Do you know a teen who is struggling with cutting or other self-harm behaviors?
An epidemic of self-injury is occurring among teens. Preteens and adolescents ages 12 to 19 are engaging in self injury in record numbers. Over 10% of teenagers are thought to have at least experimented with self-mutilation.
While self-injury among teens is increasing at alarming rates, many people struggle to understand this disturbing behavior. Adolescents who self-harm are in pain and wish that others would understand their hurt. Teens whose friends engage in cutting come into my counseling office with increased anxiety because they are worried that their friends might kill themselves. Parents come into my office frightened and lost, wondering how to help their child who has fresh scars on their body. School counselors and teachers are puzzled by how to handle cutters who display their cuts to each other between classes.
Those of us who work with and raise teenagers need to educate ourselves more about self-harm and about how to help those who struggle with it. Lack of knowledge in this area, overreaction to adolescents who self-injure, treatment of self-harm as a suicidal gesture, or forced handling of teen cutters can oftentimes lead to more damage than help. Being open to learn what is beneath the urge to cut, burn, and hit should be of main importance in relating to someone who self-injures.
What is self-harm behavior?
Self-injury, self-harm, self-inflicted violence or self-mutilation is an act of physically hurting yourself on purpose in an effort to cope with an overwhelming and distressing feeling or situation.
Self-harm is clearly a sign of a troubled person. A common misperception, however, is that teens who self-injure are cutting themselves in an active attempt to commit suicide. The opposite appears to be true: Most studies find that self-injury is often undertaken as a means of avoiding suicide. While some people who self-mutilate do attempt suicide, it is usually because of the emotional problems and pain that lie behind their desire to self-harm, not the cutting itself.
Self-injury in teens may appear to be attention-seeking. However, this behavior is more likely attention-needing. A person engaged in self-harm needs to be heard with empathy and care. Most adolescents who self-injure keep their behavior a secret for fear of others’ negative reactions.
Acts of self-inflicted violence are:
- Done to oneself
- Performed by oneself
- Physically violent
- Not suicidal
- Intentional and purposeful
Many people find creative ways to hurt themselves. Here are the most common forms of teens hurting their bodies:
- Excessive scratching
- Hair pulling
- Intentional bone breaking
- Hitting or Bruising
- Interference with wound healing
Self-injury is a behavior that over time becomes habitual, chronic and repetitive. Like any other bad habit, even though other people think the person should stop, most self-injurers have a hard time just saying “no” to their behavior – even when they realize it is unhealthy. Once adolescent is in the cycle of self-injury, the smallest things might trigger self-harm behaviors.
There appears to be a contagious factor to self-inflicted violence. While mimicking of this behavior was formerly observed mostly in jails, prisons, and inpatient psychiatric facilities, it is now observed at schools. Seeing peers relief their feelings through cutting, may encourage other students to copy the behavior. Media treating self-injury as sensational by depicting famous self-injurers (Angelina Jolie, Johnny Depp, Kelly Holmes, etc.) seems to promote the “benefits” of the behavior. Certain websites on the internet provide detailed descriptions of why or how teens hurt themselves. By doing so, they inevitably suggest self-harm ideas to kids who are struggling with emotional pain.
What type of teenager engages in self-harm?
Self-harm does not discriminate against gender, race, culture, and economic background. Teens who self-injure may be male or female, Caucasian or African-American, rich or poor, very well or less well educated, and live in any part of the world. They may be “nerds,”“jocks,””goths,”“skaters,””punks,” or “preps.”
Why do teens engage in self-harming behavior?
Most adolescents who hurt themselves struggle to recognize the motivations for their behavior. However, they can describe the emotional condition they are in when they have an urge to self-harm. Here is a list of most commonly cited reasons of why teens choose to self-injure:
A Method of Coping. Most commonly, self-harming behavior is a coping mechanism to deal with emotional pain, stress, or trauma. Broad research indicates that there is a strong correlation between self-inflicted violence and history of child physical and sexual abuse.
Self-injury helps some people feel better by giving them a way to physically express and release their tension. It lessens a desire to commit suicide. It ends the feeling of numbness. Cutting can validate teen’s feelings, creating a ‘real’ pain that is easier to cope with than the hidden emotional pain.Self-inflicted violence is used as a way to temporarily feel better.
A teen experiences an overwhelming preoccupation with the relief experienced after a cutting incident. This may be partly due to an increased level of endorphins that are released during self-harm. When adolescents cut or burn themselves, endorphins are quickly secreted into their bloodstream, and they experience a numbing or pleasurable sensation – a euphoric feeling. It is similar to what morphine does in a human body. Just as with morphine, a tolerance can be built up and self-injurers might find themselves hurting their bodies more severely in order to experience the same sensations that were there when they first engaged in self-inflicted violence.
Establishing Control. Maintaining a sense of control when the rest of the life seems out of control leads some adolescents to self-mutilation. By planning and carrying out acts of self-harm, adolescents, in a sense, structure their life by controlling their emotional states (their feelings of isolation, frustration, loneliness, and sadness). Teens may also hurt themselves in order to control intrusive, obsessive, or otherwise unwanted thoughts. Self-inflicted violence only temporarily increases teen’s perception of control in their life.
