The reasons why so many teenagers self-harm and how you can help
Counsellor and psychotherapist Liz Quish, a crisis counsellor in Pieta House supporting and counselling teenagers and adults who present with self-harm and suicidal thinking, has some advice for worried parents
Self-harm amongst teenagers can be extremely challenging to anyone who doesn't understand why a teenager would deliberately harm themselves. You may wonder how physically hurting yourself could make you feel better. If anything, would it not make you feel worse?
Teenagers harm themselves for a number of reasons. These reasons include:
• Inducing a sense of release
• Validating inner pain
• Gives a sense of control over a situation they feel they have no control over
• Helps them to stay alive.
Self-harm is a communication of distress and inner emotional pain. Teenagers engage in self-harm as a way of coping with their distress, not necessarily as a means or desire to end their lives.
In many cases, the act of self-harming is the mechanism that actually keeps them alive. Many teenagers in this level of distress do not want to die, but simply want the emotional pain to end.
The act of self-harming gives them a momentary release. Teenagers who engage in the act of self-harming do not usually intend to cause lasting injury.
The purpose of engaging in self-harming is to facilitate the releasing of stress, thus, inducing an altered, more peaceful state. However, this, in most cases, is short-lived, with feelings of guilt and shame emerging quickly after the act, and a vicious secretive, cycle then emerges.
Self-harming can be difficult to detect because of its secretive nature. The following signs may indicate that a teenager is self-harming and parents are advised to be alert to the following possible signals. The more warning signs you can identify with, the more likely the teenager is engaging in self-harm.
• Looking for excuses not to engage in PE and sports activities which would require changing clothes and exposing their bodies which may have marks and scars due to self-harming acts
• Noticeable change in character: sad, withdrawn or anxious. These presentations may indicate a level of emotional pain and, as such, the teenager who comes across this way may be engaging in self-harm as a way to cope with their inner pain
• Talking about themselves in a negative way: "I am useless, stupid, and no good, I have no friends." Ongoing statements like these clearly suggest a low level of self-worth. Again, the teenager may be engaging in self-harm as a way of punishing themselves and to release their stress
• Unexplained wounds, scars and bruises. Parents need to be diligent regarding these physical signs: check in and follow-up as to how they came about
• Wearing long-sleeved tops and long trousers even in hot weather. This is regarded as a classic sign of self-harm, in association with other significant factors such as low mood, sadness and low self-worth
• Disappearing more than usual and spending longer periods of time in their room and locking the door. While teenagers clearly like their own space and privacy, parents need to be alert that the teenager maybe self-harming when alone. Obviously, not every teenager who retreats into their room is self-harming. However, if your teenager shows a significant amount of the signs outlined above, extra attention is warranted
• More frequent and longer periods of time spent in the bathroom. Teenagers, particularly girls, enjoy pruning and pampering themselves and seem to spend forever in the bathroom. This is very normal behaviour during this developmental stage. However, it is worth checking this out if other signs of self-harm are also evident
• Lack of engagement with friends. Has the teenager stated to isolate themselves for no obvious reason?
• A collection of instruments that can cause injury and facilitate cutting. Generally, the teenager will go to great lengths to hide the tools they use to self-harm
• A collection of plasters, soothing creams and antiseptics hidden in room.
• Blood spots on clothing and bed linen (turn clothes inside out to check)
• Refusing to go clothes shopping. Again, the teenager maybe trying to hide wounds and scars.
• Finding laxatives in room. Weight loss. Vomiting. This is not a very common form of self-harm. Nonetheless, parents need to be mindful.
• Teenager reacts with passiveness and retreating to room when challenged on an issue.
• Looking for reasons to avoid family functions and seeking opportunities to be home alone more frequently. This of course might be considered normal teenage behaviour and indeed it is. However, such a sign in association with other signs outlined above may be an indicator that the teenager is distressed and seeking opportunities to be alone so they can release emotional pain through self-harming.
What you can do
Discovering that your teenager is self-harming is a daunting and frightening experience. You may feel afraid, angry, disgusted and ashamed. On discovering your teenager is harming themselves, it's important to take action in a proactive rather than a reactive manner.
A - Attend to your own feeling and compose yourself
I - Inform the teenager you are aware of their self-harming with compassion
D - Discuss the need for professional help and decide on actions together.
A - Activate a support system for yourself
R - Refer the teenager for professional help
M - Maintain a positive relationship with the teenager.
Self-harm is not necessarily an indication of suicide: it is a coping mechanism, utilised by many to stay alive. Self-harming is not attention-seeking, but rather attention-needing.
It is a very secretive act and usually goes undetected for a long time. The burden of self-harm can be hard to carry, as can the guilt and shame associated with the act. A vicious cycle emerges and many teens have no clue how to break the cycle.
We must remember that the act of self-harming is serving a purpose, relieving stress momentarily. Recovery is not as simple as just stopping. In the majority of cases, self-harming does dissipate and cease only when teenagers have developed and embraced more effective and nurturing ways of coping with their distress.
All behaviour has a function and purpose. The key to supporting a teenager who engages in self-harming acts is to uncover the reasons and causes for the self-harming behaviours.
Please seek professional support from a counsellor who is skilled and trained to deal with the issue of self-harm.
'Overcoming Self-Harm and Suicidal Thoughts: A Practical Guide for the Adolescent Years' by Liz Quish. Published by Hammersmith Press, €14.99