Teens and Self-injury

Reviewed Jul 8, 2017

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Summary

  • Deliberate infliction of injury as a means to manage painful emotions
  • Most common injury: cutting
  • More common in girls

As an experienced therapist specializing in treatment of self-injury, Andrew Levander paints a sobering portrait of the typical person he treats: A teen girl between the ages of 14 and 17, possibly with major depression or bipolar disorder, who cuts herself with a razor blade or glass on her forearms, stomach, or legs. She has long felt invalidated at home.

“Upwards of 60 percent to 70 percent of self-injurers are victims of early childhood sexual or physical abuse,” says Levander, clinical director of the outpatient self-injury treatment program at Vista Del Mar Child and Family Services in Los Angeles. “What the behavior does commonly … is to put them in a position of control over their body, to put them in charge of their pain. It’s easier to understand pain they create, rather than pain inflicted on them.”

What is self-injury?

Self-injury is the deliberate infliction of injury as a means to manage painful emotions. Cutting probably is the most common form of self-injury, experts say. People who self-injure also may:

  • Hit themselves
  • Pull out their hair
  • Break bones
  • Burn themselves
  • Scratch or pick at themselves
  • Bang their head

In severe cases, people who self-injure may even amputate digits, eat harmful substances, or inject themselves with toxins.

Who self-injures?

Research suggests that about 2 million to 3 million Americans self-injure. Levander puts the estimate between one and four percent of the general population.

Women make up the majority of people who self-injure and the problem is more prevalent among teens. Girls as young as age 11 may start self-injuring. Men and boys also may self-injure, but only “20 percent to 30 percent [of adolescent self-injurers] are boys,” Levander says. The root of the difference may be that women often internalize anger or pain, while men externalize it.

People who self-injure often share common characteristics, says Steven Levenkron, the author of Cutting: Understanding and Overcoming Self-Mutilation.

  • A feeling of “mental disintegration,” or the inability to think
  • A feeling of rage that can’t be expressed
  • Feeling powerless
  • Feeling like an outsider
  • Experiencing fear of punishment
  • Feeling as if they can’t trust anyone with their feelings
  • Inconsistent school performance
  • Experiencing anxiety, depression, and low self-esteem

People who self-injure also often experience eating disorders.

Why do people self-injure?

While some people attempt to control emotions with alcohol, drugs, or food, others may find relief in razor blades, explain Karen Conterio and Wendy Lader, PhD, the pioneering authors of Bodily Harm: The Breakthrough Healing Program for Self-Injurers.

As Levander explains, self-injury may become a way to feel mastery of helplessness and anger. Self-injury may be a coping mechanism for deflecting psychological distress and turning it into pain that seems understandable. It can become a way of coping with stressful situations.

Self-injury is not a failed suicide attempt and people who self-injure are not a danger to others. Also, people who self-injure rarely use it just to seek attention.

A growing trend

Health-care professionals report growing numbers of self-injury cases. It is touching younger and younger children.

Several years ago, Levander and his colleagues received a grant to study self-injury, and with guidance from Conterio and Lader, they developed the program at Vista Del Mar. It was the first of its kind in the United States. Still, Levander notes, the small number of treatment programs available are unable to serve the growing need.

How can loved ones help?

“The first thing is to think about what the person is communicating in a nonverbal way,” Levander says. “Not paying attention doesn’t make it go away.” Criticism won’t help, either. The best thing you can offer your loved one is acceptance and support.

  • Read about self-injury. You must be informed in order to help someone.
  • Talk about the problem. It’s important that you convey your concern.
  • Be supportive without reinforcing the behavior. Project confidence, optimism, and empathy. Say, for example, “You’ve been so brave to deal with this issue.”
  • Work with a health care professional to help the person.
By Kristen Knight
Source: Andrew Levander, MA, MAC; BBC News; GuardianUnlimited; Discovery Health Channel; The Healing House; Self-injury: You Are NOT the Only One; Vista Del Mar Child and Family Services, www.vistadelmar.org/residential-treatment/; Bodily Harm: The Breakthrough Healing Program for Self-Injurers by Karen Conterio and Wendy Lader, PhD, Hyperion, 1999; Cutting: Understanding and Overcoming Self-Mutilation by Steven Levenkron. W.W. Norton, 1998; Women and Self-Harm: Understanding, Coping, and Healing from Self-Mutilation by Gerrilyn Smith, Dee Cox and Jacqui Saradjian. Routledge, 1998.

