Self-Injury (also commonly known as SI; cutting; self-harm; self-mutilation; self-abuse; and self inflicted violence) is the deliberate harming of one’s body without the intent to commit suicide. It is an intentional act of physical violence done to yourself by yourself. Cutting (making scratches or cuts on your body with a sharp object to break the skin and make it bleed) is the most common form of SI, but burning, skin-picking, head banging, hair-pulling, hitting the body with objects, and scratching are other methods. When cuts or burns heal, they often leave scars or marks. People who injure themselves usually hide the cuts and marks and sometimes no one else knows.

SI is a negative way of dealing with strong emotions. Although self-injury provides the victim temporary relief from stress, self-injurious behavior is ultimately a dangerous and futile coping strategy which interferes with intimacy, productivity and happiness. Generally, people who injure themselves start in their young teens. Although SI is recognized as a common problem among the teenage population, it is not limited to adolescents. People of all sexes, nationalities, socioeconomic groups and ages can be self-injurers, though the National Mental Health Association and S.A.F.E. Alternatives report that those who seek help for self-injury are more likely to be teenage girls from middle or upper class backgrounds. According to CNN.com, one in five teens say they have purposely injured themselves at some time.

Why Do People Do It?

Self-injury is a mechanism for coping with emotional distress. The problems causing a teen to self-injure, need to be resolved and the teen must learn healthier ways to deal with emotions. Some of the reasons teens give for self-injuring include:

• Relieve tension or stress. Self-injurers do not have a healthy way to deal with their stress. They may not have ever developed ways to cope, or their coping skills may be overpowered by emotions that are too intense. They may be dealing with feelings that seem too difficult to bear and self-injury is an attempt to relieve that extreme tension.
• An unresolved history of abuse. Some people who cut have had a traumatic experience, such as living through abuse, violence, or a disaster. Self-injury may feel like a way of “waking up” from a sense of numbness after a traumatic experience. It may be a way of re-inflicting the pain they went through, stopping flashbacks, expressing anger over it, or trying to get control of it.
• Low self esteem.
• Feelings of loneliness or fear.
• A need to feel in control. Self-injurers may be dealing with bad situations they think cannot change. Inflicting the injury provides them a sense of control.
• Mental health problems such as depression, anxiety, or obsessive-compulsive disorder can be the root cause of self-injury.
• Wanting to get the attention of people who can help them.
• Peer pressure/curiosity.

Warning Signs

People who self-injure become very adept at hiding scars or explaining them away. Because teens who self-injure often do not know how to ask for help, it is important to watch for some of these signs that a teen may be harming him or herself:

• Unexplained injuries, such as cuts, scratches, burns, bruises, etc.
• Making excuses for injuries or scars if they are discovered
• Acting embarrassed or ashamed about injuries
• Wearing concealing clothing (e.g. long sleeves even in hot weather)
• Secretiveness or withdrawal
• Having trouble dealing with emotions
• Spending time with people who self-injure, especially on the internet
• A history of eating disorders
• Having trouble functioning at work, school, and in relationships
• Low self esteem

Getting Help

Self-injury can become very serious and sometimes addictive. The underlying cause of their stress needs to be addressed to stop the behavior. Here are some tips for parents of teens:

• Teach your teen positive coping mechanisms and problem solving skills. You can find a list of good coping skills on last week’s entry on this blog. Examples include encouraging your teen to find positive activities to relax or deal with emotions, such as exercise, playing an instrument, journal writing, sports, dancing, reading, etc.
• Talk to your teen calmly and directly; do not lecture, judge, or get angry.
• Do not try to force your teen to stop – he or she needs to make that change on his or her own.
• Be supportive by listening and letting your teen know that he or she is not a bad person and can find better ways to deal with his or her emotions. Encourage your teen to talk their problems out with you, other responsible adults, or friends.
• Seek help from a doctor or counselor who is comfortable helping your teen work through the healing process. The help of a mental health professional might be needed for major life troubles or overwhelming emotions. Therapists and counselors are trained to help people discover inner strengths that help them heal. These inner strengths can then be used to cope with life’s other problems in a healthy way.
• Encourage your teen to avoid people, music, and internet sites that glorify self-injury, and to seek friends who share his or her positive interests.

Resources

If your teen or someone you know is feeling suicidal or has a serious injury, call 911 or go to the emergency room immediately. For more information about teen self-injury such as cutting and how to get help, go to the web site of The Center for Young Women’s Health at http://www.youngwomenshealth.org/si.html, or call S.A.F.E. Alternatives (Self Abuse Finally Ends) at 1-800-DONTCUT (800-366-8288).