That Kind of Breaking

The guidance counselor was kind and calm. Anyone who can maintain those two qualities while in the confines of a public middle school all day has my immediate respect. I sat and listened as he began to speak.

“Your daughter tells me things have been rough at home, that your family has had some pretty big challenges.”

“Yes. That’s true. We certainly have.”

It had been about two years since my husband’s traumatic and failed fight for his life, and though he was a stepfather to my children they loved and missed him deeply. I had returned to the workforce, my son had moved to his dad’s and his sisters didn’t often see him, we had made the transition from homeschooling to public school, and my older daughter had recently been released from a five-day stay at the psych ward.

Yup, I’d say those were some pretty big challenges.

“Well, she’s been having a tough time dealing with it all, as you can imagine.”

Teenage Problems, Social Issues and Bullying

This was the coming-to-life of some of my deepest held fears at the time. In all fairness, I had quite a few fears, pretty much all of which included my kids. I knew that my older daughter’s struggles and rages were traumatizing our family. I knew that her continuing self harm and relentless thoughts of suicide were more than taking their toll.

I knew that I tried so hard to protect my younger daughter from her sister’s struggles, even as I didn’t know how to define or predict what those struggles might be. I knew how frightened I was, and I could only imagine how terrifying it must feel to a 13-year-old girl whose world had been shattered long before her sister’s mental balance had.

I knew that my youngest was getting lost in the shuffle of psychiatric appointments. I knew she felt invisible and dispensable as so much of my time was spent talking her sister ‘off the ledge’, cleaning and bandaging her self-inflicted wounds, walking on eggshells, trying to find an answer, a balance, a cure.

I knew that the older often goaded the younger, then immediately wanted her sympathy and compassion. She showed us all macabre, dark drawings she’d made, somehow expecting us to praise the depictions of death and blood she produced.

I could make no sense of it as an adult. I certainly could never expect my youngest teen to have the ability to process and make peace with all that was going on. And yet I felt powerless to guide her. How can you teach someone to do what you are unable to do yourself?

And so here we were, in the school guidance counselor’s office. I was waiting for what I didn’t want to hear, but what I needed to know.

 Worried

My daughter had ended up there after having had a particularly rough day, and she’d thankfully confided in her counselor about the unfathomable mess that was our family. She’s always been one to think she can tough her way out of anything (I have vivid memories of a three-year-old determined to swim in the deep end of the pool, working hard to hide the panic on her face) and I was so glad to see that she’d taken the chance to share her confusion and pain with a trusted adult.

The counselor continued, gently breaking the news to me that my daughter – the one here with me, not the one (hopefully) waiting in the car – had been cutting herself as a way to deal with her distress and pain.

My stomach dropped then just as quickly threatened to jump up out of my throat. I was facing my daughter, whose eyes were filled with many things, including fear. I knew she’d seen me deal with her sister and that she’d seen me be both gentle and brusque in trying to stop the ongoing and escalating self harm. Of course she had to be nervous about what my reaction to this news would be.

Outwardly I pretty much held it together, meaning I didn’t curl up in the corner in a fetal position. I fought the sudden nausea I felt.

But inwardly I was breaking, as if there was a  tire screeching, metal crushing, glass shattering  75 car pileup, the kind where you know things are so out of control you are clueless as to where or how to start administering any kind of aid. The kind where you are the lone witness and all you have are Band-Aids and the phone lines are down so try as you might you can’t call for the 50-plus ambulances that you need.

That kind of breaking.

 Car pileup

Tears sprang to my eyes.

“Oh, sweetie.”

It was all I could say.

© Monica Simpson and Help To Hope, 2014
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A Tough Task

“Yes. I’m her mother. Can I help you?”

I got the call while I was sitting in the car outside my younger daughter’s middle school. I’d left work, picked my older daughter up at her high school, and driven to the middle school to park and wait for the day’s final bell. The interaction with my daughter sitting next to me was stilted and unnatural, as it so often was at the time.

 girl in car

Source

Her behavior after release from her first hospitalization for a mental health hold had been shaky. We’d had high hopes and bundles of nerves, and we were trying hard to make right something that we weren’t even able to completely identify.

