Self-injury
is the act of deliberately destroying body tissue, at times
to change a way of feeling. Self-injury is seen differently
by groups and cultures within society. This appears to have
become more popular lately, especially in adolescents. The
causes and severity of self-injury can vary. Some forms may
include:
- carving
- scratching
- branding
- marking
- picking,
and pulling skin and hair
- burning/abrasions
- cutting
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- biting
- head
banging
- bruising
- hitting
- tattooing
- excessive
body piercing
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Some adolescents
may self-mutilate to take risks, rebel, reject their parents'
values, state their individuality or merely be accepted. Others,
however, may injure themselves out of desperation or anger
to seek attention, to show their hopelessness and worthlessness,
or because they have suicidal thoughts. These children may
suffer from serious psychiatric problems such as depression,
psychosis, Posttraumatic Stress Disorder (PTSD) and Bipolar
Disorder. Additionally, some adolescents who engage in self-injury
may develop Borderline Personality Disorder as adults. Some
young children may resort to self-injurious acts from time
to time but often grow out of it. Children with mental retardation
and/or autism may also show these behaviors which may persist
into adulthood. Children who have been abused or abandoned
may self-mutilate.
Why
do adolescents self-injure?
Adolescents who have difficulty talking about their feelings
may show their emotional tension, physical discomfort, pain
and low self-esteem with self-injurious behaviors. Although
they may feel like the "steam" in the "pressure cooker" has
been released following the act of hurting themselves, teenagers
may instead feel hurt, anger, fear and hate. The effects of
peer pressure and contagion can also influence adolescents
to injure themselves. Even though fads come and go, most of
the wounds on the adolescents' skin will be permanent. Occasionally,
teenagers may hide their scars, burns and bruises due to feeling
embarrassed, rejected or criticized about their deformities.
What
can parents and teenagers do about self-injury?
Parents are encouraged to talk with their children about respecting
and valuing their bodies. Parents should also serve as role
models for their teenagers by not engaging in acts of self-harm.
Some helpful ways for adolescents to avoid hurting themselves
include learning to:
- accept
reality and find ways to make the present moment more tolerable.
- identify
feelings and talk them out rather than acting on them.
- distract
themselves from feelings of self-harm (for example, counting
to ten, waiting 15 minutes, saying "NO!" or "STOP!," practicing
breathing exercises, journaling, drawing, thinking about
positive images, using ice and rubber bands, etc.)
- stop,
think, and evaluate the pros and cons of self-injury.
- soothe
themselves in a positive, non-injurious, way.
- practice
positive stress management.
- develop
better social skills.
Evaluation
by a mental health professional may assist in identifying
and treating the underlying causes of self-injury. Feelings
of wanting to die or kill themselves are reasons for adolescents
to seek professional care emergently. A child and adolescent
psychiatrist can also diagnose and treat the serious psychiatric
disorders that may accompany self-injurious behavior.
For additional/related
information see other Facts for Families: #4 "Depression,"
#38 "Manic Depressive Illness," #70 "PTSD," #52 "Comprehensive
Psychiatric Evaluation," #66 "Helping Teenagers with Stress,"
#5 "Child Abuse", and #10 "Teen Suicide."
Article
# 73 Updated 12/99
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