I Can’t Help But Hurt Myself

Dr. Paul Randolph

Self-injury is one of the least discussed problems faced by teenagers today.  While drug abuse, alcohol, eating disorders, pre-marital sex are very large on the list of concerns by parents, this problem often is under the radar.  What exactly is self-injury?  One of the most popular forms is known as cutting, where a teen deliberately cuts their skin with a knife or other sharp object.  This is not a suicide attempt, though some teens who do this may be suicidal at times.  Other forms of self injury include pervasive scratching, picking at scabs, burning, punching oneself or objects, inserting objects into body openings, bruising or breaking bones, and some forms of hair pulling.

            Some estimate that nearly one percent of the teen population are self-injurers.  Self-injuring teens are normally middle to upper class, and are in the upper half of their class.  Almost half report some form of physical or sexual abuse as a child.  Most also say that they were discouraged from expressing emotions, particularly anger and sadness.  In my own counseling experience, many teens have parents who are overly controlling of their child’s life.  There is also a higher number of females who struggle with this problem.  The onset is typically during puberty and can last for 5 to 10 years or longer if not addressed. 

            There is a cycle to this form of self-abuse that is often activated by stress.  This stress can be triggered by a difficult situation or problem, or a long standing, difficult emotional experience that puts the teen into the habit of cutting.  Stressors can include anxiety, anger, frustration, agitation.  A teen will gradually turn to self-injury more regularly because it provides a sense of regained control and emotional relief.  The irony is that it gives this sense of control and relief but feels to the teen as if they cannot control the impulse and guilt which contradicts peace. 

            Regardless of the method used, self-injurers will often conceal their wounds with clothing.  One of the signs is that your child refuses to wear anything other than long sleeved shirts and pants, even when the weather is warm.  You may also notice various marks on the skin.  If you find evidence of the injury, they will make an excuse like “I was playing with the cat and it scratched me.”  It is important that if you suspect your teen is involved in self-injury that you remain calm and not freak out.  There is a lot of shame and guilt associated with this practice, and it is clear that there is some communication break down between you and your teen.  So go easy in expressing your concern, reassure her of your love, and listen without being judgmental or combative.  As a parent or friend who wants to help, realize that there are reasons for this behavior.  Begin by trying to understand this person’s world.  It is important to talk to a counselor who has experience in this area.

            Just what is your teen saying by this practice?  My colleague at CCEF, Dr.Ed Welch outlines some of the major messages or meanings behind why someone would practice self-injury.  These can include:

“I am guilty, I must be punished.”

“I am not perfect”

“You hurt me because I deserve it.”

“I am angry.”

“I can’t feel this way any longer; hurting myself is the only way to stop my feelings.”

“I feel out of control (and other people have been in control).  This way I can gain control (and no one can stop me).”

“Words cannot express my pain.”


            It is obvious there are a lot of meanings and messages behind self-injury.  All of these messages reflect the heart of your teen.  It is at the level of the heart that you can begin to understand the motivation behind the behavior.    Many school guidance counselors will refer you to a psychologist or psychiatrist, who will prescribe a treatment program including cognitive and behavioral therapy, medication, and inter-personal therapy.  While all of these can be helpful, if self-injury is really a cry from the heart of your teen, then ultimately the heart must be reached. 

            As people of faith, we have an answer the world cannot give or understand.  It is the message of God’s grace, the power of the gospel.  Given the limitations of this type of article, this can seem simplistic, but it is deeply profound and liberating.  I would encourage you to explore this further through through publication, Self-Injury:  When Pain Feels Good by Dr. Edward Welch.  You can obtain it through our web site by sending me an email on my contact page.

Maybe you are a teen who is reading this article and struggling from some form of self-injury.  You may feel trapped, you may hate your behavior, but you also feel like you need it.  There is a cure, there is an alternative, start by reaching out to someone who cares.