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TEENAGE SUICIDE: PREVENTION: HOW TO ASK YOUR TEENAGER ABOUT SUICIDE (PART 4)

Wednesday, November 19th, 2014

WHAT SHOULD I DO WHEN I NOTICE SOME WARNING SIGNS?
(part 1; part 2; part 3)

Many parents fear asking their child about suicide thinking that by asking they might give their teenager some ideas or perhaps plant a thought in their head that may be acted upon later. As result they never ask and end up surprised! Don’t be that kind of parent, ask your teenagers about suicide. Questions never killed anyone, if anything the question will let your teenager know you care. However, don’t forget that relationship is always the key to getting good information. So if you want to get the truth from your child you will need to approach them with great care and loads of respect. Chances are you will have earned the right to ask them about suicide because you have been working hard to connect with them over the past few weeks and months by meeting them right where they are and taking the time to really listen (without judgment and without pressure) to what has been going on in their life.

HERE ARE SOME THINGS TO THINK ABOUT WHEN ASKING ABOUT SUICIDE:
First, take a deep breath and try to stay calm. Of course there is a chance that when you ask them if they have ever thought about suicide that they will say yes. This “yes” may be one of the scariest “yes’s” you have ever heard and you will need to be prepared for the emotional impact this has on you. No parent ever wants to hear about their child having considered suicide, but don’t forget that you are not alone; many other parents have gone before you and survived.

Second, once you have calmed down you will need to try your best to ask about the following 4 things (White, 1999): (Remember, you are not a mental health professional and no one expects you to be, however, having more information is going to be really helpful when trying to help your teenager cope with this stuff both now and in the future).

STUFF TO ASK ABOUT:
IDEATION: Thinking about suicide and planning your death are two different things. Studies have found that 20-30% of teenagers will report experiencing thoughts of suicide at some point during their teenage years (Brener, Krug, Simon, 2000; Kandel, Raveies, & Davies, 1991). While these numbers are alarmingly high, it would seem that thoughts about suicide are fairly common during the teenage years, so you will need to be ready to deal with them.

INTENT: As stated above thinking about suicide and wanting to die are two different things, however they always need to be assessed together. When your teenager tells you that they have thought about suicide your next question needs to be about motivation; do they want to die?

MOTIVATION: By asking about their intentions you are attempting to figure out if they really want to die, are attempting to manipulate, are crying out for help, or have some other reason for wanting to die (White, 1999). Remember, that just because they maybe attention seeking or manipulating does not mean that they are not a serious risk! In most cases they will say “no” when asked about motivation, however its fairly common for someone who has experienced thoughts of suicide to be somewhat ambivalent about their desire to die; a part of them wants to die, yet another part of them doesn’t. Helping them resolve this conflict may be the key to keeping them safe.

Here are some questions you could ask to assess INTENT (White, 1999):

“Why do you want to die?
“What are the contents of your thoughts?”
“What does death mean to you?”
“How long have you been thinking about hurting yourself?”
“How frequent and persistent are the thoughts?”
“Are you pre-occupied or obsessed with the idea of killing yourself?”
“Can you control your thoughts?”

PLAN:
Having a plan is often the most important part of determining what is going on with your teen. Suicide can occur without a well thought out plan, however most individuals experiencing thoughts and intentions will often very quickly arrive at a plan. Some will spend days, even weeks, planning their attempt without telling a soul.

Questions to ask yourself in addressing your teenager’s plan (White, 1999):

How far has the adolescent developed the plan?
When is the proposed plan going to occur?
How specific is the plan? (place, time, method)
Is the plan effective and feasible?
Is the adolescent’s chosen method lethal?
Will he/she have access to the chosen means when he/she needs it?
Does he/she know how to use the means?
Has he/she rehearsed his plan?
Has he/she taken precautions to avoid rescue?

METHODS AND MEANS:
When asking about your teen’s plan you will want to try and figure out just how plausible their plan appears to be. While every suicidal thought, intent, and plan should be taken very seriously and properly addressed by a competent mental health professional, some plans need to be taken much more seriously than others. The more lethal the means the more dangerous your teenager might be.

