A context for self-harm

When we discover our child is engaged in self-harming behaviour – whether burning, cutting, or otherwise interfering with their body – our automatic response as a parent is to be fearful. We fear because we don’t understand why our loved ones are doing this, and we intuitively know it relates to their attachment to themselves.

The child’s relationship to their harming behaviour is a private one. It provides him or her with a physical and emotional form of stimulation.

Our skin is our body’s largest organ, and we use it in many ways to soothe ourselves and to present ourselves to others. We manipulate our skin through dying and styling our hair; getting a tattoo; piercing a body part; tanning our skin; reshaping our body; or adjusting, and changing our appearance. This is a widespread phenomenon, and when taken to the extreme, it can result in what we refer to as self-harm.

When we take a step back from our concerns about the child’s behaviour, we can see the behaviour in attachment terms.

When we try and take choices away from our adolescents, we change the meaning of the behaviour and it becomes an interactive rather than a private one.

We relate to the behaviour as it appears to us. It becomes something we see as harmful, and we want them to stop. Therefore it has a different meaning. The behaviour moves into the relationship, and we begin to say, “I want to control you. I am determined to control you.”

When we intervene, the cutting becomes involved in the context of our relationship with the child.

The child has a personal and individual reason for the behaviour, and in order for them to stop they will have to meet that reason for doing it in another way.

By stepping back and offering proximity and conversation, we begin to understand the reason for the behaviour, and thus we are able to offer them substitute alternatives.

When we are triggered in this way by our adolescent’s behaviour, mindfulness helps us get past our automaticity and move into the present moment. Then we are more able to have a conversation in which we might ask, “How does that behaviour help you?” rather than, “How does it hurt you?” Our curiosity can be interactively mindful, non-judging, and intended for the benefit of the child.

In my practice I try to see behaviour, including self-harm, in the context of choice. I see the person separate from the behaviour. The harming is what they do, not who they are.