In addition to obvious depression and unmanageable rages, she’d become involved with a boy at school who shared some of her struggles. He was a nice enough kid, but the dysfunctions they shared caused them worrisome co-dependence, especially when it came to their self harm behaviors.

teen couple

 Source

And while being together could be uncomfortable for both of us, I had serious concerns about leaving her unattended. She had alluded to running away on a number of occasions,  even trying to run off on that weekend before I’d had to call the ambulance. I knew that her thought processes were off-kilter enough that she could make some dangerous decisions.

My youngest daughter’s guidance counselor had called while we waited. “I have her here in the office with me. Is there any way you can meet with us before the school day is over?”

“I’m actually parked right outside. I can be right there,” I replied. The evasive, non-committal tone of the conversation made it clear to me that no good news was waiting inside.

I did the quick mental gymnastics: If I leave her here in the car while I go inside, will she be safe? Will she run? Will she be here when I get back? Should I make her go inside with me, feeding her insistence that I never trust or understand her?

I swallowed hard as I told her that I needed to go inside and speak with someone, and that I’d see her when I was done. She sat with her earphones on, black eyeliner encircling her downcast eyes, too cool and too annoyed to acknowledge much of anything. I put my car keys in my purse and walked to the school entrance.

Photo: D Sharon Pruitt

I signed in and was directed to the counselor’s office where my younger daughter peered up at me nervously from her seat. She was dressed like a typical middle-schooler, sporting a bulging backpack, carefully styled hair, colorful braces, and inches of plastic bracelets halfway to her elbows.

I tried to smile, to remain calm, to not read into the situation anything that wasn’t specifically presented. After all we’d been through as a family in the past years, that was a tough task to handle.

© Monica Simpson and Help To Hope, 2014
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https://twitter.com/HelpToHope

A Friday in February

+++ SELF HARM TRIGGER WARNING+++

*****

“Can you step in to my office, please?” It wasn’t unusual for my daughter’s therapist to ask me back for the final part of the session, so I followed her. My daughter sat sadly in a leather chair, and I took my place next to her.

“She has something she needs to show you.” I was puzzled as my daughter stood part way and started to unzip her jeans. Still hunched over, she pulled down one leg of her jeans further than the other. I winced as my eyes began to water.

There, etched in large, crude letters covering most of her thigh, carved not with a pin but with the thick blunt end of large household scissors: FUCK

My hand instinctively went to my mouth in deep grief. My heart raced and my stomach began to churn with anxiety as my daughter quickly zipped her jeans and sat down.

She had not shown me this damage she had done to herself, and she had purposefully not cleaned the cuts.

I kept thinking how badly it must sting, to have tight denim on the open scrapes she had self-inflicted only the night before. She’d worn those jeans all day; I imagined how every time she’d moved or adjusted her pants, the wounds would have ruptured anew from the bond they’d made to the fabric.

girl in jeans

(Photo Source: Google Images)

Her self harm and self hatred had become unmanageable.

I wanted to scoop my daughter up, to take her home, to clean her wounds and make her pain disappear. But weeks’ worth of trying had made it abundantly clear that such a thing was beyond my capability. And on top of that, my daughter deeply and openly resented going to any type of mental health counseling.

Her stock was placed firmly in the peer group she had chosen, and any efforts to intercede for her safety were complained against. She went to therapy because I made her go, but her emotional loyalties were to those who had taught her about self harm and with whom she was dangerously emotionally enmeshed.

I believe that a small part of her was hoping desperately for help and rescue, though the larger and more visible part of her was resentful and angry at the intrusion of counseling appointments twice or more each week. But what choice does a parent have? It was soberingly clear this was not a phase she would outgrow.

“We’ve been talking,” said her counselor, “and while I think she is right on the cusp of needing to be hospitalized, we have come to a compromise.”

To the best of my understanding, while my daughter was saying she wanted to die, she did not have a specific plan to carry out that desire. And that’s how we ended up in the therapist’s office on a Friday afternoon in February, planning a long holiday weekend of what was basically house arrest.

jailcell door

(Photo Source: Google Images)

“She has to be with someone 24 hours a day. She must sleep, eat, and be in the same room with you all the time. She cannot be alone except for short bathroom breaks.”

My mind raced to take in all the information, envisioning how we would put the plan into action. I’m nothing if not a planner, but even I was overwhelmed by this. “We’ve agreed that if she will stick to this plan, she won’t have to go straight to the hospital when you leave here today.”

I nodded as I looked at my daughter’s therapist, trying to take in the details and instructions, but inside of me there was a thunderous voice of fear and uncertainty: “WHAT??? Are you nuts?!? I think she should be hospitalized! NOW! How can I do this? This is impossible! I cannot keep her safe!!!”

