In this article, I will talk about self-harm for teenagers. I will examine feelings and emotions that fuel the want or need to harm as well as note body image issues and how much pressure is put upon young people to look perfect. I will explore possible recovery strategies to help young people begin their journey back from this addictive behaviour and talk about how powerless a person can feel when addicted to harming.
When working with a young person who is self-harming I like to first find out if they want to stop. Asking this question can be helpful because this gives the power back to the teenager, which can help them feel less pressure. When working with teenagers in a school setting the common feeling was that adults didn’t get them and that they pressured them to stop without finding out why the teenager might be self-harming. If the young person answers “no” (they do not want to stop) then we can explore why this might be. It’s helpful to find out what the payoff might be in order to continue. The work will be to help the client reach a place where they can consider the possibility of stopping.
When working with self-harm there seems to be a paradox – this being that the person harms to feel better. However, it’s the self-harm that is actually causing some of the distressing feelings. The payoff is that in the moment of harm, and for some time after, the person has a break from all the pain they feel inside. The downside is that after the high all of the original feelings come back, this time with the shame and remorse from the person having harmed themselves. What seems to help people in this situation is working out a relapse prevention strategy. At this stage, we will discuss what actions we can put in place to stop the person harming when their cravings start. When we first put the behaviour down we will feel very strong cravings to harm. It’s important to remember this is not forever; over time everything starts to calm down and we can take a step out from the eye of the storm.
I encourage clients to reach out to other people who understand. The main importance here is that self-harm is fed with secrecy, so, by telling someone it takes the power out of it. However, it is helpful to pre-warn a friend or family member beforehand. You can tell the family member that you need them to stay calm and allow you to speak and say the words “I’m OK but I feel cravings to harm so I’m reaching out”. The reason why reaching out is so helpful is because the cravings are too strong for us on our own and thus it always wins out in the end. All of this feels really difficult at first but, once practised for a while, becomes very effective.
Power of the pen
The pen is powerful because it allows us to transform painful horrible emotions in our minds, where they have all the power, to the paper, where we can see the truth of what’s going on in our minds. It is amazing how many people come along to therapy after writing down feelings says “wow, I didn’t know I was that much of a bully to myself”. If a client feels safe enough, I encourage them to bring in their writings, so we can bring them into the light together.
Once we have worked through and started practising using the tools we can then start looking at the underlying issues. We look back into the past to see where it might be affecting the present life. Let’s explore together how we feel about our body image. Self -harm is an act of harming the body, it shouts “I hate myself and I want to punish my body”. I often wonder where these messages of hate might have been formed; when we are told something over and over again we start to believe it without question. I challenge this thought process in a gentle manner with the client – by shining a light on the darkness we can bring it into the light.
Self-harm is a very strong secretive behaviour that leaves the person feeling unable to stop. It is a scary feeling when out of control, especially if it leaves scars on the body. It can feel like there are two people inside of us and one wants to harm whilst the other does not. Without help and support, the side of us that wants to harm wins, leaving us powerless. However, I believe that by finding some tools to stop, looking at our inner emotions, and having counselling this painful addiction can be broken.