1. Middleton-Cross Plains Area Schools
Teens and Self Injury
Dale Kaufman, MSSW
School Social Worker
Middleton-Cross Plains Area Schools

2. Agenda General information regarding Self-Injury
View “Cut: The Movie” (56 minutes)
Resources
Evaluations
Please provide me with your address if you would like a copy of the PowerPoint for this presentation.

3. DEFINITION of Self-Injury:
Deliberate self-inflicted harm resulting in tissue damage without the conscious intent of suicide
Behaviors include (but are not limited to):
Cutting, scratching
Burning
Interfering with the healing of wounds
Hitting or biting oneself
Head banging
Hair pulling

4. Incidence and Onset 4% in the general population
= numbers of males and females (though more females present for treatment)
Typical onset: puberty
though can be seen in young children and adults
Often lasts 5-10 years
But can last longer without treatment

5. Background Factors in Teens who Self-Injure: Generalized
Found in = numbers in all ethnic groups
Nearly 50% report physical/sexual abuse (At least 50% have NOT reporting abuse)
Many report that they were discouraged from expressing emotion, particularly anger and sadness
Feelings of emptiness, over/under stimulated
Unable to express feelings
Lonely, fearful of intimate relationships or adult responsibility
Feeling invalidated/disconnected from parents

6. Behavior Patterns Cutting arm/legs most common practice
May attempt to conceal injuries (long sleeves/pants)
Often make excuses
Significant # also struggle with eating disorders/substance/alcohol abuse
Big difference between self decorating (tattoos/piercings) and self harm
Teens who self harm are seeking relief from emotional distress

7. Warning Signs
Unexplained, frequent injuries including cuts and bruises
Wearing of long pants/sleeves in warm weather
Low self-esteem
Overwhelmed by feelings
Inability to function at home, school or work
Inability to maintain stable relationships

8. Dangers
Can become desperate about lack of self-control and addictive-like nature of acts
May lead to true suicidal attempts
Self-injury may cause more harm than intended. Can result in medical complications or death
Eating disorders/AODA intensifies threat to overall health and quality of life

9. Why? Purposes of Self-Injury:
Analgesic
Connecting body and mind
Control
Cleansing
Punishment
Words cannot express pain
Combating a sense of invisibility
Rescue fantasy
Vengeance

10. Why? Reasons for Behavior:
Feelings of emptiness
Over/under stimulated
Unable to express feelings
Lonely
Not understood by others
Fearful of intimate relationships and adult responsibilities
Way to cope with or relieve painful/hard to express feelings
Relief is temporary
Self-destructive cycle often develops without treatment
Wanting to fit in
Feeling emotionally dead inside
Self harm feels alive and confirms existence
Coping strategy

11. Stigma
Self-injury is not a behavior that “works” for someone who is not in acute emotional distress
Important for caregivers to recognize that there is NO safe amount of self-injury
Self-injury, like substance abuse and eating disorders, is a coping strategy used by people who are in emotional distress
Those who self-injure feel great amounts of pain and often, shame

12. CUT: Teens and Self Injury
A documentary produced and directed by Wendy Schneider

13. Parents…what you need to know
Injuring is a coping strategy and not the problem itself
Instead of focusing on behavior understand that the child needs help to identify and express emotional issues verbally

14. Parents…what you need to know
2. Some parents find it hard to deal with their own emotional response..
Don’t minimize the problem (assuming that he/she is just doing it “for attention”
Know that self-injury is never a healthy coping strategy. It is an indication that the child is having trouble coping with stressful issues and emotions.
Some teens are more open with a professional than their parent
Don’t overreact…result could be more hiding of behavior

15. Parents…what you need to know
3. Fear, anger and guilt are all normal reactions. Try to process your own feelings and remain understanding of your teen
Remember…your child is in a great deal of emotional pain that he/she has not been able to express directly

16. Parents…what you need to know
4. Have appropriate expectations of your teen
Adolescents generally find it difficult to indentify, much less discuss feelings and issues that underlie self-injury
It takes time and work

17. Parents…what you need to know
5. Don’t expect to be able to fix the problem yourself
Be available to listen and empathize but…
Teens are usually in need of professional assessment and possibly treatment
Parents are NOT betraying their child by seeking help
By seeking help, you are modeling healthy parental attitudes and showing that you can accept problems and deal with them constructive

18. Parents…what you need to know
6. Try not to threaten or overprotect your teen in an effort to stop the behavior
Power struggles rarely work
Openly express concern
Indicate that you want to help
Encourage teen to talk to you and/or another trusted adult
Get professional help, if warranted
If you observe an actual injury, you can, if necessary transport teen to ER or doctor

19. Parents…what you need to know
7. Don’t hesitate to seek help
Therapy
Hospitalization

20. Parents…what you need to know
8. Take care of yourself!!!!!!
Affects the entire family
Therapy can help both parents and siblings
Important to identify and express your own feelings in a healthy way
9. Don’t expect a quick cure…it takes time to heal

21. Parents…what you need to know
If you believe your child is suicidal, IMMEDIATELY contact your therapist, if you have one or call 911
Self-injury is a strong risk for suicide
Take suicidal statements seriously