I looked over at my daughter, who had disappeared inside herself. She was definitely angry, but she was more frightened by the thought of actually having to go to the hospital on a mental health hold.

sad_girl_by_majed_ahmad-d33oeft

(Photo Source: majed-ahmad, http://fav.me/d33oeft)

Despite my own fear, I chose to believe the part of her that was the frightened child, the part that felt trapped and afraid and just wanted to go home. So we went home with plans to return in four days.

 

© Monica Simpson and Help To Hope, 2013

Uncertain

+++ SELF HARM TRIGGER WARNING +++

*****

“She needs to have her medication changed.” These were the words of the therapist who had been seeing my daughter for a few weeks. “And I’d like to arrange for some testing, too.”

There were mornings when, in a panic, my daughter had had to leave school. Thankfully, on some of those days, I was able to miss work and take my daughter to an emergency therapy appointment. Her dad had even left work a time or two to pick her up and take her when I was unable. Oftentimes she calmed down and was able to return for part of the school day.

crowded high school hallway

(Photo Source: Google Images)

The steepness of her downward spiral was becoming painfully clear. Still, I worried that she was being rescued in an unhealthy way, unsure of what was in her control and what was not. I felt uncertain as to whether she was just manipulating me, or if the bulk of her actions were really symptomatic of things beyond her control.

Was she just trying to get out of classes she didn’t like? She was skipping so many of them anyway that maybe she was just using panic as an excuse. I looked forward to psychological testing, hoping it would provide some answers. I didn’t realize that it would not happen until months down the road.

The anxiety was believed to be caused by medication, thus the therapist’s advice to switch to something else.  The change was made from one SSRI antidepressant to another. The side effects were no different. Panic and anxiety grew. Physical ills plagued my daughter. Depression deepened to a place far beyond blackness. And I began to see more clearly that what she was experiencing was very, very real.

I felt that despite all my best efforts to provide stability after her dad had left years earlier, after my attempts to address and allow for grief following her stepdad’s death less than two years prior, I had failed. Miserably. I only knew that I was at my wit’s end. I had no more ideas, only a deepening panic. My heart broke for her struggle, but I felt powerless.

Anger and rage poured from my mild-mannered, fair-skinned, introverted middle child. Although she was at her dad’s at least pretty much every other weekend and then some, she saved her raging for me. She has come to tell me in the ensuing years that it was a safety issue to her, that she felt I was a safe place for her to unload her fury and frenzy.  At the time, I was simply bewildered and deeply hurt.

angry teen girl (google)

(Photo Source: Google Images)

She self harmed daily with much more than just a single cut. There were times when, after she cut, I would calmly clean and bandage her wounds. I would offer her my tears as a cleansing balm, hoping she would see the love I had for her, and that it would somehow fill the chasm of her need. Other times, I would remain detached and aloof, thinking that if I approached this matter-of-factly, the emotional dysfunction she was seeking to feed would instead be starved out.

Although she often cut while alone in her bed at night, I reminded her that she needed to be sure to clean her wounds to avoid a dangerous infection. (These types of conversations are not covered in parenting books, by the way.) After all, my late husband had succumbed to sepsis, his body unable to fight and overcome a serious infection, which had ultimately taken his life.

While she would at least sometimes attempt to sanitize a cutting instrument with a lighter, the concept of death by infection seemed to somehow intrigue her as she began to allude to her own demise. In fact, at least once she said she welcomed the idea of such a manner of death.

Her bed sheets and pillowcases became bloodstained. She left bloody tissues or clothing lying on the floor, evidence of the previous night’s anguish. I hated to go to bed every night, truly fearful that on any given morning I would find my daughter dead from one cut that had accidently gone too deep.

I remember wondering for a while if she was cutting on purpose, to manipulate me, to see how she could get me to react or what kind of sympathy she could garner. So sometimes I simply didn’t engage with her after she had self harmed. I told her to find the bandages and soap and take care of it herself.

And then there was the time I had just had enough. I was so fed up, so terrified, so OVER it. I was furious with panic and confusion. And I told her so. And that’s the time she remembers. Of course.

I can’t undo it, but it still feels shameful to me. I didn’t know then what I know now, and I try hard to see it as one incident in the scope of the whole journey. But I’m still embarrassed and deeply saddened by my behavior that evening.

