Have you ever encountered self-injury in a friend or loved one? Even if you haven’t, chances are you know someone who intentionally harmed themselves. In 2006, researchers estimated that 14-17% of adolescents and young adults have engaged in self-harm behaviors (Whitlock, Eckenrode, & Silverman).
In a 2007 study, over 46% of adolescent participants reported that they had engaged in non-suicidal self-injury (Lloyd-Richardson, Perrine, Dierker, & Kelley).
The results of other studies confirm that adolescent self-harm is an issue that is all too prevalent and needs to be taken seriously. The psychology community refers to self-harm as Non-Suicidal Self-Injury (NSSI). The definition of NSSI is:
The intentional infliction of injury by an individual upon his or her person in a socially unacceptable manner but without the intent of suicide.
What is your gut reaction to the phrase “self-injury”? If you’ve never experienced an instinct to harm yourself, you might feel unable to relate or understand why someone would hurt themselves. You might wonder what the warning signs or and how you can help someone who is self-injuring regularly.
In this article, we will explore these issues and work towards an increased awareness of self-injury and how to address it.
What Does Self Harm in Teens Look Like?
Self harm in teens can take multiple forms. Individuals may rely on one primary method or a variety of methods. Counselors often note an escalation in these behaviors, beginning with milder forms of scratching or cutting and increasing to a more severe level.
Researchers have discovered that self-injury often displays addictive features (Nixon, Clouter, & Aggarwal, 2002), which explains why it can be so hard to stop.
Methods of self-injury are distressing to hear about, but it’s important to understand the forms this behavior can take. Researchers have identified the most common forms, including biting, cutting, hitting oneself, and burning (Lloyd-Richardson, Perrine, Dierker, & Kelley, 2007).
Punching objects, interfering with the healing of wounds, pinching oneself, pulling out hair for the purpose of hurting oneself, and breaking bones are more examples of forms of self-injury.
Still, further examples include punching objects, disturbing wounds in the process of healing, pulling hair, and breaking bones. Tools of choice can be razors, pencil sharpeners, scissors, paper clips, etc. Any sharp object can be utilized.
As for the physical location of injuries, we often see cuts on the arms and legs, particularly the upper thighs.
What Causes Self-Injury?
If you haven’t struggled with self-harm, you might find it too hard to grasp why someone would hurt themselves. It’s vital to form an understanding of the reasons behind self-injury. This allows us to offer true empathy and support.
Of course, self-injury isn’t caused by just one factor. Here are a number of possible issues that may lead to a desire to hurt oneself:
- Self-injury can be a form of manipulation, but it should not be assumed that this is the primary reason.
- It can be a way to “wake up” from a sense of numbness.
- It can be a way to punish oneself for real or perceived failure in some other area of life.
- It can signify a lack of ability to process intense emotions (a common struggle in adolescence); it may seem easier to deal with physical wounds.
- Along the same lines, self-injury is a way to focus on something other than one’s emotions.
- It’s often assumed that self-injury is a form of attention-seeking. This can be true, but again, this shouldn’t be the default assumption. And even if it is true, it’s crucial to consider why there’s a felt need for attention along with a lack of ability to communicate this need in a constructive way.
- Self-injury can serve as a release of tension (Nixon, Cloutier, & Aggarwal, 2002).
- It can be a way to feel in control when other aspects of life feel out of control.
- It can signal a lack of ability to express one’s emotions verbally, and a choice to instead communicate them through self-harm.
- Similarly, self-injury can indicate that an individual feels unable to soothe their emotional pain in any other way, whether it takes the form of depression, anger, or some other condition.
- When someone is injured, the brain may release chemicals that produce a soothing effect.
Self-injury may seem like a relief at the moment, but it provides false and destructive relief. After an incident, the individual often feels a sense of shame and guilt, which can trigger an even greater desire to self-harm. The behavior then becomes a cycle.
