Self-mutilation is the act of using one’s nails or another cutting object (knife, razor, scissors, needle/pin, nail/screw, etc.) to inflict damage upon one’s own body. The motive may exist as a form of rebellion or simply to get attention, but all self-mutilation cannot be placed in this category. Self-mutilation may evolve from intense emotional pain or a sense of being emotionally overwhelmed. It can be a cry for help, but most often those who self-mutilate go to the extreme to keep it a secret.

First, let’s realize that self-mutilation is not new. Physical pain has been used in various cultures for centuries to express and cope with emotional pain. Some Native American rituals for expressing grief include self-inflicting deep cuts on the upper arms as a method for releasing grief and pain. Some religions require their followers to practice self-flagellation as a mild punishment for sins. These practitioners confess that the act of self-flagellation is a release mechanism for overwhelming feelings of guilt.

This said, self-mutilation is a dangerous method for dealing with emotional pain. The danger in self-mutilation is three-fold. First, teens and young adults can easily permanently scar themselves, even with shallow cuts; unintentionally cause damage to muscle tissue and inflict massive loss of blood in their lack of understanding of the composition of the human body; or their choice of self-mutilation tools can lead to infection and complications, sometimes severe. Second, relying on such a raw, primitive method of dealing with emotional pain hinders the learning of positive, more socially acceptable methods of coping. Finally, the situation inspiring the self-mutilation is often avoided because it is not dealt with directly and it is not elevated to those who can help. Not dealing with the catalyst of self-mutilation can lead to severe harm to the individual or other members of the family who are in danger from the same source.

The assumption that youth who self-mutilated are deeply depressed, deeply disturbed, doing drugs, or are on their way to more seriously destructive behaviors towards self or others is generally inaccurate. With great difficulty I admit I was a self-mutilator. My own experiences with self-mutilation began when I was about 13. I found myself in a variety of situations in my life with which I did not know how to deal and I felt I had no one to help me. The emotional pain and fear would become so overwhelming I felt that I would lose my mind. It was quite by accident that I came to realize that physical pain could release some of that emotional stress and provide at least momentary relief.

It is critically important that we teach our youth how to deal with situations beyond their control, provide them with an outlet for emotions – both conversational and physical, and insure that they understand that they are accepted and loved regardless of the situation in which they find themselves.

The catalyst for self-mutilation can be as “minor” as not being taught how to deal acceptably with emotions. However, situations with which self-mutilators may be dealing also include more severe situations such as addiction of a family member, terminal illness of a family member, stigma of association with an individual or group, shame from poverty, shame from abuse, or general lack of self-acceptance based upon the lack of acceptance by others.

Those who have never experienced self-mutilation generally cannot understand the mindset that controls the process. A good analogy is that of a pressure cooker. The steam builds in the pot until the valve trips, allowing release of the excess steam so that the pot does not explode. The object is for the pain to stop – even for a few minutes. Physical pain provides a temporary outlet for the emotional pain with which the individual does not have the knowledge to deal.

Recognizing the behaviors of a self-mutilator are not easy for they do not want to be caught. Being caught means they will lose their only coping method and they will be saddled with additional shame with which they do not know how to deal. Be wary if your youth/teen wears long sleeves or long pants on the hottest summer days. They may refuse to wear a bathing suit on a family trip to a water park. They may suddenly not want you in the dressing room with them when they try on clothes. Of course, all of these things can also be normal reactions to growing up, depending upon the child. Recognizing risky behavior in a youth/teen is not as easy as it may seem.

This is why it is so important for parents and those who are responsible for our youth to keep both their eyes and the lines of communication open between them and their children. It is incredibly important to talk with the children/youth in your care, but it is even more important to listen. Families must encourage their youth to express their emotions in a safe environment through safe and acceptable methods. No topic should be taboo. Your youth/teen must know that he/she can come to you in any situation and find acceptance and your love.

NOTE: All self-mutilation is not about overwhelming emotional stress. There are some ADD/ADHD medications that can cause increased anxiety in youth that erupts through self-mutilation. Additionally, not all psychological medications work on youth the same way as on adults. Some drugs designed to calm will excite youth, sometimes resulting in adverse reactions. All cases of self-mutilation should be reported to the family doctor or pediatrician by the parents in order to obtain the proper assistance.