(Source)

One memorable night she came downstairs to my room and showed me her arm. The fresh carvings were somewhat erratic and still bloody, so it took me a few seconds to decipher what I saw.

U  R  SHIT

There it was, on her arm, under my nose. Still wrestling with my own culpability in her struggles, and because she had presented herself to me for inspection, I asked her slowly and as gently as I could, “Um, who are you saying that to? Are you trying to say that to me?” Because if so, I would have much preferred she just declare it to me, not carve it into her body as a permanent reminder.

I remember the tears in her eyes.

“No, mom. It’s to me.”

And so we wept together as I silently begged for some kind of help to save my daughter from herself.

© Monica Simpson and Help To Hope, 2013

Do you have a teen who is self harming? Please see Responding to Your Teen’s Self Harm. Information regarding self-injury (cutting, burning, biting, bruising, etc.) can be found at  S.A.F.E. Alternatives, Self Injury Foundation and Self Injury Outreach and Support.

Searching For Help

I started January of that year searching for a therapist for my daughter. The family doctor had listened as she and I had talked openly of her pervasive sadness and increasing self injury. He prescribed an antidepressant for her, and made it clear that mental health counseling was essential.

Besides the constraints imposed by insurance, I wanted desperately to find a mental health professional close to home. I was, after all, still a widowed single mom with two daughters. I had intense and constant worry about my younger daughter, not only about her exposure to her sister’s maladaptive coping skills, but also about her  getting lost in the shuffle now that my older daughter’s issues were taking virtually all of my time and energy.

I had to fit in my daily work schedule as well as transporting both girls to and from two different schools at different times. Their dad, who had left more than ten years earlier, had given some lip service to helping transport them, but claimed that he really couldn’t help on a regular basis because of his work schedule.

This left most of it to me, except for those rare occasions when I could find someone willing to carpool on our schedule.  So for better or worse, proximity to home became a factor for hiring a therapist.

I finally located a counselor whose office was close to us. She was kind, professional, knowledgeable, and not a very good fit for my 15-year-old daughter. Still, I pressed my daughter to give her a try. “She’s not here to be your best friend. She’s here to offer her knowledge and help work some things out.”

angry girl in therapy (google)

(Photo Source: Google Images)

And this is where I must say, that is a terrible attitude to take into therapy. Imagine telling your deepest pains and fears to someone you just don’t click with, to someone who may be very nice but with whom you really feel no personal connection. I wouldn’t do it.

But I mistakenly expected my daughter to. I was wrong. I wanted her to do it because I was scared and exhausted and weary to the core, but I was still wrong. I didn’t know how to be two places at once, or how to keep my younger daughter from feeling forgotten and lost, but I was still wrong.

I have since referred other people to this therapist. I meant it when I said she was kind, professional, and knowledgeable. But I also meant it when I said she was not a good fit for my daughter at that particular time. Still, for a few weeks, we made regular trips to see her.

During those weeks, my daughter began to feel the effects of the antidepressant she had begun. She was exhausted, felt physically ill, experienced increased anxiety, and ironically fell deeper into depression. Many days I would take her to school, only to have her call me in a panic, unable to stay beyond even part of the morning. By this time, her self injury was increasing in both frequency and intensity, as was my fear.

Both carefully crosshatched as well as untamed cuts often covered her forearms, etched with safety pins, push pins, or blades taken from disposable razors. Her anger would spew out in screaming rages, in torrents of sobs neither she nor I could help her to control. What had happened to the loving, affectionate, self-assured girl who had been my daughter?

One moment she would curse me to the four winds, and the next she would fall into my arms for comfort and reassurance. Her terror was matched by my own, but I did not have the luxury of letting mine be known.

Her moods and tirades ruled our home, and I grasped desperately for ways to quell the unpredictable storms. I tried reason. I tried consequences. I tried being emotionally neutral or removed. I tried tough love. I tried empathy and understanding. Always I tried to convey my unconditional love for her.

In truth, the deeper she fell, the deeper my heart broke. The more she pushed me away, the more I longed for her to know the love and safety that were ready and waiting for her. It’s not that I could have loved her more than I already did. It was that I ached more deeply for her to know the love that was already hers.

TEEN-BEING-HELPED-BY-MOM-copy1

(Photo Source: Google Images)

There were many times when my daughter vented her anger that I simply laid down on the floor during our conversations so that she would not have any reason to feel threatened. I didn’t realize what I was doing until afterwards. I did it instinctively, recognizing that she felt susceptible to some deep, unnamed danger. What I failed to understand was that her biggest threat came from within.

