AAMFT Consumer Update
Adolescent Self-harm
By definition, self-harm refers to hurting oneself to relieve emotional pain or distress.
The most common forms of this behavior are cutting and burning. The least common
forms of self harm include pulling out bodily hairs, punching walls, and ingesting
toxic substances or sharp objects.
Many adolescents today are struggling to cope with extreme levels of stress in school, in
their families, and in their peer relationships. Some of these youth are over scheduled and
being hurried through their adolescent years by parents and peers alike. Teens have
become vulnerable prey to our highly toxic, media driven world. Being in front of a
computer or TV screen for close to six hours a day has become business as usual and
more important than spending time with family and friends. Adolescent girls are
constantly being bombarded by images in the media about how they should look and act.
Especially for young women, failure to live up to these idealized images can lead to
developing an eating disorder and/or engaging in self harming
behavior as a form of self punishment.
What Causes Adolescent Self Harming
Behavior?
Like substance abuse, adolescent self harming behavior has no one single cause. It
cuts across all cultural and socioeconomic levels. We do know, however, that more
adolescent females engage in this behavior than males, and that self harming
adolescents are rarely suicidal. Most of these adolescents are seeking quick relief
from emotional distress. One major reason why adolescents gravitate towards self
harming behaviors is the endorphin effect. When adolescents cut or burn themselves,
endorphins are quickly secreted into their bloodstreams and they experience a numbing
or pleasurable sensation. For some of these youth, cutting or burning themselves numbs
away unpleasant thoughts and feelings or they feel "high" from the experience. Like
addiction to a particular drug, the endorphin "high" provides fast acting
relief for adolescents from their emotional distress and other stressors in their lives. Other
important reasons as to why teens engage in self harm include:
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Feeling emotionally disconnected from or invalidated by their parents
Wanting to "fit in" within a particular peer group that encourages and rewards
Self harming behavior
Feeling emotionally dead inside or feeling invisible in their parents' eyes. Self harm
makes them feel alive inside and helps confirm their existence in reality.
For girls, self harm may be used as a coping strategy with overly demanding
parents, especially in situations where the father is the dominant voice when it
comes to discipline and decision making
How Do You Know When to Seek Help?
Since adolescents often engage in self harming behaviors in privacy or with their
friends, parents may not be aware that this problem exists. In addition, parents also
need to be aware that there is a big difference between self decorating and self harming
behavior. It is a popular fad among youth today to body pierce and tattoo as a form of self
decorating. Teens who self harm are seeking relief from emotional distress, they are not
self decorating. Here are some signs that might indicate that a
teen has a problem with self harming behavior:
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Cut or burn marks on their arms, legs, and abdomens
Finding knives, razor blades, box cutters, and other sharp objects hidden in
the teen's bedroom
Regularly locking herself or himself up in the bedroom or bathroom following
a bad day at school, negative encounters with peers, and family conflicts for
lengthy periods of time
The family physician, a teacher, or other adult observes cut or burn marks, or
that the teen appears to be regularly removing bodily hairs
The teen's peers cut or burn themselves.
Reports from a sibling indicating that he or she found blood encrusted razors
or caught the teen in the act of self injuring
What Kinds of Treatments Work?
By far, the most effective treatment for adolescent self harming problems is family
therapy. A skilled family therapist will be able to help improve family communication,
teach conflict resolution and problem solving skills, and help foster more meaningful and
closer relationships between parents and teens. Skill building groups can be helpful to
self harming adolescents as well. A good group should teach teens effective tools for
managing their moods, challenging unhelpful thinking, visualization and meditation skills,
and healthy activities to better manage stress.
How Can Adolescent Self Harm
be Prevented?
Parents play an integral role in preventing their teens from engaging in self harming
behaviors and from joining an unhealthy peer group, where this problem may be the
glue that keeps them together. At home, parents can make spending time together as
a family a priority. Parents can put the teen in charge of selecting and planning a
weekly family outing. The family mood needs to be more calm and inviting for the
teen. When conflicts do erupt or crises occur, family members should work together
as a team to solve these situations. Teenagers need to feel a sense of place in the
hearts and minds of their parents. They need to feel appreciated and know that their
parents will be there for them unconditionally. It is the parents' responsibility to
create firm boundaries between their work and family lives. One way to help foster more
meaningful connections between parents and teens is to share family stories. Parents
should share with their kids what their struggles and high points were in adolescence.
They can also share with their teens any important words of wisdom and stories that their
own parents shared with them when they were growing up. Self harming behavior can be
dangerous, particularly if the youth is abusing alcohol and other drugs. Parents need to
take a firm stance and set consistent limits with these behaviors. Parents also need to
model for their teens' responsible use of alcohol and healthy ways to manage stress.
It is a parent's right to meet their teen's friends, as well as their parents, and voice
your concerns when warranted. Should a parent discover that their teen is engaging
in risky and dangerous behavior such as self harm, they should rest assured that a
family therapist will be able to skillfully assist the family and teen with this serious
issue.
Consumer Resources
Books
Alderman, T. (1997). The scarred soul: Understanding and ending self inflicted
violence. Oakland, CA: New Harbinger.
Conterio, K. & Lader, W. (1998). Bodily harm: The breakthrough treatment program
for self injurers. New York: Hyperion.
Miller, D. Women who hurt themselves: A book of hope and understanding. New
York: Basic.
Clarke, A. (1999). Coping with self mutilation:
A helping book for teens who hurt
themselves. Center City, MN: Hazeldon.
Selekman, M. D. (2002). Living on the razor's edge: Solution oriented
brief family therapy with self harming adolescents. New York: Norton.
The text for this brochure was written by Matthew D. Selekman, M.A., LCSW
This article is courtesy of AAMFT.
www.aamft.org