The Practice of Self-Mutilation
A disturbing situation has emerged among teens: the practice of self-mutilation. Teenagers who self-mutilate – overwhelmingly girls – are inflicting pain and injuries on their own bodies. While it's estimated that only 1 percent of the American population self-mutilates, the emotional issues that drive them – and the physical fall-out from such practices as cutting and burning – make self-mutilation a serious problem.
Types of Self-Mutilation
Cutting is but one of the self-mutilating behaviors adolescents may exhibit. Other common practices of self-mutilating behaviors include burning, bruising, breaking of bones (especially digits), picking at the skin or "wound interference" (the practice of producing a wound and not allowing it to heal).
What Causes Self-Mutilation?
There is no stereotypical person who will choose to mutilate his or her own body, but experts say it's a process that stems from the inability to deal with stress or intense emotions.
"Self-mutilation is a desperate attempt to have some control over unbearable feelings of aloneness, loneliness and helplessness," says Margaret Paul, therapist. "When a teen or young adult has not learned healthy ways of managing these intense feelings, they turn to physical pain as a way to blot out the emotional pain or gain a sense of control over the pain they feel. In a strange way, they are really not trying to hurt themselves – they are trying to protect themselves from something even more painful than the physical pain."
According to SAFE-Alternatives, an organization that helps self-mutilators, those who practice it say they do it when they feel fear, anger, guilt, sadness, anxiety or other emotions that are just too much to handle. Those who self-mutilate often feel they can't express themselves verbally or otherwise. As these feelings remain inside, they build up to dangerous levels and can eventually result in self-mutilating behavior.
"Cutting is physically painful – it hurts," says Paul. "But to a mutilator it's absorbing. It's doing something. It's controlling something. It's causing something. It's making it happen and not being at the effect of outside forces over which they feel like they have no control."
When parents learn a child is hurting herself, they often feel helpless. "My daughter was in her late teens when I first began noticing the mutilation," says Judy Smith*, a medical specialist. "It's been going on for a long time. She is now in her early 20s, and what my daughter does is disfiguring. She is terribly scarred on her breasts, her arms, face and on her hands. I noticed it again when she was in college. I asked her what it was, and she would say that she was breaking pimples. It went far beyond that, and I realized that pretty quickly."
According to SAFE-Alternatives, most adolescents who self-mutilate tend to be perfectionists. They feel they must live up to or exceed the standards set for them by their parents and peers. When they are unable to do this, their emotions become confusing, and they tend to result to what they know – causing harm to their own bodies.
"Children are put under a huge pressure to perform," Paul says. "They have to perform in all aspects of their lives. They have to do well in school; they have to get good grades; they have to have enough friends; they have to look a certain way. There are these huge pressures on them to look and perform in certain ways, and they are often not seen for who they are."
What Can Parents Do
Parents may discard their child's altered behavior as a phase or something that will pass. And the "weirdness" of the behavior might induce a "taboo" effect – parents will often approach the issue timidly.
"Their parents don't even begin to know how to see [the kids] for who they are," says Paul. "So even if the parent tries to go and talk to [the child], they are talking different languages. The parent isn't really getting what the child is truly feeling, what the pressures are, what the fears are, what the stressors are, what the overwhelming feelings are about. These feelings can get so intense as to be unbearable that the child wants to jump out of their skin. A parent doesn't want to hear that. They want to know that their child is normal and that all is well."
Parents should not assume they are the cause of the stress in the child's life. Adolescents experience intense stress in places other than the home, such as school and work. "Although the home environment needs to support what's going on with the child, it's not always that the parents are hypercontrolling or unavailable," says Paul. "It may be that [the parents] don't understand what's going on at school or what's going on with peers or how to help their child."
What to Look For
There are signs parents can watch for if they suspect their adolescent may be practicing self-mutilating behaviors. Unexplained or frequent injuries, wearing jeans, long pants or long sleeves consistently – even in warm or hot weather – exhibiting the want for isolation or "being alone" and the presence of blood stains on the inside of clothing may be clues into a child's self-mutilating behavior.
"I wish I had answers for other people," Smith says. "It's easy to say clichés like 'keep the channels of communication open,' and that's fine if it's a two-way street. The only thing I could suggest is obviously checking the resources available. People should go for at least one crisis visit with a psychologist. Talk to somebody who knows about this. Pay for the time, sit down with them for one or two sessions and help yourself, as a parent, not to be an enabler."
These behaviors are not attempts at suicide. They are attempts to gain control over life. "Self-mutilating behaviors, as well as eating disorders, drug or alcohol use and extreme violent behavior are all cries for help," Paul says. "These kids are saying, 'I don't know what to do, so this is what I do instead. And don't try to take it away from me because it is all I have.' There is no place where we learn how to manage our intense fear, anxiety, hurt, anger, depression or whatever the feeling is. There is no one place that teaches that. A person must find a method that works for them. Whether spiritual meditation, breathing or something else that helps an adolescent manage inner stress, having the equipment to deal or cope is the first step in gaining control."
*Name changed to protect privacy.