'I am distraught: my 14-year-old daughter has cut her arms with a razor. I don't understand what is happening and she won't talk to me. Any advice?' B.
Step 1: Self-harming is distressing and disturbing for everyone involved and it would be sensible to seek out the help of a professional who is used to working with this issue if it happens again. It is most common among teenagers, who find it difficult to regulate and talk about their feelings as they negotiate the emotional turbulence of adolescence.
Step 2: Understanding that self-harm has different functions might help open up a constructive dialogue with your daughter. First, it is felt to reduce intense emotional agitation or, alternatively, create feeling when someone is experiencing numbness or dissociation; cutting creates a sense of reality when trying to control feelings that appear overwhelming. A second function is that of self-directed hostility: for example, punishing themselves for perceived shortcomings or having feelings they believe to be unacceptable, such as anger. They consider the controlled pain they feel when cutting themselves preferable to the emotional pain they feel they have no control over. Self-harm also communicates something powerful about the sufferer: they want their feelings to be taken seriously and they think that this is the only effective means they have to share this.
Step 3: Gently ask your daughter to think about how self-harming helps her communicate these messages, without judging or blaming her, so that she can put her feelings into words. In this way, she can begin to see it as an extreme avoidance tactic, where by desperately wanting not to experience her emotions, she forces herself instead to feel other more disturbing ones combined with the added misery of enduring physical pain. Establishing other, more constructive, activities will help shift the focus away from hurting herself towards helping herself. Help her to see that by learning to name her feelings spontaneously and tolerating distress, she can shape different responses to the emotional surges that in reality are nothing to fear and which are a normal part of adolescence.
Cecilia is Mind journalist of the year. If you would like her to answer your problems email her at email@example.comReuse content