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A Bloody Cry for Help
Teenagers and Deliberate Self-Harm
An article from David R. Smith at TheSource4YM.com
7/19/2009

The pressures of life were getting harder and harder to handle. "Carrie" faced incredible expectations from those around her and struggled in academics, relationships, and personal identity. When burdens became too intense, she would reach for a razor to "ease the pain."

Carrie's not alone.

The Recent Battle Against an Ancient Pain
"Carrie" is just one of the girls I know who faces the torment known as Deliberate Self-Harm (DSH). Although it has only recently hit the radar of most parents and youth workers, self-injury is nothing new. Forms of DSH date back to the biblical era, with both Testaments recording examples of it. (For one of the clearest, see Mark 5:1-5).

It's a topic that has dominated the minds and hearts of youth workers and parents alike for the better part of a decade. We get plenty of concerns emailed to us about this quandary, and often field questions about it at our parenting and training seminars.

But what is this confusing and detrimental practice? Who does it? And most importantly, how can we stop it?

The Paradox of Pain
My friends at To Write Love On Her Arms in Cocoa, FL define DSH as, "The deliberate, repetitive, impulsive, non-lethal, and un-aided injuring of one's body for the purpose of regulating emotional stability." Wow, that amount of detail requires some serious reflection!

The most important part of that definition deals with the regulation of emotional stability. For many of us, it's slightly paradoxical to think that teenagers intentionally injure themselves physically to ease emotional pain, but that's the mindset behind the problem known as self-injury. Teenagers who injure themselves are actually crying out for help.

Every teenager experiences stress (in varying ways), and most have a unique way of handling it, too. There are healthy coping mechanisms, for instance, exercise, listening to music, or talking to a trusted friend; however, there are more dangerous strategies to managing stress, including drug use, alcohol abuse, and even self-injury. The stress-inducing depression teens experience must be dealt with, and too many of them find self-injury to be a quick fix.

Unfortunately, this "solution" only puts them in a devastating tailspin that leads to even more pain and anguish.

The Marks of Pain
Self-injury can take many forms: scratching, burning, marking, biting, etc. One of the newest documented forms of self-injury is referred to as embedding, where teens actually wound themselves and place objects within their body. However, the most familiar form of self-injury is known as cutting. Teens who "cut" typically use a sharp instrument like a knife or razor to slash their body in various places, such as their arms, legs, or chest.

Self-injury doesn't discriminate, mainly because depression doesn't. Boys and girls from all economic classes, social positions, and ethnic backgrounds can fall victim to this agony. In fact, high profile celebrities like Angelina Jolie have talked openly (5:30 into video) about their struggle with cutting. More recently, Disney's iconic pop princess Demi Lovato has had to answer questions about visible wounds on her wrists.

So, how big of a problem is this?

The Invisible Masses
Defining the scope of this problem is a difficult one, and researchers admit that it's tricky to grasp the full extent of damage. Many experts hypothesize that roughly 1% of the total U.S. population exhibits some form of self-injuring behavior (though this number also includes issues such as eating-disorders). Their research also suggests two other alarming findings: first, the number of cases of self-injury is on the rise, and second, without treatment, many who begin self-injury as teens continue the practice well into adulthood.

As for cutting, it's estimated that 1 in every 200 girls between the ages of 13 and 19 years old cut themselves regularly. Similar studies suggest that the frequency of self-injury is much higher in homosexual, bi-sexual, and/or transgender communities.

Putting a Stop to the Pain
It's a given that any caring and loving adult will intervene and try to help a teenager caught in this life-and-death struggle. But what's the best recourse? How can we truly help?
  1. Be observant. I'm not merely talking about keeping an eye open for signs of bodily damage caused by self-injury, though that's absolutely critical. Instead, look for the things that can instigate harsh bouts of depression that lead to self-injury, for instance, divorce, death in the family, relationship troubles, and other major stressors. If you know a teenager who is wrestling with a big issue in their life, keep a watchful eye on them. Also, inspect signs that indicate a loss of normalcy, like long sleeves on hot summer days, negative shifts in overall disposition, or isolationism. Noticing these sorts of "signs" might help prevent future pain. Like our grandmothers said, "An ounce of prevention is worth a pound of cure."


  2. Treat the problem, not the symptom. In case a "cure" is called for, remember, the scars on the outside are merely indicative of those on the inside. The external wounds stem from internal woes. Our goal should never be restricted to only helping a teenager stop self-injury; it should also include the healing and transformation of their soul. Getting a teenager the help he/she needs is a crucial task. Though there are varying degrees of internal pain that teenagers experience which results in varying amounts of self-injury, our responsibility is to minister to all of them.


  3. Get help. Self-injury is a really big problem, and it often requires a big solution. Students who struggle with self-injury may very well require professional help; if so, refer them to a trusted specialist. But don't overlook the support that comes from teens being in a godly one-on-one relationship with a loving and caring adult. Since so many of the problems that can lead to self-injury can be limited or even prevented by these healthy relationships, continually urge the teenagers and Christ-like adults in your life to forge a bond with one another. Also, remind teenagers of their obligation to help their peers. Oftentimes, they are the first to notice the signs of self-injury. These "eyes and ears" can play a pivotal role in solving the problem. Teach them what it means to truly be a good friend so they understand their obligation to help one another. (Here's a great fact sheet on cutting and some practical tips for anyone helping a teenager face the turmoil of self-injury.)
Whether we are parents or youth workers, we have the task of "shepherding" teenagers; they are our concern and our responsibility. Like a good shepherd, we must know the needs of our flock and recognize their cry for help. There can be devastating outcomes if we don't.


David R. Smith David R. Smith is a 15-year youth ministry veteran who helps youth workers and parents through his writing, training, and speaking. David specializes in sharing the gospel, and equipping others do the same. He co-authored his first book this year, Ministry By Teenagers. David provides free resources to anyone who works with teenagers on his website, DavidRSmith.org. David resides with his wife and son in Tampa, Florida.



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