Adolescents and Self-Injury

Adolescents self-harming behavior appears to be on the rise today. These days, adolescents are faced with more decisions, stressors, and transitions than ever before. As a means to cope with these changes, some have turned to a behavior called cutting or other means of self-injury as an outlet to cope with painful and distressing emotions. There are many beliefs as to why this has been on the increase.

Self-injury can include a variety of behaviors but is most commonly associated with:
• Intentional carving or cutting of the skin
• Sub dermal tissue scratching
• Burning
• Ripping or pulling skin or hair
• Swallowing toxic substances
• Self bruising

In today’s competitive, fast-paced cultural environment, there is tremendous pressure put upon teenagers to achieve academic excellence, to outperform peers in classes and activities, on top of higher academic standards and heavy course loads. In addition in many families, parents put in long works hours and have less time to spend in family pursuits, leaving many adolescents feeling frustrated and disconnected from family members.

Many self-harming adolescents have voiced their concerns about feeling emotionally disconnected and invalidated in the various social contexts in which they interact on a day-to-day basis. They will often report that they are having difficulty managing their self-defeating thoughts and painful or angry or depressed feeling related to stressors. Self-injury becomes an efficient way to gain quick relief from emotional distress or other major stressors in their lives.

There are many ways to treat self-harm. One effective method is that of cognitive-behavioral skills training, which includes having the adolescent identify the activating events leading one to self harm. Identifying these cognitions, (beliefs and attitudes one has in response to these events), and the emotional or behavioral response that follows is the key. By developing such skills in identifying how one has self-defeating thoughts that lead to self-injury, adolescents via skills training, learn how to stop these negative thoughts and patterns, and learn other effective ways of channeling this energy into something positive.

In addition to skills training, the therapist must also provide to clients an arsenal of techniques and strategies for managing any emotional distress they might be experiencing. The more techniques the adolescent can utilize on his or her own, the less likely he or she is to self-injure in the future. For example, such strategies can take the form of relaxation training, visualization, meditation, and exercise. Deep breathing is an effective way to assist one in soothing oneself when faced with stressful events, as is visualizing a safe place one can focus on. Mindfulness is another form of meditation that offers both deep relaxation and insight. It promotes a way of being that focuses on what is present, where one can cultivate a deep acceptance and ability to relax more fully in the present moment rather than focusing on other stressors that cause discomfort.

Family therapy is another effective means of helping adolescents build connections in order to build strong, supportive and meaningful relationships. By exploring family communication and how family members interact with one another, in addition to exploring strengths and resources within the family, patterns can be altered in order to promote healthier family interactions, which support the adolescent.