The 4 most common means of teenage suicide are:

Guns: Firearms typically account for about 60% of all completed suicides in the United States and any suicidal thought or plan that incorporates their use needs to be taken very seriously!
Cars: While there does not appear to be any statistics regarding teenager’s use of cars as a means of suicide, it is safe to say that not every death by auto accident is an “accident.”
Drugs: Drug overdose is very common in western culture and many, if not most, of the suicide attempt victims I have worked with decided to kill themselves by taking a handful of pills, or combine pills with alcohol.
Combination of all three

When asking about METHODS and MEANS you need to ask about two things:

ACCESS: Does your teen have access to the tools they are planning to use? Consider guns, knives, explosives, belts, ropes, sheets, medications (prescription and over the counter), drugs and of course alcohol.
KNOWLEDGE: You will need to find out how much your teen knows about the means they have mentioned. Do they even know how to use a gun? Do they know how to hang themselves? Etc.

PLEASE REMEMBER…Any person who is experiencing thoughts of suicide needs to be assessed by a mental health professional as soon as possible!

***Any advice given on this website is offered in generic form. In other words, all of our site visitors have unique qualities that play a role in their personal mental health. We do not know you personally and can therefore not take into consideration these qualities when offering advice, and do not claim to do so. All information provided on this site is designed to support, not replace, the relationship that exists between a patient/site visitor and his/her existing psychologist, mental health professional, teacher, or professor.***

REFERENCES:
Brener, N. D., Krug, E. G., Simon, T. R. (2000). Trends in suicide ideation and suicide behavior among high school students in the United States, 1991-1997. Suicide & Life-Threatening Behavior, 30, 304-312.
Kandel, D. B., Raveis, V. H., & Davies, M. (1991). Suicidal ideation in adolescence: Depression, substance use, and other risk factors. Journal of Youth and Adolescence, 20, 289-309.
White, T. W. (1999). How to identify suicidal people: A systemic approach to risk assessment. The Charles Press Publishers, Inc., PA.

by Joe James, Psy.D.
other articles on teens

TEENAGE SUICIDE: PREVENTION: WHAT TO LOOK FOR (PART 3)

Wednesday, November 5th, 2014

WARNING SIGNS!! LOOK FOR WARNING SIGNS!
(part 1; part 2)

SIGNIFICANT CHANGE IN “NORMAL” BEHAVIOR:
While there are occasions when someone may significantly hurt him or herself “out of the blue”, most cases involve warning signs. The problem is that most of us don’t notice them! There are a few things you can be looking for. First, and foremost is a significant change in behavior, such as increased drug use, moodiness that appears to be over and above “normal”, withdrawal from either friends or family, and an increase in impulsive high-risk behaviors (Debski et al., 2007).

Perhaps most common is the proverbial “change in friends.” Rather than spending time with the friends your teenager has had since the 5th grade, he or she may begin to bring some “new” kids over to the house. While it is good for your teenager to branch out, meet new people and make new friends, most often this group of friends is the one your parents told you about when you were a teenager. They look and act in a manner inconsistent with your values and will often result in you making statements like “I just don’t like his friends” and “things really started to change when ‘so and so’ started coming around.” While a significant change in friends does not mean your teenager is thinking about suicide, this change often comes with many of the other warning signs such as doing drugs, the onset of a depressed mood, a drop in school performance, and run-in’s with the police.

SUICIDAL STATEMENTS:
Second, making statements about suicide or expressing some type of preoccupation with death should be taken seriously. For some these types of behaviors can become so common that you may begin to ignore them. If you find this to be the case, please consult a mental health specialist immediately. Suicidal statements, even those that are passive in nature (ie. “you guys would be better off without me”), need to be taken seriously and addressed directly. Some studies have found that as many as 83% of teenagers who successfully killed themselves made a verbal threat to do so during the week prior to completion (Brent, 1995, as cited by Rubin, Wainrib, & Bloch, 1998).