Self-punishment. Some teens believe that they deserve to be punished or believe that self-injury will prevent some punishment from an outside source. Adolescents who engage in self-inflicted violence are often overly critical of themselves. Excessive self-criticism leads to feelings of shame and blame, which lead in turn to self-punishment. Some teens who self-punish themselves do it due to history of abuse in their life. Although hurting themselves might make teens feel better at that moment, self-injury does not alter their past. It does not teach them or help them to deal with their past in a healthy way.
Communication. Self-mutilation can be an expression of emotional pain or feelings that teens struggle to put into words. Many teens who engage in self-harming behaviors need to learn how to communicate their feelings directly. Scars and wounds can serve as a way of expressing what teens think, feel, or experience. However, this method of communication has definite drawbacks – the meaning and messages behind an act of self-injury may be misinterpreted.
What are some signs that your teenager may be self-mutilating?
Since adolescents often engage in self-harming behaviors alone, parents may not be aware that this problem exists. Being observant can often uncover early signs of self-injury, such as:
- An abnormal number of cuts/burns on the wrists, arms, legs, hips or stomach;
- Wearing of long sleeves and pants even in warm weather to cover the marks;
- Frequent ‘accidents’ that cause physical injury;
- Evidence that your teenager's friends are self-mutilating;
- Finding razors or knives in strange locations;
- Your teen locking themselves away for long periods of time in their bedroom or bathroom;
- Reluctance to be part of a social circle or social event.
What can parents and other adults do to help an adolescent who self-harms?
- Don't panic or get angry if you discover your teen is engaging in self-injurious behaviors. Address your teen calmly and lovingly. Reacting loudly or angrily can often push your teen further away and increase the self harming behaviors.
- Remember that most teenagers engaging in self-injurious behavior are not attempting suicide.
- Do not judge or blame your adolescent for what has happened. They are already condemning themselves. They don’t like being a self-injurer.
- Avoid issuing ultimatums and asking your adolescent to stop self-injuring – you may be removing the only coping mechanism they have. An alternative and healthier coping mechanism needs to be found first.
- Acknowledge that the behavior is a coping mechanism and not just a bizarre habit.
- Understand that this is not the time for discipline or punishment.
- Be aware that your teen’s behavior is only a symptom of a more serious underlying problem.
- Understand that your teen may not be able to explain why he or she engages in this behavior.
- Try hard to cover any feelings of disgust associated with cutting or burning. Reacting with horror is likely to exacerbate your teen's struggles.
- Try to listen to what your child is saying. Spend time with your teenager. Numerous self-harmers suggest that feeling invisible to their parents was a major contributor to their self-mutilation.
- Assure your teen that you love and care for her/him and will assist them in getting help.
- Remember to seek help for yourself. Caring for a child who self-harms is difficult. Don’t be afraid to seek extra support while you are helping your child.
- (School staff) Keep an individual focus rather than a group focus on self-injurious behavior at school in order to avoid imitating behaviors. Any activities that detail self-harm behaviors (movies, television programs, support groups, etc.) can trigger self-injury in at-risk adolescents.
- Know that counseling for a teen that self-injures is crucial! Addressing the pain that underlies self-injury most often requires professional help for both teens and parents.
Seek professional help!
Research indicates that a combination of individual and family therapy with a self-harm experienced counselor has been most effective in helping teens move past self-injury.
I can help your teen to address self-harming behaviors through individual and family counseling.
When providing individual counseling, I can help your teen address the root of the problem – the emotion that is causing the urge to injure. I can assist your teen in learning to identify the triggers that lead to the desire to self-inflict physical pain. I can also help your teen find healthy coping skills to deal with negative emotions, so that they don’t keep returning to self-injury or other distractive behavior when distressing circumstances arise.
Family therapy with me can help you address the difficulties in your family related to your teen’s self-harming behaviors. In our family therapy sessions, I can help you improve the lines of communication with your teenager. I can also aid in the healthy expression of feelings and new ways of handling family interactions for the entire family.
Why do I offer counseling for adolescents who self-injure?
I am inspired to do this work because I am passionate about helping adolescents to have better relationships with parents, peers, and self.
It gives me joy to see once frustrated and hurt teens come away from my office with a sense of hope, increased confidence, and improved ability to communicate their feelings and thoughts.
I specialize in helping teens that self-injure find the cause of their pain and assist them in finding healthy coping skills to deal with the stresses of their life.
Are you ready to start family counseling for your teenager?
I offer a 15-minute phone consultation at no charge. If you and your teenager are interested in pursuing my services to address self-injuring behavior, then you can schedule an initial appointment with me.
Olya Pavlishina, LMFT
360. 356. 8756
*Some information on adolescent self-injurious behavior was adopted from The Scarred Soul: Understanding & Ending Self-Inflicted Violence by Tracy Alderman, Ph.D.