Five Reasons Teens Self-Harm

I remember the first time I saw a cutter. In school we had been taught to observe our client’s appearance and check their wrists for scarring, scabs or burns. When I asked about the marks on her wrists, she showed them proudly. Multiple scars every which way in varying shades of healing. She let me know that she kept razors in her wallet, room, and mouth. My heart rate accelerated. Should I demand that she give me the razors in her possession now? What if she was lying? I couldn't search her. This was definitely a safety issue. Who do I tell?

I remember blinking in surprise when she denied wanting to die. Questioning her further, she laughed at my ignorance. "I'm not trying to kill myself. I just like keeping the razor in my mouth in case I need it."

Everyone has their first. She was mine. Almost 25% of teens admittedly engage in self-harm, so if you haven't had your first yet, it probably won’t be long. Any form of self-harm in one we care about is scary. It should be. As parents, teachers, doctors, and counselors, their safety is our number one concern.
            The most common question I get is: "Why do teenager hurt themselves on purpose? I don't understand that." Unfortunately there is no formula for why this behavior occurs. And though cutting may be the most well known form of self-harm, the behavior can also manifest in burning, embedding, biting or any intentional infliction of pain. There are a variety of reasons behind self-harm, and much of the time suicide has very little to do with the practice. However, there are trends and similarities found in the practice.  Here are a few common types of those who engage in self-harm.

The Hurt One
            The most common reason for cutting is to leave tangible evidence of emotional and psychological pain. As a seventeen year old girl once told me, "when I see the blood run down my arm, it makes me happy; it’s a pain I can see." They need something to represent the immense hurt and pain that they feel on the inside. ‘Doesn't it hurt?’, you ask. ‘Yes most of the time, but that's the point.’ The physical pain momentarily can mask the pain of the soul. Some claim that they don't feel the pain when they cut. The way they talk about it, it appears similar to a disassociative state where their ability to be fully present is compromised. They may feel it later but not during the trance of the ritual. Even if they don't feel it, seeing the self inflicted cuts leaves them gratified. The goal is to leave physical evidence of their hurt. While many in this category hide their scars in shame, others enjoy the attention the behavior brings. When loved ones show concern, it makes them feel special.

The Self-Punisher
             The thought process of the Self-Punisher is "I am bad and deserve to be punished." Low self-esteem and shame are large factors here. Peer bullying or a punitive parent can contribute to this way of thinking. Self-Punishers don’t generally care one way or the other if you know about the scars. Often times, less obvious self-harm tools are used, like biting or burns. Their self-harm is done in the spirit of self-loathing, typically after an event that reinforces their feelings of worthlessness.

The Controller
            Some people use self-harm as a means of calculated control. An example would be "if you make me go to school, I will cut myself!"  It is intentionally manipulative. One teen had a habit of locking herself in her room whenever she cut, intentionally arousing the concern of her parents. Even if she didn’t say anything, her parents knew if she was locked in her room she was cutting, and she consciously manipulated this concern. Parents are often frozen in fear as they don't want to see their child hurt themselves, but also know they can't give them everything they want because of threats. Because the teen will generally get what they want, acquiescing to their wishes is a positive reinforcement of the controlling behavior. However, parents must be extremely cautious on calling their child’s bluff; sometimes the controller will do what they have threatened even if it means their very life. Suicide attempts are a very real issue here. Threats of cutting can be a slippery slope to suicide attempts. Scars are not generally hidden by The Controlling self-harmer because they want people to see. It is especially crucial for parents to be involved in the counseling process with this type of self-harm.

The Angry One
            Revenge can be the motivation behind the self-harm of the Angry One. There are elements of hurt and control, but rage overwhelms them both. Parents and significant others are typically the intended target. In one situation, after an altercation with a family member, a girl carved 'I hate my life' into herself. She looked at me directly, her angry gaze meeting mine days after the event, saying “I knew that when he found out what I did, he would be mad. And there is nothing he could do about it." A small smile met her lips. It wasn't happiness but satisfaction. Others say that cutting calms their anger. The endorphins released after any painful experience can improve mood. The positive results (self satisfaction, anger from their intended target, sense of calm, etc) reinforce the behavior.

The Experimenter
            Of all types of self-harm, this one is the least dangerous. While there are always safety concerns when someone cuts which should be addressed seriously, this is the type of self-harm that stops the quickest. They don't continue because they weren't doing it for themselves. They don't get anything from the behavior. One 12 year old shrugged her shoulders when I asked her about the light scratches on her arm. "My friends cut so I thought I would try it. I didn't like it so I only did it that one time." She didn't show shame, but more just disinterest in the topic. It was like a "been there done that" attitude. With self-harm in popular teen movies, music, and media, many will get the idea from people they have never even met. The "emo" movement often gives a place of belonging to the cutters. Just like a preschooler playing the mommy, teens will ‘try on’ cutting. I will warn: it is crucial not to assume that someone practicing self-harm falls into this category. Parents especially tend to suppose their child is an experimenting cutter. Teens aren't always honest about self-harm. Any self-harm behavior requires professional consultation.
           

Research suggests that cutting has addictive qualities similar to scary movies, thrill rides, and sugar rushes- all which give endorphin rushes, which is why people return to them again and again. Other clinicians have suggested a correlation between abuse and cutting. While there is no research to back up this correlation, self-harm originates in pain, whose sources can range from horrific abuse, to the pain of a family divorce, to mild depression.

Parents sometimes make the mistake of disciplining the teens if they are caught in the act or after the fact. This encourages two unhealthy behaviors:
1) Secretive self-harm, thus closing of the honesty door between parents and their kids
2.) Alternate, equally harmful behaviors (i.e. drugs, alcohol, sexual promiscuity, eating disorders etc..)
            Studies show that family counseling is the quickest way to change these behaviors. If family counseling isn’t an option, professional support of another type should be sought as soon as possible. If there are ever concerns about life threatening situations, call 911 or the local crisis number immediately (360-696-9560 for Clark County, WA).

Further Resources
www.intheknowzone.com
Girls and Boys Town National 24 hour hotline: 1-800-448-3000
Cutting by Stephen Levenkron
More questions? Post a question or contact me: 360-798-2058