Skills to help young people who experience overwhelming emotion

So if we understand self-injury as a behaviour that helps young people manage their internal and external world, in order for them to reduce or stop this behaviour we need to build on their resources and skills so that they can find other ways to cope.  Rather than eliminating these uncomfortable emotions, the focus is on building tolerance to uncomfortable thoughts and feelings and develop skills to help the young person use heathy strategies rather than unhelpful ones, so that they can reach their goals.

Getting to Know Your Emotions

A good start for many young people is being able to understand their feelings.  Many young people in out-of-home care have grown up in an environment where they did not have people helping them to recognise and name their emotions.

You can help a young person by encouraging them to identify:

• Thoughts: What the young person thinks about when they feel a strong emotion
• Physical sensations: How a young person feels in their body
• Actions: How a young person behaves in response to these emotions

This can be done through conversations, encouraging a young person to reflect in a diary or try using the Emotional Record Tool.

Getting a Handle on Your Emotions

Emotion regulation is an ability or skill where a young person manages to keep strong or extreme emotions in check so that they do not become overwhelming.  Emotions may still be felt very strongly at times, but the young person has the resources to be able to respond in constructive ways.

As someone who has a supportive relationship with the young person and are often present when they experience difficult emotions, you are in a good position to help them explore more helpful coping strategies.  There are many ways a young person may be able to do this, the most important thing is to explore with them and help them to keep experimenting until they find a menu of things that work for them. Below are some strategies that can be tried and may be useful.

Distress Tolerance or Distraction

Distress tolerance is the ability to experience painful feelings, at least for short periods, and to cope in ways that do not involve more harm.  Like when a young person might experience a craving for substance use, if they experience an impulse to self-injure then ‘distraction’ can be useful.  The intention is not to avoid facing the pain, but to give the person time for strong emotions to subside, so that they can think more clearly about how to cope with negative events in the medium to long term

This may be to inflict real but harmless pain or something that represents pain symbolically.  Some examples are:

• Use a red pen to draw on the areas you might normally cut
• Sticking pins into a voodoo doll
• Work it off with exercise or some sort of physical activity
• Scribble with red pen on a pieces of paper
• Stamping on empty cans
• Throwing rocks into water
• Yell, scream or sing loudly

Other types of distraction techniques could be cleaning or cooking; pleasurable activities for the young person; paying attention to someone else or generating elaborate alternative thoughts or fantasies using their imagination.

Relaxation and Self-Soothing

Again there are numerous relaxation and soothing techniques and each person will vary in what works for them.  As a carer you are in the best position to provide a young person a range of ideas and helping them explore each one until they find some that work best.  Take guidance from the young person about what they feel comfortable with.

These techniques do not need to all about breathing or lying down but can include activities that use all the senses.  For example:

• Looking at beautiful images or photos
• Listening to soothing music or sounds of nature
• Burning scented candles or oils or being outside in a park
• Eating a favourite food slowly
• Taking a bath, getting a massage or playing with a pet

Self-soothing

As a baby/child we learn how to self-soothe (regulate our emotions) through modelling from our carers.  Common practices babies/children respond to are:

• Rocking motions in prams or arms or even movement from going for a drive
• Being held tightly or wrapped tight in a blanket
• Soft toy or blanket that the child sees as safe and feels soft
• Music that is soothing 

For many young people in out of home care, they have not had these experiences but can still respond to them as adolescents.  Therefore consider things like movement such as going for a drive, listening to music, or activities that involve rocking and feeling cocooned such as a hammock. These can be really helpful when the young person is distressed.

Mindfulness

Mindfulness is about ‘paying attention’.  

The ability to be aware of your thoughts, emotions, physical sensations, and actions – in the present moment – without judging or criticising yourself or your experience. 

Mindfulness skills can help a young person focus on one thing at a time in the present moment, and by doing this they are better able to control and soothe overwhelming emotions.  It helps a young person be able to control their attention, so they are able to tune into what’s going on in their mind and body, and in the outside world, moment to moment.  This obviously can have positive influence on identifying triggers and separating their thoughts to their feelings.  Below are some mindfulness techniques.

Mindfulness techniques

Try and focus on something around you, something simple, watch it for awhile, consider it's colour, shape, weight, smoothness etc and see if that can distract you from negative thoughts.

Mindful breathing teaches us you to separate your thoughts from you emotions and physical sensations. This is particularly useful when you are distracted by your thoughts. As an exercise Mindful breathing involves sitting quietly and focusing on the breathe, taking slow long breaths and paying attention to the sensations as the breath flows in through our nose and out through the mouth, as it fills and empties from the lungs and abdomen. Try Smiling Mind for tools. 

Encourage young people to explore these ideas one by one so that they can see what works for them. 

Remember that something may work in one situation but not in others. Creating a list of things with young people that they can try at different times in different environments, is a useful reminder for them when they are distressed.  A good idea is to write these down and for the young person to have them in their wallet or phone so that they are easy to access when their emotions become distressed.  When they are feeling that way, recalling information often proves to be quite difficult. 

Also, encouraging the young person to practice these when they are experiencing a lower level of distress is a great way for them to learn the new techniques and make it easier for them to use it when they need.  Modelling these things yourself and reflecting yourself on what you are doing, is also really useful so that the young person can see these strategies in action and notice the effectiveness.

Self-Care

The importance of sleep, diet and being physically active can never be underestimated when we think about emotions, mental health and wellbeing.  Encouraging regular healthy eating, sleep and exercise cannot be forgotten.