Self-Injuring: A Cry for Help
By: Deborah Johnson, Ph.D.
"Sometimes I cut myself. Sometimes I burn myself." She was a beautiful 16-year-old girl explaining her secret behaviors for when she felt overwhelmed with life and hurtful memories. I was a 23-year-old youth pastor trying to listen and help, feeling stunned by behavior I had heard of but never seen.
Sadly, I've heard similar admissions numerous times over the years from a wide variety of young people. And the numbers are growing.
What is it? It is called self-injurious behavior, self-mutilation, self-harm, or self-injury. What it means is "intentionally inflicting physical damage to one's own body, usually without suicidal intent." (This does not include sanctioned behaviors such as tattooing or body piercing.) Examples include: scratching, cutting, burning, hair pulling, self-hitting, and head banging. Injuries most often occur on one's arms, wrists, thighs, stomach, and breasts - places easy to conceal.
Who does this? Self-injury generally begins in early to middle adolescence and happens more frequently for girls. It is often associated with abuse, anxiety, depression, and eating disorders (25 to 45 percent of individuals with eating disorders also self-harm). Self-harm is a mainly private behavior with participants hiding the evidence. Some may be more open as if to say, "See how much I'm hurting?" or may celebrate their identity as a "cutter" or "burner."
Why do this? It's most often about control and emotional release. One girl said, "Self-injury is pain that you can control. Just enough causes you to focus off whatever was tormenting you before. So, you are in control." Five reasons often given for self-injuring include: (1) Overwhelming emotional pain, (2) To make myself feel real or to at least feel something, (3) Punish myself because I feel bad, or because I feel I am bad, (4) Keep unwanted memories away, and (5) Release anger, anxiety, and/or despair that builds up.
How does it happen? Often self-harm is an accidental discovery that becomes a means of dealing with stress. Many negative emotions then lead to an episode of self-harm. There will be mounting tension before one gives in to the compulsion to self-injure. Some students report dissociating before or just as they self-injure. Some report not even feeling the pain. The act itself brings immediate relief, because the previous tension was so intense. However, any positive feelings are soon replaced with guilt, embarrassment, and more self-hatred. All of this can fuel another cycle of harm.
How can I recognize this? Watch for markings on the skin, scars, and continual wounds; clothing or consistent efforts to extensively cover or hide arms or legs; hearing repeated explanations of "accidents"; and disquiet within your spirit.
"‘I will restore you to health and heal your wounds,' declares the Lord" (Jeremiah 30:17, NIV).
How can I help?
1. Intervene! Ask: What happened? What is this injury from? Has this happened before? Or, Have you had an "accident" like this before? What were you thinking or feeling right before this?
2. Help her get the help she needs. She won't be able to "fix" this on her own. Refer her to a pastor, counselor, or doctor. Help her tell her parents.
3. Provide a caring, listening ear and support for the long haul. Healing will be a process.
4. Affirm ...
a) Her worth and & value to God: John 3:16; Jeremiah 31:3; Psalm 139:1-3,14-16.
b) God's help and healing: Isaiah 53:4,5; Jeremiah 30:17.
c) God's plan for her future: Jeremiah 29:11-13.
5. Create a safe, caring, accepting environment so she can voice concerns. Be honored when she trusts you enough to do so.
6. Instruct her in ways to handle stress and how to express her feelings verbally.
7. Develop a detailed safety plan for your Girls Ministries team. How will you respond to a young woman who tells you she is self-harming? What is your standard plan of action? Who will help? Talk about this with your team, parents, the church.
8. Read material and educate yourself.
9. Trust the Lord and pray. God will use you to help and heal.
MYTHS about Self-Injury (SI)
1. People who SI just want attention and to manipulate people.
- The majority of people who harm themselves do so in private. They are often embarrassed by their scars and behavior, and wish to keep them secret. Often they go to great lengths to act normal. They are generally trying to replace physical pain with very real emotional pain.
2. People who SI will eventually commit suicide.
- Generally the self-mutilator uses physical pain to cover emotional pain but doesn't intend to destroy the whole body. Often this is for different reasons than suicide. If the person mentions an intention to die, give her serious attention.
3. People who SI may also harm others.
- SI is a private ritual of behavior that is a secret kept at great lengths. The goal is to release emotional pain rather than to harm.
Self-Injury: Hope and Healing for Kids Who Cut by Marv Penner (2005) Zondervan Publishers.
Secret Scars: Uncovering & Understanding the Addiction of Self-Injury by V.J. Truner (2002) Hazelden
Reverend Debbie Johnson, Ph.D., is a professor of counseling and psychology at Central Bible College in Springfield, Missouri. She has been a youth minister, associate pastor, pastoral counselor, and teacher at both CBC and Southeastern University. Best of all, she is aunt to six wonderful children! You may contact Debbie at email@example.com.