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Understanding Self-Injury

April 04, 2019 | Rachel Velishek, LPCC

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All behaviors have a motive. Self-injury behavior is no different. Self-injury, also known as self-harm, self-mutilation, or self-abuse occurs when an individual intentionally and repeatedly harms themselves without intending to be lethal. An estimated 15 percent of teens report engaging in some form of self-injury. I believe those numbers are not a true reflection since not everyone reports self-injury.

I have personally witnessed a rise in self-harm behaviors for teens within our area; every school district, all demographics. I hear fear in the voices of concerned parents, anger from siblings, concern from friends, and an overall sense of helplessness from those who worry about the self-injuring child/teen. Sometimes the fear is disguised as anger, the concern is masked with withdrawal, and the underlying motive for the behaviors is not addressed.

Very few things get my blood boiling as much as hearing the phrase “for attention” when discussing self-injury. Self-injury is not usually done for attention. If you disagree with me, that’s fine; that is your opinion. But consider this: if a person is willing to self-injure for attention, isn’t that a behavior in need of discussion? At what point in our society did we start ignoring the hurt and pain of others? When did we start to ignore the feelings of children and teens because it causes us discomfort?

Sometimes in life the most uncomfortable discussions are the ones that are the most important to have. I believe we are all unique, we are individuals, and our perceptions of self, world, and future are based on our own personal experiences. I cannot give a specific reason why a person self-harms, but, there are six common reasons people self-injure:

  1. Distraction so that they can alter focus and regain control over their thoughts and feelings which are often overwhelming and unavoidable. This is common when someone is feeling overstimulated.
  2. Releasing tension, which is often associated with overwhelming thoughts and intense and/or conflicting emotions.
  3. To feel something physical when they are otherwise feeling numb, empty, and/or alone.
  4. Express themselves and non-verbally communicate thoughts and feelings they do not understand or cannot verbalize.
  5. Punishment for perceived wrongdoing, negative body image, or disappointment with the intent to compensate for the negative belief that they’re a bad person.
  6. Achieve a temporary sense of euphoria that immediately occurs. Research has shown that the feel-good endorphins that are produced can be addictive and can cause the individual to view self-injury as soothing.

Self-injury has, unfortunately, become an unhealthy way to cope. It provides the individual with temporary relief of painful or difficult-to-express thoughts and feelings. It has the possibility of becoming a self-destructive cycle if left untreated. When a person engages in self-injury, they most often are seeking relief from negative emotions and/or attempting to resolve interpersonal and/or personal conflict.

An adolescent has a higher risk of self-injury. The brain and body are undergoing significant developmental changes which creates the perfect storm. A teenager does not have the developmental capacity to link emotions and higher level thinking because the brain is still learning to communicate. As they age, they develop the capacity to learn healthier, more positive methods to regulate emotions such as exercise, meditation, and healthy communication of thoughts and feelings.

Parents, siblings, friends, teachers, or nurses, if you suspect or notice something, say something. Signs and symptoms might include changes in sleeping and eating habits; loss of interest in activities; avoidance of activities that require exposure to skin such as swimming; wearing clothes to cover arms; legs, or torso; hiding objects like razor blades, lighters, or matches; injuries that cannot be explained; frequent or reoccurring injuries; injuries that are not healing; decline in self-care; and fluctuations in mood.

If you suspect self-injuring behaviors, communicate your concerns calmly and directly. Do not react with threats or anger and do not ask the person to promise they won’t do it again. Take the time to talk about your concerns and observations. Listen to what the individual has to say without judgment, criticism, or analysis. Learn to be a big heart with ears, actively listening without interruption and listening with your heart. Be present. We often communicate concern to others but lack follow through. Take the time to consistently follow up with the individual so that your behavior models your concern. If you notice self-harm, try your best not to overreact. Yes, it’s a concern but, overreaction has been shown to cause more withdrawal and self-injury behaviors.

Model positive self-care for the individual. If possible, offer to treat the wound and encourage physical and emotional healing. Start with “I” statements such as “I noticed,” “I would like to help,” “I am scared too,” and “I am ready to listen.”

It is possible that self-injury can resolve on its own, but it’s also possible outside help may be necessary. Resolve your personal thoughts, feelings, and beliefs and recommend the self-harming individual to a licensed mental health professional who can teach the person healthy techniques to deal with intense emotions. Counseling can help the individual understand the motive or the “why” behind the self-harming behaviors. Remember, we cannot fix a problem if we don’t know what the problem is and how it started. Only then can we create a plan to prevent recurrence.

Rachel Velishek is a licensed professional clinical counselor with Fisher-Titus Behavioral Health, Fisher-Titus Medical Park 2, Suite C, 282 Benedict Ave., Norwalk. Her office can be reached at 419-668-0311. For more information on Fisher-Titus Behavioral Health, visit fishertitus.org/behavioral-health.