Behavioral Health Articles

Self-Injurious Behavior

by Lisa Loomis, LCSW

Self-Injurious Behavior (SIB) or “cutting” has been getting considerable media attention lately. With an estimated one to two million people in the United States alone intentionally hurting themselves, it is easy to see why some people are beginning to call it an epidemic. Self-Injurious Behavior is defined as the deliberate, repetitive, impulsive, non-lethal harming of oneself. While the cutting of arms and legs is the most common practice, individuals may also burn, scratch, poke, punch, or choke themselves. When a child engages in SIB, it leaves many questions for the family such as, “Why are they doing this?,” “Are they just doing this for attention?,” “Are they suicidal?,” and “What can I do to help my child?”

There are many reasons that a child would intentionally hurt himself or themselves, including to avoid or get relief from overwhelming emotions such as sadness or guilt, a physical expression of emotional pain, not feeling real or connected to life, feelings of being numb, and self-punishment and/or self hate. For many children who self-injure it is very difficult to put what they feel into words or thought, so they tell us through their scars, burns, and wounds. While there are children that engage in Self-Injurious Behavior for attention, the majority of children who cut feel compelled to do so, and they try very hard to keep their behaviors a secret.

Many studies agree that cutting is a psychological response to an underlying problem, such as anxiety and/or depression. Self-Injurious Behavior is commonly referred to as a “para-suicidal” act, which basically means that most individuals who hurt themselves do not actively want to end their lives. If at any point you feel that your child is suicidal please seek help for them immediately at the nearest Emergency Room.

Once a parent finds out that a child is cutting, there are many things that can be done to assist the child in the healing process. Parents may feel that they must take away and or hide all sharp objects and punish their child. A word of caution: punishment does not work and often adds to the guilt, shame and isolation that a child already feels about their cutting. It is suggested that parents tell the child that they are willing to talk and listen. A parent is not required to have all of the answers for their child, just an open ear and mind. When talking with children about cutting, please try to avoid any negative or judgmental responses. There may be temptations to demand that the child stop cutting, but in order for a person to stop cutting that individual has to want to stop.

Self-injury is viewed as a way to cope with stress, much like exercise or talking with friends. For this reason, many professionals recommend not taking it away without providing another coping skill to put in its place. Therapy for children who cut is essential, as it provides a non-judgmental and supportive forum where self-injury can be processed and explored; it can also help children learn alternative ways to discuss and communicate concerns and emotions. Dealing with a self-injuring child is emotionally taxing work; therefore parents with a self-injuring child should get support for themselves as well.

A quote from Helen Keller speaks to the hope that is often shared with family members of cutters, “Although the world is full of suffering, it is full also of the overcoming of it.” Children who self injure seek to overcome and cope with their suffering in ways that some people might find difficult to understand, but know that it is very difficult for the child who has to carry around the secret shame, guilt and emotional pain of their cutting behavior.

Lisa M. Loomis, LCSW is a licensed clinical social worker, and manager of the School Based Health Centers in Marathon, Cincinnatus and DeRuyter Schools operated by Family Health Network of CNY. She is also an adjunct instructor at TC3 and Empire State College.