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Adolescence

5 Things Youth Workers Should Know About Self Harm

Ash San Filippo
January 17th, 2020

“Today was a great day,” Aaron thought as he pressed the razor blade into his forearm. He watched the blood slowly pool in the wound and then drip around his arm onto the cement floor. “At least it started out that way.”

With the first cut, he felt the tension in his shoulders begin to ease.

With the second, his breathing began to even out.

With the 10th, he felt the guilt of relapsing.

With the 25th , a familiar peace set in.

As he replayed the day’s events in his mind, the emotional relief began to leave. His breathing once again increased and the tension returned to his face and shoulders.

Tears mixed with the blood.

“Why am I such a f*** up?” he whispered to himself as he began to dab his forearm and shoulder with a Kleenex.

The day had started out great. For the first time, at age 17, he felt like he actually had friends.

They spent the day together: Walked around the mall, got high, went to a movie.

Aaron was on top of the world.

After returning home, he texted Monique a bit of gossip about the mutual friend that they had just hung out with.

Monique’s response was sharp and unexpected. She was upset with Aaron because he was badmouthing their friend.

Aaron melted down.

He went from being on the top of the world to the depths of despair in seconds.  The world was crumbling around him. He thought he’d never have friends again.

On the verge of a panic attack, he had run to the basement, grabbed his hidden razor and began to cut.

Now, as he cleaned up, he was getting light headed.

Like always, the cuts didn’t hurt, but he realized he cut too deep and too much.

Fortunately, when he stopped responding to Monique, she got worried and called me. She was exasperated by his drama but still concerned for him.

I called his mom. She found him in the basement, still bleeding and rushed him to the emergency room.

Several stitches later, he was back in his room, thinking about the razor he had hidden under his mattress.


When working with teens who self-harm, people often find themselves anywhere from mystified to intrigued to scared.

My hope here is to demystify self-harm a little bit, and in a subsequent post, I’ll give you some practical tips for helping students who struggle in this area.

1. Self-Harm Works

Self-harm is a strategy people use to manage strong emotions or numbness. And for some, it works really well.

Teens who are prone to strong emotions often report a period of peace and clarity following a “cutting session.” On the other end of the spectrum, some struggle with unbearable numbness. Cutting helps them to feel alive again.

Since self-harm tends to work well to help teens feel better, they might not want to stop. They might feel like they’ve finally found an effective means of managing their feelings and be afraid to let it go.

As someone who’s never personally struggled with self-harm, that was hard for me to grasp at first. It can seem bizarre that taking a blade to your skin could change your emotional state in a positive way, but it can.

In order for us to effectively help teens work through this behavior, we must radically accept the fact that their actions make sense based on their beliefs and experiences. We must lay aside any disgust, disdain or disappointment we might be feeling and treat them with dignity and respect.

That is not to say that we affirm self-harm as good, godly or positive. But we affirm the teens in the midst of their struggle.

2. Self-Harm Isn’t a Suicide Attempt

Perhaps because wrist cutting has been referenced as a stereotypical method of a suicide for years, many have associated self-harm with a suicide attempt. It isn’t. In fact, it can be looked at as the opposite of a suicide attempt.

People who self-harm are looking for a way to live, while people who attempt suicide are looking for a way to escape living.

That isn’t to say that people who self-harm cannot be suicidal. But the action of harming themselves isn’t an attempt to take their lives.

3. Self-Harm is Addictive

If you’re trying to put self-harm in a category, put it closer to substance abuse than suicide. People who have been injuring themselves for a while can be addicted to the response their body has to the harm they inflict. And like with any addiction, there is a law of diminishing returns. This means they’ll have to inflict a greater level of harm in order to get the same response from their body.

If you have a teen who is in this place, take a deep breath, you might be in for a long journey. Overcoming any addiction comes with bouts of successes and failures, self-hatred and self-righteousness, ups and downs. Remember to not tie your identity to their success. Walk alongside them as they journey toward health, but don’t ride the rollercoaster with them.

4. Self-Harm Isn’t an Identity

I have a cutter in my youth group” is a nasty little phrase that we use all too often in youth ministry.

It’s false.

It’s a lie.

Our teens aren’t “cutters,” they’re humans made in God’s image. And if they’ve accepted Christ, they’re holy, perfect and blameless. Even in the very moment they’re harming themselves, they’re completely pure.

Teens soak up identifiers, hungry for labels. Let’s give them the labels God gives them and let the worldly ones fade away. The more a teen becomes immersed in the false identity of their harmful behavior, the harder it will be for them to change their course.

5. Self-Harm Isn’t the End of the World

As youth ministers, there are certain things that can really affect how we view teens. Things like sexual experimentation, drug use, doubt, and cutting might tempt us to feel differently about certain kids.

Be encouraged, their behavior isn’t the end of the world. They’re young and sanctification takes time.

My prayer is that as you walk with teens on their journey, you are able to lead with empathy and love.

In my next post, I’ll give some practical tips to help you lead your teens toward healing in the area of self-harm.

Ash San Filippo

Ash SanFilippo is committed to giving youth workers the tools needed to reach teens who are experiencing hopelessness. That is why he’s at TreeHouse, whose mission is to end hopelessness among teens. Check out TreeHouse at thyouth.org

Disclaimer: The views and opinions expressed in the YS Blog are those of the authors and do not necessarily reflect the opinion or position of YS.

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