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Scary Stuff! Part 3: Self-harm

When making a little list of some of the scary stuff youth workers deal with, self harm, a struggle more than a small number of teenagers wrestle with, was one I was hesitant to discuss; mostly because I’m no expert, and have limited first-hand experience walking alongside students who are on this scary path. So…I’m going to offer a few thoughts and hope that some of you will add to the conversation in the comments.

How do you help a teenager who is hurting him/herself?

Remember…The Problem Usually Isn’t The Problem

Self-harm is almost always a symptom of a larger struggle going on beneath the surface. Because of this, simply focusing on getting a teenager to stop harming himself isn’t enough. Helping a teenager identify, and seek help for, the larger issue is vital for spiritual, emotional, relational, AND physical well-being.

Your “Response Level” Should Mirror the “Harm Level”

Did the teenager just attempt suicide? Is she threatening to do so? Then a swift and full response is warranted. Is the teenager in a year-long battle with cutting? Then a slower, more engaging response may be warranted. Your engagement is needed once you are made aware of self-harm, but how you respond can (and should) be different in each case.

No Secrets

While there are some parts of the adolescent journey you may choose to keep from a student’s parents, self-harm IS NOT one of them! If you know a student is engaged in any form of self-harm, you will need to let her know that mom and dad need to know, too. One way to help a student inform mom and dad is to offer to be there with her when she does.

Know Your Limits…And They Are Many!

Unless you are a trained counselor, helping a teenager work through the issue(s) that are resulting in their self-harm is beyond your pay grade. You can, and should, walk alongside him as he gets the help he needs, but you probably aren’t the one to provide that help.

Help Mom and Dad, Too

Learning that their child is purposely harming themselves is a massive blow to parents. Denial, guilt or a desire for a quick-fix are all very likely responses. In your effort to help the teenager, don’t forget to offer as much support to mom and dad, too. While it’s not always the case, it is likely that many of the struggles causing self-harm are related to things happening within the family dynamic.

Few things are scarier than finding out that a student under our care is purposely harming himself. But Jesus has a way of doing his greatest work in the scariest of moments! Please add your thoughts to this important conversation.JourneytoFreedom

Kurt / @kurtjohnston

Need resources to help you as you help teens struggling with deep-seeded hurts and habits? LIVE Journey to Freedom is an editable curriculum that will move ministry from being focused on behavior Band-Aids and cut through to the real issues going on for true healing in Jesus. Learn more.

One thought on “Scary Stuff! Part 3: Self-harm

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    I have a unique perspective on this topic as someone who not only has worked in youth ministry and currently works in mental health with youth in schools, but as someone who began struggling with self harm around the ages of 13-14. By 15, it was an almost daily part of my routine, my default response to stress and anxiety. At age 26, I can say that it has gotten better, and while still may be a struggle at times, its a symptom of underlying issues. Things were rough at home growing up, and I was diagnosed in college with PTSD as a result of repeated trauma over time. I had mixed experiences disclosing to adults when I was in middle/high school, and ended up shutting down and shutting people out when things didn’t go so well.

    As you stated (and in my personal experience), self injury is usually the symptom of the problem… As such, its important to remember that when asking a youth to disclose to their parents. No, you can’t keep secrets for liability’s sake- I run into the same predicament in schools- but depending on the situation, there may be a need to reach out to other community support agencies, like a social worker, if you’re not sure the parents will respond in the most favorable manner, or if could make things worse for the child at home (this was my experience, as I was in an environment rampant with emotional abuse). I would also second your advice for helping the child get professional help. Keeping a running list of good, Christian therapists in your area would be a good start (and information about their payment options). You can’t force a parent to get their child in therapy, but having information so they have to do less ‘work’ to figure that step out helps. For me, I know the battle for my emotional well-being is so intertwined with my spiritual well-being, so having a therapist who encourages me in my walk is essential. While you can’t be their therapist (even if you were trained, the dual role as youth minister/therapist would be unethical) you do need to be there to talk. As someone who has been there- don’t be weird about it. Don’t pretend they didn’t disclose to you. But don’t draw attention to it either, especially in a group. Your youth is likely to get questions about scars from other youth, so be wary of that, and help find ways to respond to comments if they come up. DO check in with that youth. It took a lot of courage for them to open up about something so deeply personal and shameful… If you never bring it up again, it can give the impression that talking about it wasn’t okay. a simple “hey.. how are things going? I just want to check in and see if you’re okay.” and reminding them to be gentle with themselves, and that you’re there if they need to talk is good. Often times with self harm, an individual experiences a crisis moment before injuring- letting the youth know you can be someone to call in the moment can be an amazing support. Now for the don’ts….. When a youth initially discloses to you, or if they’re in immediate crisis, yes, it may be important to assess the wound(s) to ensure physical health… but DON’T ask to see their arms/legs/wherever they choose to harm on a regular basis to ensure progress. That only brings more shame. It IS okay to directly ask if they have harmed sine the last time you talked… but don’t dwell on it, and don’t take it personally. Its easy for a youth to feel guilty for letting you down when they have harmed…. but slips are part of recovery. They are already going to be their own biggest critic when they mess up, so responding with love and getting them to acknowledge every day they’ve been self-injury free as a victory is important. Another important thing to keep in mind is that while self-injurious behavior can be a risk factor for future suicidal ideation and it is important to assess in initial response what the student’s intent behind the harm was, DON’T treat the self-harm as a suicide attempt, because its actually an act of self-preservation. Whatever it was they were experiencing was so overwhelming they couldn’t take it anymore- and the harm helped calm them down- its their coping mechanism. There’s a whole physiological side of self-harm that could be delved into to help understand this, as counter-intuitive as it sounds, but I won’t do that here. Another thing that may be controversial is removing access to things that may be used to harm… Yes, you may have policies about no knives etc umbrella’d under a ‘no weapons’ clause- but I grew up in the south where nearly every kid had a pocketknife on them at all times, so it was normal for someone to have a knife. This would be something to take points on from the child’s therapist, but as a mental health professional now, and as someone who struggled with SI for many years, taking away a ‘tool’ doesn’t solve anything. You can’t remove access to one coping mechanism before teaching someone to appropriately use another. If a youth shows you whatever it is and tells you they’re going to harm, then yes, you need to remove access… but don’t go out of your way to go through their things all the time…. it may not be a knife or razor blade, it could be a thumbtack, a safety pin, scissors, nail clippers, a lighter, etc.- the list goes on and on. Its more important to let them know you’re there for them and that they can call you when they feel the urge to harm.

    This may be a lot more than should go in a ‘comment’, but I hope its offered a different perspective and can encourage those in youth ministry to respond with compassion and love- and maybe start to understand it a little more. There are going to be slips-and that’s okay. The biggest lesson I’ve learned is that just because I have a slip, doesn’t mean I become a slave to it again. Psalm 116 is a beautiful testament of God’s grace and love for us in times of struggle. Verse 16 has always hit home for me. “Lord I am your servant, you have freed me from my chains.” When we give our lives to Christ, there’s such freedom in that salvation, such redemption. No matter the stumbles I have, my struggles with anxiety, depression, and self-harm don’t own me. There’s so much stigma associated with self-injury and mental health issues. With stigma comes shame, which leads to withdrawal and darkness…. But as youth ministry leaders, you have the opportunity to speak TRUTH into a youth’s life, to be heard over all the lies in their head that they aren’t good enough. With Truth comes light. and darkness cannot exist in the light.

    Feel free to contact me if you’re ever interested in discussing this topic further.

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Scary Stuff! Part 3: Self-harm

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