Self Injury

I see an alarming number of children that harm themselves, and this is one of the most difficult behaviors for parents to understand. Self injury can take many forms from overt physically violent behaviors like cutting, burning to less violent forms like overdoses and substance use. I like to give parents and kids a basic framework from which to think about self injury.

In non-technical terms, the 4 categories basically look like this:

1. "It feels good"

2. "It stops a negative feeling"

3. "It gets me attention"

4. "It gets me out of something"

"It feels Good"- some kids describe a rush of pleasure when they injure. I don't really see this description very often. Of course, this is the major motivator behind substance abuse and dependence.

"It stops a negative feeling"- Most of the kids I see identify this as their number one motivation. Many kids who self-injure are depressed, anxious, or they have experienced some type of trauma. They feel horrible or their thoughts are intolerable, and they have learned that the self-injurious behavior temporarily distracts them.

"It gets me attention"- This is another major motivator, but it's the one kids are least likely to admit. Whether conscious or not, self-injury is an attention-grabbing behavior. Parents need to be very aware of how their own reaction to self-injury could actually be rewarding self-injury. Kids also use self-injury and the threat of it to manipulate parents, friends, and their boy/girlfriends.

"It gets me out of something"- Many of the circumstances that lead up to self-injury involve a kid being in trouble, feeling overwhelmed, threatened or trapped. Many of the kids I see started out using self-injury in a moment of desperation and then continue to use it under less severe circumstances because it worked before. Self-injury takes away a parent's power, afraid to challenge the self-injuring child for fear they will repeat the behavior.

So those are the basic theories. I hope this helps some parents out there. With this knowledge, the next step is to get the kids working on alternative behaviors, understanding their own motivations behind the behavior, exploring their sources of stress, improving communication before they get into that overwhelmed place. For parents, we need to work on identifying the underlying issues that might be overwhelming a child, examining the ways in which a parent might actually be reinforcing the self-injury.

If you or your child are dealing with this problem, please seek help with a local mental health provider.