Self-harm in adolescents

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Some adolescents suffer from a deficiency or failure to deal with feelings of emotional pain, awareness of them and express them in healthy ways, so their reaction takes a violent direction in an attempt to harm themselves, and this is a result of misunderstanding of the self and misinterpretation of all the situations, people and experiences surrounding it.

Self-harm is an act in which an individual intends to cause harm to his body, and this behavior occurs in an impulsive manner, and is a behavioral problem in controlling impulsivity. It can be associated with a variety of mental disorders such as borderline personality disorder, depression, anxiety disorders, eating disorders, and post-traumatic stress disorder. Self-harm introduces the individual into a closed circuit, the beginning of which is psychological pain that cannot be tolerated by the individual, which turns it into pain and physical harm that results in a temporary feeling of relief that quickly disappears and enters the individual again in the same circle of self-harm. It is worth noting that the practitioner of self-harm behavior does not aim to end his life. Often his goal is to try to express or control the pain. In this article, we will shed light on the symptoms and causes, then methods of support and self-help directed at the individual practicing this behavior, then offer means of assistance to family and friends, and finally offer specialized psychological treatment.

Self-harm signs and symptoms:

Self-harm is not limited to cutting or scratching the skin, but rather includes any act that an individual undertakes to intentionally harm himself. Some of the more common methods:

Severely cut or scratched the skin

  • To burn himself
    To hit himself or his head
    Punching things or when an individual throws his body against walls and solid objects
    Sticking things on the skin
    Deliberately preventing wounds from healing
    Swallowing toxic materials or inappropriate objects
    Self-harm can also include less explicit methods such as putting oneself in a dangerous situation such as driving recklessly, binge drinking with too many drugs, and engaging in unsafe sex.

Causes of self-harm ?

There is no single or simple reason that leads one of them to harm himself, and in general, self-harm results from the inability to adapt healthily to psychological pain in relation to problems of personal identity and the difficulty of finding a place for the person in the family and society, where the person suffers from difficulty in controlling His emotions, expressing them, or understanding them. The mixture of emotions that stimulates self-harm is a complex mixture. For example, there may be a feeling of worthlessness, loneliness, panic, anger, guilt, rejection, self-hatred, or a confusion of sexual identity.

By self-harm, a person may try to do the following:

Control or reduce distress or extreme anxiety and feel relaxed
Distraction from painful feelings through physical pain
A sense of feeling in control of his body, feelings, or life situations
Sensation of something, even if it is physical pain, when feeling emotionally empty
Express inner feelings in an external way
Transferring feelings of depression and turmoil to the outside world
Receive punishment for perceived mistakes

Risk factors:

Certain factors can increase the risk of self-harm, including:

Gender:
Females are more likely to harm themselves than males.

  • Age:
    Most of those who self-harm are teenagers and young adults, although others in other age groups also harm themselves. Self-harm most often begins during the early teenage years, when feelings are most volatile and when teens face increased pressure from peers, as well as loneliness and conflicts with parents or other power figures.
    Having friends who self-harm
    People who have friends who intentionally harm themselves are more likely to start self-harming. Life Problems:
    Some of the people who self-harm have been experiencing neglect or physical, sexual or emotional abuse, or they may have experienced other traumatic events. They may have grown up and still live in an unstable family environment, or they may be young people questioning their personal identity or nationality.
    Mental health problems:
    People who self-harm are likely to be impulsive and explosive, as well as enjoy a high degree of self-criticism, and are bad at solving problems. Self-harm is also commonly associated with certain mental disorders such as borderline personality disorder, depression, anxiety disorders, post-traumatic stress disorder, as well as eating disorders. Excessive use of alcohol or drugs.
    People who self-harm often present themselves under the influence of alcohol or illegal drugs.

Once an individual understands why he is self-harming, this enables him to learn positive ways to stop self-harm, and to search for resources to support him during this suffering.

If self-harm helps why should you stop it?

Although self-harm and picking wounds can give you temporary relief. But in the long run, it will be costly, as it causes more problems than it can solve.
You may injure yourself severely, even if you do not intend to do so, so you could misjudge the depth of the wound or it could end up with an infected wound.
The feeling of relief is temporary, and other feelings such as shame and guilt soon follow, while at the same time keeping you away from learning more effective strategies for feeling better.
Keeping your secret away from friends and family is difficult and keeps you alone.
If you don’t know other ways to deal with emotional pain, it puts you at risk of greater problems, including major depression, drug and alcohol addiction, and suicide.
Self-harm can become an addiction. You might start out with a motivation or something you can do to feel more in control. But you soon feel as though cutting or self-harm takes hold. It often turns into compulsive behavior, which seems impossible to stop.

How can I deal with the emotions and feelings that make me want to self-harm?

Self-harm is most of the time a way to deal with emotional pain. So you should be aware of what feelings make you want to hurt yourself? Is it the feelings of sadness? Feelings of anger? Or feelings of self-contempt? Or feelings of emptiness or loneliness? Or feelings of guilt? ….. and others. If you are having difficulty accurately identifying the feelings that trigger your desire to self-harm, you may need to work on emotional awareness.

Emotional awareness means knowing what you are feeling and why, and understanding the relationship between your feelings and your actions. Once you know the feeling that drives you to self-harm, you can start developing healthier alternatives. Look at the different emotions below and alternative positive ways to deal with them:

1- If you hurt yourself to feel lonely or isolated:

Try: Talk to someone close, write down how you feel, meet a friend, do a certain sport like walking, surround the body with a warm blanket.

