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Self-mutilation on the rise among teens; family, friends can point them toward helpcomment (0)

February 9, 2006

By Rod Marshall

"I hurt myself today to see if I still feel. I focus on the pain, the only thing that’s real.”
Perhaps you have heard the haunting lyrics penned by Trent Reznor or seen the spellbinding video of the late, great Johnny Cash singing about life’s pain. Maybe you even began to sing along in your best Johnny Cash impression. Maybe as you sang along, you became uncomfortable with the lyrics. “I hurt myself today. What does that mean?”
Many parents and teenagers in today’s society have come to know all too well what Reznor may have meant when he wrote this sobering poetry.
Approximately 1 percent of today’s teenagers engage in some form of self-injury or self-mutilation, also known as cutting, and there is no evidence that this phenomenon is any less prevalent within the church than in the general population. Ninety-seven percent of teens who disclose self-injurious behaviors are female, but boys also engage in self-injury.
Most teens that self-injure come from middle- to upper-class families. Most are of average or above-average intelligence and are well educated. Many are creative and artistic. Most teens that engage in self-injury are not suicidal. Some people who engage in self-injurious behavior may suffer from depression, anxiety, bipolar disorder, eating disorders, obsessive thinking, compulsive behaviors or substance abuse. 
Many cutters come from a family with at least one alcoholic or depressed parent. Some cutters have experienced a traumatic event in their lives, such as physical or sexual abuse, and they might cut as a way of “waking themselves up” from a sense of numbness that often accompanies trauma.
Most people who cut will inflict wounds upon themselves on their wrists, arms, legs or bellies. The cuts are usually superficial but almost always deep enough to draw blood. They usually use the same object to inflict the wound, and there is often a ritualized pattern to the cutting behavior. Cutting is an unhealthy, but usually effective, coping mechanism. Teens and adults who engage in cutting often report temporary relief from anxiety immediately after the cutting ritual. It is important to note that this relief is temporary.
Most people who engage in self-injury will try to hide the fact that they are doing so. There is often a strong feeling of shame associated with the self-injurious behavior. People usually do not intend to permanently hurt themselves when they self-injure. Self-injury is usually someone’s best attempt at feeling better, not ending it all. 
Most people who self-injure do not intend to keep hurting themselves once they have begun. Self-injury, however, can be quite habit-forming. It can become a compulsive behavior, meaning that the more a person does it, the more they feel the need to do it. 
Self-injury seems to be on the rise. Its prevalence has increased dramatically over the past decade. Some teens are even being encouraged by their friends to try self-injury when they disclose to their friends that they are feeling overwhelmed. There are even Web sites meant to serve as sources for information about self-injury that seem to come dangerously close to condoning or even recommending self-injury to struggling teens.
One site has a gallery of celebrities who have admitted to struggles with self-injury. It is important to remember that self-injury is ultimately an unhealthy coping strategy. There is significant risk of scarring and infection and accidental permanent damage. 
There also are some very good resources about self-injury on the Internet. One of the best series of articles about self-injury can be found at www.kidshealth.org in the teen health section.
If you are struggling with self-injury, then what can you do?
• Tell someone you trust. The first step is often the most difficult, but you will benefit greatly from breaking your silence. Choose carefully whom you will tell. It is best to tell a trusted adult who is not likely to overreact (a parent, teacher, school counselor, coach, doctor or nurse). Many self-injurers experience a great sense of relief by being able to tell someone about what they have been dealing with.
• Identify the trouble that’s triggering the self-injury. Self-injury is a way to respond to emotional stress or pain. Try to figure out what’s leading to the impulse to harm yourself.
• Ask for help. Let someone know that you think you might need help in dealing with this challenge. Go to a trained counselor and be honest with them.
• Work on it. Realize that this problem is not going to go away immediately. The process of healing is sometimes longer and more difficult than we expect. Know, however, that you are not on this journey alone.
What can you do if a friend or your own child tells you that they have been engaging in self-injury?
• Listen to your friend or teen. Let them talk to you and tell you about what is going on in their life.
• Tell someone. You are not a trained professional. You can greatly help your friend or teen by listening, but don’t promise to keep secrets. Think of an adult you trust, and tell them how you are trying to help.
• Help your friend or teen to find resources. Help your friend or teen find a good counselor who has expertise and, where applicable, experience in working with teens. There are many outstanding ministers of youth and lay counselors in our churches, and their ministry is quite valuable. Self-injury, however, may be best addressed by a trained professional counselor.
• Help your friend or teen find alternatives to self-injury. Distraction from cutting is not a very effective long-term treatment, but it can be an important part of the healing process. Be available to talk and, more importantly, to listen. Join them in beginning some kind of physically demanding aerobic exercise program, such as running or jogging. Help find alternate coping mechanisms when they feel overwhelmed. Sometimes you just need to know that someone cares enough to listen.
• Acknowledge your friend’s or teen’s pain. When you are helping someone through a difficult time, it is helpful to acknowledge the struggle they are facing. Avoid any sentence that begins with the words “at least.”
• Don’t deliver an ultimatum. Be there for your friend or teen. Don’t tell them that you will no longer be their friend if they don’t stop the self-injury behavior. Don’t set deadlines. Give them time and be accepting of their sometimes slow recovery. Shame is almost never a healthy or effective way to motivate someone to change his behavior. Avoid anything that might be shaming. It will make the problem worse instead of making it better.
• Don’t accidentally reinforce the behavior. Sometimes self-injury can have a mystique about it. Don’t let your friend or teen think that it’s just part of who they are or that self-injury is a sign of strength.
• Don’t be responsible for your friend’s or teen’s recovery. Healing can take a long time. Don’t think that if they continue to struggle that you have done something wrong.
• Pray for your friend or teen daily. The Bible describes Satan as the great accuser. When someone is struggling with issues related to self-esteem (as self-injurers often are), remember that Satan is telling them they aren’t good enough, they aren’t pretty enough, they aren’t smart enough or whatever is most likely to upset them. Pray often that the self-injurer would be able to see himself not as Satan sees him (for all his weaknesses) but as God sees him (created in His image, worthy of divine love, the object of ultimate affection). Ask God to allow the Holy Spirit to help you see them with eyes of faith and hope.
Editor’s Note — Rod Marshall is a licensed counselor and director of counseling for Alabama Baptist Children’s Homes & Family Ministries.

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