Let me start by saying this: I’m a bit of an expert on this topic but not in the way you think. My background and education is heavily in child development and education and communication, but I never studied self-harm in a classroom. I took a smorgasbord of psych classes, but those didn’t venture there.
No, I didn’t study self-injury in the tradition sense. I learned with a blade to my skin. My arms and thighs bear faint shiny lines, my skin’s memory of the deeper cuts.
I’m a natural researcher. I like to understand the why of complex issues, including my own. Even before I stopped my bloody habit, I read up on the primary reasons why kids hurt themselves.
(Note: throughout this piece and even in the title, I talk a lot about cutting. That’s because that was my particular self-injurious habit. But these reasons apply to other harmful behaviors, like burning yourself with matches, cigarettes, or friction, which is the more common method among adolescent males, while girls typically choose like I did. Also, this isn’t limited to teens. Adults and even younger children self-injure as well.)
Because acronyms help facts stick in our head, I’ve created one here: COPE. Teens – or kids or adults – cut for Control, as an Obsessive Behavior, as Punishment, or as an Emotional release. For me, it was all of the above. (Some kids start out of curiosity or after seeing others self-injure, but if it becomes habitual, one of these motivations has typically come into play.)
Control: Um, have you been watching the news lately? This world feels out of control. Add to that the increasing demands on kids to perform, perform, perform in academics and athletics and church and everywhere else, and the pressure feels unsurmountable. Whenever everything seems out of control, many of us choose maladaptive behaviors to regain some semblance of control. For some, particularly when other hurts are out their hands, controlling one clear and easily understood kind of pain – like using a blade of some sort to make a red line on your skin – offers a sense of stability in an unstable world.
Obsessive behavior: Self-injury can be a compulsive behavior. Sometimes it starts that way; other times the compulsion develops over time. As the person links the emotional release (see E below) with the act of cutting, self-mutilation can shift from an act to a habit. The next time difficult feelings build, the craving to self-harm can too for those who cut. The behavior that may have been about control in the first place begins to take control. Something that was once a choice can become like an addiction.
Punishment: Sometimes kids – especially perfectionists – hurt themselves as a form of punishment. Not measuring up. Failing a test. Making a mistake. Disappointing a valued adult. Cut. Cut. Cut. Cut. As Demi Lovato put it in a 20/20 interview with Robin Roberts, “It was a way of expressing my own shame of myself on my own body. I was matching the inside to the outside. And there were sometimes where my emotions were just so built up, I didn’t know what to do, and the only way that I could get instant gratification was through an immediate release on myself.” (The video of that interview can be found here.)
Emotional release: We all get physical pain. If we stub a toe, for example, it hurts. Emotional pain is harder to understand. It’s intangible. Furthermore, the body’s neurochemical response to physical pain is to dispense endorphins, which improve a person’s mood. For me, cutting hurt physically – of course – but it felt good emotionally and made my brain clearer. The thin slices in my skin somehow – pun intended – cut through the pain and anxiety I felt. (This isn’t the answer for every self-injurious person, but now antidepressants have a similar and safer effect for me.)
As the acronym COPE suggests, this behavior is not typically related to suicidal desire. While some research indicates that those who self-injure are more likely to attempt suicide, the act of self-injury itself is not the same as a suicide attempt. Those unfamiliar with cutting often link it to the act of slitting ones wrist. I can understand that assumption, because the behaviors appear similar. In reality, though, people cut as a way to cope with intense emotional demands rather than as an attempt to fatally self-harm. Most people who habitually hurt themselves are not and will not be suicidal.
How would you know if someone is cutting? Some common signs of self-injury are wearing long sleeves in hot weather, having frequent yet similar unexplained injuries, or making excuses and unlikely stories about injuries. (If the injuries are bruises or something else that could be abusive in origin, reporting your concerns to authorities is a good first step to consider.) And of course, if someone tells you she is hurting herself, then that’s a clear indication.
How can you respond? First, don’t overreact. If someone who is engaging in self-harm trusts you with that information, you have entered a sacred space. Honor them. Listen. Ask how you can help him or her bear the pain. It’s okay (and wise) to ask if they have any cuts that require medical attention, either due to depth or infection, but show more concern for the person than the behavior.
Second, don’t underreact. Most pastors and ministry leaders aren’t trained to support kids with these sorts of struggles. You need to be somewhat knowledgeable, as you’ll likely be on the front lines for families as a sort of first responder before other helps are sought. But, please, don’t try to help where you’re not qualified. In the same way a primary care doctor isn’t expected to do complex surgery – and could do harm by attempting it – you can show great love to those you serve by identifying when someone better trained is needed.
Finally, be mindful that the cuts aren’t the primary problem. The core issue – the why – is what needs to be addressed. When adults treat cutting like the main dilemma instead of digging deeper, then kids learn to hide their behavior instead of changing it… and sometimes we’re comfortable with that because we didn’t really want to see the pain anyway. Let’s be willing to see the hurt and dwell in that discomfort with those who need support instead of merely trying to push pain further into darkness.
And what if this piece is describing you? If you’re reading this and recognize your own behaviors and reasons described here, please know you are not alone. (While I’m writing about teens, you’re not alone if you’re an adult engaging in these behaviors too. I started cutting when I was 11 – fitting the pattern shown in research that most self-injurers start between ages 11 and 15 – but all of my scars aren’t from adolescence.) Find someone to tell. Seek out professional help, not because you’re crazy but because this is an indicator you’re having great difficulty dealing with life’s demands. Needing help doesn’t mean you’re a failure; it means you’re human. All of us need support from time to time. If you’re hurting yourself to COPE, now’s your time to receive some extra measures of love.
Finally, trust me as I say something that might be hard to believe: you don’t deserve shame for what you have done or are doing to yourself. Self-harm is the tool you’ve found to deal with feeling overwhelmed. Just because you need to update your toolbox with a healthier strategy doesn’t mean you need to be ashamed of what you’ve done to get you to this day and place.
Self-injury might seem like a new phenomenon. It isn’t. Martin Luther beat himself for sinning, for example, but we all hurt ourselves in less extreme ways. Many of us – myself included – eat unhealthy foods as a way to deal with life. Others drink in excess or do drugs. Some smoke. All of these actions hurt our bodies. So instead of gasping at a way of hurting that seems foreign to us, let’s offer empathy and grace to one another and ourselves as we all learn to cope with better methods.
Key Ministry encourages our readers to check out the resources we’ve developed to help pastors, church leaders, volunteers and families on mental health-related topics, including series on the impact of ADHD, anxiety and Asperger’s Disorder on spiritual development in kids, depression in children and teens, pediatric bipolar disorder, and ten strategies for promoting mental health inclusion at church.