Teens and Self Injury
Dale Kaufman, MSSW
School Social Worker
Middleton-Cross Plains Area Schools
dkaufman@mcpasd.k12.wi.us
Agenda
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General information regarding Self-Injury
View “Cut: The Movie” (56 minutes)
Resources
Evaluations
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if you would like a copy of the
PowerPoint for this presentation.
DEFINITION of Self-Injury:
• Deliberate self-inflicted harm resulting in tissue
damage without the conscious intent of
suicide
• Behaviors include (but are not limited to):
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Cutting, scratching
Burning
Interfering with the healing of wounds
Hitting or biting oneself
Head banging
Hair pulling
Incidence and Onset
• 4% in the general population
• = numbers of males and females (though
more females present for treatment)
• Typical onset: puberty
– though can be seen in young children and
adults
• Often lasts 5-10 years
– But can last longer without treatment
Background Factors in Teens
who Self-Injure: Generalized
• Found in = numbers in all ethnic groups
• Nearly 50% report physical/sexual abuse (At
least 50% have NOT reporting abuse)
• Many report that they were discouraged from
expressing emotion, particularly anger and
sadness
– Feelings of emptiness, over/under stimulated
– Unable to express feelings
– Lonely, fearful of intimate relationships or adult
responsibility
– Feeling invalidated/disconnected from parents
Behavior Patterns
• Cutting arm/legs most common practice
• May attempt to conceal injuries (long
sleeves/pants)
• Often make excuses
• Significant # also struggle with eating
disorders/substance/alcohol abuse
– Big difference between self decorating
(tattoos/piercings) and self harm
– Teens who self harm are seeking relief from
emotional distress
Warning Signs
• Unexplained, frequent injuries including
cuts and bruises
• Wearing of long pants/sleeves in warm
weather
• Low self-esteem
• Overwhelmed by feelings
• Inability to function at home, school or
work
• Inability to maintain stable relationships
Dangers
• Can become desperate about lack of selfcontrol and addictive-like nature of acts
• May lead to true suicidal attempts
• Self-injury may cause more harm than
intended. Can result in medical
complications or death
• Eating disorders/AODA intensifies threat
to overall health and quality of life
Why? Purposes of Self-Injury:
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Analgesic
Connecting body and mind
Control
Cleansing
Punishment
Words cannot express pain
Combating a sense of invisibility
Rescue fantasy
Vengeance
Why? Reasons for Behavior:
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Feelings of emptiness
Over/under stimulated
Unable to express feelings
Lonely
Not understood by others
Fearful of intimate relationships and adult responsibilities
Way to cope with or relieve painful/hard to express feelings
Relief is temporary
Self-destructive cycle often develops without treatment
Wanting to fit in
Feeling emotionally dead inside
Self harm feels alive and confirms existence
Coping strategy
Stigma
• Self-injury is not a behavior that “works” for
someone who is not in acute emotional distress
• Important for caregivers to recognize that there
is NO safe amount of self-injury
• Self-injury, like substance abuse and eating
disorders, is a coping strategy used by people
who are in emotional distress
• Those who self-injure feel great amounts of pain
and often, shame
CUT: Teens and Self Injury
• A documentary produced and directed by
Wendy Schneider
• www.cutthemovie.com
Parents…what you need to know
1. Injuring is a coping strategy and not the
problem itself
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Instead of focusing on behavior understand
that the child needs help to identify and
express emotional issues verbally
Parents…what you need to know
2. Some parents find it hard to deal with their own
emotional response..
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Don’t minimize the problem (assuming that he/she is
just doing it “for attention”
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Know that self-injury is never a healthy coping
strategy. It is an indication that the child is having
trouble coping with stressful issues and emotions.
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Some teens are more open with a professional than
their parent
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Don’t overreact…result could be more hiding of
behavior
Parents…what you need to know
3. Fear, anger and guilt are all normal
reactions. Try to process your own
feelings and remain understanding of your
teen
• Remember…your child is in a great deal of
emotional pain that he/she has not been
able to express directly
Parents…what you need to know
4. Have appropriate expectations of your
teen
• Adolescents generally find it difficult to
indentify, much less discuss feelings and
issues that underlie self-injury
• It takes time and work
Parents…what you need to know
5. Don’t expect to be able to fix the problem
yourself
• Be available to listen and empathize but…
• Teens are usually in need of professional
assessment and possibly treatment
– Parents are NOT betraying their child by seeking help
– By seeking help, you are modeling healthy parental
attitudes and showing that you can accept problems
and deal with them constructive
Parents…what you need to know
6. Try not to threaten or overprotect your teen in
an effort to stop the behavior
• Power struggles rarely work
• Openly express concern
• Indicate that you want to help
• Encourage teen to talk to you and/or another
trusted adult
• Get professional help, if warranted
• If you observe an actual injury, you can, if
necessary transport teen to ER or doctor
Parents…what you need to know
7. Don’t hesitate to seek help
• Therapy
• Hospitalization
Parents…what you need to know
8. Take care of yourself!!!!!!
• Affects the entire family
• Therapy can help both parents and
siblings
• Important to identify and express your own
feelings in a healthy way
9. Don’t expect a quick cure…it takes time to
heal
Parents…what you need to know
• If you believe your child is suicidal,
IMMEDIATELY contact your therapist, if
you have one or call 911
• Self-injury is a strong risk for suicide
• Take suicidal statements seriously