In Self-Injury, Dr. Wendy Lader demonstrates her brief analytic approach to working with clients who purposefully injure themselves. Self-injury, which often takes the form of cutting or burning, is best viewed as a coping strategy: Clients usually injure themselves because they want to avoid some painful emotion, and self-injury brings a sense of control over these unwanted feelings.
Dr. Lader's approach is to analyze early childhood beliefs and relationships and then incorporate psychoeducation and cognitive–behavioral strategies into the session. Interventions are designed to reduce self-injury by increasing awareness of impulsive behavior and expressing any avoided emotions.
In this session, Dr. Lader works with a teenage girl who began cutting herself soon after her mother remarried. Dr. Lader talks with the client about the loss of her father, then gives the client a tool to help her monitor the emotions she experiences preceding the impulse to cut herself. This is an excellent example of a first session with an adolescent client who self-injures.