Self-Injury and Adolescents by Dr. Kelly Everson and Dr. Brandi Rials

Palm Beach Behavioral Health and Wellness has recently received an increase in calls related to adolescents engaging in self-injury; a topic of great concern for our families. In general, cutting behavior in adolescents and young adults has become somewhat of a current phenomenon, with websites (both “for” and against cutting) and popular media consistently incorporating this topic intotheir shows.

The first thing to know and understand is that cutting is rarely a suicidal gesture. Parents are understandably very concerned when they observe cuts on their children, but it is important to acknowledge that this is typically very different from a child trying to end her own life. Cutting is usually a person's attempt at feeling better, not ending it all. Although some people who cut do attempt suicide, it's usually because of the emotional problems and pain that lie beneath their desire to self-harm. People may cut themselves on their wrists, arms, legs, or stomachs. Some people self-injure by burning their skin with the end of a cigarette or lighted match.When cuts or burns heal, they often leave scars or marks. People who injure themselves usually hide the cuts and marks and sometimes no one else knows.Cuts can be more serious than intended; it's possible to misjudge the depth of a cut, making it so deep that it requires stitches (or, in extreme cases, hospitalization). Cuts can become infected if a person uses non-sterile or dirty cutting instruments — razors, scissors, pins, or even the sharp edge of the tab on a can of soda.

Why do people cut themselves? Some people cut because they feel desperate for relief from bad feelings. People who cut may not know better ways to get relief from emotional pain or pressure. Some people cut to express strong feelings of rage, sorrow, rejection, desperation, longing, or emptiness.When emotions don't get expressed in a healthy way, tension can build up — sometimes to a point where it seems almost unbearable. Cutting may be an attempt to relieve that extreme tension. For some, it seems like a way of feeling in control.The urge to cut might be triggered by strong feelings the person can't express — such as anger, hurt, shame, frustration, or alienation. People who cut sometimes say they feel they don't fit in or that no one understands them. A person might cut because of losing someone close or to escape a sense of emptiness. Cutting might seem like the only way to find relief or express personal pain over relationships or rejection. Additionally, self-injure has somewhat of a cult following among some teens that use it as a means to attract attention or “fit in”.

What should you do if your child is self-injuring? First, always have open discussions regarding their feelings, particularly to ensure that they have adequate coping skills for managing stress. Encourage them to tell someone when they are struggling, even if it isn’t you. Some children and adolescents need to talk to their teacher, coach or a peer before they will go to a parent. Next, identify the trouble that’s triggering the cutting behavior. It’s important to know the situation and feelings that your child has that are triggering self-injury. This is often where a mental health professional comes in.  Asking for help is very important. Mental health professionals can help with adding coping skills to your child’s (and your) repertoire, in addition to being a reliable “check point” for assessing severity of underlying issues. Please do not hesitate to call if your family is struggling with this issue.

Palm Beach Behavioral Health and Wellness serves the emotional and behavioral needs of children, adolescents and families in the Jupiter area. Drs. Everson and Rials are Florida Licensed Psychologists who offer individual, group and family therapy, in addition to psychological and psycho-educational testing services. They can be reached at (561) 429-2397 and