Advice Column, Health, Tween & Teen Advice

Cut to the chase…

I work with a lot of high-school aged people, in fact they form about half of my professional interactions. As a result of this, I come across many who self-harm in one way or another. It can be hard to understand why people deliberately hurt themselves. Cutting is a way some people try to cope with the pain of strong emotions, intense pressure, or relationship problems. They are often dealing with feelings and situations that seem insurmountable. Some people cut because they feel desperate for relief from their emotional state, while some people cut to express strong feelings of rage, sorrow, rejection, desperation, longing, or emptiness. It can also form a system of self-punishment or punishment to those who love and care for the person in question.

People who self-harm may not have developed adequate ways to cope with their challenges, or their existing coping skills may be overpowered by emotions that are too intense. When emotions aren’t expressed in a healthy, regular way, tension can build up, like a pressure cooker, to the point of boiling over. Cutting and other types of self-harm are often attempts to release the pressure and tension felt. For some, it seems like a way of feeling in control. For others it’s just a way of feeling something…anything.

How common is it? 

Much more common than it used to be. Studies from the 1990’s suggested rates of 3% or lower. But more recent studies focussed on females, suggest that as many as 20% of girls between 10 and 18 years of age are now self-harming. Researchers at Yale University recently reported that 56% of the 10- to 14-year-old girls they interviewed reported engaging in self-harm at some point in their lifetime, including 36% in the past year.

Cry for attention?

So many people will take one look at the behaviour and say that it’s just a cry for attention and should be pandered to. Sometimes they are half-right in that it is a way of drawing attention to themselves, but to ignore it? Never. Think of it this way: If your child does not know a better way of drawing attention to themselves and their emotional turmoil, that is a huge, flashing warning sign that they have inadequate skills for dealing with their challenges.

Why don’t they just talk to us? 

The urge to cut might be triggered by strong feelings the person can’t express such as anger, hurt, shame, frustration, or alienation. People who cut sometimes say they feel they don’t fit in or that no one understands them. Cutting might seem like the only way to find relief or express personal pain over relationships or rejection. They often lack the perspective required to realise that even if we don’t fully understand what they are going through, we can still be of help and support to them.

It’s addictive.

When we are injured, you brain releases a bunch of dopamine (our most addictive happiness hormone) to compensate for the pain. It becomes like a distraction from the mental pain that a self-harmer goes through, a really exhilarating one at that. It’s something that can be leant on when they are not feeling happy and need an instant “fix”. Think about the stressed person who needs a quick smoke to relax and you’ll be a bit more in the picture. Except that this “smoke” can accidently kill you a lot more quickly and maim you in a much more visual way.

It’s dangerous!

Firstly, there is the risk of accidental death as a result of self-harm. An artery or vein pierced or nicked accidentally can be fatal. A head bashed against a wall can cause concussion or fitting that could lead to death or permanent brain damage. Burning can lead to full combustion… let me not go on. Aside from this there is the risk of infection and septicaemia. Take it from someone who nearly lost an appendage to a simple thorn-prick, it’s no joke.

Types of self-harm to look out for:

Scratching or pinching: severely scratching or pinching with fingernails or objects to the point that bleeding occurs or marks remain on the skin. This method of self-injury is probably the highest reported type.

Impact with objects:  Banging or punching objects to the point of bruising or bleeding. This is no joke and I’ve seen one person repeatedly break their wrist this way. This same individual took his own life many years later, sadly.

Cutting: Usually synonymous with self-harm, this type of self-harm occurs in roughly 1/3 of cases and is more common among females. This is accomplished with anything from scissors to surgical blades and can be the riskiest in terms of accidental death.

Impact with oneself: slapping or punching oneself to the point of bruising or bleeding.

Ripped or piercing skin: This type of self-harm includes ripping or tearing skin, usually with objects like needles, pins, hooks or other jagged surfaces.

Carving: this type of self-harm is when a person carves words or symbols into the skin and is considered separate from cutting.

Burning/Branding: using lighters to brand themselves is a very common as its relatively quick and uncomplicated. Look for tell-tale “smiley” marks.

One thing to note, 70% of those who repeatedly self-harm use multiple ways to self-harm with the majority reporting between 2-4 self-harm methods used.

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