What Every Parent Needs to Know About Self-Injury - Tonja Krautter

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      Introduction

      As often as ten times a week, I receive calls from parents 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 overwhelm parents when they are told that the child they have struggled to protect since birth is now choosing to harm herself. I use the feminine pronoun because while this phenomenon is not limited to one gender, it is more visible among females than males. It is also not limited to a particular age, race, culture or socioeconomic status.

      It seems incomprehensible, especially to parents, that a child would take a knife, razor blade, lighter or fist and intentionally harm herself. Parents ask, “What is my child trying to achieve?” The answer, unfortunately, is not simple. There are multiple reasons why kids self-injure. Accordingly, helping them to recover from this problem must start with a thorough examination of the problem itself.

      There is no denying that society evolves on a continual basis throughout time. I think most people would agree that this is not necessarily a bad thing. In fact, many changes are viewed as positive. However, this is not the case for all societal shifts. It is for this reason that I have created a book series entitled What Every Parent Needs to Know About … that addresses a variety of topics. The sole purpose of this series is to inform and educate parents about dangerous trends and behaviors that are becoming increasingly common among youth in our country. Some of these trends have evolved gradually over the several decades; others are startling new phenomena. In either case, they are present in our society and therefore, our children must face many of them today.

      This book, What Every Parent Needs to Know About Self-Injury, will discuss the emotional and physical challenges faced by individuals who strive to recover from self-injurious behavior. It will provide insight and understanding to parents who want to learn more about self-destructive behavior. By blending clinical expertise with personal stories, the book will offer guidance and demonstrate practical strategies that can be utilized by caregivers to help children who are currently suffering from this problem.

      What Every Parent Needs to Know About Self-Injury will educate parents on all facets of the problem of self-injury including cause and effect, cultural forces, risk assessment, treatment planning, therapeutic fit, relapse, and relapse prevention. In addition, I hope that every parent will gain a thorough understanding of both the physical and psychological consequences of self-injury, and how this behavior may affect the child socially, educationally, and/or occupationally.

      By exploring the roller-coaster of emotions that coincide with this condition, and providing strategies to help combat the problem, parents will gain a better understanding of which responses are helpful, and which are more likely to be detrimental in dealing with a child struggling with self-injury. Armed with these insights, parents will be better equipped to help their children through recovery. Ultimately, with proper understanding, support, and treatment, individuals can overcome self-injurious behavior.

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      I was inspired to write this book for three primary reasons. First, self-injury is still a largely misunderstood condition that affects millions of individuals in our country. I feel compelled to emphasize the fact that self-injury does not only affect the individual sufferer but the family as a whole. As you will see through the many illustrations presented in this book, parents and siblings struggle significantly when their loved ones face this problem. It is for this reason that I strongly encourage family involvement in the treatment and recovery process. Often family members are the greatest resource for the individual who is suffering since they are also living with it on a daily basis in their home.

      The second source of inspiration for this book came from something I learned in my profession: Highly-stressed individuals need a means to relieve their internal tension. This certainly applies to individuals who self-harm. Some individuals deal with distress in positive, healthy ways such as exercise, journaling, and/or artistic outlets. Others turn to negative and unhealthy means of stress relief, including substance abuse, disordered eating and/or self-injury. For an individual who self-injures, it is usually a combination of this personal distress with certain personality traits, family dynamics and cultural influences, that leads to the onset and maintenance of this problem.

      Once fully established, the problem can be viewed as a cycle of negativity that has destructive consequences for the individual, and in turn, for everyone else in the family unit. Mental health professionals constantly search for creative ways to reduce a patient’s isolation and help them to obtain the support necessary to feel more understood. The opportunity to hear and learn from the stories of other individuals who have dealt with self-injurious behavior helps both patients and their families gain insight and feel less alone.

      The third, and most important reason for writing this book, is to offer some tangible explanations and relief to parents confronted with a child who self-injures. Parents typically feel hopeless and helpless when their child has been identified with this condition. Perhaps this is mostly due to the fact that most kids who are diagnosed do not want to get help – at least not initially. This leaves the parents feeling like they are fighting to keep their child safe without their child’s cooperation. This can be infuriating for parents who simply do not understand why they are hurting themselves.

      In this book, I offer a psychological perspective on self-injury and discuss how parents can cope with their child’s condition. I also discuss the consequences of self-injurious behavior in the home, and review ways in which family members can help. In addition, I share many personal stories from individuals who went through treatment and recovery. I know that there are thousands of people who have traveled the same path as families I reference in this book, and there will be thousands more to come. I hope that learning about the journeys of others through the complicated world of self-injury might somehow provide hope and solace to them.

      In closing, I want to acknowledge that every child and family situation is different. I would never suggest that this book addresses all the issues and manifestations of a child who self-injures. As readers will discover, self-injury does frequently break the spirit of many individuals and their families for a period during treatment and recovery. For a while, many of the individuals presented in this book lost nearly all of the daily battles that recovery presented. On the other hand, they did manage to win the long-term battle through perseverance, family support, and the timely discovery of substantive information along the way. It is my sincere hope that What Every Parent Needs to Know About Self-Injury will increase the knowledge base of this condition while emboldening parents to believe that they, too, can survive their child’s journey of recovery.

      What is Self-Injury?

      “When I cut, I want to draw blood. When I break, I want something to shatter. I want a trail that marks my pain.” - Amber, age 18

      Self-injury, also known as self-mutilation, self-harm, or cutting, is a largely misunderstood condition that affects millions of people. It is a growing epidemic in our society and one that cannot simply be written off as teenage angst. Both teenagers and adults suffer from self-injurious behavior, and the number is on the rise. With a reported two million cases in the United States alone, this disorder has become rampant.

      A Physical Expression of Emotional Pain

      The formal definition of self-injury was created by Karen Conterio and Wendy Lader, authors of Bodily Harm: The Breakthrough Healing Program for Self-Injurers (Hyperion, 1986). They write, “It is the deliberate mutilation of the body or a 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 following quote from a patient in their book captures this sentiment succinctly: “How will you know I am hurting, if you cannot see my pain? To wear it on my skin, tells what words cannot explain.” - C. Blount

      Other patients concur with the idea that self-injury is a way to express physically what they cannot express verbally. Some patients cannot express their sadness

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