“Basically I started [cutting] because I was struggling with an eating disorder,” explained South student Anna (not her real name). “I was very overwhelmed and had a ton of anxiety. I felt so trapped and there was so much going on and I was so overwhelmed. I wanted to do something to feel better.”
Dr. Katie Cullen, a researcher at the University of Minnesota, classifies self-harm as the, “Deliberate direct destruction or alteration of body tissue.” In addition to cutting, burning and self-battery are common forms of self harm.
Anna’s story echoes approximately 20-23% of teens’ experiences across the US, Canada, and select European countries who have tried self harm, according to research performed by Jennifer J. Muehlenkamp, PhD, of the University of Wisconsin-Eau Claire.
Anna said many of the people she knows at South self-harm. “I saw it in the media. I had friends who did it. I saw it on social networking sites… You learn about it in early middle school. By sophomore year of high school I was like, ‘Oh hell yeah! Everyone does it!’”
A common misconception about self-harm is that people do it for attention. Anna feels otherwise, “In reality, people spend an overwhelming amount of time trying to hide it. It’s not an attention thing.”
This perception can be dangerous, she explained, “It’s really not helpful if you call people attention whores and stuff like that. That will probably just trigger them to do it. The best thing you can do is just be supportive.”
If you think someone close to you is struggling with self-harm, it is best to talk to them. Share your concerns and help them find the resources they need. As a family member or friend, it is necessary to educate yourself on how to help. Understand the psychological reasons behind self-harm. Urge them to seek treatment. Positively reinforce healthy alternatives. Most importantly, be supportive in the event of relapse. Recovery can be a challenging process; compassion from family and friends is crucial.
It is important to note that self-harm is often not performed with suicidal intentions. Cullen explained that people use self-harm as a coping mechanism, “to help them address some type of problem… or negative emotion.” Depression is common among those who self-harm.
This contributes to Cullen’s analysis that students who self-harm typically have “more of a hard time managing stress or negative emotions.”
Because of this, students, like Anna, often participate in “more than one strategy to decrease negative emotion,” such as eating disorders or substance abuse.
In Anna’s experience, the consequences of self-harm lasted far longer than immediate relief. “It got to a point where I was doing it three, four, five times a day,” she explained. “It’s an overwhelming cycle. You get upset and then you feel a little bit better; you get upset and you feel a little bit better.”
“[Self-harm] does not only make bad feelings go away,” said Cullen. “It brings on new bad feelings.” It can leave deep and lasting scars both physically and emotionally. If you self-harm, Cullen said, especially in adolescence, “You’re not developing the way other people are.” Those who participate in self-harm “haven’t been honing skills” for dealing with setbacks and negative feelings, she said. “You are damaging yourself so much,” Anna said. “It’s not worth it.”
“[I stopped] because I got a ton of scars,” explained Anna. “It hurts. It’s hard to go through your everyday life with tons of scars. You’re always trying to cover them up and it’s really hard. You can’t go swimming with your friends because then everyone would know,” said Anna. “[Self-harm] is not a permanent solution to your problems.”
Anna sought treatment for her eating disorder at Park Nicollet Clinic’s Melrose Center in Minneapolis. Her problem with self-harm was addressed at the same time. She credits her therapist and “learning what triggers” her self-harming behavior as the most helpful developments on her road to recovery.
Unfortunately, she also found relapse a common part of recovering, “I’ve definitely relapsed, you can’t just do it cold turkey… You stop and go back, you stop and go back… It’s like an addiction. You’re giving yourself so much adrenaline every time you do it and you’re giving yourself such a big release it is so hard to stop,” Anna explained.
“I do think [self-harm] has some similarities [to addiction],” said Cullen, but she made clear that they are not the same. While those who self-harm might get a rewarding buzz or relief out of physical pain, it is different from a drug-induced high or buzz. “[Self-harm and addiction] are both bad habits,” she clarified.
“People have said you never really get rid of [the habit],” said Anna. People say you’ll be 40 with kids and [really want to cut]… You just have to have the willpower not to. The farther you get away from it the easier it is.”
Organizations like To Write Love On Her Arms (TWLOHA) work to raise awareness about self-harm and “present hope for people struggling with addiction, depression, self-harm and thoughts of suicide.” Their website offers a multitude of resources, regardless of what you may be facing.
TWLOHA has links to treatment centers worldwide, helpline numbers, and even literature about a variety of mental illnesses and addictions. TWLOHA serves as “a bridge to help” rather than an counseling service. Their site is a helpful place to start for struggling students.
For students seeking help, “I would tell them that it’s really important to tell a school social worker,” said Anna. “I wouldn’t say ‘go to your parents.’ I would tell someone [struggling with self-harm] to find someone that can help you find a therapist. Therapists can help you work through the emotional issues surrounding self-harm.”
Social workers and the school-based clinic at South offer resources for students engaging in self-harm. Students can work with social workers to seek outside help, or doctors who can refer to treatment clinics. Treatment plans vary for students depending on their goals for treatment and the magnitude of their struggle with self-harm.
In addition to treating self-harm, treatment plans address the underlying mental illness such as depression or borderline personality disorder (BPD).
The most common type of treatment is Dialectical Behavior Therapy (DBT). DBT is a type of therapy that “tackles self-harm head on,” said Cullen. Those in DBT work with a therapist to address self-harm. It helps patients regulate emotions and constructively address them to replace self-harm as their means of coping. Medication prescribed usually treats the larger problem, such as depression or anxiety, of which self-harm is a symptom.
Cullen gave her own bit of advice to teens struggling with self-harm, “Things can get better. It’s important to be hopeful if you seek help and work toward the goal of getting better.”