SYMPTOMS OF DEPRESSION:
Because depression is so closely related to suicide, the symptoms of depression and teenage suicide should be closely monitored. Symptoms include (Debski et al., 2007):

Major changes in eating or sleeping habits (too much or too little of either)
Expressions of hopelessness, guilt, shame, or worthlessness
Intense anger toward self and/or others
Drop in school performance
Loss of interest in usual activities (ie. quiting the football team)

SELF-HARMING OR CUTTING:
Studies have shown that teenagers who deliberately hurt themselves (i.e. cutting) are 4 to 10 times more likely to die (Goldachre, & Hawton, 1985; Hawton & Harris, 2007, both as cited by Hargus, Hawton, & Rodham, 2009) and as many as 70% of teenagers who reported an act of self-harm also reported at least one suicide attempt (55% reported multiple attempts) (Nock, Joiner, Gordon, Lloyd-Richardson, & Prinstein, 2006, as cited by Hargus, Hawton, & Rodham, 2009). That is pretty alarming! You should take self-harming behaviors very seriously.

Significant changes in behavior, making suicidal statements, symptoms of depression, and cutting/self-harm are all behaviors that can very easily get “lost” in the day to day busyness of life. That is why it is so important for you to do what you can to connect with your teenager on a regular basis. Your teenager doesn’t need you to breath down their neck (and most likely will let you know this on regular basis) but they most definitely need and want the adults in their life to show them that they care.

***Any advice given on this website is offered in generic form. In other words, all of our site visitors have unique qualities that play a role in their personal mental health. We do not know you personally and can therefore not take into consideration these qualities when offering advice, and do not claim to do so. All information provided on this site is designed to support, not replace, the relationship that exists between a patient/site visitor and his/her existing psychologist, mental health professional, teacher, or professor.***

REFERENCES:

Debski, J., Spadafore, C. D., Jacob, S., Poole, D., & Hixon, M. D. (2007). Suicide intervention: Training, roles, and knowledge of school psychologists. Psychology in the Schools, 44(2), 157-170.

Hargus, E., Hawton, K., Rodham, K. (2009). Distinguishing between subgroups of adolescents who self-harm. Suicide & Life-Threatening Behaviors, 39(5), 518-537.

Rubin Wanrib, B., Bloch, E. L. (1998). Crisis intervention and trauma response: Theory and response. Springer Pub, NY.

White, T. W. (1999). How to identify suicidal people: A systemic approach to risk assessment. The Charles Press Publishers, Inc., PA.

by  Joe James, Psy.D.

(more articles on teenagers)

TEENAGE SUICIDE: PREVENTION: WHAT TO LOOK FOR (Part 2)

Wednesday, September 17th, 2014

BROKEN RELATIONSHIPS: LOSS OF A BOYFRIEND OR GIRLFRIEND
(part 1 can be found here)

Chronic health problems or long-term personal issues often trigger adult suicide attempts. Teenage suicide attempts are often triggered by problems in relationships; especially significant “break ups” or major disruptions in relationships with close friends or family members. When relationships end it can be very difficult, even under the best of circumstances, so when your teenager looses their boyfriend or girlfriend it can be very traumatic, especially if they have emotionally invested a lot of themselves in the relationship. For many teenagers their relationship with their significant other is viewed as the “best thing that ever happened” to them. Consequently, when this relationship is lost you may need to treat it as such. This may be really hard to understand as an adult because so often we are tempted to see these relationships as “childish” or “just a phase.”

Parents of suicidal teenagers often overlook the loss of this kind of relationship. For some it is because the teenager has kept the relationship a secret. For others it is simply because parents often underestimate the power of these young relationships over their child. The answer to this problem is awareness. Parent getting and staying connected with their kids; parents earning the right to talk with their teenagers about their “love life” by meeting and loving their child as they are, listening well, and communicating a genuine sense of love and care that transcends the felt need to lecture and coerce.

