Originally published October 22, 2015
Self-Injury can be an overwhelming and confusing issue for those of us who work with children and adolescents who engage in this behavior. It is a scary behavior and one that is hard to wrap our minds around.
Here are some tips on what to do, or not do, if/when you discover you may have child or adolescent, or are educating a child or adolescent who is self-injuring.
- ask about the injuries and behavior in front of others. Most individuals who are self-injuring will do so in secret. If their behaivor is discovered, they may try to brush it off as no big deal. Saving face and embarrassment with their peers or in front of their family will likely be their first priority.
- ask to see the injuries. This can be an extremely harmful tactic and is mostly viewed as a power struggle. There are many bodies of research that have found new injury checks to be ineffective. If the individual has discovered the only method of coping is through self-injury, he or she will find a way. Put yourself in their shoes and think how you would feel about the experience of being asked to reveal a part of yourself you may be ashamed of. We don’t want to punish the individual.
- assume the injuries are done for attention. This is a common school of thought, especially in educational settings, but also one of the biggest myths. Self-injurers are doing so because they lack adaptive coping skills with major life stress and/or traumatic events. It is a method of being able to regulate their emotions without engaging in an externalizing (disruptive) behavior. Teens, once ‘found out’, may report they are injuring as a way of seeking attention, but this is usually a tactic to avoid humiliation amongst their peers, teachers, and/or family.
- refer to the student engaging in self-injury as a ‘Cutter’. Cutting is just one of many ways individuals can self-injure. Cutting is simply the method, but so is burning, picking, biting, scratching, scraping, and interfering with healing wounds. Placing a label like on an individual turns that into their identity, and that can cause more harm, which may pave the way for more challenges, socially, as well as more potential injuries.
- suggest the student self-injuring replace the behavior with a less harmful one. A couple of examples I continue to come across include wearing a rubberband around the wrist to snap when the urge to injure triggers or rubbing an ice cube across the area that is usually chosen for the injury. This is never a good idea. The indiviudal is really just substituting one form of injury with another. Regardless of the severity, injuries are injuries.
- Communicate, Communicate, Communicate! If you are an educational provider and you discover a student is engaging in this behavior, parent notification should be done. This will allow the parent and/or guardian a chance to seek out the appropraite therapeutic intervention. I have not met an indivudal, who self injured, who was against exploring alternative strategies.
- Listen. The indivdual will want to be validated as well as will want to feel a sense of safety and security.
Self-Injury is sometimes considered a social contagion; especially with teens. It may seem like the individual is copying the behavior from others; however this is usually seen in an in-treatment setting. We have to also remember that self-injury is serving a function for a much bigger issue. If an individual begins self-injuring because of another person is self-injuring, there are already pre-existing coping and expression issues.
Self-Injury can be a very complex issue to manage and treat. Finding replacement behaviors while implementing therapies and strategies to assist the indiviudal in dealing with the emotional issue will take time. So perhaps a final “Do” should be to have patience and persist in your perseverance.