Self-harm in adolescents

Self-harm in adolescents

“I injured myself doing the dishes” or “The knife slipped off while cutting bread.”… Cuts on the forearms or wrists can be explained similarly. After all, who assumes that someone will intentionally cut their skin with razor blades or knives? Cut until blood flows, and deeper and further still. But there are more and more people who regularly self-harm to find relief from deep emotional distress. Doctors call this behaviour dissociative auto-mutilation. Experts say that between 0.7 and 1 per cent of the population sustain injuries in various ways, and the trend is rising.

Intelligence or social status doesn’t matter.

They come from all social and educational backgrounds and are predominantly girls and young women. There is no unanimous scientific explanation for the unequal gender distribution. However, social and societal behavioural norms are discussed, for example, which require women to deal with aggression and anger differently than men.

As a result, women are more likely to carry negative feelings and thoughts inward and direct them against themselves than men. There is agreement, however, that traumatic experiences in the life history of people who injure themselves play a significant role. It is striking how often these people had to experience sexual abuse, were physically abused or mentally neglected.


SVV due to loss of experience or chronic illness

But experiences of loss, such as parental divorce, can also pave the way for self-injurious behaviour (SVV), chronic illness, and repeated surgeries. The consequence of various traumatizations in the course of life, especially in childhood, can be a disturbed development of the personality. A personality that is much more vulnerable than other people and who finds it difficult to perceive and express feelings. And who finds her way of dealing with problems and conflicting feelings or injuries through self-harm and to regulate her inner self.

Wide range

There are different forms of self-harm. Cutting, also called scoring, is the most common form. Most cut themselves with razor blades, broken glass, or knives, preferably in places that can be hidden from others under clothing, such as the arms, legs, breasts, and torso. But also burning with cigarettes, irons or hotplates, scalding, biting, hitting one’s own body up to broken bones, pulling out hair, or extreme nail biting are examples of self-harm. I also have eating disorders such as bulimia or extreme physical activity.


Often early onset

Self-injurious behaviour usually occurs for the first time between the ages of 16 and 30. But it is assumed that children nowadays injure themselves for the first time before the age of twelve. Self-harm is not a one-off act but has an addictive character for those affected: the desire for the “drug self-harm” is felt to be indomitable, and not doing so leads to extreme mental distress with restlessness, fear and a disturbed perception of the environment. And those affected continue to increase the “dose” by injuring themselves more and more frequently and more severely.

A never-ending vicious circle

Even seemingly minor discrepancies between people can represent an unmanageable burden for those affected. And cause them to get into severe mental distress without the environment noticing. The inability to cope with negative feelings or to deal with them objectively results in great helplessness, frustration, and spreading anger, which is directed against oneself. This feeling of self-hatred splits the perception: those affected report a great emptiness; they feel dead inside, as if dazed, their body disconnected from consciousness, from reality, numb. And only one single wish dominates her thinking: to feel something again, to finally end this terrible situation. And suddenly, the whole “ritual” of self-harm takes place automatically.

At this moment, very few people feel the pain they inflict on themselves by cutting, burning or hitting themselves. But no matter what form of self-harm it is, doing it immediately brings infinite relief. It was as if a balloon inflated to bursting was suddenly released, and all the pressure could escape. All at once, there is relief and relaxation, and with the blood leaving the body warm over the skin, the unbearable tension leaves the body. “And I can feel myself again; I’m alive!” That’s roughly how many explain the state they’re suddenly in. But the positive feeling lasts only briefly because of the “awakening.”

A cry for help scratched into the skin.

Anyone who hurts themselves needs help. Because even if those affected usually act secretly and are afraid and ashamed of the reactions of those around them, this cruel way of dealing with themselves is a cry for help. And while a shocking number of people who self-harm have suicidal thoughts, the injuries themselves are rarely committed to killing oneself. Incomprehensible to others, self-harm is a form of caring for those affected; they take care of their bodies, “caring” for them in the only way available to them.


Don’t look away.

When confronted with self-injurious behaviour, most outsiders react helplessly, either looking away or blaming those affected. However, knowing that those affected make enough accusations against themselves is essential. They suffer significantly from their behaviour and inability to prevent it. On the other hand, it is correct to approach the person cautiously and encourage and support them to seek professional help. The faster, the better. The first step can be opening up to a doctor you trust. Psychotherapy and possibly also psychotropic drugs are used in the treatment.

Have courage

The path to treatment is usually long and often rocky. Because those affected have to learn a new, previously unknown language, so to speak: namely, to translate their skin incisions into words, to find a new, better form of expression for them. And they have to learn to do without their old, wrong principle, which works well for them: self-harm.

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