Self-Mutilation: Adolescents in Pain

Sophia was 13 when she first cut a vertical line across her wrist by using a razor blade. She watched the gash of blood ooze down her arm. After a moment of pain, she became relaxed and seemed to be at peace. She did not feel remorse, only release.

Sophia is among many of the young adolescent girls who have fallen victim to self-mutilation. She is one of a number of adolescent girls who cut themselves to supplant emotional feelings with physical pain. According to one study in the Journal of Abnormal Psychology, 14%-39% of adolescents engage in self-mutilative behavior. Those adolescents who self-injure do so because of an internal dynamic, and not in order to annoy, anger or irritate others. Their self-injury is a behavioral response to an emotional state, and is usually not done in order to frustrate their family or friends. Self-mutilation is a “coping technique” for many adolescents who cannot soothe their inner emotions. Cutting and other forms of self-mutilation release endorphins that produce a euphoric feeling. Many of the adolescents I work with indicate that the act of cutting makes them feel “alive.”

What to look for if you suspect your adolescent is cutting or engaging in self-mutilative behaviors?

Unexplained cuts, bruises, burns or bumps on arms, thighs, and legs
Carrying knives, matches or lighters in pockets, backpacks, or purses with no reason for needing them (e.g., not a smoker)
Wearing long sleeves and/or long pants to cover up arms and legs, even in hot weather
Blood or burn stains on clothing
Constant picking at scabs or wounds and making them worse or not allowing them to heal
Bald spots on their head where they have lost hair follicles due to hair pulling/scratching their head
Questionable excuses for excessive amounts of cuts (e.g., “The cat or dog scratched me”)
What to do if you suspect cutting or other mutilative behaviors?
Parents should not ignore self-mutilative behavior nor criticize their adolescent for such behavior. If you have an adolescent who cuts himself or herself, you can’t force them to stop. But you can let them know that you’re there to help.

There are a number of strategies that can be used to help adolescents refrain from self-mutilative behavior. It can be tough to remain calm when talking to them about it because it’s such an upsetting subject, but it’s very important to let your adolescent know you care about them and you don’t think they are a bad person for doing this.

It is best to encourage them to talk to someone who can help them to stop the behavior and deal with their underlying problems. Ultimately, adolescents who engage in self-mutilative behaviors will need to be assessed by a professional psychologist or counselor who can recommend the best treatment plan for them. This may include a combination of behavioral therapy, medication and specialized treatment of associated problems. The strategies/interventions identified below have been used by many of my clients to help fight the “urge” to injure. These include:

Relaxation and Breathing techniques
Yoga, Tai Chi, Kick Boxing, or other forms of exercise
Meditation or Hypnosis
Doing artwork to represent emotions
Reading a good book
Writing down feelings before engaging in self-harm
Drawing on body with bright colors, or buying a “special” pen that can be used to mark body parts instead of using a blade.
Ask friends/family to write down things that they like about the individual and keep these in a place where they are visible.
Talking to someone who is trustworthy so that feelings in the moment can be explained and processed. Keep talking until the urge goes away and, if possible, stay in the company of others.
Keeping a rubber band around the wrist area and snapping it against the write when there is the urge to engage in self-harm.
Although cutting and/or other self-mutilative behaviors can be difficult to stop, it is possible. Once the adolescent who is self-harming gets help in solving the problems that are at the root of the behavior, chances are good that they will be able to stop hurting themselves and lead a healthier, happier life.