Understanding Self-Harm

I'm excited that over the last decade, there has been more and more discussion about mental health in the church. When I was first diagnosed with bipolar disorder back in 2000, people had no idea what to say. There was either silence, or well-intentioned folks telling me, "You should just pray more." After I was hospitalized, then sent to a treatment center in another state, people told my grieving mother, "Well, if Hilary was just closer to God, she'd be fine."

Understanding self-harm and finding hope in God's peace.I'm so grateful that the Church is starting to move forward. There is more discussion in church about mental health issues (I loved Perry Noble's honest post about antidepressants) and more Christians are opening up and sharing about their struggles with anxiety, depression, and addiction.

However, there is still silence around some issues in the church, and self-harm is one of them, even though it exists all around us. It is difficult to estimate the percentage of the population that self-harms due to the shame and lack of reporting; however, Healthy Place estimates that 1 in 5 women and 1 in 7 men self-harm, with 90% beginning in pre-adolescence or adolescence.

And it's not just "other" people that do it. There are probably several adults in your church who have a history of self-harm, and some who still currently struggle with it. Any youth pastor has probably come across at least one (or more) teenagers who self-harm in the youth group.

It is such a difficult topic to discuss because it is confusing. As a counselor, I see a lot of teenagers who self-harm, and consistently, their parents admit that they can't understand why. And I get it. If you never have intentionally harmed yourself, it is difficult to understand why somebody would actively choose to hurt themselves.

Self-harming is a complex behavior, so this article is not meant to be complete and comprehensive. However, my hope is that these five observations I've made might give you a small glimpse into the behavior, so you can approach those who are harming themselves with compassion instead of confusion. Reflecting over the past ten years and my own past as a self-harmer, here are a few things I've observed:

1. It's not always a "cry for attention"... There is still a myth that self-harming is simply a "cry for attention." I've found several well-meaning writers on Christian sites promoting this idea just recently! This unfortunately is a dangerous thought process, because it makes it easy to minimize the behavior. I've heard people say, "It's just a cry for attention, she'll get over it if we ignore it." They view it as a quick "passing phase," without realizing the significance of the behavior.

I started self-harming when I was about 12 or 13. I hid it for three years before people found out (after an especially awful night where I self-harmed to the point where I could no longer hide it). Even after treatment and two hospitalizations, I still continued off and on occasionally until I was 19. It was not a quick "passing phase" or a quick "cry for attention." It was a pattern of unhealthy behaviors that I hid consistently.

Many of the clients I've worked with over the years have a similar story. I've worked with numerous teenagers who self-harm for months or even years before they tell anyone, and many of them will continue it through college and some will keep doing it into adulthood. Be cautious about writing it off as a "passing phase" or "just a cry for attention." It is a significant behavior, one that carries risk and danger with it. It must be taken seriously.

2. ...But sometimes it is a cry for attention. This is where it gets complicated because there are definitely kids I've worked with that use the self-harm as a cry for attention. Parents often get frustrated when they view the self-harming as a manipulative tactic: "They just do it to get attention/because it freaks us out/to get a rise out of her boyfriend." And yes, sometimes people self-harm because they are desperate for help and support, but are unable to ask for it directly.

However, instead of being frustrated that someone is self-harming because you perceive it as manipulative, remember that it may be a cry that they actually do need something. Maybe they need stability during a period of transition, a reprieve from a developing mental health disorder like anxiety or bipolar, or more attention from their parents. Even self-harmers whose parents discover it accidentally often later report a sense of relief that they don't have to hide anymore and are grateful for the increased parental support and attention.

3. There are benefits to the behavior. Parents often feel confused about why their children won't stop self-harming. One thing to remember is that there are benefits to it. If you have never self-harmed, this is a totally confusing concept. For most people, we go to great lengths to avoid being hurt. So why would you purposely do it? How could it possibly be helpful?

There are several benefits to self-harming (sadly), but the primary reason that people mention is that it becomes a way to "take back" control. Research shows that at least half of people who self-harm have been victims of abuse at some point. Due to violation of their bodies by someone else, they have not been allowed to have control over their own bodies. Self-harming allows them to choose when they hurt, instead of waiting for their perpetrator to harm them again.

People who suffer from depression, anxiety and bipolar disorders often feel out of control of their emotions, so self-harming becomes a way to say, "my behaviors and emotions are all over the place, but at least I can control when and where I hurt."

There are other benefits such as a way for teenagers to fit in with a group of friends who all self-harm. Recent research has also shown that "physiologically, endorphins are released when we are injured or stressed." If you are scared or feeling out-of-control, the sense of regaining control blended with this flood of endorphins really does help the person feel better.

4. Because of this, it is a very difficult behavior to stop. Parents will often say, "I don't get it! You are hurting yourself, that can't feel good." But it does! For many who self-harm, it does help them feel better. They get a temporary burst of endorphins and a sense of control over their lives. 

Because of this, it is a challenge working with teenagers and adults who are suffering. So instead of shouting, "Why are you doing that? It's crazy!" at your loved one, focus more on the underlying reasons that are causing the behavior. Talk to the person. Is he or she going through a significant 
transition? Do they feel out-of-control of their emotions? 

If they are reluctant to tell you, find a good counselor who they will talk to. It's important to help them find ways to be healthy, instead of simply telling them to quit self-harming "because it's stupid."

5. There is hope. 
I haven't self-harmed in 13 years, but I still remember vividly the helplessness and hopelessness I felt when I would self-harm. It was such a lonely, isolated period of my life, and it wasn't until I completely committed my life to God that I was able to move forward.

And yet, in spite of the long period of time that has elapsed since my last incident, I still have the urge to self-harm at times. Even with all of my training as a social worker and God's incredible powerful work in my life, I still find myself having brief moments where I think, "If only I could self-harm just one more time, I know I'd feel better." In the past, I would berate myself because I thought that if I was a good Christian, I would be completely past those behaviors.

However, I realize now that those urges appear when I feel the most out-of-control of my life. Instead of viewing that desire to self-harm as a sign that I'm not a "good enough Christian," I view it as a dashboard warning light that I've let my fear override my belief that God has a plan for my life. That I feel out-of-control because I've temporarily forgotten the beautiful, transforming plan God has for me. It is only when I give my fears over to Him that I find freedom from those urges.

If you or someone you love is struggling with this issue, there is hope. In John 14:27, Jesus tells his Disciples, "Peace I leave with you; my peace I give you. I do not give to you as the world gives. Do not let your hearts be troubled and do not be afraid."

Those are incredibly comforting words to me. That even in the moments when I don't have peace, where I am afraid and my heart is troubled, God gives me a deep, abiding peace. I don't need the short-term relief that self-harming might give me. Instead, I need the deep, long-lasting peace that only God can give. For those who are struggling with the guilt and shame that accompanies self-harm, there is peace in Jesus.

I've found that over the years, to truly heal from self-harm, simply stopping the behavior is not enough for many of us. Instead, it is a difficult process that involves finding a strong support group, time with a counselor, and for some (including myself), a powerful medication that allows the brain to stabilize. 

All of those tools blended with a deep-rooted belief that Jesus will give me peace to overcome the hopelessness and fear I struggle with, means that in spite of my scars, I can be healed and set free.

And you (or your loved ones) can too.  

*If you would like more information about self-harming, Healthy Place has great information and support. 

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