 

© Monica Simpson and Help To Hope, 2013

Darkness Descending

After my husband’s death, I took over the off-site property management of an apartment complex he’d managed for years. I did my best to learn the job without the benefit of a teacher, and even managed to figure out some of the many details he’d kept brilliantly within his own mind, thus taking them to the grave. (I had plenty of one-sided conversations with him about this, believe me!)

But a year and a half after he died, the apartments were sold and the new owners brought in all new staff. Not only did I have to lay off some dear and hardworking people, I lost my own job as well.

I found more work relatively quickly, but the stressors of a sharp learning curve and constant change, both personally and professionally, were wearing me down. I missed the calming reassurance of my husband’s presence the most in the quiet, solitary hours of nighttime, so my sleep schedule was often erratic at best.  I was weary and worn, pulled on every side, knowing there wasn’t enough of me to cover all the bases that needed to be manned.

I felt that I was leading my little family into a new school year in about as unsettled a manner as I could imagine.

schoolbooks

(Photo Source: Google Images)

The previous fall, less than 6 months after my husband died, we were of course all still reeling with the loss. I had homeschooled both of my girls up to that point. They had always been involved in enrichment programs, youth groups, parks and rec activities, and/or homeschool co-op, as well as having friendships with neighborhood kids.  In the interest of allowing them to honor their own grief and needs, I let them each choose whether or not they would stay home for school.

My younger daughter had chosen to no longer homeschool. But my older daughter chose to remain at home for one more year, her final year before high school. She was an introvert to be sure, but had always made friends easily and was fierce and loyal in her friendships. She was compassionate and empathetic, with a heart quick to love, give, and forgive.

A year later, in preparation for high school, she had gone to freshman orientation. Later, we had walked the empty halls to find her classrooms so as to ease her in to her daily schedule.

As I dropped her off that first day of school, she was anxious and tense. “Mom, I just want to throw up.” I did my best to lovingly but firmly send her on her way, confident that she would make friends and find her place. After all, aren’t the majority of high school freshmen nauseous with worry on the first day of school? Don’t we all have to learn to make our way, to take a big, scary leap into the world at some point, and learn that we will indeed survive?

I watched with curiosity and concern while she went about making her way. I came to learn later that because of her quiet nature and unique style, other students made erroneous and unkind assumptions about her. Like all of us who were not in the popular crowd in high school (which by definition is most of us), she was misunderstood and unfairly mislabeled by adolescents whose opinions I wish hadn’t mattered to her. In response, she latched on to the first crowd that welcomed her.

They wore, for the most part, black clothes, black hair, black makeup, and hair in their faces to obscure wounded and mistrusting eyes. I observed relational dysfunction, adolescent angst, and the deep longing we all have to find a place where we feel loved and worthy.

They talked of things dark and macabre, and from them she learned of self harm and the relief they claimed it offered. While some of them had blonde hair and wore neon colored clothing and toothy smiles, they all shared a brokenness that drew them together. And I could fault none of them for the wounds that had been visited upon them.

I was sad for their pain, heartbroken and even angry for what my daughter was exposed to through them, but I understood that they were really just a group of wounded souls, holding on to one another for dear life. They were brokenness begetting brokenness. Still, when your child is in the quicksand, you don’t just feel sad that she has fallen in. You fight through hell and high water to get her out.

quick sand

(Photo Source: Google Images)

As we neared the end of December, my anxiety increased as I realized my daughter’s depression, confusion, and self harm were increasing. She had written a lengthy and scathing diatribe of a suicide note to her sister shortly before Christmas. And while many siblings may go through times of severe dislike and perhaps even loathing of one another, this note was particularly troubling. It was rambling, coherent, precise, and inconsistent all at the same time.

My younger daughter had the sad and scary task of first reading it, and then bringing it to my attention. I will always be proud of her for summoning the courage to do that.

Chaos, despair, and self injury were enveloping my daughter’s first four months of high school. The road ahead looked more desperate and steep to me than any I’d ever seen, darker even than the realization less than two years earlier that my husband would soon die.

In an effort to bring order to the chaos, my daughter and I went to see the family doctor who’d treated her for most of her life. He prescribed an antidepressant and made it clear that mental health counseling was not optional.

 

© Monica Simpson and Help To Hope, 2013

In The Beginning

It began about sixteen months after my husband died.

