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Janelle Booker
We all know the worrying statistics – mental health difficulties in young people have sky-rocketed in the past decade or more and there don’t seem to be a lot of clear explanations for this. Parents of our current teens and young adults have tended to sacrifice their own needs and enjoyment to give their children the best opportunity of a happy and healthy life, are understandably shocked and confused when they discover that their child is struggling so much with their mental health. Finding out that your child has a problem with anxiety or depression can trigger a big tangle of difficult emotions. But finding out that they are deliberately cutting themselves can be terrifying.
Some of the mums and dads I work with are disbelieving when they speak to me prior to me seeing their teen. “She says she’s cutting but I don’t see any evidence of it,” is a statement that I have heard more than once. Their assumption seems to be that their teen is seeking attention by being dramatic. Other parents see the evidence for themselves and panic. They assume that their teen has made a suicide attempt and they threaten (this is how it feels to the teen) that they will be taken to hospital if they ever cut again. Which, of course and unfortunately, exacerbates the teen’s distress.
Working with young people for many years, I have grown very accustomed to people, often (but not always) girls and young women, cutting themselves. Usually in neat rows of short, fine lines. Some are raised scars and others are barely visible. Across their thigh or inner arm or stomach. Usually where they can hide them from others.
Cutting is a very effective (though not an adaptive or preferable) way of regulating a dysregulated and distressed state. Human beings will always find a way of regulating when they are in an uncomfortable state of dysregulation. You probably do it yourself, without realising it. Some are healthy ways of regulating, but many are not. As adults, we have several options available to us to regulate when we are uncomfortably dysregulated and you may be familiar with some of them – drinking a glass of wine after a stressful day, spending money, eating chocolate or ice cream, flirting with a person who is not your partner, the list goes on. Although most of us are not aware, these actions help us to get some instantaneous relief when out internal state becomes uncomfortably out of balance.
The brains of our teens and young adults are undergoing a major reconstruction, from the onset of puberty until the age of 24 or 25. During this time, amongst other changes, the intensity of their emotions is ramped up. For many young people, their emotional and physical state can becomes so dysregulated and stuck that it feels unbearable and unchangeable. Some, when this happens, will experience an intensity of emotion that feels absolutely intolerable, while for others their emotional distress will trigger an unbearable emotional numbness.
What some young people discover is that making a superficial cut to the skin has a profound and almost instant regulatory effect on the mind and body. Endorphins are quickly released into the bloodstream (just as when we drink a glass of wine or buy something we desire) and this brings about a sense of calm and ease. Distress and pain subside quickly. And while there may be some pain that kicks in at some point, it is physical pain which can be a lot easier to tolerate than emotional distress. And, just as your mind gives you a little nudge the next time you start to feel dysregulated (“I need a glass of wine”), the teen’s mind, the next time she becomes dysregulated, will remind her that she can always cut to find relief from the distress, thus setting up a cycle.
In my experience, cutting is something that most people are ashamed of and want to stop doing. Many are successful in stopping themselves from cutting most of the time they experience the urge, although this takes great energy and effort. The good news is that there are alternatives to the quick-fix solutions that our mind instantaneously provides us with when we are dysregulated. Adaptive ways of regulating, rather than maladaptive ones. Like talking to a trusted person about how we are feeling or what happened to us, or going for a run, or spending time in nature or with an animal. Finding what works for each person, however, takes time and practice and lots of patience.
If you suspect that your daughter is cutting, the first thing you can do is to get calm yourself (self-regulate). And then choose a time and place to speak to her about it – when you are both calm and unhurried and alone. You don’t need to say too much. Let her know that you can see that she is struggling and offer to listen to her without offering advice or judgement. Ask her whether there is anything you can do that might help her. And ask whether she would like to seek professional help to learn how her manage her distress in a different way.
Finally, supporting a child who is in psychological distress is difficult, exhausting and can be overwhelming so make it a priority to find some support for yourself if you haven’t already. A close friend or family member, a church leader, a psychologist, your GP. The best way to help a dysregulated child is to help them to regulate themselves (this is called co-regulation) and this is only possible when you are calm and regulated yourself.
Janelle Booker is a Counselling Psychologist who has a special interest in working with teens (and their parents) to enhance their capacities for self- regulation so that they can live a life of greater calm, connection and vitality. She works from West Perth in Western Australia but also sees clients via telehealth.
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