Discovering your child or student has been cutting or engaging in any kind of self-injurious behavior can be both baffling and disturbing. While this behavior has been glorified by many celebrities, on YouTube and through various memes, it is not a normal part of “teen angst.” Cutting is a sign of deep rooted psychological pain that requires a thoughtful and compassionate response. In this article we will examine the reasons a teen may hurt him/herself, how to identify and respond to this behavior and what kind of treatment is most effective.
Research has shown some people are more vulnerable to using self-harm as a coping strategy than others. These individuals are often seen as hypersensitive or emotional, they may have reactions that seem over the top to those around them and they usually have a difficult time recovering from having hurt feelings or going through a stressful event. Various studies estimate that anywhere from 1 in 10 to 1 in 14 teens will engage in this behavior at some point during their teenage years and approximately 5-10% will carry it into early adulthood.
It can be very difficult for parents and educators to understand why in the world someone would intentionally hurt him/herself. After all, you have probably spent a great deal of time trying to protect your child from the dangers he/she might face in the world. So it is especially frightening to find out that your child or student may be cutting or engaging in other forms of self-harm. Most of the time this behavior is the result of a particularly challenging or painful interpersonal interaction. A teen may perceive he/she has been judged, rejected or criticized and as a result feels an overwhelming amount of distress. The event leading up to feeling rejected or abandon could be anything from a relationship break-up to being left out of a social activity to not receiving an immediate answer to a text message. Cutting is used as a way to regulate one’s emotions. Many teens report when they feel physical pain on the outside it dulls the emotional pain they feel on inside. When some teens experience a sense of failure or rejection they cut as a punishment; ultimately this serves the same function – to help the teen re-regulate his/her emotions. In other words, for a teen who lacks positive coping skills, cutting is a way to solve the problem of feeling terrible.
Cutting and self-harm are not in and of themselves mental illnesses or disorders, however the presence of these behaviors may indicate your teen is suffering from depression, anxiety or another mental health condition. A common question many parents and educators have about cutting is whether or not it should be interpreted as a suicide attempt or gesture. The strong emotions associated with cutting may also lead a young person to have thoughts about suicide, although it is usually not the case that those who cut themselves are attempting suicide. Cutting and self-harm is one of many risk factors a therapist or psychiatrist would look for in evaluating if a teen is suicidal.
Identifying when a teen is engaging in self-harming behavior is often a joint effort between parents, educators and pediatricians. Below is a list of some of the signs to watch for:
- visible cuts, scratches, burns or other injuries
- unseasonable clothing such long sleeves or long pants during the summer/warm weather
- evidence of an injury that has no explanation; i.e. blood on clothing or in the bathroom
- wounds or injuries that do not appear to be healing
- increased isolation
- increased irritability
- avoidance of school, activities or friends
- statements about feeling lost, empty or like people hate him/her
Parents and educators should expect to have all kinds of reactions when they lean their loved one or student has been cutting. Many react initially with disgust, confusion or embarrassment. Some are hurt and angry their teen did not seek them out for help first. Some parents are already feeling burnt out from years of parenting their sensitive child and see this as “just one more thing,” while others blame themselves for not doing enough. Although all of these reactions are normal it is not helpful to express them in front of your teen.
The most effective first step to helping a teenager who is cutting is to validate the underlying feelings that drive him/her to cut or self-harm. Cutting is not an acceptable or healthy coping skill, though it may be the only one your teen has for the time being, Keep in mind, you can validate your teen’s feelings without validating cutting as a behavior. Not sure how to validate or what that even means? Think of when your son/daughter was much younger and fell at the playground. Chances are, at least once, your son or daughter came running to you to treat his/her injury. Like most parents you probably said something like, “Oh, my poor baby, I see your skinned knee, I’ll fix it, I’ll make it better”. That’s all there is to it – the most basic validation for your teen is similar to the one you gave on the playground, “I see you are in pain, I know you are hurting inside and I want to help you.”
It is important to have as calm of a demeanor as possible when raising this issue with your child or student and anticipate he/she may initially respond with anger. For many teens cutting is a highly shameful behavior which they will go to great lengths to hide from others. As a result of this they may be embarrassed or defensive if they are caught or found out. It can also be frightening for a teen to be told he/she has to give up this behavior since it has likely proven to be effective in helping them manager their emotions. For some teens, cutting may be socially acceptable in their peer group and may be used as either a way to express strong emotions, rebel against authority or try to exert some control and independence.
In response to growing concerns that some teens learn about cutting through the internet, many social media sites have attempted to prohibit graphic or suggestive images that glorify cutting and self-harm or give directions on how/where to cut. While it is a positive step that social media sites are paying more attention to this issue, it is still important parents and schools remain proactive in monitoring and communicating about what their teen is viewing. Like many things, the internet can both helpful and harmful. A lot of teens report using the internet to seek help and support from other teens and young adults who have gone through what they are going through and in that way, the internet can be extremely useful in breaking down some of the shame and isolation that goes with self-harm.
Many parents and educators say that teens cut “just for attention” and therefore the behavior should be ignored. At some point, with the help of a highly skilled and experienced therapist, ignoring it may be an effective strategy. However, this can be a dangerous approach for a teen and family who has not yet received professional help. An adolescent who is hurting him/herself needs and deserves attention. It is important to seek advice from a mental health professional trained to deal with this behavior and the emotions that accompany it.
While it can be devastating to learn that your child or student has been cutting it is important to understand that it is a treatable condition. Remember, your teen is not bad, manipulative or a lost cause – he/she needs your help and support.
Help is available for families affected by self-harm. You may call West County Psychological Associates and ask to speak to a therapist who can assist you and your family.