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Self-Injury: Understanding Teenagers
Who Mutilate Themselves
by Karen Carr, Ph.D.
T errie is a 16-year-old student in a suburban high school in the U.S. It’s been a hard year for her. She broke up with her boyfriend over the summer and she had a major fight with her best friend a few weeks ago. She feels intense pain and anger inside and nothing seems to relieve it. She assumes that no one really understands or cares.
Terrie knows some other girls who say that cutting yourself can make you feel better. That always seemed weird to her but she is desperate and decides to try it one night after arguing with her parents. She takes a razor blade and makes several cuts on the inside of her forearm. It doesn’t really hurt that much and there’s a comfort in feeling the warmth of her blood run down her arm.
David is a 15-year-old missionary kid who just started boarding school this year. Although he was looking forward to doing just as his two older siblings had before him, he is now struggling with his new environment and being away from home. His school feels overly structured, excessively strict and oppressive to him. Most of the time he feels numb inside but he’s never been one to talk much about the way he feels. Sometimes when he’s really frustrated with his teachers or dorm parents, he punches the door in his room or bangs his head against the wall. Somehow that gives him a sense of relief. He feels less tension and the physical pain is a comforting reminder that he is capable of feeling something—even if it hurts.
Both of these teenagers are harming themselves as a way of coping with pain. They are not alone. An estimated eight million Americans are currently self-mutilating, among them many teenagers cut themselves. Others burn themselves with cigarettes or matches. Still others repeatedly reopen old wounds by picking at a scab, or pulling out their hair, biting their fingernails to the quick, or even breaking their own bones. Most of these actions result in minor injuries that can be covered or hidden (with the exception of the broken bones). They are usually not life threatening, but without proper care they can lead to infection or permanent scarring.
 Most people who injure themselves
do so for a combination of reasons.
Self-injury is the intentional harm of one’s own body without any conscious intention to commit suicide. This is an important distinction because self-injury may be confused with a suicidal attempt or gesture, but the underlying motivation of self-injury can be quite different from someone who is attempting suicide. Although some people who inflict injury on themselves do commit suicide, we shouldn’t jump to the conclusion that self-injury means that someone is necessarily suicidal.
Why Teenagers Injure Themselves
Like most adjustment problems, self-injury is rarely caused by one simple thing. Instead, most people who injure themselves do so for a combination of reasons. Here are some of the most common.
Relief from painful or upsetting feelings: People who injure themselves often have trouble identifying, expressing, and releasing their emotions—especially their painful ones. If a teenage boy is feeling isolated, alienated, depressed, frustrated, disorganized, tense, fragmented, or empty he may hurt himself to gain a little immediate relief. The physical pain produces a flooding of endorphins and provides a tangible wound that can be nurtured and healed unlike the hidden inner emotional pain. In this way, self-injury serves as a kind of coping mechanism that temporarily brings relief and lowers stress when one doesn’t know how else to handle a problem.
Physical Expression of Pain: We all feel some inner pain or unhappiness at times that we can’t quite describe or put our finger on. For unhappy teenagers, this can be especially troubling. They are upset but they don’t know why. Hurting oneself turns the invisible pain into a tangible, external reality. As odd as this may sound, in the hurting teenager’s way of thinking, it seems better than an unnamed inner pain.
Revenge: Many teenagers go through a period of being quite angry with a parent or other person. If they cannot express that anger directly, they may seek out a hidden, alternate way. Some adolescents, for example, use drugs or drink alcohol or fail at school in order to unconsciously get back at their parents. Self-injury sometimes serves this same purpose. It can be a disguised way of expressing anger or resentment.
Self-punishment: People who have been abused or mistreated or made to feel very badly about themselves may engage in self-mutilation because they think they deserve it. They feel so guilty or worthless that they punish themselves for their perceived badness.
 Continued on Page Two
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