BROKEN RELATIONSHIPS: LOSS OF FREINDS
Problems in school seem to be a pretty common theme with teenagers and suicide attempts; problems with grades and performance, of course, but perhaps more are their relationships with friends (White, 1999). As a parent you send your kids to school to get an education, but an education is only half of what they receive. Peer relationships are vital to your child’s development, however; as you may already know, teenage peer relationships can be very complicated. Social blunders often overlooked in the adult world are exploited by teenagers and used as a means of singling out certain individuals and targeting them for social punishment. Time and again I have worked with teenagers who made a mistake, made someone else angry, or hurt a specific person’s feelings and subsequently were socially destroyed; targeted, attacked and essentially “kicked out” of their group of friends. As a result many teenagers will begin to feel rejected, lonely, hopeless, and worthless.

BROKEN RELATIONSHIPS: FAMILY FIGHTS
A significant breach in the relationship between a parent and a child can be devastating at any age. Family fights are often the trigger of suicide attempts and need to be handled with care (White, 1999). May of the parents of suicidal teenagers I work with often appear surprised when I inform them that abuse (physical, emotional, and sexual) is often associated with suicide attempts. Perhaps this is due to the dramatic nature of abuse as a very “messy subject” and inability to cope with their child being abused. However, abuse, in all its forms, is often a trigger of suicidal thoughts and cannot be overlooked. Also the loss of a significant family member, especially a parent, through death, divorce, or abandonment can be a major trigger. Many times teenagers (and children) will begin to think that they were the reason their parent is gone, blaming themselves for their situation in a manner in which they will begin to struggle with feelings of self-hatred and self-destruction.

OTHER TRIGGERS TO BE AWARE OF:

  • Use and/or abuse of drugs and alcohol (some drugs can trigger this kind of stuff)
  • Feeling hopeless, alone, or alienated
  • Recent suicide of a friend, family, or role model
  • Legal problems
  • Moving
  • Failure
  • Access to a weapon (White, 1999)

***Any advice given on this website is offered in generic form. In other words, all of our site visitors have unique qualities that play a role in their personal mental health. We do not know you personally and can therefore not take into consideration these qualities when offering advice, and do not claim to do so. All information provided on this site is designed to support, not replace, the relationship that exists between a patient/site visitor and his/her existing psychologist, mental health professional, teacher, or professor.***

REFERENCES:

White, T. W. (1999). How to identify suicidal people: A systemic approach to risk assessment. The Charles Press Publishers, Inc., PA.

by Joe James, Psy.D.
other articles on teens

TEENAGE SUICIDE: WHAT TO LOOK FOR

Thursday, September 11th, 2014

Unfortunately teenage suicide is relatively common. It is the 3rd leading cause of death among teenagers (White, 1999), with thoughts of suicide occurring in as many as 29% of teens, 19% having made a plan, and as many as 8% having attempted (Brener, Krug, Simon, 2000; Kandel, Raveis, & Davies, 1991). Dealing with teenage suicide can be very difficult because it is affected by many factors that can change quickly making prediction very, very difficult. Adults and parents tend to downplay self-destructive behavior stating “its normal”, “I did the same thing when I was a kid”, and “they don’t mean it, they just want attention.” This kind of thinking can be a big mistake (White, 1999).

SO WHAT SHOULD YOU BE LOOKING FOR?
TEENAGE DEPRESSION
First and foremost, you need to be on the look out for symptoms of teenage depression. Teenage depression often looks a little different; irritability and aggression appear to be more common, especially in boys. Also a depressed teen may struggle with acting without thinking first. Depression accounts for up to ½ of all serious suicide attempts and needs to be taken seriously (Fergussion et al., 2003).
Depression often shows up in teenagers as:

  • Sleep disturbance (sleeping too much or too little)
  • Difficulty concentrating
  • Feeling of hopelessness
  • Change in eating habits (eating too much or too little)
  • Hyperactivity or loss of energy
  • Serious risk taking
  • Change in school performance
  • Thoughts of suicide or other morbid preoccupations
  • Adolescents may also present with significant irritability, sexuality, and physical symptoms (stomach pain, headaches etc.) (White, 1999)

Many of these symptoms of depression may come and go, that’s normal, however when a few of them come around and seem to have trouble leaving for a week or two something is up and action may need to taken to protect your child. Also, please know that prior suicide attempts place your child in a very high-risk category and you will need to speak with a mental health specialist regarding enacting an adequate Safety Plan to ensure your teenagers safety.

