Cutting, burning, or picking at oneself is something many teen girls (and sometimes boys) get ensnared by. It's a dangerous addiction used to escape an unpleasant reality. Even though thoughts of suicide are often present, the majority of teens who cut do it for the effect it has on their body, not as an attempt to end their life. Many self-cutting teens describe their experience as so compelling that they forget about everything else. Some get an endorphin rush as well. It becomes a habit as a way to deal with emotions. And if you think you'd know if your teen cuts, guess again! It is very hard to tell if someone cuts or self-harms. Teens are very, very good at hiding it. Even the most vigilant parents get duped. Unfortunately, once the habit is established it is very hard to stop.
Stopping the Pain: A Workbook for Teens Who Cut & Self-Injure, by Dr. Shapiro, is a good supplement for teens who enjoy journaling and are currently in therapy. In this post I will share some tips from the workbook as well as some suggestions based on my experience working with teens who self-injure.
Numero Uno: Safety Plan!!!
No matter how small the cut, your teen is demonstrating that she needs help. Talk with your teen about what life stressors she is escaping and set up counseling with a professional.
Set up a safety plan. Talk with your teen about her motivation to stop the cutting. Try to get her to commit to not cut for a certain number of days to buy some time before you can arrange counseling. Have her remove the objects she uses to hurt herself. Offer some alternative ways to relax or release tension. Let her know she will have urges. Then make plans- A, B, C, D, and E- on how to respond in order to let those urges pass. Often, teens simply need to distract themselves on the phone with a friend or get busy with a project. If that doesn't work, she could call a family member to chat about anything to keep her mind off the cutting. If that person is not available, the plan could be to go for a walk or some other activity. You may want to have a code word to communicate when an urge is coming on. Whatever the plan, make sure your teen agrees that the plan will be helpful, the plan is clear, and be sure to review it often.
Numero Dos: Learn Coping Skills
You can teach your teen to try these out: going for a walk, journaling, deep breathing, medication, yoga, hot bath, guided visualization, going out in nature, dancing, sports, hanging with friends, running, letter writing (even if you don't intend to send them), massage, reading, gardening, or building. Make a menu with your teen of coping skills to pull her out of a stressful situation or when she just needs some self-care. Display this "menu" somewhere that it can be seen often. Your teen can also learn more coping skills in therapy.
Numero Tres: Awareness
Learn to notice when an urge comes. What happens right before the urge? What triggers it? Observe patterns of urges. Do they follow certain situations or occur at a certain time of day? Determine when your teen most likely will self-injure. These insights can be explored in therapy to help process the root cause of the distress, which will contribute to a healthier solution for your teen. Gaining self-awareness is crucial in learning to overcome addictions and will help individuals get on a path to wellness.
If you or someone you know hurts themselves to try to feel better, please let them know you care and try to get them the help they need.
If someone is suicidal, they can always call SLO Hotline at (800) 783-0607. They are available 24/7.
Although self-injury if difficult to stop, I have seen many teens successfully overcome it. Often all they need is to know there is hope and help is on the way.
Take care of yourself,
Stephanie Patterson, M.S., LMFT
Downtown San Luis Obispo and Atascadero, California