Bob Pegler, CAS, Manager of Community Relations

Self-mutilation is a complex behavior that has many different meanings. Among traumatized adolescents, it can become a progressive and chronic condition.

Examples of non-suicidal self-injurious behaviors include cutting, burning, breaking bones, slapping, excessive scratching and swallowing items such as glass and nails. The typical age of onset for self-mutilation is 10–15 years old. There is significant crossover between self-mutilation, certain eating disorders and substance abuse. Fifty percent of self-mutilators are anorexic or bulimic and over thirty percent have a history of significant substance abuse.

There are also strong links between depression and self-harm.
We know that certain neurotransmitters have lower levels in the brains of people who are prone to depression and self-harm. Some of these changes are probably brought about
by trauma. Other brain changes can be brought about due to dysfunctional attitudes and degrading self-talk.

There are three forms of trauma that lead to self-harm addiction.

• One example is overwhelming single event trauma
• Another is repetitive trauma.
• The final example is trauma replication.

Examples of single event trauma include rape, sexual molestation, physical and verbal abuse and shame, excessive discipline, marital discord/divorce, substance abuse in the home and multiple foster care placements.

In trauma replication, the young person cycles abusive behaviors that are similar to what they experienced. These include sexual promiscuity, physical abuse of self, running away and self-defeating behaviors and attitudes.

Self-mutilation is complicated because it actually “works” for the young person in the short run. Self-harm restores a sense of internal cohesion and harmony. It recreates events that are seared into the memory, providing temporary relief. It may help the individual process traumatic memories.

Finally, for many young people today cutting is “cool.”

There are many general statements that can be made about self-mutilators, although no one will fit all of these:

• Self-mutilators punish themselves
• Feel ashamed
• Think they are alone
• Are anxious
• Think they will eventually grow out of it
• Think that if it doesn’t show it doesn’t count
• Use tricks to deter themselves from the behavior
• Use scars to isolate
• Suffer greatly

There is treatment and hope for chronic self-mutilators. These adolescents tend to be intelligent and insightful. They make good use of group focused therapies. They are helped by peers with models apply in much the same way they do with chemical addictions.

The negative self-talk is helped through cognitive therapy. Finally, the pain that the adolescent feels often permeates the entire family so on-going family therapy can help everyone.

If your teen cuts or self-harms, help is available. Please call 1.800.255.TEEN or Email for more information.