Summary

  • Deliberate infliction of injury as a means to manage painful emotions
  • Most common injury: cutting
  • More common in girls

As an experienced therapist specializing in treatment of self-injury, Andrew Levander paints a sobering portrait of the typical person he treats: A teen girl between the ages of 14 and 17, possibly with major depression or bipolar disorder, who cuts herself with a razor blade or glass on her forearms, stomach, or legs. She has long felt invalidated at home.

“Upwards of 60 percent to 70 percent of self-injurers are victims of early childhood sexual or physical abuse,” says Levander, clinical director of the outpatient self-injury treatment program at Vista Del Mar Child and Family Services in Los Angeles. “What the behavior does commonly … is to put them in a position of control over their body, to put them in charge of their pain. It’s easier to understand pain they create, rather than pain inflicted on them.”

What is self-injury?

Self-injury is the deliberate infliction of injury as a means to manage painful emotions. Cutting probably is the most common form of self-injury, experts say. People who self-injure also may:

  • Hit themselves
  • Pull out their hair
  • Break bones
  • Burn themselves
  • Scratch or pick at themselves
  • Bang their head

In severe cases, people who self-injure may even amputate digits, eat harmful substances, or inject themselves with toxins.

Who self-injures?

Research suggests that about 2 million to 3 million Americans self-injure. Levander puts the estimate between one and four percent of the general population.

Women make up the majority of people who self-injure and the problem is more prevalent among teens. Girls as young as age 11 may start self-injuring. Men and boys also may self-injure, but only “20 percent to 30 percent [of adolescent self-injurers] are boys,” Levander says. The root of the difference may be that women often internalize anger or pain, while men externalize it.

People who self-injure often share common characteristics, says Steven Levenkron, the author of Cutting: Understanding and Overcoming Self-Mutilation.

  • A feeling of “mental disintegration,” or the inability to think
  • A feeling of rage that can’t be expressed
  • Feeling powerless
  • Feeling like an outsider
  • Experiencing fear of punishment
  • Feeling as if they can’t trust anyone with their feelings
  • Inconsistent school performance
  • Experiencing anxiety, depression, and low self-esteem

People who self-injure also often experience eating disorders.

Why do people self-injure?

While some people attempt to control emotions with alcohol, drugs, or food, others may find relief in razor blades, explain Karen Conterio and Wendy Lader, PhD, the pioneering authors of Bodily Harm: The Breakthrough Healing Program for Self-Injurers.

As Levander explains, self-injury may become a way to feel mastery of helplessness and anger. Self-injury may be a coping mechanism for deflecting psychological distress and turning it into pain that seems understandable. It can become a way of coping with stressful situations.

Self-injury is not a failed suicide attempt and people who self-injure are not a danger to others. Also, people who self-injure rarely use it just to seek attention.

A growing trend

Health-care professionals report growing numbers of self-injury cases. It is touching younger and younger children.

Several years ago, Levander and his colleagues received a grant to study self-injury, and with guidance from Conterio and Lader, they developed the program at Vista Del Mar. It was the first of its kind in the United States. Still, Levander notes, the small number of treatment programs available are unable to serve the growing need.

How can loved ones help?

“The first thing is to think about what the person is communicating in a nonverbal way,” Levander says. “Not paying attention doesn’t make it go away.” Criticism won’t help, either. The best thing you can offer your loved one is acceptance and support.

  • Read about self-injury. You must be informed in order to help someone.
  • Talk about the problem. It’s important that you convey your concern.
  • Be supportive without reinforcing the behavior. Project confidence, optimism, and empathy. Say, for example, “You’ve been so brave to deal with this issue.”
  • Work with a health care professional to help the person.
By Kristen Knight
Source: Andrew Levander, MA, MAC; BBC News; GuardianUnlimited; Discovery Health Channel; The Healing House; Self-injury: You Are NOT the Only One; Vista Del Mar Child and Family Services, www.vistadelmar.org/residential-treatment/; Bodily Harm: The Breakthrough Healing Program for Self-Injurers by Karen Conterio and Wendy Lader, PhD, Hyperion, 1999; Cutting: Understanding and Overcoming Self-Mutilation by Steven Levenkron. W.W. Norton, 1998; Women and Self-Harm: Understanding, Coping, and Healing from Self-Mutilation by Gerrilyn Smith, Dee Cox and Jacqui Saradjian. Routledge, 1998.

