those behaviours and that's interesting because I used to nibble skin down the sides of my fingers but you know what made me stop it was when I got an adult brace in 2008 I think it was and I realized that I was pushing my front tooth and so that's probably what had led to some movement in my teeth to begin with so indirectly my nibbling my skin was also affecting my teeth so there was two types of indirect self-harm and I realized in the bath my fingers looked gross so if I was going swimming or anything my fingers looked gross and I was like I don't want to do that anymore so I'm going to put that I'm going to put that down and make a conscious

choice to not do that to break that cycle this is such a fascinating conversation and as we talk if people are watching on YouTube they'll be able to see that I'm drinking a cup of tea which isn't something I usually do but we're talking in the afternoon and often I'll record podcasts in the morning but I wanted to squeeze this one in because it had such an interesting topic that's relevant to kind of the trauma-y stuff that I'm talking about at the moment, but also because it's just hugely interesting. But I'm drinking a cup of green tea with lemon. And I have a cup of that every day at 1.30pm. Like I'm quite a creature of having, I tend to have lunch at the same time. And then

as I'm preparing to come back online, it's about one o'clock, 1.30pm, I'll quite a creature I tend to have lunch at the same time and then as I'm preparing to come back online it's about one o'clock 1 30 I'll have I'll have a cup of green tea with lemon but that's the only caffeine I have all day and it's quite weak but actually if I don't have that my body is expecting it and feels a bit wobbly and caffeine can be a really big deal, can't it, in terms of indirect self-harm? Yeah, definitely. I mean, any of those sort of addictions, I suppose, people have. So whether it's smoking alcohol, caffeine, they can have a massive impact. again it's not the direct intention of it um although i would argue potentially uh green tea sounds lovely um i've got a tea drink myself but i've heard that it has quite uh calming effects and um it can be quite a positive uh you know yeah i don't think

i don't think i'm a risk to myself or others with one cup of very weak tea. It's got antioxidants and good stuff in it. So I think, you know, I'm doing all right. But, you know, I am concerned about caffeine and human brains, especially young brains. So my 10 year old will often say, can I have Coke at the pub if we're going out? And I'm like, no, Coke is not a treat um it's never a good thing I know daddy drinks pepsi but it's not it's not like a rite of passage you know caffeine is the largest unregulated drug in in the world and this is not necessarily something that I want my 10 year old to have and I had a conversation about this in my private

psychologist group as a practitioner parent as well to think about actually what are how do we explore this safely you know what I know is if we say no to kids that they potentially go off and do it to excess anyway and it's it's thinking about not making it a big deal but not necessarily having it as a treat either I don't want him to think that that coke is a treat so as we record this um we went out for a meal yesterday to celebrate the end of his sats which is quite an important rite of passage for a 10 year old and he said can I have a coke and I was like no not today baby because I will sometimes say yes but I didn't want him to think that the way we celebrate

is with the buzz that comes from caffeine does that make sense absolutely yeah those associations are so important and um in you know recognizing those behaviors and reducing them what you mentioned earlier as well about the trauma aspect of it. I mean, we see in so many cases with trauma, rates of eating disorders and direct self-harm as well and alcoholism, all of these risky behaviours. I mean, it doubles with when you add trauma to it. really important that childhood um you know the effects it can have on whether you develop these behaviors it is such an important uh time you know of someone's life and whether they'll go on to develop those for sure and i think i'm just trying to be generally more mindful about everything so i went away um in april this year to go and see Take That with my friends not necessarily because Take That were playing but because we were looking at getting together that

weekend and we're like what should we do oh Take That are playing let's do that um but I decided actually I'm not going to drink this weekend because I really want to value the time with my friends but also because I'm driving home for two hours the next day. I just don't want to ruin my night's sleep and then ruin the way that I feel the next day. Or I'm not a great drinker anyway, so I'll sometimes feel quite sick and two drinks is about as much as I can handle. But I was like, you know, what would happen if I freed myself up to not drink at all um so I didn't and one of my friends didn't either and you know that weekend has been so restorative for me I still think of it really fondly like the whole week afterwards I just felt incredible like to have

had that time with my friends um you know the joyful experiences we had together that were take that related or non-take that related you know and it just had such a lasting impact that's just warmed my cockles in a way that I know it wouldn't have done had I drunk because my body and mind would have needed to recover from that energy and i think that is the gift that i've given future me to not have to do that and it's actually i've avoided indirect self-harm there brilliant yeah i mean that's a brilliant example it sounds like it's a great experience um it's definitely having that introspective awareness um like yeah I think you know psychology professionals they tend to have that awareness anyway um just from the you know

learning about it and so yeah having that awareness and again it comes back to who you surround yourself with so um you know your friend was it sounds she sounds really supportive um you know didn't drink either but obviously in some groups especially I think in um you know male friend groups there can be that sort of stigma around those sort of um behaviors where you know they'll say oh you know you're no fun or you know they'll kind of make fun of you and then you might feel pressured to you know oh okay then I'll have a drink um so I think yeah it's so important who you surround yourself with in that way absolutely and you know when we got together to have lunch two of my friends had

