As a therapist, when I assess children and adolescents, it is commonplace for me to screen for self-harming behaviors. Unfortunately what is even more common, is to hear an affirmative answer from the child or teenager. This speaks to the importance of being informed as parents of the causes and treatment techniques in case we personally run across this type of destructive behavior.
What exactly constitutes “self-harming” behaviors? The majority of people that I see that self-harm do so in the form of cutting. This means they take a blade, razor, knife, etc. and cut their arms, wrists, thighs, and sometimes chests. Other behaviors include burning, scratching, picking, pinching, and pulling hair.
So why are we seeing this as a common thing? Most research points to the fact that this has become a learned coping skill for our youth. This statement includes two distinct parts: learned and skill. The learned part of self-harming behaviors is that children and adolescents have been conditioned to need a way to endure the amount of stress and pressure in society. They are molded by media and peers to act, behave, and perform in certain ways. When children and adolescents do not fit this mold they see themselves as outcasts. And how do they combat this isolation? They escape to self-harming behaviors.
The second piece of this bold statement is that it has commonly become a coping skill. Usually when we think of coping skills we think of a positive and healthy outlet. But as adults can we relate to negative coping skills? (Alcohol, pornography, drowning ourselves in work?) Similarly, teenagers have found solace in cutting and therefore they believe it helps.
CUTTING AND EMOTIONS
In addition to a learned coping skill, cutting is a consequence of emotion dysregulation. Our children and youth are bombarded with multitudes of emotions daily, and if they do not have the healthy skills to regulate themselves when these various emotions arise, they again will search out a way to regulate it themselves. In more extreme cases, the child may have suffered an abuse or trauma which leaves them with mixed emotions that they do not know how to regulate so they also look to escape in self-harming behaviors. These examples are supported by statements that I hear such as “I feel in control when I cut” and “I distract myself from everything else when I pick up the blade”.
Here are some other reasons that I have come across for why children and adolescents say they cut:
To express feelings they cannot put into words
To release the pain and tension they feel inside
To be the one in control
To distract themselves from overwhelming emotions or difficult life circumstances
To relieve guilt
To punish themselves
To feel alive, or to attempt to relieve a feeling of numbness
SOCIAL MEDIA'S IMPACT ON SELF-HARM
Now in the past, most self-harmers have cut in secret. They cut in places that are easily covered by clothing so as to actually avoid the attention. However, a new trend of cutting has rapidly changed course with the introduction of new technologies. Teens are actually now showing off their cuts and scars on social media (facebook, snapchat, twitter, Instagram, etc) which gets them instant attention. Kids at school are comparing the depths and numbers of their cuts as if it is the “cool” thing to do. Children and teens once again are looking to break down the walls of isolation by following this trend, but they are not comprehending just how detrimental their actions are.
YOU CAN HELP SOMEONE YOU LOVE WHO IS HARMING THEMSELVES
So what can parents, guardians, and concerned people do to help? Safety is our number one concern! Although cutting may not be a suicidal gesture, that does not mean we take it lightly. As parents it is our job to protect our children, therefore the most important thing to do is have a frank discussion with our kids on this subject matter. Also, we can hide the “sharps” in our houses if we are concerned that this behavior has happened in the past or may be of concern for starting in the future. Having an “open door policy” so our children are not isolated in their rooms, or asking to “body scan” in order to look for fresh cuts is also a suggestion for at-risk kids and teenagers.
Once immediate and physical safety is confirmed, we can help our child or teenager come up with replacement coping skills. So when they have an urge to cut or self-harm, they can instead turn towards an alternate technique. Some of my favorites to suggest include: snapping a rubber band on their skin, holding an ice cube until it melts, wringing a frozen towel in their hands, playing with a frozen orange, or writing in red pen or marker on their skin. These are immediate replacement techniques. Also, increasing the youth’s exercise as well as learning and practicing relaxation techniques may help the child regulate their emotions. Having the youth journal will help them explore their emotions in a healthy way as well.
Don’t be afraid to directly confront the issue with your children. Whether or not your child is engaging in these behaviors, it is important to discuss this topic with them. The more direct we are, the more direct answers we will receive. Keep in mind though, that if a direct confrontation is harsh, shaming, or barraging, it will probably only increase your child’s distress levels. So please confront them with a gentle tone; one of understanding and care for the child. This approach will invite honesty from the youth, not more dysregulation.
Lastly, if at all you feel out of your element, please seek out professional help. Whether through a book, online materials, or therapy, make sure that YOU are getting the help and assistance that you need in helping your child or adolescent.