FAMILY PROBLEMS
Second, you need to be looking for problems in your family that may be upsetting your teen such as:

  • Teenage or family history of abuse (physical, emotional, and especially sexual)
  • Low levels of family connection (ie. poor relationships with parents, severe conflict with siblings)
  • Significant changes in the family such as a parental divorce or separation, a major move to a new location, or the death of a loved one
  • Family violence
  • Parental drug and alcohol abuse
  • Parental contact with the law
  • Family history of suicide (Debski et al., 2007)

***Any advice given on this website is offered in generic form. In other words, all of our site visitors have unique qualities that play a role in their personal mental health. We do not know you personally and can therefore not take into consideration these qualities when offering advice, and do not claim to do so. All information provided on this site is designed to support, not replace, the relationship that exists between a patient/site visitor and his/her existing psychologist, mental health professional, teacher, or professor.***

REFERENCES
Brener, N. D., Krug, E. G., Simon, T. R. (2000). Trends in suicide ideation and suicide behavior among high school students in the United States, 1991-1997. Suicide & Life-Threatening Behavior, 30, 304-312.

Debski, J., Spadafore, C. D., Jacob, S., Poole, D., & Hixon, M. D. (2007). Suicide intervention: Training, roles, and knowledge of school psychologists. Psychology in the Schools, 44(2), 157-170.

Fergusson, D. M., Beautrais, A. L., & Horwood, L. J. (2003). Vulnerability and resiliency to suicidal behaviors in young people. Psychological Medicine, 33, 61-73.

Kandel, D. B., Raveis, V. H., & Davies, M. (1991). Suicidal ideation in adolescence: Depression, substance use, and other risk factors. Journal of Youth and Adolescence, 20, 289-309.

White, T. W. (1999). How to identify suicidal people: A systemic approach to risk assessment. The Charles Press Publishers, Inc., PA.

by  Joe James, Psy.D.

(more articles on teenagers)

My Teenager is Cutting Themselves- Now What? (Part2)

Wednesday, August 27th, 2014

(Part 1 can be found here.)

As a parent, what should you do when you have discovered that your teenager has been intentionally cutting or hurting himself or herself? Teenage cutting appears to be more and more common these days and is something you should take very seriously. However dealing with this kind of problem can be very difficult for both you and your adolescent so it is imperative that you take the time to manage yourself, ask some really good questions, educate yourself, and take appropriate action. But first, let me give you some advice on what not to do.

Things Not to Do:

  • Act like it’s not a big deal
  • Ignore it
  • Go on an hour long emotional tirade
  • Lecture
  • Berate or belittle your son or daughter
  • Blame the behavior on something simplistic
  • Say “you just did it for attention” (even though sometimes you may believe this to be true)
  • Punish
  • Threaten to do more damage
  • Blame it all their “friends”

WHAT TO DO:
MANAGE YOURSELF:

Take a deep breath. Discovering that your teenager has been hurting him or her self is disturbing and dramatic. It only makes sense that you would be upset (if you weren’t that maybe a sign of an even bigger problem). Cutting is a behavior that can be very hard for a parent to understand and it can leave you feeling helpless, horrified, angry, disgusted and sad. However it is really important that you do not over react. Your teenager is already experiencing enough emotional pain, the last thing they need is for you to be out of control. If you need a few moments to collect your thoughts and emotions please take the time to call a friend for help. Now is not the time to leave your child alone so you may need to have someone else come over for a bit to just sit with you and your family. Your response may be the key to your teenager getting the help they need and you and your teenager developing a deeper connection relationally.

ASK QUESTIONS:
You will need to get a better understanding of what your teenager has been doing so you can do your best to ensure their safety and get them the right kind of help. Asking about self-harming behaviors is very similar to asking about suicide; it can be very uncomfortable for all parties and will no doubt elicit an emotional response from your teenager. Be prepared! For a brief outline about how to ask your teenager about suicide or cutting take a minute to look at my post on teenage suicide (link here).

