Helping Teens Who Self-Harm

Guest blogger today is Dustin Tibbitts, LMFT, the Executive Director at New Haven Residential Treatment Center for Teen Girls. He works tirelessly to help struggling teens.
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I spent an hour today with a young woman who had not harmed herself  for eight weeks.  She had not harmed herself, that is, until today.

As we talked, she unwrapped tape from her forearms – tape she had wound around paperclips pressed tightly against her skin,  hidden under the long sleeves of her sweatshirt. She handed me the various bits of metal she was planning to use to harm herself again later,  and we talked of her reasons for wounding herself.

Pain.

All of her reasons boiled down to pain. The emotional pain caused by the shame she suffers for decisions she made in the past. The emotional pain, “burning through her veins”, as she described it, due to the abuse she suffered at the hands of someone who should have been safe and trustworthy.

Her solution to assuaging her emotional pain is to distract herself from it by inflicting physical pain. Physical pain is something she can control;  it is straightforward;  it is easy to understand;  it demands attention NOW. Ironically (and effectively), it helps her to numb out, to forget.

As we talked, she allowed her words to spill out,  like a trickle of water that has filled a deep basin over time, and is only just beginning to crest the lip of the reservoir.  She surprised herself with her own eloquence.  When she was finished,  we sat together for a moment,  both emotionally spent,  looking at each other,  sharing something deep.  We shared a connection – the beginnings of a relationship of trust and compassion.

“You know,” I said quietly, “over time you will begin to replace your pain with something else.  Do you know what that is?”

“No,” she replied.

“You’ve felt it from me today.”

“Warmth,”  she said.   “And love.”

How To Assist Someone That Is  Self-Harming

The way to assist someone who is self-harming is not to berate or cajole, to punish or threaten.  People who self-injure are already very good at doing that to themselves.  The only way to help someone who can’t seem to stop cutting  is to engage in a relationship of safety,  respect,  compassion, and trust.

It takes time, and it takes patience.   There is no silver bullet.  There is no magic technique or program.   It requires a genuine relationship of mutual trust.

Obviously,  the relationship is not enough.  We must impart new skills to the sufferer.  The dangerous coping skills they have been using can no longer be options.  We have to replace those behaviors with something else that works.

One young woman I worked with years ago mocked a psychiatrist who told her to “draw a red line on her arm”  instead of cutting.  It didn’t work for her. She also rejected the suggestion one of the hospital staff gave her to  “hold ice in her hand”  until it burned.

For her,  it was more helpful to get her hands involved in something productive.  Sculpting clay worked.  Painting worked.  Designing web pages on her laptop seemed to help.  She allowed her creativity to blossom and was able to move beyond the need to self-harm.

Others I’ve spoken with found comfort in sharing their anxieties with a trusted friend.  Having immediate access to their so-called  “self-harm Sponsor”  at any time was a key to healing.   Texting,  Facebook,  email,  and cell phone calls made their friendship accessible and immediate.

For those whose cutting is especially grievous,  only extended therapy can help.   Some need help keeping themselves safe for a time, until they can find the courage and self-control it takes to face the emotional pain head-on.

I could go on for pages and pages. The bottom line, however, is that we need to patiently and respectfully engage in a genuine relationship of trust with someone who self-harms, teach them  new tools which will help them to work through the  pain, and assist in replacing the shame they feel with love.
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New Haven Residential Treatment Center offers a unique residential treatment program that helps adolescent girls achieve positive change and growth through academic, therapeutic and environmental experiences. They have won numerous awards.

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Tagged as: coping skills, pain, self harm