QUESTION: How do you help a jr. high student when they are cutting?

ANSWER: Hi – thank you for such a timely, caring question. Cutting is on the rise, and the age of onset continues to drop. The first step to getting a self-harmer much-needed assistance is acknowledgement that there is a problem. Cutting behaviors (which may also include burning, picking, hair-pulling, scraping, head-banging, and other physically injurious activities) thrive on SECRECY. Much of the appeal of self-harming behaviors comes from the very silence and secrecy that surrounds the act of self-harm. So, in initiating a dialogue with the self-harmer, their secret is revealed and exposed. The person perceives less opportunity to engage in the behaviors, and begins to believe there may be another way to manage stress. Behavior modification can be introduced once a bond of trust has been formed between the self-harmer and a person of influence – usually a professionally trained therapist.

While I have never personally suffered from this type of self-harming tendency (although an argument could be raised that engaging in eating disordered behaviors is a similar form of self-harm), because of repeated requests to address the topic, I now offer a program to organizations seeking to bring this issue to light in their communities. The program is called Under My Skin: understanding the language of self-harm.

Professional assistance is extremely beneficial in cases of self-harm – not only to assess, treat and remedy any short- or long-term physical danger (infection, scarring, etc) that can arise from self-harm, but also to assess, treat and remedy the psychological impact self-harm has on the victim. Identifying the triggers (reasons why) a person would choose to self-harm is key. For instance, upon initial inquiry, most self-harm victims will say that they are not aware of the exact moment the idea of self-harm first crossed their mind. A small percentage were exposed to the practice through witnessing another self-harmer at work. But most do not recall where the original impulse came from – they just know that, once they acted on it and it served to temporarily alleviate their stress, they felt compelled to return again to see if it was a fluke. They then find that it was not a fluke, and they return again, and again, and again…and a vicious cycle is set into motion.

There are some excellent websites available with support forums, behavior modification ideas, books and other resources that address self-harm. You can find a list of the sites I recommend on my website HERE.

In the meantime, these are the steps I would recommend that you take:

• Let the person you are concerned for know that you KNOW about the self-harm.
• Act quickly and efficiently to identify and treat any fresh wounds and minimize risks of infection.
• Initiate a dialogue about when the self-harm occurs, methods used, and perceived benefits – let the person tell you about the self-harm in their own words, at a pace they are comfortable with.
• Maintain a caring, compassionate, non-judgmental, lightly curious attitude. If you do not think you will be able to engage in such a discussion without getting emotional or judgmental, then do the work you need to do to achieve a necessary emotional distance FIRST, or call on a professional to help you. You MUST show compassion and concern, but not panic, fear or revulsion, or the person will pull away and withdraw – sometimes for good.
• For additional guidelines, click HERE

I hope this is helpful. Less is known, and more is assumed (and thus feared) about self-harm than possibly any other psychologically-based disorder, but, ultimately, individuals who suffer from self-harm have been shown to respond positively to unconditional love, behavior modification, and understanding about the causes and remedies for their self-harming tendencies . I highly recommend that you read a book called ‘Cutting’, by Steven Levenkron, who is the foremost expert on understanding and treating adolescent self-harmers in crisis. I would also recommend that you locate a professional in your area who has expertise in self-harm and ask for help. Take it step by step, and remember that patience is key – self-harm is a shaming, damaging practice for the self-harmer, and it takes the time it takes to overcome the effects on several levels - physically, mentally and emotionally.

If you need to write again, please do.

Warmly,

Shannon

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