Why do teenagers self-harm? Clinical psychologists explain how to help teens reduce their emotional distress


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(THE CONVERSATION) Emotions are delicate things. They allow humans to fall in love, wage war, and ultimately self-harm.

It’s hard to imagine a time when young adults were more distressed than they are today. Recent data from the Centers for Disease Control and Prevention indicates that more than 40% of high school students reported feeling constantly sad or hopeless in the past year. In the same poll, about 20% said they were seriously considering suicide. Worldwide, approximately 17% of young people aged 12 to 18 intentionally injure themselves each year.

By all accounts, young people are experiencing a seemingly unprecedented level of emotional distress.

Humans tend to behave in ways that seek pleasure and avoid pain. Why then would some people hurt themselves intentionally? In a new meta-analysis, a summary of research studies that we and our colleagues published in the journal Nature Human Behavior, we reported that people felt better immediately after self-harm or thoughts of suicide.

We are a PhD candidate in clinical psychology at the University of Washington researching why youth and young adults self-harm, and a clinical psychologist studying substance use in young adults. Our research suggests that this reduction in emotional distress following acts of self-harm and suicidal thoughts likely sustains these types of thoughts and behaviors.

The challenges of studying self-harm

In his book “About Behaviorism”, the eminent psychologist BF Skinner coined the term “reinforcement” to explain why behaviors are more likely to occur if that same behavior has already led to the desired result. Over the past 20 years, leading theories have speculated that self-harm works the same way. That is, if someone felt relief from emotional pain after hurting themselves, they would be more likely to repeat the behavior in the future.

Self-harm is difficult to study. Until the last decade, most researchers asked people to think about what they thought or felt when they self-harmed, but these episodes could have happened months or even years ago. We humans, however, are remarkably bad at accurately reporting our own behaviors, especially when trying to explain why things happened. It’s especially difficult for researchers to get a clear timeline of events, making it difficult to determine how a person felt immediately before or after self-harming.

Recently, researchers have attempted to fill these gaps by taking advantage of the ubiquity of cell phones. In these studies, researchers asked participants to answer brief surveys about how they felt about their cellphones several times a day over their lifetime.

Our meta-analysis analyzed 38 of these survey-based studies, with data provided by researchers from the United States and Europe, involving 1,644 participants. In all studies, participants rated the intensity of their emotions and whether they had thought about self-harm in the past few hours.

We found that participants reported higher levels of distress just before self-harming or contemplating suicide, and reported significantly reduced levels of distress immediately afterwards. Together, this suggests that relieving distressing emotions acts as a powerful reinforcer, likely increasing the likelihood that people will continue to have self-harming thoughts and behaviors. It also implies that treatments need to focus on how to help people replace self-harm with other ways of relieving stress.

Given that approximately 40% of people who attempt suicide do not receive mental health services, we believe it is important to share strategies to help people at risk of self-harm talk about their feelings and feelings. provide resources for finding professional help.

Strategies for Discussing Self-Harm

Teenagers who self-harm and/or think about suicide are a heterogeneous group – people are unique, after all. However, our results suggest that self-harm serves an important function for young people: to help regulate emotions.

It is essential that adolescents who have self-harming thoughts and behaviors find adults and/or peers with whom they feel connected. The CDC survey mentioned earlier showed that young people who felt connected were significantly less likely to consider or attempt suicide than those who did not feel connected. So, making sure teens feel loved and supported or that they “belong” at home and at school can be a way to protect against self-harm.

We have found in our clinical work with young people who self-harm that it is important to balance validating their emotions – in other words, acknowledging and accurately understanding their feelings – while not responding to self-harm in a way that may inadvertently reinforce it. If, for example, adolescents felt that the only way to receive support or validation was to self-harm, then it would be important to ensure that validation is provided when they are not self-harming .

Here are some key ways to validate and show your support:

– Pay attention: We all know how it feels to talk with someone who isn’t paying attention or looking at their phone. Make eye contact and show that you are interested in how the person is feeling.

– Reflect: Summarize what the person is saying to show that you are listening and taking in the information. You could say something like, “Let me make sure I understand…” and then paraphrase what you hear.

– Try reading their minds: Imagine yourself in the person’s shoes or guess what they may be feeling, even if they haven’t said it directly. You might say something like, “I guess you must feel like no one understands what you’re going through. If the teenager says you’re wrong, give up on being right and try again later.

– Validate based on past events: Show that you understand how feelings make sense given what you know about the person. For example, you might ask, “Have there been times when you had experiences similar to today? You might say something like, “I can totally understand how scared you would be to fail this test, since you studied hard for the last one but didn’t do as well as you wanted to.” .

– Recognize that feelings have meaning in the present: would other people in the same situation have the same feelings? For example, “Anyone would be scared.” It communicates to the other person that there is nothing wrong with the way they think and feel. You will not be able to validate everything; for example, you should not validate that self-harm is an effective response to distress. However, you can validate that self-harm is understandable because it can provide temporary emotional relief even if it causes long-term problems.

– Be “radically authentic”: Be authentic and try to show the other person that you respect and care about them. Treat him as a person of equal status who has significant expertise on how to help solve the problem of his self-harm.

lend a helping hand

It is important that people know that help is available. The National Suicide Prevention Lifeline (800-273-8255) is free for anyone in emotional distress. Now Matters Now is another free resource that offers coping strategies for managing self-harm and suicidal thoughts for people with lived experience.

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Previous research has shown that some behavioral interventions, such as cognitive behavioral therapy – an approach that focuses on the interplay between thoughts, emotions, and behaviors – or dialectical behavior therapy – a comprehensive set of treatments that teaches mindfulness, emotion regulation, distress tolerance and interpersonal coping skills – are effective in reducing self-destructive thoughts and behaviors. Both treatments are designed to provide individuals with the skills to recognize their emotions and change their feelings without harming themselves.

Find a cognitive behavioral therapist

Find a therapist who offers dialectical behavior therapy, ideally a therapist who has been certified by the DBT-Linehan Certification Board who has demonstrated the knowledge and ability to deliver DBT following the manual.

This article is republished from The Conversation under a Creative Commons license. Read the original article here: https://theconversation.com/why-do-teens-engage-in-self-harm-clinical-psychologists-explain-how-to-help-teens-reduce-their-emotional-distress – 181419.


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