Young people learn to cope with emotions in different ways. Tears, anger, depression and withdrawal are some of the ways of responding to – and finding relief from – overwhelming feelings. Some teens are troubled by frequent intense and painful emotions. While some are able to deal with these feelings, others react differently to their problems because they have not been taught ways to handle their emotions effectively. They are unable to find the words and the buildup of feelings makes it difficult for them to think clearly. Some teens release this bottleneck by cutting or burning or otherwise hurting themselves. Self injury provides immediate relief, but this is a short-term solution with serious consequences.

Self injury is not a new phenomenon, and it is becoming more common. In one survey, approximately 13% of adolescents who responded indicated that they engaged in self-injurious behaviours. Because this is a very secretive activity, it is difficult to determine exactly how many young people are affected.

The rate of self injury is growing. Gaining a deeper understanding of self harm is an essential first step to helping yourself or another. There is treatment, but as with all mental and physical conditions, early diagnosis is key to a successful outcome.

Self injury, also called self harm and self abuse, refers to deliberate acts that cause harm to one’s body, mind and spirit. Examples include cutting the skin with razor blades or pieces of glass; burning and hitting oneself; scratching or picking scabs or preventing wounds from healing; hair pulling; and inserting objects into one’s body. Cutting is the most common form of self injury among today’s youth.

In a broader sense, behaviours such as smoking, alcohol and drug addiction, bingeing on food and staying in an abusive relationship can also be considered forms of self harming.

People who self injure may not be trying to kill themselves. Usually, they are not trying to end all feeling; they are trying to feel better.

Experts describe deliberate self injury as ineffective problem-solving. People who self injure are often seeking relief from psychological pain, unbearable tension, loneliness, depression, anger or an absence of feeling or numbness. Some people self harm to feel emotions more intensely; others do it to punish themselves for being “bad.” They either cannot or have not learned how to express those feelings more effectively.

Self injury usually starts during puberty or adolescence. It can last for up to ten years, but if left untreated, it may persist. Episodes are usually responses to a “trigger,” such as a perceived rejection or other emotional pain. Cutting behaviour can spread, and there is a rising trend for teens to discuss cutting on the Internet and form cutting clubs at school.

There is no single pattern or profile for self injurers. According to research, most are from a middle to upper-class background, with average to high intelligence, and low self esteem. Some 40% have a history of eating disorders. Almost half report physical or sexual abuse during childhood. Almost all say that they were discouraged from expressing emotions, especially anger and sadness.

By physically harming themselves, self injurers often report feeling relief from the emotions that overwhelm them. They feel pain on the outside, not the inside.

Warning Signs

People who self injure go to great lengths to hide the behaviour. But there are warning signs, such as:

• unexplained frequent injuries, such as cuts and burns
  
• wearing long pants and long sleeved shirts in warm weather
  
• low self esteem
  
• problems handling emotions
  
• problems with relationships

What Can I Do?

If you are hurting yourself, it is important to begin talking to someone you trust – for instance, a friend, family member, a teacher, school nurse, guidance counsellor. Your doctor may be able to recommend a therapist or psychologist who can help you. There may be a support group in your area.

If you are concerned about a friend or family member, it’s okay to ask. Just talking about self injury won’t cause someone to begin hurting themselves. Before you ask, learn more about self injury. It can be shocking to find that someone you care about is deliberately harming themselves, and it can be difficult to hear what they have to say.

Offer support without judging or criticising. Try not to blame, or react as though their behaviour is impossible to understand.

The path to good mental health may be a long one. Having realistic expectations can help both you and your loved one manage what may be a slow pace of change.

Treatment by a mental health professional is recommended. A specialist can help teens find alternatives and guide them toward substituting less harmful acts to express their feelings. Behavioural therapy can help to break the habit and maintain change.
 

Experts advise that early treatment is important. Some teens stop injuring themselves when their behaviour is found out. For others, being surrounded by a caring network of family, friends, teachers, counsellors and doctors reduces their need to cut or otherwise harm themselves. Assessment for depression or anxiety may reveal underlying issues that can be treated.

Where To Go For More Information

For further information, contact a community organization like the Canadian Mental Health Association (CMHA) to find out about support and resources in your community.