Teenage Self Harm

The following is a response to a mother asking about her teenage daughter’s self-harm.

   Self-harm or self-injury is more and more prevalant and should cause serious concern with any loved ones. It occurs about the same as eating disorders but is more stigmatized leading to less reporting of it. Both males and females engage it in, especially in the teenage years. Drugs and alcohol as well as social isolation and a history of abuse are highly correlated with self-harm. However, as you stated, Goth is the #1 predictor of self-harm in teenagers. In fact, in one recent survey, 53% of those who identified themselves as being interested in Goth admitted to self-harm. Even more alarming, 47% of that group admitted to attempting suicide

   Self-harm can mean all sorts of abusive behavior. Biting, scratching. branding, pulling hair and eye lashes, bruising, burning, and cutting are some examples of such self-abusive behavior. Before we go any further, it is important to note that all of these behaviors are dangerous under any circumstances. However, the concern level is higher when certain conditions are met. For instance, if an entire football team gets a brand on their arms, this would not call for a heightened level of concern. If the teen is doing it simply to fit in, then it is a totally different problem than one who is doing it for emotional expression

   This is what I presume is the case with your “Goth” daughter.Most chronic self-mutilators have a hard time expressing themselves. They do not know how to cope with certain stressors and they do not know how to tell the world that they don’t know how to cope! This causes severe emotional distress and tension. When most people feel tension, they attempt to deal with it usually by releasing it. Some people may exercise to release the tension. If the exercise is successful in releasing the tension, then it will be used again. A self-mutilator who cuts on herself does so because it releases tension and stress. It worked as a coping mechanism so she does it the next time she feels tension. When she cuts on herself, she can actually see the release in the form of blood. Watching the blood gives her tremendous relief. It’s like a tea pot that has boiled but is still sitting on the stove. The pressure continues to build until either someone lifts it off or it comes out on its own.

   Other self-mutilators will harm themselves because they want to feel something. They have become so numb to the world and to their own feelings that they would rather feel pain than feel nothing. Feeling pain reminds them that they are still alive. It reminds them that they are someone who can feel. These types usually have low self-esteems and are probably depressed.

Self-mutilators need to be listened to above all else. Most self-mutilators have learned that “no one listens” and therefore they assume that “no one cares”. Loved ones need to allow self-mutilators to open up with them about their feelings. Frequently self-mutilators have a lot of rage and anger deep inside but have never been able to let it out effectively. They will also tend to be very apprehensive when it comes to trusting others. They have been “burned” too many times from others in their lives to trust so easily. This makes it very difficult for others (school counselors, friends, and parents) to be able to be trusted. They feel like their Goth friends are the only ones who understand because they are going through the same exact thing. It’s like being told “You wouldn’t understand addicts, because you’re not one yourself”. Well, this is what the self-mutilator is telling you by… not telling you anything. Your daughter trusts the Goth friends more than she trusts you because she feels like she can open up to them about her problems. Self-mutilators need to know that it is ok and safe to open up about what they are going through. Most self-mutilators hide the places they are cutting. For instance, females will often cut on their legs so that it is hidden by their pants. Also, they do not advertise that they are about to cut themselves. They may just go to their room, or go to the bathroom.   The teenage years are a time of change and uncertainty. This makes it ripe for a teen who is already depressed. Loved ones would do well to be there in a consistent manner. Loved ones, especially parents, can be role models for effective ways to cope with life. Finally, a mental health professional should be consulted to evaluate the severity, suicide risk, and the possible need for medication.

   There are other outside sources that could prove valuable. For instance Self-Mutilators Anonymous publishes literature on this topic. Maybe, if you feel uncomfortable approaching this with your teenager, you could leave some material around the house or in her room. That way she could read it in a non-threatening manner. Or if the two of you are watching TV together, and this topic comes up, simply make a comment on it, about how misunderstood it is and how people need to just listen. This may show your daughter a point of view that she did not think you had. She may then feel more comfortable to approach you with it.

 RC