Self Harm In Adolescents

Self-Harm in Adolescents

Self-injurious behavior or self- harm is a serious health problem that many people may just take as it being a sign of attempted suicide. Adolescents can truly be a treacherous time with the growth and development of physical, sexual, and emotional aspects. Many adolescents turn to self-harm as a way of coping. Self-harm in adolescents can be anything that is a deliberate, self-inflicted destruction of body tissue outside of cultural norms. (Gratz, Dukes, &Roemer, 2002; Yates, 2004) This can include anything from cutting, scratching to burning. Most adolescents use self-harm to help subdue a wide variety of emotional issues. The Youth Risk Behavior Survey conducted in Massachusetts found that 18% of Massachusetts

high school students reported having self-injured within the last year.(Bailer, 2007) Not only has self-injury grown more prevalent , it has also grown to be a more public matter. The age that this behavior begins is usually between the ages of 14 to 24 years. (Nijman, Dautzenberg & Merckelback; 1999) Though with it becoming more public, it is becoming much more prevalent, This may be due to the mainstream media romanticizing it and making it seem like an effective coping mechanism. This causes curious adolescents to simply try it. Though when adolescents report that when they inflict the pain it causes a sense of calm and has no pain. This feeling is like a remedy to the immediate distress and it can give the adolescent a sense of control and cleansing. It is this feeling mixed with feelings of anger, anxiousness, constricted ability to think thoroughly, and the immediate relief that cam cause addiction and have the adolescent not seek other healthy methods of coping. Typically with self-harm it occurs numerous times with multiple levels of self-injury that have a low lethality. These adolescents may also have a history of relational based traumas. These traumas can stem from many things such as neglect, loss, peer conflicts, illness and abuse. In Vander Kolk, Perry and Hermam's study concluded that
childhood trauma contributes to the intitiion of self-destructive behavior, but lack of secure attachments help maintain it. Patient who repetitively attempt suicide or engage in chronic self-cutting are prone to react to current stresses as a return of childhood trauma, neglect and abandonment. (p. 1666)
As self-harm distracts away from internal problems, it reduces the impact and duration of the negative situation. It also may be difficult for the adolescent to verbalize or they may not have someone to confide in their feelings anxiety or depression. Another reason for an adolescent to self-harm is they may harm in an area that is easily seen so someone may notice it and reach out to see what the reason behind the mutilation is.
There may be a biological reason behind the onset and addiction of self-harm.

The serotonergic system has been shown to be a factor as a decrease in serotonin has been found in many patients who self-harm. It can also be seen as a drug as it effects the endogenous opiates in the body thus giving a feeling of elation. This contributes to addiction to maintain that feeling. Self-harm can be described as a behavioral addiction. This is due to it involving compulsive acts and it has significant physiological effects. Once the addiction sets in the adolescent will begin to crave it constantly. This addiction can also cause the adolescent to experience withdrawals that can encompass physiological effects. Though it can be more difficult to treat compared to a drug addiction due to the adolescent feeling that it only hurts themselves and they should be able to treat their body as they see fit. According to MacAniff’Zila and Kiselica the absence of appropriate attachment and nurturing during childhood is a major factor to the onset of self-harm. When the adolescent develops in a family where they may have been abused or neglected it makes them find it difficult to receive comfort from other people. This causes the adolescent to rely on their own resources to comfort and relieve pain. Other than parental and familial influence the reason behind the adolescents self-harm could be from their peers. This could come in the forms of rejection, poor interaction, or problems with sexual

maturity. The adolescent could also learn unhealthy means of emotional control. This could be in the form of substance abuse or seeing a peer self-harm and how it comforts them and joining in.
In finding professional help many adolescents never will.

Adolescents likely hide the majority of their self-harm and they are able to function in society. The adolescents may hide their injuries in order to keep away attention and embarrassment. When being diagnosed it is important to recognize and find the concurrent issue. This could be anything from anorexia, bulimia, depression, anxiety, or substance abuse. One possibility that could be overlooked is that the adolescent could suffer from post-traumatic stress disorder. This could be stemmed from child abuse, sexual abuse, or neglect. It is very important that the counsellor develops a sense of trust with the adolescent. This is because if the reason for self-harm stemmed from abuse it may be difficult for the adolescent to open up at all. The major components to help decrease and end self-harm is to identify and express the adolescent’s emotions and to find a healthy and constructive means to cope. It is important that the adolescent learns the full dynamic on why they self-harm this includes the original source of the problem and why it is a defective coping mechanism. It is imperative that the adolescent find other ways to cope. These methods needs to be free of shame inducing and use cognitive and behavioral ways of dealing with triggering situations. When using behavioral methods the adolescent will discover other means of coping and should be rewarded for the reduction in frequency and severity of self-injury.

Desensitization may also help to increase the adolescent’s ability to endure strong emotions without going to self-harm to cope. Cognitive therapy can be used to thoroughly understand the relationship between their thoughts and emotions and their way of self-harm. This can help the adolescent observe their emotions rather than be overcome by them. Another way to help treat self-harm is to encourage the adolescent to join extracurricular activities, volunteer, or find something recreational that they enjoy. This can help reduce environmental stress by helping cultivate relationships, improve communication skills, improve emotion regulation and foster a general connectedness to the public. Medication can also be a factor when helping to reduce and eliminate self-harm. Medications that may be used are tranquilizors, mood stabilizers, SRI’s and antidepressants. This though needs to done with congnitive and behavioral therapy. When first starting therapy the adolescent may self-harm more while digging deep into the psyche of the underlying problem. The counselor needs to mention other things to do when the urge to self-harm arises such as drawing on the area where they harm, or if they crave the sensation they could snap a rubber band or put ice on the area.