Self-Injury: Understanding Teenagers Who Mutilate Themselves
Terrie is a 16-year-old student in a suburban high school in the
U.S. It’s been a hard year for her. She broke up with her boyfriend
over the summer and she had a major fight with her best friend a
few weeks ago. She feels intense pain and anger inside and nothing
seems to relieve it. She assumes that no one really understands or
Terrie knows some other girls who say that cutting yourself can
make you feel better. That always seemed weird to her but she is
desperate and decides to try it one night after arguing with her
parents. She takes a razor blade and makes several cuts on the inside
of her forearm. It doesn’t really hurt that much and there’s
a comfort in feeling the warmth of her blood run down her arm.
David is a 15-year-old missionary kid who just started boarding
school this year. Although he was looking forward to doing just as
his two older siblings had before him, he is now struggling with
his new environment and being away from home. His school feels overly
structured, excessively strict and oppressive to him. Most of the
time he feels numb inside but he’s never been one to talk much
about the way he feels. Sometimes when he’s really frustrated
with his teachers or dorm parents, he punches the door in his room
or bangs his head against the wall. Somehow that gives him a sense
of relief. He feels less tension and the physical pain is a comforting
reminder that he is capable of feeling something—even if it
Both of these teenagers are harming themselves as a way of coping
with pain. They are not alone. An estimated eight million Americans
are currently self-mutilating, among them many teenagers cut themselves.
Others burn themselves with cigarettes or matches. Still others repeatedly
reopen old wounds by picking at a scab, or pulling out their hair,
biting their fingernails to the quick, or even breaking their own
bones. Most of these actions result in minor injuries that can be
covered or hidden (with the exception of the broken bones). They
are usually not life threatening, but without proper care they can
lead to infection or permanent scarring.
who injure themselves do so for a combination of reasons."
Self-injury is the intentional harm of one’s own body without
any conscious intention to commit suicide. This is an important distinction
because self-injury may be confused with a suicidal attempt or gesture,
but the underlying motivation of self-injury can be quite different
from someone who is attempting suicide. Although some people who
inflict injury on themselves do commit suicide, we shouldn’t
jump to the conclusion that self-injury means that someone is necessarily
Why Teenagers Injure Themselves
Like most adjustment problems, self-injury is rarely caused by one
simple thing. Instead, most people who injure themselves do so for
a combination of reasons. Here are some of the most common.
Relief from painful or upsetting feelings: People
who injure themselves often have trouble identifying, expressing,
and releasing their emotions—especially their painful ones.
If a teenage boy is feeling isolated, alienated, depressed, frustrated,
disorganized, tense, fragmented, or empty he may hurt himself to
gain a little immediate relief. The physical pain produces a flooding
of endorphins and provides a tangible wound that can be nurtured
and healed unlike the hidden inner emotional pain. In this way, self-injury
serves as a kind of coping mechanism that temporarily brings relief
and lowers stress when one doesn’t know how else to handle
Physical Expression of Pain: We all feel some
inner pain or unhappiness at times that we can’t quite describe
or put our finger on. For unhappy teenagers, this can be especially
troubling. They are upset but they don’t know why. Hurting
oneself turns the invisible pain into a tangible, external reality.
As odd as this may sound, in the hurting teenager’s way of
thinking, it seems better than an unnamed inner pain.
Revenge: Many teenagers go through a period of being
quite angry with a parent or other person. If they cannot express
that anger directly, they may seek out a hidden, alternate way.
Some adolescents, for example, use drugs or drink alcohol or fail
at school in order to unconsciously get back at their parents.
Self-injury sometimes serves this same purpose. It can be a disguised
way of expressing anger or resentment.
Self-punishment: People who have been abused
or mistreated or made to feel very badly about themselves may engage
in self-mutilation because they think they deserve it. They feel
so guilty or worthless that they punish themselves for their perceived
Re-enacting Previous Abuse to Gain Control: People
who have been injured or abused by another person sometimes replicate
the abuse in order to gain a sense of control or to bring relief
of their tension and pain. Their unconscious logic goes like this: “If
I hurt myself, I am in charge of my pain. I can control it and keep
it manageable. If I don’t, someone else may hurt me and I will
have no control at all over that.”
Self-Protection: Other adolescents fear sexual
victimization. They produce scars because they believe that will
make them unattractive and scare away anyone who may approach them
with a bad intent.
Relief from Numbness: Few things are worse than
feeling inwardly numb or emotionally dead. Although this is difficult
for many parents to understand, many teenagers feel inwardly numb—almost
like they aren’t really alive. They are kind of floating emotionally
or feeling dazed rather than alive and alert. This is a terrible
feeling so they look for a way to prove to themselves that they are
alive. Few things prove this better than seeing ones own blood running
or feeling physical pain. It is a terrible paradox, but many people
hurt themselves to prove that they are alive and real.
How Can I help?
The key to helping someone who is self-mutilating is to remember
that people don’t do this just by chance. There is always some
underlying cause or reason. The most important thing to do is find
out why the person is hurting themselves, not just try to get them
to stop. We need to be good listeners and draw the person out. Only
then can the real problem be resolved.
Since most people who self-injure do so in order to gain some sense
of control, it doesn’t help to take a controlling, dominant
stance or try to force him or her to change. It will need to be the
person’s choice to stop and they will have great difficulty
doing this until they have faced their emotional pain and learn better
ways of coping with emotional stress. Anything that you can do to
help the person identify their painful feelings, talk about them,
and discover effective problem-solving strategies, will divert the
focus away from self-injury and onto the real source of the problem.
|"Never hesitate to consult with a mental health professional when you become aware that someone is engaged in self-injury. "
Providing a model of self-awareness and honesty and being able to
talk about our own conflicts, grief, or other forms of emotional
pain can encourage a teenager to do the same. So does pouring our
hearts out to the Lord and allowing Him to heal us in our own brokenness.
Instead of acting as if we have it all together we need to be real
and open with our children.
Once it comes out that a person is self-injuring, it will be important
to provide ongoing support and care for him or her even after it
seems that the self-injuring has stopped. Relapse prevention principles
are useful here. It is important to help the person anticipate when
he might be tempted to hurt himself again—under what circumstances
and in what way. Then this person can be helped to develop a strategy
for what he or she will do in that situation. It’s also important
to try to reduce their shame in case they do hurt themselves again,
since shame makes it difficult to let anyone know that they still
have a problem.
Never hesitate to consult with a mental health professional when
you become aware that someone is engaged in self-injury. Self-injury
might be due to other types of problems such as sexual abuse, depression,
suicidal thoughts, eating disorders, or substance abuse.
As with any kind of behavior with addictive components, it can be
a long road to recovery with relapses and pitfalls along the way.
Christian families and caregivers will want to use all of their spiritual
resources of prayer to help their children or others learn to face
their inner hurts and find deep and lasting solutions. The child
may or may not be ready to participate in prayer with you and should
be given the choice but in either case, we should be seriously seeking
God’s guidance, support and intervention.
References and Reading Resources:
The Scarred Soul: Understanding and Ending Self-Inflicted Violence by Tracy Alderman.
A Bright Red Scream: Self-mutilation and the Language of Pain by
Bodies Under Siege by Armando Favazza.
Karen Carr, Ph.D, is Clinical Director of MMCT (Mobile Member Care
Team) residing in Accra, Ghana. She is an experienced licensed clinical
psychologist and has conducted training in crisis response, interpersonal
skills, and member care with various missions in ten countries, including
several in Africa. www.mmct.org
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