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A Silent Cry for Help: Understanding Self-harm

Identifying and Understanding Self-harming Behaviors

I watched the middle aged waitress at the restaurant assist her customers with their orders, awaiting my turn. I had seen her there many times, but she usually wore long sleeves. Today she had on a tee shirt. I noticed her arms were fully tattooed. I began to study the tattoos and saw that below the vivid tattoos were raised horizontal scars that extended up the inside of her arm. The marks looked like that of a former cutter. The tattoos bore a sad story, of that I was certain. Now at an older age, she had found a way to hide her past. Finally it was my turn, "Long road" I said nodding at her arm. "Yeah, but it's over now." She said with a reassuring smile. She was forever branded by her past. I left the shop thinking "How can we keep our teens from harming themselves so they don't have to hide their past when they get older. How can we hear their silent cries for help?"

So, I decided to write a blog to educate others about self-harming behaviors.

What is Self-harm?

Self-harm is the intentional and deliberate hurting of oneself. Most commonly it is done by:

  • Cutting
  • Burning
  • Hitting
  • Picking at the skin
  • Pulling hair
  • Biting
  • Carving

What are the warning signs?

  • Many cuts/burns on the wrists, arms, legs, back, hips, or stomach
  • Wearing baggy or loose clothe (e.g., wearing hoodies or long sleeves during hot days to conceal the wounds)
  • Always making excuses for having cuts, marks or wounds on the body
  • Finding razors, scissors, lighters or knives in strange places (i.e., the nightstand drawer or under the bed)
  • Spending long periods locked in a bedroom or bathroom
  • Isolation and avoiding social situations

Why do people self-harm?

  • To escape their feelings
  • To cope with life stressors
  • To express their pain
  • To punish themselves (Some people mutilate their bodies to punish themselves for what's going on in their lives. They lack the appropriate coping skills and suffer from low self-esteem so they feel that they deserve what they are doing to themselves.)
  • To feel euphoria. (It's true. When we get hurt endorphins are released into the blood stream, resulting in a "natural high" or a feeling of euphoria. Self-harming behaviors can be addictive and habit forming.)

So, what do you do if your teen is self-harming?

  • Tell your teen you love them
  • Don't judge them
  • Don't expect them to be able to just stop their behavior (The behavior is a coping skill that they're using and it's addictive so they may not be able to just stop.)
  • Lock up all of the self-harming items (e.g., scissors, razors, knives, etc.)
  • Help your teen find a substitute behavior (Replace the destructive behavior with a non-harmful one i.e., holding an ice cube, taking a cold shower or squeezing a rubber ball until the urge subsides. Professional Counselors can offer appropriate substitute behaviors.)
  • Don't punish, berate, or discipline your teen for self-harming
  • Get professional help immediately (You and your teen can't do this alone. Professionals can help your teen learn appropriate coping skills to deal effectively with life stressors.)

Did you know?

Intentional self-injury is one of the most common reasons young people go to the emergency room in the United States. A national study of Medicaid data indicates 80-90% of youth that self-harm meet the criteria for at least one psychiatric disorder, mostly mood disorders. More alarming, researchers report one in twelve teens, mostly girls, engage in self-injurious behavior and 10% of these youth continue to self-harm into young adulthood! That's a startling statistic and it shows that we've got a serious problem on our hands.

Self-harming behavior is a strong predictor to suicide. According to the World Health Organization, almost a million people die from suicide each year. That's 16 per 100,000, or one death to suicide every 40 seconds. In the last 45 years, suicide rates have increased by 60% worldwide! Since self-harming is a predictor of attempted suicide it is important to catch it early and put interventions in place immediately.

Teens who self-harm wear the signs of their mutilation. You can look for the warning signs and notice any unusual marks or branding on your teens body. If your teen is self-harming get help immediately. Early intervention is crucial.

I wonder if someone could have helped the waitress so she didn't have to conceal her past... She'll have to carry those self-branding marks forever, but your teen doesn't have to. Is your teen silently crying out for help? Are you listening?

More from Raychelle Cassada Lohmann Ph.D.
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