Professional treatment can be a crucial component in breaking the cycle and developing coping mechanisms to avoid the urge to self-harm.
Risk Factors for Self-Injury
What are the risk factors that might lead someone to engage in self-destructive behaviors like cutting? Many possible factors relate to the emotions and how well they are regulated, including:
- A habit of internalizing emotions, especially anger
- Low self-esteem
- Mental illness, including depression, anxiety, PTSD, etc.
- Having a friend who self-injures
- A general difficulty with emotional regulation
- Being abused either now or in the past
Warning Signs of Self Harm in Teens
Self harm in teens is usually accompanied by a strong sense of shame, leading to attempts to hide the outward signs of the behavior. Even so, there are still signs that can indicate the possibility that self-harm is occurring. These signs can be used to assess the situation, but they can also be present in the absence of self-injury.
- Visible scratches, marks, or other wounds that are explained away or brushed off as quickly as possible.
- Wearing a lot of bracelets or armbands all the time to hide wounds.
- Wearing long sleeves during hot weather.
- Increasing isolation (often linked to depression).
- Suddenly refusing to wear a bathing suit (this might also be due to modesty or body image issues).
- In general, wearing unusually concealing clothes.
According to research, self-injury is a significant risk factor for suicide attempts. Researchers Klonsky, May, and Glenn (2013) found an association between the two. Moreover, they discovered that self-injury was the second leading risk factor for suicide attempts, suicidal thoughts being the first.
This study also found associations between suicide attempts and impulsivity, anxiety, depression, and borderline personality disorder. Numerous other studies have identified a link between self-injury and suicide attempts.
This doesn’t mean that self-injury always leads to attempted suicide; oftentimes there’s no link at all. However, since there is an increased risk, the possibility of suicidal thoughts should be discussed as soon as possible. If suicidal tendencies are present, seek professional help immediately.
How to Help
Let’s revisit the question of your instinctive reaction to the issue of self harm in teens. You might find it frightening or feel helpless when you realize someone you love is hurting themselves. These are normal reactions.
Your own feelings need to be processed as a first step, so you can respond from a place of calm support rather than emotional reactivity.
The primary need of someone who self-harms is to have a place of compassion and safety where they can find support and empathy and learn to express their feelings.
Self-injury carries medical risks, such as the risk of infection, so if you are not the parent or guardian it’s important to contact them about this behavior. Adolescents may fear this disclosure and might respond better if they are included in the process of telling their parents. Remind them that you are on their side, but that you have an ethical obligation to consider their safety.
Avoid responses that may be instinctive but are probably not helpful:
- Anything that communicates shame or blame, since these feelings are most likely already present and may contribute to the problem.
- Demanding that the behavior stop immediately. This might just lead to the teen hiding it better. (Instead, remind them that you are worried about them and available to talk anytime they need it. If the behavior is more serious and risky, immediate professional intervention may be needed.)
- Not taking it seriously.
- Punishing them.
- Discussing it with anyone besides caregivers or professionals.
Treatment for Self-Injury
As we have seen, self-injury can become a pattern that is very hard to stop. The individual may use it as a coping mechanism and a consistent way to ease their emotional pain. When they attempt to stop the behavior, they often experience intense urges to revert to it.
But there is hope! Professional therapy can be a path for healing and recovery from these devastating behaviors. It can take several forms, including individual, family, or group therapy. Medication may be another possible method of treatment.
In therapy, a person who self-injures will develop the ability to cope with and communicate their emotions and needs in a healthy, constructive way. They will learn skills for expressing emotions and connecting with other people in their relationships.
Part of the therapeutic process is also identifying the underlying reasons that led to self-injury, such as anxiety, depression, anger, etc. These underlying conditions will be treated as well.
Therapeutic treatment for self-injury is important and may even save a life. If you or someone you love is harming themselves, don’t hesitate to reach out for help. We want to help you find the path to healing.