[dropcap]I[/dropcap]ntentional self-injurious behaviors by young people naturally create panic and dismay among parents and professionals wanting to help stop these behaviors and find solutions. As a clinical therapist in a residential treatment facility working almost exclusively with adolescents for the past eight years, I have noticed an alarming rise in the number of youth who have begun to engage in these behaviors.
The first step in addressing self-harming behaviors is to understand its purpose. Self-injury is not equivalent to a suicide attempt. That is not to say that a self-injurious individual does not think about suicide, it simply means that self-harming behaviors serve a different purpose. Just like drinking, drugs, risky sexual activity, avoidance, aggression and isolation, self-harm is considered a negative coping skill. The good news is that it is, in fact, an attempt to cope.
Conversely, suicide attempts occur when the individual has given up attempting to cope. When suicide becomes a viable option to a person, he or she is no longer considering how to manage the difficult situation but is looking to end the pain and stress they feel. They are looking for a way out rather than a way through. While many of us focus on adopting healthy coping skills such as reading, exercise, talking to a trusted friend, going to therapy, prayer, meditation or going on vacation to manage life’s stressors, many of our youth have either not learned or are not using these skills.
Next, consider self-injury as a symptom of a larger problem. If you were to break a leg, you would not simply manage the pain with medication, you would address the break. Mental illness is no different. Self-injurious behaviors indicate and inform that a larger, more serious problem is present. Further, the behavior indicates that individuals lack the skills to manage the problem on their own. Without proper resources and support, human beings often look for the easiest way to escape emotional pain to be able to function. Self-harm can, unfortunately, provide quick but temporary relief to the anxiety, depression and isolation our young people increasingly feel.
Self-harming behaviors are often accompanied by a great deal of secrecy as youth go to great lengths to hide injuries and scars out of fear and shame. When self-harm has been disclosed or discovered, be sure to seek the help of a licensed clinical therapist, preferably one with specific knowledge of self-harming behaviors. Never assume that superficial wounds are superficial problems. Pain tolerance varies from person to person and should not be taken lightly. Self-harm should not be considered a phase or a taboo subject that, if ignored, will work itself out. Addressing the issue openly, while frightening, is imperative. Shame loves to live in the dark. Shining light on the subject will decrease the shame that keeps you in the dark.
Initially addressing self-harming behaviors can be a source of great anxiety for adults. The goal is to keep communication open. To do that, remain mindful of your facial expressions, tone and body language. If you present as angry, panicked or distraught, your child may be less likely to speak openly about the subject in the future.
Sit down with your child and take a deep breath. Make gentle eye contact. Ask direct uncomplicated questions: “Are you self-harming?” “Have you thought of suicide?” If the answer is yes to either or both, ask them to tell you more about it and then listen non-judgmentally until they are finished. If you are able to calmly express your concerns and handle what they share, they will be much more likely to keep the doors of communication open.
Throughout, keep in mind, that the self-harm itself is not the problem. The problem is the emotional pain your child is dealing with, which may stem from any number of issues he or she may be facing. Under no circumstances should those problems be minimized or dismissed by your response. Take what you are told seriously even if the issue seems minor or manageable. Listen for the source of emotional pain.
While most adults tell me they cannot fathom why anyone would intentionally cause themselves pain, individuals engage in self harm for reasons that are widely varied and not invalid. Cuts and wounds for many can provide temporary emotional relief in a physical way via endorphins released into the blood stream. Self-injury can be effective in distracting from emotional pain, provide a means to communicate what one cannot put into words, and can even be used as a form of self-punishment. Physical pain can even generate feelings of emotional numbness to someone otherwise overwhelmed.
The best way to find out why your child has chosen to engage in these behaviors is to ask them how they usually feel directly before and directly after engaging in self-harm, before shame and fear return. Hopefully, this will help you gain a better understanding of the reasons your child has sought this form of relief. Your best bet is to open dialogue and be willing to listen without judgment.
A common theme among teens who opt to self-harm is pain and stress in social situations. Socialization today bears precious little resemblance to socialization of previous generations. Where has traditional socialization gone? Into the palms of our hands. Current technology allows human beings to interact with others without actually interacting at all. We can isolate from one another all day and escape into our individualized technological worlds at night. We can make a “friend” or even “date” someone we have never met and live in fantasy worlds of our own creation. To youth with no additional real-life social skills, the world outside the screen can seem pretty frightening, especially when it goes badly.
Our youth, and plenty of adults, are losing the ability to manage real-life relationship struggles by talking through problems. And no wonder, considering our society is losing the ability to listen, empathize, interact socially and address interpersonal conflict. Texts can be ignored, incoming calls can be denied, “friends” can be “unfriended” and emails can be deleted all without ever having to directly deal with the other person. Worse yet, problems among peers can suddenly and irreversibly be put on display for the entire world to see before ever considering the fallout. With the immensity of these life struggles and regularity of public shame and taunting that ensues, our youth need improved ways to resolve problems, find sanctuary and gain skills to navigate these troubled waters.
To help our youth address what life throws at them, they need coping skills. But they’re not the only ones. Adults and youth alike are in desperate need of a range of mechanisms – communication skills, social skills, problem-solving skills and conflict-resolution skills – of both the time-tested and new-and-improved variety. Our society has become fascinated and consumed by fast fixes and overnight success. The distance social media and technology provide prevents human beings from interacting face-to-face, learning the value of hard work, problem-solving and being human with one another.
Again, these are not just problems for our young people. Adults must be examples for children and youth who need to witness and experience ways to socialize well, resolve conflict with one another, exhibit empathy, listen and problem-solve through first-hand opportunities. We must demonstrate kindness, compromise, critical thinking and consider the impact of our behavior on others. If we want our children to be honest, treat their bodies with respect, love themselves, respect authority, communicate openly and solve problems in healthy ways, we must be willing to make those changes in ourselves and lead the way.
By Amy Freer, Licensed Clinical Social Worker, Pinnacle Pointe Behavioral Hospital, Little Rock, AR