Fresh Ideas: Teens who harm themselves need understanding, therapy

One of the hardest things to face as a therapist is the self-harm that some teens are engaging in. Cutting, carving and burning your own skin is a concept most people simply can't understand. Historical evidence, though, suggests that people have hurt themselves in these ways for thousands of years. Currently, almost one-fourth of teens report self-injurious actions on at least one occasion.

Nonsuicidal self-injury is the clinical term used to define people purposefully hurting themselves without meaning to kill themselves. When asked, most teens will tell you that the physical pain they experience when they cut themselves distracts them from their emotional pain. Research is beginning to show that this is indeed one of the factors involved.

Yet, because mental health professionals have only recently understood how common nonsuicidal self-injury is, research is new and we are just beginning to understand the complexities involved in self-harm situations.

As any parent or friend of a teen who has hurt themselves will tell you, it is extremely upsetting when someone you love does this to themselves. Because it is so upsetting, friends and family usually rally around to support the struggling teen, so self-harm elicits the support and attention the teen needs.

Recent studies have compared teens that hurt themselves to those who don't. In laboratory studies, teens who hurt themselves tend to emotionally and biologically react more intensely when stressed than teens who don't hurt themselves (such as increased emotional distress and heart rate). These intense reactions are believed to be biologically based. And, once stressed, teens who engage in self-harm are less able to tolerate negative thoughts and feelings than their peers.

In general, teens who hurt themselves report taking greater steps in everyday life to avoid anxiety-provoking situations and they feel less equipped to solve and communicate about their problems. Some teens that hurt themselves are mentally ill or have suffered from child abuse. Finally, teens that hurt themselves tend to be self-critical, and self-harm can be a way of punishing themselves.

If someone you know is hurting themselves, it is important to seek mental health treatment. With individual and family therapy teens can learn better problem-solving skills so that they don't feel so overwhelmed with the demands of teen life. They can learn positive ways to calm themselves when they are upset.

Oftentimes, they need to heal from painful experiences in their past. These teens need to learn how to think about themselves in less critical ways. Families can help by focusing on problem-solving and soothing, staying away from punitive or critical words or actions. With the right interventions, most teens learn better ways of handling life's ups and downs.

• Lisa Keating, Ph.D., is a Carson City clinical psychologist.