When Emotional Wounds Become Physical

Laura Fite, LPC discusses the signs of self harm and how to address them.

When Elizabeth’s mother died of cancer during Elizabeth’s sophomore year of high school, the former honor student didn’t know how to cope. Her grades slipped, and Elizabeth was engulfed by feelings that she couldn’t control. She began to spend more and more time alone and resented her father’s pleas to help with her younger siblings. Some of Elizabeth’s classmates described how cutting helped them escape overwhelming feelings, and, one afternoon, feeling depressed and angry, Elizabeth went into the bathroom, locked the door, and used a clean shaving blade to cut her arm. Seeing the blood stream down her arm made Elizabeth feel alive again rather than just going through the motions of life as she had been since the death of her mom.

Statistics show that cutting and self-harm are coping mechanisms that 13 to 23 percent of teens have engaged in; however, accurate statistics are difficult to obtain because so many teens do not report their cutting.

In most cases, self-harm is not a suicide attempt; rather, self-harmers cut to cope with life stressors and overwhelming feelings. Self-injury occurs for a number of reasons. The person may feel numb and depressed, so cutting helps him/her feel alive again. Once a person starts cutting, it can become addictive and difficult to stop because it releases endorphins, and gives a sense of control over uncontrollable feelings. Cutting allows the teen to punish herself when she feels like a failure. Just like a person taking a drink of water on a hot day or scratching itchy skin, the self-harmer is finding relief for pain.

Research shows that young people who engage in self-harm have not developed strategies or abilities to soothe themselves in times of extreme stress. To control distress, they turn to the act of cutting with razors, erasers, paperclips and even knives. Other forms of self-harm include burning with candles, rope burning, excessive body piercing or cutting with scissors. The self-harm gives a person a feeling of control over areas of his or her life. Other times, people may be seeking attention from people in their lives who are not listening to them. Elizabeth’s peers suggested cutting as a coping mechanism, which is not unusual among young people. There can be a contagion effect when teens see others who are cutting.

In Elizabeth’s case, as with many cutters, she kept her actions secret. Eventually, however, her father found out through the guidance counselor at school that Elizabeth had been struggling with self-harm.

Like most parents and loved ones of cutters, Elizabeth’s father felt angry (How could she add to the stress of our family?); sad (She is so broken); helpless (How can I make her stop?); like a failure as a parent (I haven’t paid enough attention to her, etc.); manipulated (Is she doing this to get my attention?); and concerned (I want to help her and take her pain away).

While most parents have a right to feel all of the above, there are some dos and don’ts for helping loved ones.

First, keep in mind that many self-harmers have been put in positions of taking care of others’ personal needs, such as caring for younger siblings or substance-using parents, and are in such a chaotic life environment that they lack the skills to self-nurture and self-soothe.

If you are a friend or peer, please do not keep your friend’s cutting a secret. He or she needs professional help to stop the behavior. Tell a trusted adult such as a guidance counselor, another parent, youth pastor, or teacher.

If you are a family member and parent:

  • Do not ignore the problem. That only further reinforces self-harmers’ belief that their feelings and ability to cope with them in a positive way are not important and should be overlooked.
  • Do not add shame and guilt to her feelings of self-loathing.
  • Do not scream at them for “foolish behavior.”
  • Do communicate concern, love, and acceptance of them.
  • Do not punish them for their behaviors; rather, set boundaries so that they do not continue to self-harm.
  • Increase positive family time spent together.
  • Increase a positive peer support system for them rather than friends that also self-harm.
  • Do keep communication open and be available emotionally to connect.
  • Give them choices over the small things, so they have a sense of control in their life.
  • Get them the professional help they need even if they are opposed to it.

Professional help addresses many needs a self-harmer is faced with. The professional counselor can assess if there are co-occurring disorders such as eating disorders or substance abuse. Self-harmers benefit from therapy to learn emotional regulation, such as how to manage their feelings and thoughts in a healthier way. They need to learn how to not feel the urgency to react to overwhelming feelings by cutting to a feeling. Alternatives to cutting might include journaling, doing artwork, and getting feelings out. Young people can learn other self-soothing and self-nurturing skills such as going for a walk, doing yoga, drinking herbal teas, smelling pleasant things such as candles or flowers, deep-breathing, watching a funny movie, reading a positive book, listening to positive music, playing an instrument, and making positive self-statements.

The family as a whole also can benefit from professional help to assess why the self-harmer is not sharing feelings or communicating in a positive way with the family.

Self-harming is not something to take lightly. There is help, support and a listening ear for those who feel there is nothing but darkness.

*The name of the person in this article was changed to protect her privacy.

Laura Fite is a local Licensed Professional Counselor.

Some Possible Signs of Self-Harm

  • Eating Disorder
  • Scars and scabs on arms/legs or other body areas
  • Isolation from family in locked room or bathroom
  • Bloodied cotton balls/hydrogen peroxide for cleaning of cuts
  • Wearing pants and long sleeves in warmer weather to hide scars
  • Poor excuses or reasons for scars/scabbing
  • Razors from pencil sharpeners, exacto knives, broken glass, broken paper clips
  • Peers that self-harm
  • Depression
  • Major life traumas during childhood such a verbal, physical, and sexual abuse, witnessing domestic violence
  • Poor coping skills
  • Anger management problems

Websites and Online Resources

Crisis hotlines:

Categories: Tweens & Teens