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WORDS FROM THE WISE: AN INTERVIEW WITH MARGARET WOOD

 The topic of Self-Inicted Violence (SIV) has long frightened, perplexed, and

repulsed many people, including those who work as mental health professionals

!isunderstanding and "udgment are pre#alent Therefore this inter#iew is a "oy to

pu$lish !argaret %ood, &', is one of the rare, wise, and compassionateclinicians who has dedicated great eort and energy to ser#ing those who li#e with

SIV, as well as educating current and future therapists on this topic

urrently in pri#ate practice in &yndhurst , *hio , !argaret %ood has worked in $oth

the pri#ate and pu$lic sectors, and has ser#ed as a teacher and mentor to many

students in +elds as di#erse as psychiatry, social work, education, and alternati#e

medicine The following inter#iew was +rst pu$lished in The Cutting Edge in the

winter of .

• How do you view self-injury in the lives of the people you have worked with? 

I see SIV as a self-soothing mechanism of last resort, accompanied $y profound

shame and secrecy I $elie#e most e#eryone who does this originally thought they

in#ented it

• How do you go about asking clients about SI? 

/t intake I ask a new client a$out cutting and other forms of SIV in the same tone as

I ask a$out anything else If they say that they li#e with SIV I ask how much and

how often and if they know what it0s a$out I say that the reason I ask is $ecause I

am familiar and comforta$le with it Sometimes that acceptance will $ring an

admission of li#ing with SIV Then it can $e addressed "ust as any other struggle I

may $e asked when the cutting will stop I reply1 23ou0ll stop when you are ready4

• How did you learn what you know? 

I learned a$out SIV from my clients 5 the more clients, the more I learned I also

learned $y reading The Cutting Edge!

• "hat helps people who live with SI? 

In therapy, a good therapist is one who is willing to learn and to listen to what is

$eneath the scream in the gash 5 one who is willing to work in partnership with the

client while maintaining healthy $oundaries

• "hat hurts people who live with SI? 

%hat hurts people is for the therapist to o#erreact, or to see SIV as a suicidal

gesture 6ospitali7ation or con+nement of any kind is seen as punishment and only

ser#es to shut the client down and destroy any trust that had $een $uilt

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• #ther therapists ask you how you get people to stop SI $ how do you

respond? 

I teach them that I don0t 2stop4 SIV I acknowledge the importance of SIV and its

role The more it is normali7ed as "ust another coping mechanism, the more it can

$e managed $y the client8 hence, the more she or he can $e empowered

• "hat have you learned fro% people who live with SI? 

I0#e learned that stopping SIV is not necessarily the goal I learned that the shame

was, in many cases, as profound as the a$use I learned I could not use reason or

coaxing to get a client to stop cutting I learned to $e curious a$out a new client

who would come in the summer wearing long slee#es I still continue to learn9

• "hat changes& hopeful and hurtful& have you seen in the syste% over the

 years of your practice and teaching? 're there places of safety and healing

for people living with SI in the traditional %ental health service syste%? 

 There is more awareness of a$use as well as self-in"ury, which is positi#e %ith

more awareness comes more criticism There are a few pockets of optimism and a

few rays of light Some highly pu$lici7ed programs with :uestiona$le goals and

methods seem to prosper In traditional ser#ice systems the emphasis still seems to

$e on extinguishing the $eha#ior8 therefore, it will go underground again

• (ou)ve %entioned the i%portance of *sacred space!+ ,lease discuss this! 

Sacred space can $e a place or a moment when a small or large miracle of intimacy

can happen, when something for$idden 5 a secret, a ash$ack 5 can +nd the light of 

day, and is witnessed $y another person, perhaps a therapist, and is not "udged 5simply witnessed, allowed to $e

• How do you help other therapists deal with their disco%fort about SI? 

I reassure them that SIV is not a$out suicide 5 the cutting is usually done carefully

so as not to $e dangerous8 it is not a$out $leeding to death, it0s a$out getting

comfort, and it0s not meant to shock them

• How do you instill hope? 

I tell people a$out the successes I ha#e witnessed 5 the hard places people ha#e

$een and the new places they are now

• How do you nurture yourself when working with people who are in so %uch

 pain? 

I make sure to ha#e a relia$le support system, $oth personal and professional

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• "hat guidance would you give a person who lives with SI and has no access

to therapy? 

I let them know that they ha#e more inner wisdom that they think they ha#e They

ha#e creati#ely sol#ed many pro$lems $ut failed to take credit for it They should

see e#ery success as another step in self-empowerment

• "hat advice do you have for therapists who work with people who self-

injure? 

 Trust your instincts and take #ery good care of yourself Talk to a trusted colleague

If you +nd you are getting o#erwhelmed do something #ery normal, like washing the

dishes

• ,lease speak to the changes in the relationships people have with

the%selves& including their bodies& as they heal fro% the need for SI and

the trau%a that led to it! 

'eople healing from SIV $egin to see themsel#es as continuously uid $eings rather

than damaged isolated $ody parts 5 they can remem$er the a$use and talk a$out it

without $eing triggered They can ha#e a lo#ing relationship with another person

 They can $e proud of their $odies

• "hat do you see as the root cause of self-injury?  

In my experience the root cause is trauma, almost always early childhood a$use,

often sexual a$use In my experience I cannot think of an exception

•

,lease co%pare working in a traditional agency setting with your private practice! 

ommunity mental health did not want my kind of client 5 they didn0t +t into the

se#erely mentally disa$led category and they weren0t crisis clients that can $e

treated in ten sessions or less ;ortunately I am not the sole support of my family

and I can aord to $e in pri#ate practice and set me own rules Sessions can $e

more fre:uent and longer if necessary and I can ha#e a sliding scale that is within

e#eryone0s reach

• How did you avoid having a punitive attitude towards those who self-injure? 

I was a client myself, $oth as part of <estalt training, where it was mandatory, and

again when my own life was crippled $y agorapho$ia The last thing that would

ha#e $een helpful to me was anything puniti#e I treat clients the way I would want

to $e treated 5 with compassion and as an e:ual who is going through a transitory

phase That keeps $oth of us hopeful

• "hat else would you like to add? 

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!y theory of therapy reminds me of an old !ilton =rickson story a$out a horse who

wandered into a farmer0s yard The farmer, not knowing the horse, fed and watered

it, then stood next to it The horse started walking The farmer walked with him,

and the two walked together until the horse walked himself home In much the

same way, my $elief is that the client knows more that I what they need, e#en when

they are feeling lost and cra7y I can pro#ide 2food and water,4 and walk $esidethem metaphorically until they get comforta$le in their own ski