2- If you hurt yourself because you feel angry:

Try: Doing vigorous activity such as: jumping rope, running, punching something like a pillow or punching bag, squeezing a stress ball or mud, tearing off a sheet and getting rid of it, crying, taking a cold shower, massaging the neck, hands, and feet.

3- If you are hurting yourself because you feel self-contempt or for not being enough (your self-esteem is low):

Try: positive self-talk, write a list of good qualities and actions about yourself, take a cold shower, draw, chat with a friend, participate in volunteer work, read, listen to something likable, spread a beautiful scent in your surroundings.

4 – If you are hurting yourself because you feel that you cannot control things in your life:

Try to: arrange a specific thing, solve puzzles such as puncture, for example, specify a goal time. Example: You will not harm yourself for 15 minutes after that. If you succeed in achieving it, try to repeat it for the same period of approximately.

5- If you are hurting yourself because you feel numb or comatose:

Try: Focusing on something like your breath, being around people who help you feel good, doing craft activities, holding ice cubes under your arm or leg, chewing something with a strong taste like chili or mint, playing computer games.

Alternatives to craving self-harm:

1- Use a red pen and run it over the areas that you hurt when you cut yourself.

2- Pass a piece of ice across your skin where it used to hurt.

3- Place the rubber bands on the wrists, arms, or legs instead of cropping.

Helping a friend or family member who is self-harming:

First, you should know the warning signs that a family member or friend is self-harming:

Self-harm can be difficult to detect, because clothing can hide physical injuries, or hide inner turmoil by acting calmly, however, there are signs you can look out for and notice them:

Unexplained wounds or scars from cuts, bruises, or burns, usually on the wrists, thighs, or chest.
Stains of blood on clothing, towels, or bedding, blood soaked tissues.
Sharp tools or cutting tools, such as razors, knives, needles, shards of glass, or bottle caps in a person’s luggage.
Frequent accidents, the person who hurts himself pretends to be clumsy or has many unfortunate incidents in order to explain the occurrence of these injuries.
Cover-up. A self-harming person insists on wearing long sleeves even in hot weather.
He needs to be alone for long periods of time, especially in the bedroom or bathroom.
Isolation and irritability.
Second: You must know how to provide assistance to a relative or friend:

You may have noticed suspicious injuries on someone close to you, or on someone who trusted you and told you that he was self-harming. Whatever the case, you may feel unsure of yourself, what should you tell him? How can you help?

Here we offer you some means to help you to deal properly with him:

Dealing with your own feelings. You may feel shocked, disoriented, or even disgusted with your self-harm behaviors. Knowing your feelings is an important first step towards helping a loved one.

Know the problem. The best way to overcome any discomfort or distaste you feel about self-harm is by understanding why your friend or family member intentionally harms themselves. Understanding their causes helps you see the world from their perspective.

  • Do not judge. Avoid judging, criticizing, or blaming. Remember, the self-harming person feels ashamed and lonely about what they are doing.

Provide support, not warnings. Express your concern about him and let him know that you are here to help and support him. Stay away from threats, punishments, and warnings because they are counterproductive.

Encouraging communication. Encourage the person you love to express everything they feel, even if something might be uncomfortable with you. And if the person has not disclosed of self-harm, bring up this topic in an indirect and non-shocking way to him, such as saying to him: “I noticed injuries on your body, and I want to understand what you are going through.”

Prepare yourself to tackle difficulties in the family. If the person who is self-harming is a member of your family, especially your son, learn ways to effectively deal with problems and communicate positively with all family members.

Psychotherapy for self-harm:

The individual must realize that treating self-harm behavior requires sincere desire, serious work and cooperation with the psychologist to get rid of this problem, because self-harm has become a major part of his life. The treatment is based on focusing on the problem of self-harm and the disorder that is associated with it. The treatment plan focuses on this disorder, as well as on the self-harming behavior. There are several types of beneficial psychological treatment, including individual psychotherapy, represented by:

Cognitive-behavioral therapy (C.B.T): helps the individual to modify negative and unhealthy beliefs and behaviors and replace them with positive and healthy ones.

Dialectical behavior therapy (D.B.T): It is a type of cognitive-behavioral therapy that teaches behavioral skills to help withstand distress, manage or regulate emotions, and improve relationships with others.

Psychodynamic therapy: It focuses on identifying past experiences, hidden memories or personal issues that have roots in a previous stage because there is often a relationship between self-harm and psychological trauma in childhood and this is done through self-examination directed by the therapist.

Mental awakening: which helps the individual to live in the present appropriately, enjoy the world around him more, understand himself better, and help the individual to reduce anxiety and depression.

Group therapy.

Family therapy

Drug treatment.

And finally, a message we send to anyone who intentionally harms himself

Remember: you deserve to feel comfortable, and you can have it without hurting yourself.

Sources:

http://www.helpguide.org/articles/anxiety/cutting-and-self-harm.htm-

-https://www.sane.org/mental-health-and-illness/facts-and-guides/self-harm

 – https://www.childline.org.uk/Explore/Self-harm/Pages/Self- harmcopingtechniques.aspx

http://www.rcpsych.ac.uk/healthadvice/translations/arabic/mentalhealthandgrowin…harminyoungpeople.aspx

https://www.sehatok.com/psychology-

https://www.mayoclinic.org/diseases-conditions/self-injury/diagnosis-treatment/treatment/txc-2016548