EDUCATE YOURSELF:
Assumptions and misinformation can create a lot of problems in relationships, especially with teenagers. Cutting and self-harm, although quite common today, is something that you may have no experience with, meaning you will need to educate yourself if you ever hope to understand where your teenager is coming from. Cutting behaviors can be very complicated mentally and emotionally with no easy answers (there doesn’t appear to be an “easy button” for this one). Each teenager cuts for their own reason, however; the professionals who deal with this stuff on a regular basis have discovered some common themes.

Cutting is often used:

To relieve terrible feelings of tension
To obtain self-control
To obtain a sense of identity
To regain a sense of normalcy when emotional numbing has caused feeling of estrangement from the rest of the world
To manipulate others
To express self-hatred
To enhance sexual feelings
To experience euphoria
To vent feelings of anger and frustration
To relieve feelings of stress, tension, alienation (White, 1999)

Gaining an understanding of why your teenager has been cutting can be difficult and will require extensive therapy with a qualified mental health professional. Understanding the “why” behind the cutting is important. However, you should be forewarned that you may not like the “why” and most likely will feel confused and angry. Self destructive behaviors often elicit anger and confusion from others, especially parents. Consequently, by taking time to talk to your teenager about cutting you may discover that you can relate to your teenager’s reasons, putting you in a stronger position to use this tragic and horrible circumstance as a means of connecting with them relationally.

FINALLY, TAKE ACTION:
Although cutting (self-harm) and suicide are not the same thing, they are very closely related. Studies show that as many as 70% of teenagers who report an act of cutting or self-harm also report at least one suicide attempt (Nock, Joiner, Gordon, Lloyd-Richardson, & Prinstein, 2006, as cited by Hargus, Hawton, & Rodham, 2009). You will need to seek the help of a mental health professional who is passionate about teenagers and adequately trained to deal with depression, anxiety, suicide, and self-harm. Most mental health professionals are capable of handling these types of issues, however not every therapist may be the right fit for your situation. Also, please take a minute to read through my posts regarding suicide and be sure to put together an adequate safety plan with your professional.

***Any advice given on this website is offered in generic form. In other words, all of our site visitors have unique qualities that play a role in their personal mental health. We do not know you personally and can therefore not take into consideration these qualities when offering advice, and do not claim to do so. All information provided on this site is designed to support, not replace, the relationship that exists between a patient/site visitor and his/her existing psychologist, mental health professional, teacher, or professor.***

REFERENCES:

Hargus, E., Hawton, K., Rodham, K. (2009). Distinguishing between subgroups of adolescents who self-harm. Suicide & Life-Threatening Behaviors, 39(5), 518-537.

White, T. W. (1999). How to identify suicidal people: A systemic approach to risk assessment. The Charles Press Publishers, Inc., PA.

Joe James, Psy.D.

MY TEENAGER IS CUTTING THEMSELVES – NOW WHAT? (PART I)

Wednesday, August 13th, 2014

Like suicide, cutting and other types of self-harm appear to be all too common among teenagers today. In the United States cutting and self-harm is typically defined as, “hurting one’s self without the intent to die” (Hargus, Hawton, & Rodham, 2009). Although different from suicide most experts would agree that cutting and suicide appear to be closely related. Studies show that as many as 70% of teenagers who report an act of cutting or self-harm also reporting at least one suicide attempt (Nock, Joiner, Gordon, Lloyd-Richardson, & Prinstein, 2006, as cited by Hargus, Hawton, & Rodham, 2009).

Self-harm doesn’t always appear as cutting. Many times it may include:

Scratching
Biting
Burning the skin
Repetitive banging of the head, hands, arms, or feet
Eye-gouging
Ingesting foreign objects
Inserting objects into the body (White, 1999)

Most common items used to cut include:

  • Disposable razors: Far and away the biggest hit! Your teenage may be breaking the head of the razor and using the blade to cut. It is a good option for them because most parents do not consider these types of blades to be a threat, they are located in the bathroom (easy clean up and privacy), and they are easy to hide.
  • Razors from box cutters: Once again these blades are easy to hide and very sharp.
  • Kitchen knives: Most American homes have 10 or more kitchen knives. If one goes missing who will notice?
  • Pocketknives and hunting knives: Teenage boys seem to like this option as well. It is “normal” for them to have a knife so no one will think twice about it’s presence in their room.

