Understanding Self-Injury

I receive up to ten calls per week from parents who are completely devastated to learn that their child is engaging in self-injurious behavior. Regardless of what it has been called (the bright red scream, the new-age anorexia, or the newest addiction), the practice of self-injury is on the rise. Shock, fear, anger, and confusion encompass parents every day when they are told that the child who they have tried their very hardest to protect from harm since birth is now choosing to harm herself. I use the feminine pronoun because it is more common for girls to self-injure than boys, however, this phenomenon does not limit itself to only one gender. Nor does it limit itself to a certain age, race, culture, or socioeconomic status.

With a reported 2 million cases in the United States alone, this disorder has become rampant and affects a diverse population, including adults. It is estimated that one out of every 200 teen girls and thousands of boys between the ages of thirteen and nineteen regularly practice self-injurious behavior. The reasons behind the need to self-injure are complex and often neglected or misunderstood. Therefore, it is often kept as a “secret” from others, most likely resulting in the number of reported cases being significantly lower than the number of actual cases in our country.

The most common type of self-injurious behavior is cutting. However, this is not the only type. Others include burning, punching, head banging, kicking, scratching, and biting. More extreme, but much less common types of self-injury are injecting toxins into the body, breaking bones, and amputation of body parts.

It seems incomprehensible to most, especially parents, that a child would take a knife, razor blade, lighter, or even a paper clip, thumb tack, or fist to intentionally harm herself. Parents often ask, “What is my child trying to achieve?” The answer unfortunately is not a simple one. There are several reasons why kids self-injure. Therefore, the key in helping them to recover from this problem must start with an examination as to why they are doing it in the first place.

Let’s start by looking at the formal definition of self-injury as a means to understand the general reasons behind this behavior. Self-injury is the deliberate mutilation of the body or body part, not with the intent to commit suicide, but as a way of managing emotions that seem too painful for words to express.

The one common thread among the hundreds of patients I have seen is their inability to verbally express their emotions.