Self Injury:  Why Some Hurt Themselves to Heal

To the outside world, the young woman sitting in my counseling office appeared well-adjusted.  She had supportive family and friends, and enjoyed school.  Privately though, it was a different story.  “Sometimes I get all these feelings inside and I don’t know what to do,” she explained.  “That’s when I bang my head into a brick wall.  It makes me feel better.” 

It may seem like a contradiction to hurt yourself in order to feel better, but that’s exactly what an estimated two million people do when they self injure.  Self injury, also called self mutilation, is intentionally causing self-inflicted physical pain in order to cope with overwhelming feelings, traumatic events, or severe emotional pain.  Some of the most common ways to self-injure include cutting, burning, hitting, scratching, and pulling hair.  More women than men self injure.  Famous names like Princess Diana and Angelina Jolie have admitted to being “cutters,” and movies like Thirteen suggest how widespread the behavior is amongst today’s teens.         

  “Years ago, self injury was the exception, but today it is so common that it is the exception not to see it discussed in counseling sessions when working with adolescents and young adults,” said Judi Fischer, counselor and owner of Lakeshore Educational and Counseling Services in Independence. 

Why would anyone want to intentionally harm themselves?  Dr. Victoria Kress, Associate Professor at Youngstown State University, has published extensively on the topic and says there is no one reason.  “Many girls self injure to regulate strong emotions, yet some people self injure in order to gain a sense of control.  Some injure to express anger or pain when they cannot find the words or the outlet to otherwise express themselves.”  Research suggests at least half of all self injurers have suffered some sort of abuse, but there is no typical profile.    

Karen Conterio and Wendy Lader, Ph.D. are the authors of Bodily Harm and founders of  S.A.F.E. (Self-Abuse Finally Ends) in Illinois.  According to their research, the most common family scenarios that seem to be the most likely to produce a self injurer include:

·        Presence of traumatic losses, illnesses, or instability in family life

·        Parental neglect or abuse (physical, sexual, or emotional)

·        Rigid, dogmatic code of values applied in a hypocritical or inconsistent manner

·        Breakdown of family roles in which children take on adult roles and responsibilities prematurely and inappropriately

The authors also point to the popularity of today’s socially acceptable acts of body modification like tattoos and piercing as glamorizing tolerance of pain.  A factor that distinguishes modification from self injury is that self injurers feel compelled, versus tattooing being a choice.  Also, self injurers typically act in private and do not flaunt or brag about their injuries.  Rather, there’s a sense of shame and an attempt to hide their injuries, wearing long sleeves for instance, even in hot weather.       

            In most cases, self-injury is not an attempt to commit suicide. While a self injurer may feel so bad that she has had suicidal thoughts, usually the self injury is an attempt to cope with those intense feelings in order to live, not die.  However, there may be co-existing conditions such as depression, eating disorders, or substance abuse so it’s important to seek the help of a qualified therapist.    

            If you are concerned that your daughter may be a self injurer, Judi Fischer reminds parents to remain calm.  “Be careful not to overreact with hysteria, accusations, or judgment.”  Ignoring the problem will not make it go away.  However, just because you’re ready to talk don’t expect kids to reciprocate. “A child who has chosen self injury to express pain may not be able to openly express her thoughts and feelings to those closest to her,” warns Fischer.

            Willoughby-based counselor Anna Tyrrell teaches “Parenting 10-15 Year Olds” at Lakeland Community College.  She tells parents to actively choose mentors for their kids.  “If they aren’t talking with you, ask an adult friend or relative who you trust to step in.”  She also advises parents to take advantage of car rides to talk to kids.  “You have a captive audience, and if it’s an intense topic, kids don’t have to make direct eye contact, so it’s easier” she said. 

Here are further guidelines for parents on talking to their kids about self injury from the S.A.F.E. web site www.selfinjury.com

• Do not display anger
• Don’t tell them to just stop it
• Don’t injure yourself, to show them how it makes you feel when they self-injure
• Don’t think of it as "just a phase" or "just for attention"
• Don’t punish or ground them

Through counseling, commitment, and family support, self-injury can be successfully treated.  Treatment consists of recognition and validation of intense feelings, impulse control, and the teaching of healthier coping tools.  

Bio:  Susan Fee regularly invites her daughter on car rides to “talk.”  She is author of the college survival guide My Roommate Is Driving Me Crazy!  and is a counselor with Lakeshore Educational and Counseling Services in Independence.  She can be reached at (440) 963-0402 or toll free at 800-600-5327.