Self-mutilation affects nearly one percent of people in the U.S. Teenagers are particularly susceptible to self-mutilation, with girls being four times more likely to self harm than boys. Over ten percent of teenagers are thought to have at least experimented with self-mutilation.

Common methods of self-mutilation include:

• burning (often with a cigarette)
• branding
• biting
• cutting
• head banging
• pulling at skin or hair
• hitting
• bruising
• marking.

Of those teenagers that self-mutilate, an estimated 64 percent use self cutting as their preferred method.

Parents must understand the difference between self-mutilation and self-decoration. Many teenagers decorate themselves with piercings or tattoos. These decorations are not normally considered deliberate self harm. Teenagers who indulge in excessive decoration may, however, be susceptible to self-mutilation and should be watched carefully for further worrisome behavior.

Reasons Teenagers Use Self-Mutilation

Contrary to common belief, self-mutilation is rarely an attempt at suicide. In fact, those who do attempt suicide generally don't use their preferred method of self-mutilation. This misconception is further muddied by the term parasuicide, which is also used in connection with deliberate self-harm.

Rather than indicating a suicidal tendency, self-mutilation and self-cutting, in particular, may be used as coping mechanisms. When feelings become too much to bear, teenagers may become introverted and consider or experiment with self-harming. Recent research finds that the two main emotions felt by those who self-mutilate are anger and anxiety.

Physically, self-mutilation is thought to release endorphins, which results in teenagers feeling a "high," immediately after cutting themselves.

Self-mutilation is as common as eating disorders in teenagers.

Psychologically, many potential triggers can lead to self-mutilation:

• low self-esteem
• inability to control impulses
• high levels of anxiety
• apparent inability to cope with difficult situations
• tendency to hide away in their own space for hours on end
• underlying psychological conditions such as bipolar disorder or depression
• a tendency towards hyper-sensitivity
• feeling invisible or unaccepted by parents or peers.

Signs Your Teenager May be Self-Mutilating

Teenagers who carry out self inflicted violence often go to extreme lengths to prevent parents or other adults from discovering their secret.

Being vigilant can often uncover early signs that may require further investigation, such as:

• family members telling you that they are finding razors or knives in strange locations
• evidence that your teenager's friends are self-mutilating
• regularly locking themselves away for long periods in their room or the bathroom
• a reduced social circle or reluctance to attend social events
• finding sharp objects hidden in your child's room
• a reluctance to wear clothes such as short-sleeved shirts or shorts
• the appearance of an abnormal number of bruises or scars.

Dealing with a Child Who Self-Harms

If you discover that your teenager has been self-cutting or otherwise self-mutilating try hard to hide any feelings of disgust. Teenagers who self-mutilate often have very low self-esteem. Reacting with horror is likely to exacerbate your teen's low self-image.

Be cautious when seeking emergency medical help. Medical personnel in the emergency room may make disparaging remarks to your teenager or hint that they don't deserve the treatment they're receiving. Such reactions are likely to cause your teenager to feel worthless, which can lead to increased incidents of self-mutilation.

If you feel that any medical professional is not treating your teenager appropriately, request another practitioner immediately.

Seek professional help, preferably from a recognized family therapist. Some seventy six percent of teenagers who underwent family therapy indicated that they gained at least a little benefit from the counseling. In contrast, only fifty nine percent felt they benefited in any way from hospitalization alone.

A Parent's Role

Recognize your own role in inadvertently encouraging your child to self-harm. Many teenagers are rushed and overscheduled by their parents; this lack of control over their own lives can cause feelings of anxiety, which may trigger self-mutilation.

• Become knowledgeable on the issue of self-mutilation. Find out as much as possible on the subject. Understanding the condition will help you to understand your teen.
• Spend time with your teenager. Numerous self-harmers suggest that feeling invisible to their parents was a major contributor to their self-mutilation.
• Keep the lines of communication open with your teenager. Encourage them to discuss their problems, either with you or another adult if they prefer.
• Consider enrolling your teenager in a skill-building group where he or she can learn to deal with overwhelming emotions in a non-destructive manner. Other coping strategies that can be practiced with your teenager include breathing exercises, journaling or counting to ten.
• Above all, parents of teenagers who self-harm must ensure that they listen to their teen, reserve judgment and avoid issuing ultimatums.

Resources

American Academy of Child and Adolescent Psychiatry. (1999). Self-injury in adolescents.

Martinson, D. (nd). Self-injury. Focus Adolescent Services (FocusAS).

Selekman, M.D. (2002). Adolescent self-harm. American Association for Marriage and Family Therapy. AAMFT Consumer Update.

Self-Injury. (nd). Who self-injures?

Self-Injury & Related Issues. (2005). Self-injury.

Winkler, M. (2003). Prevalence of cutting, self-mutilation and self-harm among teenagers.