Adolescent Programs that Treat Self-Harm
I can tell you from parenting experience that finding out your child is cutting herself is one of the scariest and confusing of life’s few earth-shaking wakeup calls. Your child is causing herself to bleed…a lot…and you have no idea why. Questions you are not prepared to ask flood your brain: “Is she trying to kill herself? Is she going to die? What’s wrong with her? Why is she doing this? Am I to blame? What did I do? What did I not do? What do I do now? Is it too late? Where do I go to get her help?” And even worse, you find tragically that you have no answers for any of them.
“All I wanted to do was cry.”
anonymous parent of a child who cut
Self-harm can take many forms: cutting, burning, carving, scratching, branding, picking, hair pulling, biting, head banging, hitting, punching walls, shocking, poisoning and overdosing, to name some of the most common. And they all basically point to the fact that the adolescent involved is having a great deal of trouble managing his or her emotions, tensions and stressors.1
At a certain point, the discomfort, the pain, the confusion, the helplessness, builds up, the pressure becomes unbearable, and all the adolescent can think of is getting relief, any kind of relief, any way possible, no matter what it takes or how long it lasts. So they inflict harm on a part of their body, and endorphins are released immediately into the bloodstream, giving them a momentary numbing, a temporary respite from the hell within.2
Although we don’t want to admit it, adolescent self-harm is quite common, crossing over all cultural and socioeconomic level. For some reason, it seems more prevalent in females than males. And research has shown that if treated, self-harm does not lead to suicide. In fact, acts of self-harm, in general, are not attempts to take one’s life but is instead an effort to express the pain, anxiety or other emotions they are having great difficulty dealing with.3
“In general, acts of self-harm do not indicate a desire to attempt suicide.”
Do not breathe a sigh of relief, however, because, left untreated, according to the Institute of Medicine, self-harm is considered a serious risk factor for suicide. It is indicative of underlying emotional problems that could seek redress in more devastating terms, and repeated instances of deliberate self-harm can lead to suicide.3
Studies estimate some 2 million Americans engage in acts of self-harm, 1 percent of the total U.S. population. Approximately one in every 200 girls between 13 and 19 years old, cut themselves regularly. That’s nearly 70% of all teen girls who self-injure.4
“Early intervention may prevent or at least reduce chronic deliberate self-harm behavior that if left untreated may [eventually] become impervious to treatment.”
Donald Greyandus, M.D.
There appears to be no single cause for such injurious behavior.2 Family dysfunction, poverty, overt depression, low self-esteem, persistent helplessness, bullying, abuse, the realization of one’s own identity and or sexuality, and even basic impulsivity all seem to have a hand in one or more cases of adolescent self-harm. However, the symptoms of deliberate self-harm do have common feelings of emptiness, loneliness, inability to express feelings, and difficulty starting and maintaining positive relationships.
There may and may not be cries for help coming from those who self-harm. Parents may have to keep their eyes open and not overlook what cloaked tell-tale signs might be available.2 Cut marks, burn marks, and other more obvious injuries, especially if vigilantly concealed, are clear signs of problems. Teens regularly locking themselves in the bathroom or in their bedroom should be looked on with great suspicion. Hearing about friends your teen has that are doing questionable things in this regard is important to note. And finding knives, razor blades, box cutters, and other sharp objects is certainly something to follow up on with your teen.
“The most common methods of self-harm are:
Skin cutting (70-90%)
Headbanging or hitting (21-44%)
Mental Health America, “Self-injury”
Frequent injuries, written off as accidental or the result of being clumsy, may be signs of self-harm. When teens wear concealing clothing, even in warm weather, there is a good reason to question their behavior. What is important to remember is that while you may be freaking out because you see your child self-injuring, your child is experiencing the actual difficulty. They are likely to be more afraid and confused than you. Approach them with love and concern. Don’t make it worse by harsh interrogation.
Self-harm is essentially an immature, inappropriate and destructive attempt to release pent-up emotion or stress. And it does just that, it relieves the pressure, or re-directs the pain, even if only momentarily. The good news is that teens can be shown how to deal with stress and painful emotion in positive and productive ways.
If you know or even suspect your teen is engaging in acts of self-harm, contact your family doctor asap. They can refer you to key contacts in your local public and private sectors of mental and emotional health treatment. It is also important to come to grips with the fact that treatment will not be easy or done in short order. Medication may need to be involved. And residential treatment may be the first order in the business of helping your child.4
Treatment Programs That Work
Treatment programs that have been shown to be the most effective include Family and Individual Therapy (Cognitive Behavior Therapy, Dialectical Behavior Therapy, and Psychodynamic Therapy), and Replacement Skill-Building Group Therapy.5
Individual Therapy (focusing on)
- insight on underlying issues and triggers
- healthy beliefs and behaviors
- replacement thoughts and behaviors
Family Therapy (focusing on)
- conflict resolution
- relationship building, maintaining
Replacement Therapy (focusing on)
- stress management
- mood management
- helpful thinking
- coping skills
- mindful breathing
- physical exercise
- artistic expression (writing, music, art)
Excellent treatment programs across the United States are ready to help you help your teen. Somewhere near you are professional hands and hearts and minds ready to change your child’s self-harming ways.
“There is no silver bullet…no magic technique or therapy.”
New Haven Residential Treatment Center
The best of the best tell you that recovery starts with a physical and emotionally safe environment, builds trusting relationships, moves forward with lots of insightful talking (individually, in groups and within families), and finishes with the endless practicing of replacement or alternative thought patterns and behaviors.
1 “Self-Injury to Adolescents,” American Academy of Child Psychiatry (AACP).
2 “Adolescent Self-Harm,” American Association for Marriage and Family Therapy (AAMFT).
3 “Treating Self-Harm in Children and Adolescents,” Donald Greyandus, M.D.
4 “Cutting Statistics and Self-Injury Treatment,” Teen Help.
5 “Self-injury/Cutting,” Mayo Clinic.