Summary

  • Deliberate infliction of injury as a means to manage painful emotions
  • Most common injury: cutting
  • More common in girls

As an experienced therapist specializing in treatment of self-injury, Andrew Levander paints a sobering portrait of the typical person he treats: A teen girl between the ages of 14 and 17, possibly with major depression or bipolar disorder, who cuts herself with a razor blade or glass on her forearms, stomach, or legs. She has long felt invalidated at home.

“Upwards of 60 percent to 70 percent of self-injurers are victims of early childhood sexual or physical abuse,” says Levander, clinical director of the outpatient self-injury treatment program at Vista Del Mar Child and Family Services in Los Angeles. “What the behavior does commonly … is to put them in a position of control over their body, to put them in charge of their pain. It’s easier to understand pain they create, rather than pain inflicted on them.”

What is self-injury?

Self-injury is the deliberate infliction of injury as a means to manage painful emotions. Cutting probably is the most common form of self-injury, experts say. People who self-injure also may:

  • Hit themselves
  • Pull out their hair
  • Break bones
  • Burn themselves
  • Scratch or pick at themselves
  • Bang their head

In severe cases, people who self-injure may even amputate digits, eat harmful substances, or inject themselves with toxins.

Who self-injures?

Research suggests that about 2 million to 3 million Americans self-injure. Levander puts the estimate between one and four percent of the general population.

Women make up the majority of people who self-injure and the problem is more prevalent among teens. Girls as young as age 11 may start self-injuring. Men and boys also may self-injure, but only “20 percent to 30 percent [of adolescent self-injurers] are boys,” Levander says. The root of the difference may be that women often internalize anger or pain, while men externalize it.

People who self-injure often share common characteristics, says Steven Levenkron, the author of Cutting: Understanding and Overcoming Self-Mutilation.

  • A feeling of “mental disintegration,” or the inability to think
  • A feeling of rage that can’t be expressed
  • Feeling powerless
  • Feeling like an outsider
  • Experiencing fear of punishment
  • Feeling as if they can’t trust anyone with their feelings
  • Inconsistent school performance
  • Experiencing anxiety, depression, and low self-esteem

People who self-injure also often experience eating disorders.

Why do people self-injure?

While some people attempt to control emotions with alcohol, drugs, or food, others may find relief in razor blades, explain Karen Conterio and Wendy Lader, PhD, the pioneering authors of Bodily Harm: The Breakthrough Healing Program for Self-Injurers.

As Levander explains, self-injury may become a way to feel mastery of helplessness and anger. Self-injury may be a coping mechanism for deflecting psychological distress and turning it into pain that seems understandable. It can become a way of coping with stressful situations.

Self-injury is not a failed suicide attempt and people who self-injure are not a danger to others. Also, people who self-injure rarely use it just to seek attention.

A growing trend

Health-care professionals report growing numbers of self-injury cases. It is touching younger and younger children.

Several years ago, Levander and his colleagues received a grant to study self-injury, and with guidance from Conterio and Lader, they developed the program at Vista Del Mar. It was the first of its kind in the United States. Still, Levander notes, the small number of treatment programs available are unable to serve the growing need.

How can loved ones help?

“The first thing is to think about what the person is communicating in a nonverbal way,” Levander says. “Not paying attention doesn’t make it go away.” Criticism won’t help, either. The best thing you can offer your loved one is acceptance and support.

  • Read about self-injury. You must be informed in order to help someone.
  • Talk about the problem. It’s important that you convey your concern.
  • Be supportive without reinforcing the behavior. Project confidence, optimism, and empathy. Say, for example, “You’ve been so brave to deal with this issue.”
  • Work with a health care professional to help the person.
By Kristen Knight
Source: Andrew Levander, MA, MAC; BBC News; GuardianUnlimited; Discovery Health Channel; The Healing House; Self-injury: You Are NOT the Only One; Vista Del Mar Child and Family Services, www.vistadelmar.org/residential-treatment/; Bodily Harm: The Breakthrough Healing Program for Self-Injurers by Karen Conterio and Wendy Lader, PhD, Hyperion, 1999; Cutting: Understanding and Overcoming Self-Mutilation by Steven Levenkron. W.W. Norton, 1998; Women and Self-Harm: Understanding, Coping, and Healing from Self-Mutilation by Gerrilyn Smith, Dee Cox and Jacqui Saradjian. Routledge, 1998.

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