If your teenager is cutting, the cuts may often appear somewhat superficial, however psychologically they are no less significant. Arms appear to be the most common location followed by the legs. Your teenager may go to great lengths to hide their cutting including wearing long sleeve shirts in the summer, coats in the spring, and hooded sweatshirts daily.

Your teenager may be cutting for one or more reasons including:

To relieve terrible feelings of tension
To obtain self-control
To obtain a sense of identity
To regain a sense of normalcy when emotional numbing has caused feeling of estrangement from the rest of the world
To manipulate others
To express self-hatred
To enhance sexual feelings
To experience euphoria
To vent feelings of anger and frustration
To relieve feelings of stress, tension, alienation (White, 1999)

REASONS FOR CUTTING CAN BE UNIQUE

As you can imagine the reason your teenager is cutting can become complicated. They may tell you its because it relieves stress or it makes them feel alive. Some may even state that it makes them feel in control or it helps them to “get their feelings out.” As parents you might even find yourself thinking “its cuz they want something from me” or “they are manipulative and want attention.” Although it is common for parents to feel this way about their child’s cutting, especially if the cutting persists over a long period of time, it is vital that you do not allow these thoughts to effect your attitude. The resentment and anger that often comes with being a parent of a teenager who cuts, not only gets in the way of treatment, but it may cause you to emotionally withdrawal from your child, damaging the relationship and creating a greater need for the youth to cut. Understanding why your teen cuts is something you will need to discuss with your personal mental heath professional.

The common theme in each of the reasons listed above is emotion. Teenagers who cut themselves typically have difficulty coping with their emotions consequently they avoid experiencing them all together. This process of emotional hiding or emotional denial can be damaging and seems to be one of the root causes of both depression and severe anxiety (fear/stress) (Allen, McHugh, & Barlow, 2008).

TWO MORE THINGS:

First, cutting typically is not about rebellion or defiance. It’s about emotion. When addressing the issue with your teen, it is imperative that your see it as something tender, something relational with its roots in emotional pain rather than rebellion. If you view it as defiance it may make you angry causing you to push your child away, rather than seeing it as painful causing you to move closer emotionally.

Second, teenagers who cut also typically have a low self-esteem. Your teenager may not openly state that they hate themselves, but this belief can often appear in other ways (ie. other self destructive behaviors such as abuse of drugs and alcohol, damaging relationships, or aggression). Demeaning your child for cutting is counter productive. Rather than getting angry and feeling guilty or ashamed, most teens wish that their parents would move closer to them emotionally. Taking some time to really talk to your teen in a non judgmental manner will not only help you better understand their thought processes it will provide your teenager the opportunity to do the very thing they have been trying to avoid; emotionally connect with another person.

Joe James, Psy.D.

***Any advice given on this website is offered in generic form. In other words, all of our site visitors have unique qualities that play a role in their personal mental health. We do not know you personally and can therefore not take into consideration these qualities when offering advice, and do not claim to do so. All information provided on this site is designed to support, not replace, the relationship that exists between a patient/site visitor and his/her existing psychologist, mental health professional, teacher, or professor.***

REFERENCES:
Allen, L. B., McHugh, R. K., Barlow, D. H. (2008). Emotional Disorders: A unified protocol. In D. H. Barlow (Ed.), Clinical handbook of psychological disorders: A step-by-step treatment manual (pp. 216-244). New York, NY: The Guilford Press.

Hargus, E., Hawton, K., Rodham, K. (2009). Distinguishing between subgroups of adolescents who self-harm. Suicide & Life-Threatening Behaviors, 39(5), 518-537.

White, T. W. (1999). How to identify suicidal people: A systemic approach to risk assessment. The Charles Press Publishers, Inc., PA.