The many ways teens act out to harm themselves- and what you can do about it

As we discussed in our earlier blog post on this topic, self-harming behaviors are used as a coping mechanism. You might assume that it would be easier for teens to open up and ask for help than to undertake behaviors that hurt themselves. However, it’s actually the opposite; even for adults, it is harder to ask for help than to be vulnerable. Sometimes it may seem easier to just deal with it internally and hope that the pain will eventually go away. As caregivers, it is vital to recognize self-harming behaviors as signals rather than symptoms- signals to a deeper issue. It is also vital to recognize the reason behind their behaviors so we can tailor our responses accordingly. I came up with the acronym SELF INJURE to organize the different reasons teens self-harm. 

Here are some of the reasons teens engage in self-harming behaviors:

Soothing

To feel good. Self-harming can be soothing. It helps to feel something different and/or less of the emotion that is too overwhelming. When self-harming involves some form of cutting, the body releases natural pain killers to sooth the emotional pain. However, if you’ve ever taken pain medication you would know that it numbs all types of pain. Therefore, self-injury becomes a natural analgesic against emotional pain.

Emotion regulation 

Guilt, shame, hurt, grief, disappointment, loneliness, and hopelessness- these are common emotions that teens often have a hard time managing. Self-harming behaviors become ways to manage them, especially grief. Losses are experienced differently at this age. They are typically experienced more intensely and everything seems to be magnified. Grief then becomes more complicated and it seems as if the emotions will never end.

 Live 

Sometimes they do it to avoid suicide. They often see self-harming as an alternative to cope rather than giving up completely on life. As confusing as it may sound, self-harming is their way to stay alive and “cope” with their emotions.

Feel the high 

Sensation-seeking or pushing boundaries can be another reason. Self-harming behaviors can be seen as ways to push limits and boundaries and experience a high very much like riding a roller coaster or skydiving.

Internalized aggression 

Depending on how teens have made sense of their experiences, they can try to punish themselves through self-harming behaviors. How teens conceptualize cause and consequence can be very concrete. Something bad happens it must be someone’s fault. It’s either their fault or their caregiver’s fault. If it’s their fault, they have this sense of failure and shame. If it’s the caregiver’s, they have this anger and resentment. In the former, they take it out on themselves, and build walls around their emotions. They may become depressed and assume the worst about their future. In the latter, they take it out on others by becoming aggressive, defiant, and oppositional. They don’t trust others and feel the need to detach themselves to avoid more pain. It’s a way to internalize the aggressor and make sense of the abuse as something they “deserved” so they can still maintain a positive image of the aggressor. The alternative would be to realize that the aggressor may not have loved them and this is far more painful for them because they would have to re-write their lives. Teens may also experience a sort of “survivor’s guilt” if a friend of theirs was harmed or killed. Self-harming is a way of punishing themselves for not believing themselves to be worthy of making it out and continue to have a chance to live happy.

Numbness 

When teens have experienced traumatic events, they often rely on a form of dissociation. This is when they emotionally “check out” of their bodies. They watch themselves as if they are watching from the outside or as if they are watching themselves on a movie screen. In some cases, it can lead to amnesia where they do not recall parts of an experience. This can be very scary and if the teen has used this coping mechanism, self-injury can be a way to avoid dissociation and ground themselves. 

Join others 

Self-harming can provide a sense of belonging and connection. Some tens who begin self-harming do it because their friends have done it or are currently doing it. It’s a sort of tribal mentality where they believe they need to do something, such as mark their bodies, in order to belong. 

Used to the pain 

Based on their experiences, teens may have gotten used to the physical and/or emotional pain. Therefore, self-harming provides a sense of control. Sometimes teens self-harm because they are used to experiencing pain and this gives them a level of familiarity and certainty. Uncertainty causes anxiety, and anxiety can be overwhelming.

Release trauma 

Self-harming can be a channel to release tension and a form of trauma re-enactment where they have more control over the outcome. Granted, not every teen has had a traumatic experience and those who have should not use it as their “free card.” We should not see them as helpless victims who need our sympathy. But it would also be neglectful on our part to assume that difficult events did not affect them and that they should just get over it. It’s not that simple- temperament, personality, environment, age, and type of trauma will determine how an event will impact the individual. Self-harming becomes the way they cope and try to release the trauma.

Express needs 

Teens often communicate through symptoms or, rather, signals. These signals start to tell the story when language fails. If they’re being abused or were abused, their signals become the red flags to pay attention to. This is difficult because when asked, they usually don’t come out and say what’s wrong with them. It takes time and they often feel more comfortable disclosing to friends and their parents. This sometimes creates some unfortunate responses from caregivers because we know that caregivers tend to be more supportive if they were the first ones to know as opposed to being told by other adults. When this happens, the teen is often seen as manipulative and trying to avoid some consequences. 

Don’t forget to check back soon for our third part of this series where we’ll discuss what our response as caregivers should be to help teens through a difficult journey as they struggle with self-harming behaviors.