He’d battled a rare liver disease for a few years, his diagnosis coming less than two years after we were wed. His final two months were spent in the hospital, save for a Valentine’s Day discharge home that lasted less than 72 hours. About five weeks later, we gathered around him, saying our final goodbyes as he lay unconscious. The nurses, by this time very dear to me, were kind enough to turn off the alarms that began sounding after life support measures were removed.

Hospital Monitor

(Photo Source: Google Images)

We had cried, we had prayed, we had sung, we had told him the things we felt were most important to say, many of us at the same time. It was a cacophony of loving sentiments and earnest anguish expressed in the most grievous of times. He breathed his last. We lingered a while.  And then we all went home.

My adult step-kids and their cousins left to return to their families. (I sure love all those “kids”.) My in-laws drove back home after the death of their firstborn. (I love them even now.) My dear mother, herself widowed a few short years earlier, left with what I imagine were difficult thoughts at best.

My son (age 16) was living with his dad, so while he departed to a separate destination, my two daughters and I walked into our darkened and forever-changed home. And while I rarely allowed them to sleep the night in my bed when they were little, we all piled under my comforter together in the cold March darkness. It didn’t matter that they were 12 and 13 years old. No one was going to sleep much anyway.

Life changed, of course. In drastic ways that could not be undone. Grief is an odd phenomenon for so many reasons, not the least of which is that everyone experiences it differently. But we could say the same about life, couldn’t we? Everyone experiences it differently. The triumphs and losses a family experiences together are processed and assimilated uniquely by each individual.

As I did my best to adjust to being a widow, an unexpectedly single mom for the second time, my kids did their best to adjust to life without the step-dad that they had known and loved for more than half their lives. The wound was deep.

My older daughter, a few months shy of her 14th birthday when my husband died, began to grapple with adolescence in more marked ways when she turned 15. It was subtle at first, not nearly as obvious or aggressive as it became in time. She had always been quiet and observant, even as a baby. Though introverted, she was affectionate, with a natural talent for words, music, and bold creativity. But as she prepared to enter high school, any sense of worth or identity she had possessed seemed to disappear into thin air.

When the kids were quite young (ages 7, 4, and 2½), their dad had made the choice to leave our family. Having been the child of divorced parents from years ago (before the divorce statistics were so high, when – unlike today – I didn’t know anyone else whose parents had split) I knew the potential for damage to my impressionable children. I took them to a counselor, and the most useful long-term piece of advice I received was that, as young children of divorced parents, they would most likely struggle more than normal during milestone transitions as they grew up.

This had absolutely seemed to be the case up to that point, so when my daughter started to act out with impatience, eye rolling, frustration, and withdrawal, I chalked it up to the cumulative losses we’d all been through, plus the hellishness that adolescence in general can be. And I reminded myself that the ride would likely get bumpier than most, but we’d get through it.

I saw her as I saw her brother and sister: capable, full of life, with so much to experience and to offer the world. I hoped that as she entered high school she would be able to try a myriad of new things, to find her niche. I expected the confidence in her many talents and abilities would only strengthen. I was wrong.

I am not so old that I don’t remember high school and what it takes to try to find your way socially. In fact, I went to three different high schools in three different states all within the final year and a half of high school. I remember well. But as I said, we all experience life differently, and my daughter’s experience was nothing any of us expected. Her sense of identity and worth were shaken to the core. The beautiful and talented girl I saw was nowhere in her view. While I tried to reassure us both that she would return to herself, she was spiraling into an abyss of confusion and despair.

It’s worth noting that I don’t think there is one particular reason we can point to for this. I believe it was the culmination of so many things, both genetic and environmental, that landed my daughter where she ended up, with peers who tended towards emotional dysfunction and physical self harm. Her black hair, black fingernail polish, and thick black eye liner didn’t concern me near as much as the darkening shadow in her heart. She was trying. She was trying so hard. But she was at a loss, and I was simply not fully aware of all she was wrestling with.

Goth makeup

(Photo Source: Google Images)

At first she tried to make excuses about the cuts I saw on her arms and wrists. At first I tried to believe her. In retrospect, I can see that she was initially reticent and even somewhat delicate with her self injury. But as time went on, as her darkness descended, the increasingly aggressive scratches, cuts, and gashes began to mirror the turmoil she felt inside.

