Even in the height of summer, Julia preferred long-sleeved, high-necked tops to the snappy, strappy, crops worn by her peers. The reason? Pus-filled sores which covered her arms and shoulders along with vivid red scars where Julia’s nails had dug repeatedly into her flesh. Not a pin-prick of uninfected skin remained - due to her incessant picking.
Excoriation (or Dermatillomania) is just one type of self-injury. Others - including cutting, bruising, head-banging, burning, scratching, eating disorders, stabbing with sharp objects and hair pulling – are used to create the same effect; temporary relief from overwhelming feelings, anxiety and stress.
Julia had ‘issues’. Lack of self-esteem, even self-hatred, was certainly one of them, as was a plethora of repressed emotions. But there are several underlying factors: Mental disorders (such as depression), trauma (physical, emotional or sexual abuse), social factors (bullying, conflict within the home, or poor interpersonal skills), and additional stress (exams, bereavement and other distressing events). Whatever the cause, the sufferer may experience intense feelings of anger, hopelessness, an inability to communicate feelings and a complete lack of worth.
A self-injurer is “someone who has found that physical pain can be a cure for emotional pain” (Cutting* by mental health specialist Steven Levenkron)
Self-harmers are usually (though not always) adolescents who, by inflicting pain on themselves, attempt to regain a sense of control, or to break through emotional numbness. Of course, some may wish to manipulate others or it could be a plea for help but, usually, sufferers are ashamed of their compulsion and try to keep it hidden.
If you suspect your teenage son or daughter is self-injuring, what steps can you take to help them?
First of all, don’t blame yourself. Wondering whether faulty parenting has contributed to your child’s condition is a waste of time. Look instead on how you can positively help him or her to recover.
Communication, of course, is key, and it’s important that, on discovering your teen’s secret, you stay calm. Reacting with horror or disgust will only make matters worse. So don’t yell. Be consoling, supportive and reassuring. Convince your son or daughter that you’re on their side.
Ask the right questions, and leave out the ones that could alienate, such as “How long has THIS been going on, then?!” Nonthreatening questions should encourage the child to express their viewpoint, “I know you find it hard to feel confident at times. What frustrates you the most?” “How can I help you when you’re worried or feeling low?” “What can I do for us to break down any barriers between us?”
So you’ve asked the questions. Now comes the difficult bit: Listen. Without interrupting. Without disagreeing. Without judging.
As adolescents tend to focus on their flaws, be positive. Point out his or her qualities, the ones you genuinely admire them for. Encourage your teen to write three or more things they like about themselves, so getting them to focus on their strengths.
An in-depth, one-to-one with your teen will work wonders. Glad to have got the problem off their chest, he or she will be happy that you’re prepare to share the burden with them, and relieved that they’re no longer alone.
Most of all, your kindness and concern will assure them of your love – which may be all they really wanted all along!