AAMFT Consumer Update

Adolescent Self-harm
 

By definition, self-harm refers to hurting oneself to relieve emotional pain or distress. The most common forms of this behavior are cutting and burning. The least common forms of self-harm include pulling out bodily hairs, punching walls, and ingesting toxic substances or sharp objects.

     Many adolescents today are struggling to cope with extreme levels of stress in school, in their families, and in their peer relationships. Some of these youth are overscheduled and being hurried through their adolescent years by parents and peers alike. Teens have become vulnerable prey to our highly toxic, media-driven world. Being in front of a computer or TV screen for close to six hours a day has become business as usual and more important than spending time with family and friends. Adolescent girls are constantly being bombarded by images in the media about how they should look and act. Especially for young women, failure to live up to these idealized images can lead to developing an eating disorder and/or engaging in self-harming behavior as a form of self-punishment.

What Causes Adolescent Self-Harming Behavior?

     Like substance abuse, adolescent self-harming behavior has no one single cause. It cuts across all cultural and socioeconomic levels. We do know, however, that more adolescent females engage in this behavior than males, and that self-harming adolescents are rarely suicidal. Most of these adolescents are seeking quick relief from emotional distress.

     One major reason why adolescents gravitate towards self-harming behaviors is the endorphin effect. When adolescents cut or burn themselves, endorphins are quickly secreted into their bloodstreams and they experience a numbing or pleasurable sensation. For some of these youth, cutting or burning themselves numbs away unpleasant thoughts and feelings or they feel "high" from the experience. Like addiction to a particular drug, the endorphin "high" provides fast-acting relief for adolescents from their emotional distress and other stressors in their lives. Other important reasons as to why teens engage in self-harm include:

• Feeling emotionally disconnected from or invalidated by their parents
• Wanting to "fit in" within a particular peer group that encourages and rewards self-harming behavior
• Feeling emotionally dead inside or feeling invisible in their parents’ eyes. Self-harm makes them feel alive inside and helps confirm their existence in reality.
• For girls, self-harm may be used as a coping strategy with overly demanding parents, especially in situations where the father is the dominant voice when it comes to discipline and decision-making

How Do You Know When to Seek Help?

     Since adolescents often engage in self-harming behaviors in privacy or with their friends, parents may not be aware that this problem exists. In addition, parents also need to be aware that there is a big difference between self-decorating and self-harming behavior. It is a popular fad among youth today to body pierce and tattoo as a form of self-decorating. Teens who self-harm are seeking relief from emotional distress, they are not self-decorating. Here are some signs that might indicate that a teen has a problem with self-harming behavior:

• Cut or burn marks on their arms, legs, and abdomens
• Finding knives, razor blades, box cutters, and other sharp objects hidden in the teen’s bedroom
• Regularly locking herself or himself up in the bedroom or bathroom following a bad day at school, negative encounters with peers, and family conflicts for lengthy periods of time
• The family physician, a teacher, or other adult observes cut or burn marks, or that the teen appears to be regularly removing bodily hairs
• The teen’s peers cut or burn themselves.
• Reports from a sibling indicating that he or she found blood encrusted razors or caught the teen in the act of self-injuring

What Kinds of Treatments Work?

     By far, the most effective treatment for adolescent self-harming problems is family therapy. A skilled family therapist will be able to help improve family communication, teach conflict-resolution and problem-solving skills, and help foster more meaningful and closer relationships between parents and teens.

     Skill-building groups can be helpful to self-harming adolescents as well. A good group should teach teens effective tools for managing their moods, challenging unhelpful thinking, visualization and meditation skills, and healthy activities to better manage stress.

How Can Adolescent Self-Harm be Prevented?

     Parents play an integral role in preventing their teens from engaging in self-harming behaviors and from joining an unhealthy peer group, where this problem may be the glue that keeps them together. At home, parents can make spending time together as a family a priority. Parents can put the teen in charge of selecting and planning a weekly family outing. The family mood needs to be more calm and inviting for the teen. When conflicts do erupt or crises occur, family members should work together as a team to solve these situations. Teenagers need to feel a sense of place in the hearts and minds of their parents. They need to feel appreciated and know that their parents will be there for them unconditionally. It is the parents’ responsibility to create firm boundaries between their work and family lives.

     One way to help foster more meaningful connections between parents and teens is to share family stories. Parents should share with their kids what their struggles and high points were in adolescence. They can also share with their teens any important words of wisdom and stories that their own parents shared with them when they were growing up.

     Self-harming behavior can be dangerous, particularly if the youth is abusing alcohol and other drugs. Parents need to take a firm stance and set consistent limits with these behaviors. Parents also need to model for their teens’ responsible use of alcohol and healthy ways to manage stress.

     It is a parent's right to meet their teen’s friends, as well as their parents, and voice your concerns when warranted. Should a parent discover that their teen is engaging in risky and dangerous behavior such as self-harm, they should rest assured that a family therapist will be able to skillfully assist the family and teen with this serious issue.

Consumer Resources

Books

Alderman, T. (1997). The scarred soul: Understanding and ending self-inflicted violence. Oakland, CA: New Harbinger.

Conterio, K. & Lader, W. (1998). Bodily harm: The breakthrough treatment program for self-injurers. New York: Hyperion.

Miller, D. Women who hurt themselves: A book of hope and understanding. New York: Basic.

Clarke, A. (1999). Coping with self-mutilation: A helping book for teens who hurt themselves. Center City, MN: Hazeldon.

Selekman, M. D. (2002). Living on the razor’s edge: Solution-oriented brief family therapy with self-harming adolescents. New York: Norton.

The text for this brochure was written by Matthew D. Selekman, M.A., LCSW

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© 2002 by the AAMFT