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A parent's primary concern is to keep their child out of harm's way. Most parents would do anything to prevent their children from suffering even one moment of pain and would seek justice against those who hurt their children. But what if your child is the one hurting themselves? A surprising number of parents across the United States are discovering that their children are in fact secret victims of abuse at their own hands. Self-harm is a common method of coping used by people of all ages. It generally first appears in childhood or adolescence when emotions often run high and skills to handle them have not yet developed. This practice of intentionally inflicting physical pain onto oneself has been called self-harm, self-mutilation, or non-suicidal self injury (NSSI). It is most commonly referred to simply as cutting because that is the most frequently discovered form of self-harm. Cutters, as they are sometimes referred, may cut words or phrases into their skin or simply make small random cuts. Though cutting is the form of self-abuse most talked about, there are various ways victims will choose to inflict pain on themselves including burning, punching, or pulling out their hair. Tools used to injure include things like knives, razor blades, or lighters. Other cutters might make tools out of household objects including broken plates or collectibles, favorite childhood toys and other unlikely weapons. Though there are a small percentage of boys that engage in self-harm, this behavior is far more common in girls. According to industry experts, boys experience the same feelings and frustrations that cause girls to cut but they express those feelings differently. Instead of turning that anger inward they are more likely to express those feelings outwardly through punching holes in walls or disappearing into a world of violent video games. Self-harm is typically done in private and hidden to such an extent that even close family members are unaware it's going on. For that reason, it is hard to guess an exact number of suffers. PsychologyToday.com estimates that at least as many as one in five young women between the ages of 10-18 engage in some form of self-harm and that is a conservative estimate. The article goes on to cite a particular Yale University research study that found "56 percent of the 10- to 14-year-old girls they interviewed reported engaging in NSSI at some point in their lifetime, including 36 percent in the past year." Understanding what causes children and teenagers to self-harm will better prepare parents to talk with their children should it come up in their families. Though the resulting wounds are far from healthy, self-mutilation is not generally considered suicidal behavior. There are a number of self-inflicted deaths that are the result of cutting too deep or engaging in other more dangerous forms of self-harm, but these are generally considered to be accidental. People who cut aren't trying to kill themselves. Rather they are using pain to cope with the problems in their life. Experts agree that cutting is generally done for the following three reasons: a need for escape, a need to feel, and a need to be seen. The first, and most often discussed reason for self-harm in children, is that it can provide temporary relief for a constant emotional pain that is not being dealt with. This is often the case in situations where the child has been abandoned, neglected, or abused in some way. The cutters find that the stimulation caused by administering physical pain can cause a temporary distraction from the torment of their emotional pain. The second reason people cut themselves is to deal with feelings of overwhelming numbness. In this situation, the cutter feels detached from their emotions and is desperate to feel anything, even the pain caused by self-harm. Inflicting physical pain upon themselves, while unpleasant, reminds them that they are still able to feel things. It provides a sense of feeling alive. A third common reason for cutting is to physically manifest the pain on the outside that they feel inside. This may be the most hopeful of all the reasons behind cutting because the wounds act as a subconscious call for help. In this case, the cutter may know that they need help but aren't sure how to ask for it or who to ask. They hurt themselves as a symbol of the pain inside to anyone that will see. They may still go to great lengths to hide their wounds, but they secretly want their behavior to be discovered and dealt with. Not all of these reasons are experienced by every cutter but most cutters have experienced all of these reasons for cutting, at some point or another, during their time of illness. Though it seems counterintuitive to people observing the condition, self- harming feels soothing to the person who engages in it. After a while, self-harm can become addictive and people who initially only engaged in the behavior periodically will typically find they are harming themselves more and more often. Because of this, it is important to know how to spot the warning signs for self-harm and get help for the cutter as soon as possible -- before the habit becomes too deeply ingrained in their identity. The most obvious warning signs of this behavior would be seeing the scars or marks left behind by the harmful activity. These can be hard to discover because generally the cutter will go to great lengths to make sure that their secret will not be discovered, such as cutting in places that are generally hidden by clothing. Other warning signs include wearing long sleeved shirts and long pants even in the summer and avoiding activities where more of the body would be exposed, such as swimming or changing clothes in front of other people. An increased interest in sharp objects or a tendency to have these objects on hand or hidden in their room could be a warning sign that those objects are being used to self-harm. Impulsive or reckless behavior such as drinking or using drugs increases the likelihood of people engaging in self-harming behavior. Having relationships with peers who cut or otherwise self-harm also puts your child at an increased risk for copying their behavior. However, it would be wrong to assume that victims of self-harm fit into one mold. This condition is not always obvious. Girls, in particular, will keep up the appearance of being successful despite their inner turmoil. Self-harm can be a release for girls who feel the need to be perfect in all aspects of their lives. They do well in school and social life only to escape with these secret rebellions of self-abuse. This illusion of a successful image lures the unsuspecting parents into believing that everything is fine. According to the Mayo Clinic, there are certain personality traits that can put young people at a higher risk for choosing self-harm as a coping mechanism. One of the most common signs is being withdrawn and having a difficult time establishing interpersonal relationships. Children who often ponder deep questions about their identity or the future of the world are often struggling with deep problems that they cope with through self-mutilation. Additionally, children who often express feelings of helplessness or worthlessness are exhibiting signs of depression that they could be dealing with through self-harm. Victims of childhood abuse or neglect are at an increased likelihood to experience the emotions, or lack there of, that lead to self-harm. Additionally, children and teenagers dealing with borderline personality disorder or post traumatic stress disorder are also more likely to injure themselves to cope with the feelings associated with those disorders. The way a parent responds to discovering that their child is engaging in self-harm is very important to the recovery process. The first reaction will likely be one of shock or outrage. It is vitally important not to shame the child for their behaviors. Having an understanding of what cutting signifies for the child can help parents to react in ways that are helpful to the child as opposed to reinforcing feelings of inadequacy that can ultimately make self-mutilating behaviors worse. Yelling at the child for the harm that they have caused will only lead to further shame and feelings of being out of control. These feelings will most likely result in a stronger desire to cut. Upon finding self-harming behavior in their child, a parent should remain calm and encourage the child to open up about the feelings that caused this behavior. Therapy is a helpful tool to not only discover why the child is engaging in self-harm, but to also treat any underlying conditions or disorders that led to these negative feelings in the first place. Most people benefit from outpatient therapy but in certain severe cases of self-harm a stay in a psychiatric hospital may be necessary to help the victim develop healthier ways of expressing their emotions. Medications are also a common tool to deal with the feelings that led an individual to self-harm. With time and proper treatment, people of all ages can learn to overcome self-harming tendencies even if they have been engaging in the harmful behavior for years. accessHealthNews.net PAGE 05 Understanding Self-Harm in Children By Regina Creason