What Every Parent Needs to Know About Self-Injury. Tonja Krautter

      Giving Voice to Pain that has No Words

      Those who self-injure are desperately trying to give voice to pain that has no words. The origin of this pain is different for each individual. As mentioned in the previous chapter, these reasons may include tension reduction, self-punishment, a sense of belonging, and the desire to “feel alive” or conversely a way to “numb” their pain.

      Understanding the specific reasons an individual is self-harming is essential in order to achieve a successful recovery. However, one thing that self-injurers tend to have in common is their unwillingness or inability to verbally express emotional distress. Therefore, gaining insight and knowledge about why your child engages in self-injurious behavior may not be easy. In fact, most kids are unwilling to talk about this behavior and keep it a secret, particularly from their parents.

      To make matters even more complex, often self-injury is a symptom of a more serious mental illness such as Post Traumatic Stress Disorder, Borderline Personality Disorder, Major Depression or Bipolar Disorder. If this is the case, treating the underlying illness is highly recommended as it will lead to improved psychological well-being and aid in the recovery process for self-injury. However, parents will not necessarily know if there is an underlying mental health issue until their child is evaluated by a professional. This evaluation usually does not occur until there is acknowledgement of the problem.

      Although self-injurious behavior is usually concealed rather than flaunted, it has received enough attention in the media to make the topic less “taboo” and therefore more frequently discussed. Perhaps these barriers were first broken down years ago when Hollywood stars such as Roseanne Barr and Johnny Depp as well as royal favorite, Princess Diana, admitted to the behavior. Fortunately, recognition of this problem has led to an increase in treatment intervention.

      Acknowledging the Problem

      The first step in treatment and recovery is acknowledging that there is a problem. This is not always easy to do. Your teen may experience great confusion, guilt, and shame for her actions. Admitting that there is a problem and seeking treatment demonstrates courage and great strength. The teen can be proud of herself for taking that first step in recovery. You, as parents, can be proud that you supported your teen in doing so.

      Although self-injury is much better understood today than it was in the past, it is still accompanied by myths and stereotypes. Unfortunately, admitting to the problem means risking these misconceptions. For example, the fear of being labeled “suicidal” commonly prevents admission of the problem. As discussed, for the most part, individuals who self-harm do it to cope with distressing emotions, not with the intent to commit suicide.

      In addition, the fear of being referred to as a “cutter,” which then follows with labels such as “psycho,” “borderline,” “Goth,” or “emo,” commonly inhibit identification of the problem. These labels often lead to disrespect and rejection from others. For example, Sarah is the senior class president at her local high school. She recently admitted self-injuring to some of her classmates. In turn, several of them questioned her leadership capability. Rhonda is the chief editor of her high school newspaper. Some of her classmates noticed the multiple scars on her forearm, and began treating her differently. One eventually asked her how many times she tried to kill herself and if she would ever hurt anyone else. When her teacher found out, he questioned her ability to perform her duties for the paper.

      It is no wonder that many self-injurers hide this problem. For the same reasons, parents also often deny that a problem exists. Parents are understandably protective of their children. They certainly do not want their child to experience the pain and humiliation of a negative label as well as mistreatment from others. So they join with their child and avoid discussion of the problem.

      Many parents will even go to great lengths to steer clear of topics they know are upsetting to their child, in an effort to minimize their child’s distress, and make them less likely to self-harm. In this example, parental intentions are good. However, the outcomes usually are not. Attempting to help your child feel better by helping them ignore or avoid their own distressing emotions often backfires. There is no lesson in it for them. Children need to learn how to manage their distress in healthy and functional ways. Otherwise, their distress may become too difficult to ignore and eventually lead them to negative coping methods (e.g., self-injurious behaviors, eating disorders, substance abuse, violence, etc.).

      Another reason parents often deny there is a problem is because they see their children’s behavior as a reflection of their own parenting abilities. If you read this sentence and it stung a little, you are not alone. I know many parents who have struggled with acknowledging their child’s self-harm because they worry that it will somehow signify that they have failed as parents. The reality is that self-injury is a coping mechanism and a choice. Your child needs support, understanding, and guidance to help her get back on track and away from something that can be both psychologically and medically dangerous. Her problem is not about you. It is about her.

      When a parent (even unknowingly or unintentionally) makes the problem about them, it sends a negative message to the child. How do you think the child feels if they know (and they always know!) that their parent is refusing to acknowledge their problem because of their own embarrassment and shame? The answer is that it makes the child feel awful. My question to parents is this: How is your child going to be able to admit the problem and get help when they know that their own parents, the people who are supposed to love them unconditionally, cannot handle acknowledging it? Children need motivation to get better. They need love, understanding, and support. Parents can help their child find the motivation necessary to change only when they can acknowledge that something needs changing.

      Finding Motivation

      Once the problem is acknowledged, the next step is to find the motivation to stop. This may not be easy either since self-harm serves a purpose. First, the teen needs to understand why she is doing it and then find alternative ways to fulfill the same need. For example, if she self-injures to reduce stress, then she needs to think about healthier ways to relieve tension. The purpose of treatment is to eliminate the emotional distress the person is feeling. The possibility of finding some relief from these painful feelings can be a strong incentive to reach out for help.

      This said, parents should prepare for the fact that many teens resist treatment out of fear that they will lose their coping mechanism. They are scared and unwilling to give up the one behavior that, in their mind, helps them deal with their problems. Therefore, it is important to assure them that during treatment, alternative behaviors will be explored to help relieve their distress. In addition, the unproductive thoughts that lead to the distressing emotions will be identified and challenged. The result should be an overall reduction in emotional distress, along with learning healthier, more functional coping mechanisms that can be utilized in time of need.

      Seeking treatment as early as possible is vital. Getting help early leads to higher rates of success. The good news is that this is a behavior that can be stopped with help from a trained professional. Moreover, that help might ultimately change your teen’s life in more positive ways than either of you might imagine.