a glass of champagne and I considered it for a moment and I just thought you know what I know I will feel a bit wheezy headed and likely want a nap if I have it and actually that's not what I'm choosing for myself this afternoon so throwing no shade on them but they had one glass of champagne and you know that's how that went down for them and that you know they had a great time as well but yeah I think when we were in the arena like I don't also don't want to spend like nine pounds on a pint of something I don't really like anyway but yeah it just wasn't right for that occasion but I'm not saying I won't ever drink again I don't know I might you know I likely will but I'm just doing it more mindfully I guess I don't want this episode to come across really preacherly that's not at all what we're saying but we're just yeah

having a curious conversation really about some of these things that we might never have considered or that we don't routinely discuss with our clients? No, definitely. Yeah, I don't want it to come across like that at all. It's mainly just kind of spreading the awareness to, you know, perhaps be more mindful of those behaviours and the effects that they can have. Obviously, a drink every now and again, it's, you know, probably not going to be particularly harmful. It's, you know, it's a bit of fun um it's when it accumulates and it starts causing those um negative effects i think that that's when you you know perhaps need to check um what it's doing for you and you know if you if you do need to alter those mindsets um but yeah generally it's just about starting that awareness off i think yeah and i think often it

can be really useful to take it back to the window of tolerance and to look at how we regulate ourselves when we are hyper and how we regulate ourselves when we're kind of a bit freeze or flop bit hypo aroused and actually i often find that can be a really helpful conversation with clients to think about what strategies they use to either bump themselves up or to kind of bring themselves down and many of those will be in direct self-harm but what we try to role model is actually soothing within breathing is a really great alternative to that or you know a bit of mindfulness or maybe going for a walk I find going for a run really really helpful because my knees don't seem to mind it short runs they the manage you know really really helpful um because my knees don't see my mind it's short runs they the manage um you know really really helpful for keeping me well but also shifting my mindset in a way that

probably is going to be better for me than a mars bar or better for me than a glass of wine and have a more lasting impact for me definitely yeah um and it comes down to I can't remember the specific term I think it's risk reduction but it's when you're you know when your client is perhaps self-harming and they you encourage them to adopt other strategies you know that might still be you know harmful in a way for example using an elastic band against your wrist instead of cutting yourself I can't remember the specific term for that now but um you know just stepping back so that you're getting the similar sensation but in a way that actually isn't going to to risk so if you if someone's liking the elastic band they're getting that sensation on their wrist without cutting their

wrist that can open them up to kind of blood infections and and you know blood loss as well and pain and yeah um i can't remember the term either but um you know i think it's something you know yeah i do something we'll often see in um in kind of dialectical behavioral therapy as well that kind of thing so um thank you so much for your time um if people want to come and have a look at your research more fully is linkedin the best place for them to do that eva yes linkedin um i'm eva hyphen perry on linkedin um i'm happy to if you want to send me a message i'd be happy to talk to anyone um to discuss further it's an interesting subject and you know i'd really like to share you know what I found and spread that awareness for the community start a discussion

yeah it really is I think it's going to be a case of watch out world for when you go on to do whatever kind of professional qualification that you do but yeah thank you for having this conversation with our audience and for demonstrating that actually really brilliant stuff goes on even at earlier stages of people's psychology career brilliant yeah thank you for having me on it's been really nice to discuss with another professional um yeah thank you you're so welcome take care of yourself and be kind to yourself and always ask someone to hoover your house should you want them to brilliant thank you what an absolute pleasure to speak with Ava please do go and follow her over on LinkedIn and I would love to know your

thoughts about this episode do come and let me know what you think on my social media Dr. Marianne Trent I am that everywhere. But also come into the group, the free Facebook group, the Aspiring Psychologist Community with Dr. Marianne Trent and let me know what you think to it there. Perhaps it might be a useful one to share with your service if you think that they might find that beneficial. The Aspiring Psychologist Community is also the home of Marianne's motivation and mindset videos. So that's the only place you can watch them. So come and join and come and join in. If you enjoy the podcast, please do rate it. Please do review it. Please do subscribe, follow the show as it helps us to reach a wider audience. And it's the kindest

thing you can do for absolutely free. If you love these kinds of growth conversations that really help you stretch and grow and think about important issues in psychology, if you think this is how good the free stuff is, imagine how good the stuff is in the Aspiring Psychologist membership, which you can join from just £30 a month. Do check out the details in the Aspiring Psychologist membership, which you can join from just £30 a month. Do check out the details in the show notes or on any of my socials or just DM me the word membership and I will be in touch with you.

Please do come and follow me on socials. I'll often drop voice notes to new connections so you may have your very own personalised podcast episode just from me to you be kind to yourself i will look forward to bringing the next episode to you from 10 a.m on saturday for youtube and wherever you get your podcast from 6 a.m on monday take care if you're looking to become a psychologist

then let this be your guide with this podcast at your side you'll be on your way to being qualified it's the Aspiring Psychologist Podcast with Dr. Marianne Trent. My name's Jana and I'm a trainee psychological well-being practitioner. I read the Clinical Psychologist Collective book. I found it really interesting about all the different stories and how people got to become a clinical psychologist.

It just amazed me how many different routes there are to get there and there's no perfect way to become one and this kind of filled me with confidence that no I'm not doing it wrong and put less pressure on myself. So if you're feeling a bit uneasy about becoming a clinical psychologist I'd definitely recommend this just to put yourself at ease and everything will be okay. But trust me you will not put the book down once you start.