YOU REPORT: WHAT’S DRIVING THE TEENAGE SELF-HARM EPIDEMIC?

More and more young people are cutting themselves as a way of coping with stress. Child psychotherapist Louis Weinstock examines the reasons why

A14-year-old girl feels so overwhelmed by thoughts and feelings about her father’s sudden death that she starts to cut her arms with a pair of scissors. Why? Because each cut brings an instant but temporary relief from her heart-shattering grief. It may be difficult to understand, but this teenager’s behaviour is far from unique. More young people than ever before are turning to self-harm: intentionally damaging or injuring their bodies by cutting, burning, strangulation, head-banging, skin-picking, hair-pulling and self-poisoning as a way of dealing with the unique stresses of 21st-century life.

Secondary schools have witnessed a surge in cases, with 70,000 incidents estimated in the past year alone, and NHS England figures show that the number of girls treated as hospital inpatients after cutting themselves quadrupled between 2005 and 2015, while the number of boys admitted had more than doubled. These figures are shocking. And yet they show how more and more young people – typically adolescents, and three times more girls than boys – are turning to self-harm as a coping mechanism. Dangerous though it is, it can bring a sense of relief or control to a situation (internal or external) that feels confusing, overwhelming and beyond control.

So why do people deliberately harm themselves? We all do things that damage us, from smoking and drinking too much to binge-eating. We humans sometimes choose things we know aren’t good for us to bring temporary relief to the thoughts and feelings inside ourselves. Psychiatrist Armando Favazza describes self-harm as a ‘morbid form of self-help’. Studies tend to confirm this: that the main reason people report engaging in self-harm is to reduce emotional distress. Another common reason is self-punishment, although either motivation can lead to a temporary sense of relief.

One of the most incredible recent neuroscience discoveries was that we experience physical pain and the emotional pain of social rejection in the same parts of the brain, including the anterior cingulate, a hook-shaped piece lying an inch behind the forehead. Paracetamol was proven in a similar study to relieve the pain of social rejection, and it seems, from the clients I have worked with, that self-harm can also provide this kind of emotional ‘pain relief ’. There is some evidence that after self-harming, endorphins are released which create a mini-euphoric state. This explains why some adolescents self-harm at the end of a stressful day. These discoveries challenge the idea that self-harm is just attention-seeking behaviour.

A client of mine started self-harming – first with nail scissors, then burning herself with a lighter – when she was 11 years old as a way to cope when her parents were fighting. Self-harming, she said, was a way of ‘anchoring’ her inner turmoil. She showed me a graphic novel about a lesbian girl who self-harmed, with a brilliant depiction of the girl before and after she had cut herself. The ‘before’ image was captioned: ‘difficult to understand’, next to the ‘after’ image, of the girl’s cut arms,

SCHOOLS HAVE WITNESSED A SURGE IN CASES, WITH 70,000 INCIDENTS ESTIMATED IN THE PAST YEAR ALONE”