Understanding Self-Injury

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A Note from the Editors: Pastor Scott Sauls has said the following: “Studies indicate that when we suffer mental illness alone, the results can be tragic, even horrific. When we suffer inside a support system, however – when we bring our pain and sorry and stress into the light in the context of redemptive community – the chances of coping well become exponentially higher.” Far too often in recent months, Americans have experienced the tragic and horrific results of untreated mental illness even as we struggle with mental health challenges in our own hearts and homes. Mental illness isolates the sufferer and destroys community at every level, from friendship to family to church to city. Teenagers are at the forefront of this epidemic. At Rooted, we seek to be a small part of your support system, just as you seek to support and encourage the students in your care. This week, we will share articles that examine different facets of mental health, remembering that no matter the challenges we face, we have a living hope in Jesus Christ.

 

Have you ever used something that was a quick-fix, but wasn’t the best tool for the job? Have you succumbed to that desperate need for coffee on vacation and used paper towel as a makeshift filter? Or have you grabbed a butter knife when a flat-head screwdriver couldn’t be found?

Similar to the way we see naked humankind first improvise with fig leaves in Genesis 3, coping mechanisms like self-injury arise from a reactive, and sometimes desperate need to deal with something we cannot tolerate (like emotional distress) or something we need support in (like depression or interpersonal conflict). As bizarre as it may sound, these coping mechanisms serve a purpose and are effective at bringing relief from something (e.g. consuming anger, loneliness, or numbness) even if they are harmful to something else (e.g. the body).

So, we may use the paper towel coffee filter to the detriment of the actual coffee maker or the quality of the coffee in the end; but we were far less concerned with the coffee maker or the quality when we stuck the paper towel in there. We wanted coffee, and we wanted coffee immediately.

As discussed in my article yesterday on understanding coping mechanisms, these provisional substitutes perform an immediate function (e.g. covering Adam and Eve’s nakedness) but also serve other purposes that tend to require our curiosity to uncover. It can be tempting to try to eliminate the harmful behaviors (e.g. cutting, burning, scratching, or bruising) without understanding their various purposes. But this is an unwise path that might be comparable to God ripping off Adam’s and Eve’s fig leaves, thereby ridding them of their makeshift clothes – this gesture would remove their coping mechanism, but leave their fear and shame intact (and perhaps increase it). Adam and Eve need more than better clothes; they need total restoration. They need reconciliation with God, others, and themselves, which comes through the One who conquers death. They need the tender, patient, love-filled invitation to be seen and known.

A maladaptive (or dysfunctional) coping mechanism like self-injury might be better understood as a survival mechanism, arising less from the logical, decision-making part of our brain (the prefrontal cortex), and arising more from the protective, reactive, survival part of our brain (the brainstem). This part serves us well by activating when we sense danger, sending us into “fight, flight, or freeze” mode. However, sometimes our signals don’t work quite like they should, meaning danger is sensed where there is no actual danger (e.g. the smoke detector in our house goes off and we flee the house immediately, only to find that someone has just burned dinner on the stove).

Take, for example, the student who finds himself picking up a razor to score his thigh yet again. He has reached a point of being unable to tolerate something that is happening internally, some smoke detector that’s screaming at him. This could be an experience of deep distress, of overwhelming numbness, of anger, sadness, or something else (which he may not even be aware of). And, likely without thinking, he’s immediately found something that brings relief, distraction, an alternate feeling, a sense of control, or an expression of what is happening inside. This kid is just reacting to that smoke detector; he hasn’t taken (or isn’t able to take) time to consider whether or not there is real danger, or just burning meatloaf.

It can often take some serious time and work to unlearn that “flee the house” behavior (self-injury). It isn’t as simple as someone explaining to you that there was, in fact, no fire. And it isn’t as simple as someone offering you some scripture that talks about the hope we have in Jesus. Those are a very good start, but they don’t reflect how God, Himself, deals with people’s reactive self-protection; they don’t consider the mysterious, multi-faceted nature of humans. We are not merely behaviors to be fixed, minds to be trained, or hearts to be reshaped.

As we consider what it means to enter into confusing, hard, and difficult coping mechanisms like self-injury with our students and parents, it is important to remember that our hope is not in our ability to figure out the “why,” and our goal is not the total eradication of the destructive behavior. (Did I just say that? Yep!)

As shepherds who walk alongside hurting families and kids, our purpose is none other than Love Himself, who is in the business of re-storying us, and teaching us how to live as whole humans. So what are some of the ways it might look to love these students and to invite them to Jesus?

Incarnation

Like Jesus, we are invited to love incarnationally, meeting these families right where they are in their darkness. We make calls to check in, we visit the student in the hospital (if possible and desired). And we practice gentle, patient, empathetic listening. We don’t seek to listen just to figure out “why.” We seek to listen for the sake of the other, for the sake of connection and support. We seek to enter their story to bear witness to it, and to bear the burdens and pain of it with them. We follow a deeply involved, deeply relational God who loves to enter into the darkness to bring light, healing, and wholeness. And we remember that it is only by, through, and in Him that we enter into these places with our students and families.

Long-suffering

Also, like Jesus, we are invited to be long-suffering and patient, as change happens slowly. We are invited to put aside our own need to fix, rescue, or find answers (which is so hard!) for the sake of love. We are invited to pray, to pursue faithfully, and to empathize with the difficulty of facing broken things about ourselves that aren’t quickly healed. We recognize, here, that love is inefficient, and that God’s story of our redemption and restoration is infinitely more creative than our own.

Seeing and Knowing

Remembering God’s gentle and engaging question in the garden—“Where are you?”—we are invited to see and know our student beyond their fig leaves, which distract. We have the privilege of getting to invite them to see and know themselves in light of the dignity and worth with which they’ve been created. This is a wonderful time to remind them of the way Jesus sees them, and to share with them the glory we’ve seen in them. Are they creative? Compassionate? Justice-seeking? Welcoming? Thoughtful? Perseverant? Courageous? It is worth taking time to think of specific examples to share with them of where we’ve seen the image of God in them. We want to reinforce that they are not merely “a cutter” to you, even if they have begun to relate to themselves this way.

As we deal tenderly-yet-strongly with students and parents going through a chapter of self-injury in their story, we want to keep in mind that it is a destructive coping mechanism to be taken seriously, and it warrants professional help. It is not always associated with suicidality; these are two different things. However, folks who are struggling with self-injury do have a higher likelihood of struggling with suicidal thoughts, so we always want to ask if that is the case.

Although it can be helpful to understand the primary functions of self-injury (it reduces negative emotional experiences – whether that is pain or numbness, and it communicates distress outwardly), we also want to respect that it is not often easily resolved. Adopting a compassionate posture of empathy, curiosity, and support is one of the most important things a parent or youth worker can offer, and seeking the help of a professional counselor is very important. Below are some of the warning signs to look for:

  • Scars (especially linear cuts)
  • Regular unexplained cuts, bruises, scratches, or missing patches or hair
  • Isolating behaviors (draws away from friends, from you, spends more time alone)
  • Wearing long sleeves or long pants in hot weather when they normally don’t
  • Brushing off injuries as frequent “accidents” or results of being clumsy
  • Withdrawing from once-enjoyed activities
  • Mood changes that aren’t common to them, or expressions of helplessness, hopelessness, or worthlessness
  • Other unpredictable, impulsive behaviors

 

 

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