 

© Monica Simpson and Help To Hope, 2013

Responding to Your Teen’s Self Harm

“I wish he would just tell me it’s all my fault. Then I would know I could fix it.”  This is what a shocked and saddened father told me recently when he found out his teenager was self-harming. How do we process the fact that our adolescent is purposefully choosing to physically wound him- or herself?  How do we fight the panic as we wonder if this is a suicide attempt? How do we answer the ensuing questions: “Does my child want to die? What did I do wrong? How do I make it stop?”

I have been that parent. I have asked those questions. I have cried in bewilderment and fear, wondering just where I went wrong and how I can back up and make it right again. I have pondered what happened to that toddling child who looked to me to make the world right, just as I have wondered what has happened to me, the mother who lived in the illusion that I could do just that.

Mom and Toddler from Stock.xchng
(Photo source: stock.xchng)

There is a deep and abiding sadness when we realize that what we are dealing with is well beyond the scope of our knowledge or experience, and also has the potential to be dangerous and destructive in the long-term.

IS IT A SUICIDE ATTEMPT?
Many parents wonder if their teen is harboring a death wish, if self-harm is a suicide attempt gone awry. I certainly wondered this. It made no sense to me whatsoever. The good news is that the vast majority of adolescents who self-harm fall into the category of non-suicidal self injury (NSSI).

If the emotional struggles that prompt one to self harm are ignored or left untreated, it stands to reason that this could eventually lead to a higher risk for suicide. And certainly there is cause for concern that self injuries could become more severe and dangerous than intended. This is not a behavior to be ignored, but non-suicidal self injury is just that, self injury without the intent of suicide.

I sometimes explain it this way to friends or parents who are as baffled as I was: When I was young, back in the olden days, and someone was having a tough time, they might get drunk, smoke pot, or engage in promiscuous and risky sexual behaviors in an attempt to relieve their anxiety and sadness, or just to get their minds off their problems. Granted, those are pretty poor coping skills, and self-injury can be classified as that as well, as a poor coping skill.

Like other poor options, it doesn’t mean kids want to die. It means they want the pain to stop; they want a distraction from whatever is causing them distress. Ironically, they are causing themselves physical pain in response to emotional or psychological pain.

But more often than not self injury is a non-lethal attempt to escape distress.

WHY SELF HARM?
Why would anyone choose to carve their own skin to the point of pain and bloodshed? Why do some teens intentionally burn or bruise, pick at, puncture, scratch, pinch, embed foreign objects into, or otherwise harm their bodies? When I was in high school, self injury was simply nowhere on our radar. It just wasn’t thought of. Southern Comfort, joints, and parking cars in dark deserted areas were, but purposefully harming oneself was not.

In today’s culture, estimates say that 1 in 8 to 1 in 5 teens hurt themselves physically on at least a somewhat regular basis. Some numbers indicate that 1 in 3 to even 1 in 2 adolescents have tried self harm at least once. It may be unknown to us parents and other adults, but it’s quite well known among the kids themselves. It’s not an unusual phenomenon to them and science shows the release of endorphins (a ‘feel good’ chemical our bodies produce) when one self injures can in fact give temporary emotional relief. This can lead to repeated acts of self harm, as teens look for a continuing, albeit short-lived, reprieve.

Some teens say they practice NSSI in order to “feel anything at all”. This may not be typical risk-taking behavior as we think of it. For instance, if I wanted to really feel something, I might take a bungee jump off a land bridge just to feel the adrenaline rush. (Thankfully, I don’t need that much adrenaline to get through my days.) Sometimes the rush of self harm can feel addicting. It can be devastating to hear your child say they are engaging in ongoing self harm or other risky behaviors just to feel anything at all. In my experience, this is a clear sign that there are some serious concerns to be addressed.

Self harm is not so much the problem as the symptom.

IS IT MY FAULT? DID I CAUSE THIS?
Short of being an abusive/neglectful parent or person in your teen’s life, I would advise you to not point a finger at yourself or even at a spouse, ex-spouse, grandparent, or anyone else you might like to lay blame on for what your child is experiencing. Of course we have said and done things that have caused our children angst, anger, embarrassment, and exasperation. (Isn’t that our job??)

We live in an imperfect world filled with imperfect people, and neither we nor our children are exceptions to that. We can second guess ourselves until we run out of breath and life, and we will always come up with things we should have or could have done better. Welcome to The Wonderful World of Parenting.

