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Cutting to Cope: Follow up Q & A


March is Self Injury Awareness Month


Common Questions and Answers

Q - Why is my child doing this? Is it just to manipulate me? A - It is not about manipulation, but rather coping.  It is not a suicide attempt, but rather a way to cope.  That is not to say, adolescents do not have suicidal thoughts, it is to say with self injury the goal is to survive.  Self injury is used as a way to get relief from negative emotions:  feeling worthless and punishing, feeling numb and trying to feel alive and connected, and feeling the adrenaline rush that allows an escape from the emotional pain.   Q - Where do adolescents get the idea to self injure? A - Peers, hearing about in social media, celebrities, music, TV.  If it worked for someone else (or someone else tried it), why not try it to ease their pain.  But it is unhealthy, dangerous, and provides very temporary relief from ongoing emotional turmoil.   Q - I thought only girls self injured.  Boys do too? A - Yes, boy do self injure.  Boys can be more aggressive in doing things such as punching things as a form of self injury as well as cutting. In addition, boys are not as likely to be in treatment, so it appears they self injure less than girls.  While it is less, they do self injure.   Q - It was only one time (or it was just superficial scratches), should I be concerned? A - One time is one time too many.  One time can turn into the first time of more times.  One time probably means there was some type of emotional distress.  Trying something that is dangerous and unhealthy as a way to cope even one time should not go unchecked.  Prevention or intervention early is better than intervention after multiple times or years of self injuring.   Q - Should I tell someone that my friend is self injuring? A - The answer is a resounding, Yes.  Adolescents supporting each other is wonderful, but chances are you are not equipped to handle such a issue alone.  There are treatment facilities with several staff members and outpatient facilities that use multiple levels of support to help someone who is self injuring.  If you care, tell someone so that your friend can get effective treatment.   Q - What can we do to help?A - Seek out help from your school counselor and from your pediatrician; they are sometimes the front workers.   Arrange treatment from a psychologist who is trained to work with individuals who self injure.  Medication may be needed to treat underlying issues of depression, anxiety, or other mental health issues.  There is often shame and embarrassment associated with self injury, keeping it a secret only validates and enforces the shame is warranted and maintaining an image is more important (even though that may not be the intended message).   Q - Are there signs that we can notice to alert us to the possibility of self injury?A - It is not always easy to tell when someone is self injuring because often the scars are hidden.  If your child is wearing long sleeves in the summer that is a cause for concern.  Other things you can look out for are: long periods of time in the bedroom or bathroom, blood stains on bedding or in garbage, a change in behaviors (friends, grades, sleeping, eating, clothing), sexually acting out, eating disorder, substance abuse, and the list can go on.  None of these things definitely equal your child is engaging in self injury; it means your child is at risk and these are signs of an emotional struggle. In addition, there is such a sense of low self worth and sometimes self loathing.  The pressure of having to be perfect or at least appear perfect is an unattainable feat that can lead to more distress.  What to wear, have the best body (boys and girls), how much money does your family have, what grades, what high ranking college (Harvard, Stanford, Yale, Princeton, Columbia preferably), compete in school, compete in sports, be the best, be number one, go, go, go.  It is overwhelming and exhausting to even think about the pressures that adolescents face; and not all are equipped with the skills to counter or deal with the messages that add to their negative self beliefs.  Here is a clip from Gilmore Girls when Paris finds out she is not accepted in to Harvard. While her reaction was rather intense, she was able to express herself by going off during the  meltdown and then later recover because she was resilient. Frequently I see adolescents who feel just as intensely about college and grades or other pressures, but would self injure rather than have an outburst.  And if by chance they had an outburst, the guilt would lead to self injury.   Q - What advice do I have for parents?A - Ask if he or she is self injuring and express your concern.  Listen non-judgmentally. Talk to your child in a validating way.  It does not mean you support the behavior.  Focus on the emotions rather than stopping the behavior.  Avoid getting angry, threatening, demanding your child stops, falling apart, or ignoring you child (or that you know about the self injury).  Keep in mind, your child may not be able to easily discuss, identify, or describe all that is contributing to their emotional discord. And again, validate.   Q - What resources are available for people who want to learn more? A - On my Resources page, you will find book and links to help you learn more.   Please keep the discussion going.  Ask questions and talk with your adolescents, friends, family, school staff, colleagues to increase awareness so that someone can be S.A.F.E. (Self Abuse Finally Ends - a trademark of treatment founders in Chicago - www.selfinjury.com).  Follow me on Facebook this month


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