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SELF-INJURY: THE SECRET LANGUAGE OF PAIN FOR TEENAGERS
Education, Spring 2004 by Austin, Len, Kortum, Julie
Why would students purposefully harm themselves? Why would they cut their own wrists, yet not be suicidal? These questions are addressed in this article that explores the myths and types of self-injury in which children and teenagers engage. Research indicates a connection between self-injurers and home abuse, and anorexia. This article discusses those connections and the psychological nature of self-injury, and its addictive quality. In addition, there are suggestions for parents, teachers and counselors, on how to give assistance to those children who would harm themselves. A case study is also included.
"You have so much pain inside yourself, you try and hurt yourself on the outside because you need help, "
- Princess Diana, 1996
Self-injury has not been a topic discussed over family dinner.
Although self-injury has been plaguing lives for quite some time, with increasing incidences being cited in middle school and high school, it was not until 1996, when Princess Diana admitted to bouts with self-injury, that articles, books, and television documentaries began to appear. Now, conversations about self-injury are appearing at the dinner table, despite its remaining distastefulness.
Today, researchers are describing the phenomenon of self-injury among teenagers as "the deliberate, direct, non-suicidal destruction or alteration of one's body tissue" (Favazza, 1996), and quantifying it under three major categories: a) Major Self-Injury (the most rare form which usually results in permanent disfiguration), b) Stereotypic Self-Injury (which consists of head banging and biting), and c) Superficial Self-Injury (the most common which involves cutting, burning, and hair pulling) (Anonymous, 1999).
Why would students purposely hurt themselves? Our personal research indicates that most students self-injure themselves because they are unable to handle intense feelings, and so they turn to self-injury as a way to express their feelings and emotions. We tell audiences, "Pain that is self-inflicted is pain over which a person has control. Just enough pain will cause a person to divert their attention away from the outside pain over which they have no control to the known pain they self-inflict." We like what psychologist Scott Lines so eloquently said, "The skin becomes a battlefield as a demonstration of internal chaos. The place where the self meets the world is a canvas or tabula rosa on which is displayed exactly how bad one feels inside."
Research indicates that cutting is the most common method of adolescent elf-injury, and is usually done with razor blades, knives, or matches.
In the following excerpt, note the priority system involved in cutting, and how this priority system centers on victim convenience (i.e., the ability to hide the injury the easiest). In the 1999 docudrama movie titled, Secret Cutting it was revealed that the most common parts of the body injured include (in ranked order) "the forearms and wrists, upper arms, thighs, abdomen, and occasionally, breasts and calves. The reason for the variation in the ranked locations is that those most concealed by clothing are the most preferred areas."
Crucially important to the victim is concealment of the injury. By keeping self-injuries away from peering eyes, the adolescent can increase the ability to do it more often without interruption. The fact that self-injury has been so little documented until recently is due in part to the "almost expert awareness" on the part of the victim to be able to avoid detection.
It is common to associate a great number of ancillary activities with self-mutilation, but differentiate between what is, and what is not harmful self-injury needs to be made.
Adolescent activities such as skin piercing, tattoos, and group rituals fall into the category of simple adolescent trends. Although these activities fit the description of self-injury, the motivation to engage in these actions differs greater from intention physical self-injury. For instance, teens want a tattoo, and they do it for the tattoo or from peer pressure, and not the pain that is involved in the procedure. When a self-injurer cuts his or her skin it is to feel the pain, and not for the decorative results (Levenkron, 1998).
We tell high school students that self-injury is a self-inflicted act most often used as a coping mechanism for relieving an unwanted emotion, or as Jimmy Buffet (1999) said in a song, "It's a permanent reminder of a temporary feeling." Basically, it is a way to alter a mood state by focusing pain in a controllable area of the body. Think of a child who is riding his or her bike right after a heated argument with a sibling. That child would still be feeling angry or upset about the argument. But if that child falls off the bike and skins a knee, the primary concern instantly becomes focused on the knee, not on the anger. Falling off the bike made the child focus on the feeling of physical pain, or the skinned knee. The emotional anger that the child was feeling on the inside has now seemed to vanish.
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