Here is an example from my own experience: My first husband left our family when our kids were 7, 4, and 2 ½. As time went on, it became clear that our parenting styles were very different. By observation as well as admission, it was obvious he was quite permissive, and I felt the kids were exposed to things that they weren’t ready for (such as R-rated movies in elementary school).

In response to this, I chose to be a more structured and sheltering parent, which most likely came across as overprotective and controlling. And perhaps in response to that, their dad became even more permissive. Were we trying to offset one another’s perceived parenting flaws? In doing so, did we cause confusion and frustration for our children? Of course. (And there are plenty of things I did just plain wrong on my own, regardless of my ex-husband’s actions and choices).

Life is challenging, and we all do the best we can with what we have. This applies to our children as well. Sometimes our best efforts fall short of the highest good. We keep trying, but we are far from perfect. Some teens (and some 50-year-olds!) are at a lower spot on the learning curve, and this can be part of the bigger picture of one’s choice to self harm. Sometimes mental health or emotional issues are involved, and sometimes we just need help learning healthier ways to cope.

Usually there is not one specific incident we can point to and name as the cause for self harming behavior.

WHAT DO I DO NOW? HOW DO I FIX IT?
Like the father mentioned above, we parents often question our own responsibility when it comes to our kids choosing to self harm. And like him, we may wish to have the blame placed squarely on our own shoulders so that we can guarantee the result: “I broke it, so I can and will fix it.” We hope to regain something we never really had in the first place: complete control. That control would seem to remove the possibility of an unknown outcome, eliminating worry and pain for both ourselves and our adolescent children.

But it really doesn’t work like that.

Remember that self injury is a poor coping mechanism in response to some kind of emotional difficulty (anger, sadness, anxiety, fear, and many others). Recall also that NSSI is more often than not the symptom, not the problem. We cannot go back and undo the many things that have caused our child’s struggle, nor can we wish into sudden existence the ability for our teen to skillfully and maturely deal with difficulties.

We cannot learn what our adolescents need to know; they must learn it for themselves. They must take in the possibility of acquiring better ways to cope. Then they must actually practice those better ways. Ongoing NSSI issues can, and often should, be addressed with the help of a trained mental health counselor.

This doesn’t mean we renounce the responsibility we have as parents, though. It means we don’t blame our kids or others, especially not in front of our kids.  It means that we take an honest look at things we ourselves could do better, that we have the courage to face the things that frighten us, and that we choose to enter in to the process of becoming as emotionally and mentally healthy as we can be.

The road to wellness can feel challenging and overwhelming. As my late husband used to say, “That’s why parents get paid the big bucks!” (Funny guy, he was.) But as difficult and scary as it may be, facing those big issues is the best road to health for all of us, and we give our children a great gift when we choose to offer such an example.

Threats and intimidation of your teen will do more harm than good, as will pretending everything is fine. Continuing self injury is a sure sign that some emotional distress needs to be tended to. Parental negligence or fear caused by threats will not serve our kids well in any way. While the majority of adolescents practicing NSSI may outgrow the behavior on their own within 5 years, receiving help is still encouraged. If we can offer our growing children better alternatives to handle pain and anxiety, why would we not?

Let go of the concern that your child’s struggles will reflect poorly on you as a parent. Choose instead to seek and make available the best help and support you can find.

And if contributing factors indicate that your teen will not be in that 80% who may eventually stop self harming on their own, then seek immediate help. If you see behaviors that concern you (such as depression, anxiety, substance use/abuse, change in personality or behavior) please be courageous enough to intervene on behalf of your teenager.

Oftentimes, in order for a self harming teen to change and heal, the family must change and heal as well. A good therapist – and a good parent – will look at the family system and help to identify areas that may have contributed to the difficulty. This is not a blame game, this is an opportunity to step up and learn healthier ways of relating to yourself and each other. It’s not a matter of “fix this kid”. It’s more a matter of “how do we all learn and heal and grow healthy together?”

Winter Walk from Stock.xchng
(Photo source: stock.xchng)

My daughter shares that her high school dance teacher used to tell her students, “Practice doesn’t make perfect. Perfect practice makes perfect.” Not that we will ever be perfect parents, but we can learn to use better, wiser skills, and to model them for our kids. My formerly self injuring daughter adds her own concluding thought: “In rehearsal, on the stage, and in life, we need to give it our all to expect rewarding results.”

We learn better so we can do better.

© Monica Simpson and Help To Hope, 2013