This post is in partnership with the Center for Youth Ministry Training and is a product of the Communicating the Gospel to Youth class, taught by Dr. Andrew Zirschky as part of CYMT’S MASTER OF ARTS IN YOUTH MINISTRY degree program through MEMPHIS THEOLOGICAL SEMINARY.

There may come a time in your ministry, when you realize something is not quite right with a student. Maybe its long sleeves in the summer, or perhaps it is not attending pool parties because they would have to wear shorts. Whatever the warning signs are, one day you may face a moment when you realize a student in your ministry is someone who self injures.

Some of you may be unfamiliar with the term “self-injury” which is the term used here to refer to the act of deliberately harming ones own body. This is referred to by many different names culturally, such as cutting, self mutilation, self harm, etc. These terms are all problematic for a number of reasons. First, not all self injurers cut, many use other forms of injury. Self mutilation or self harm implies that damage or harm has been done, and many people who self injure do not think they are harming themselves. So for the purposes of this discussion, we will use the term self injury because it accurately represents the act without placing judgement on the person preforming it.

The American Psychological Association defines this specifically as Non-Suicidal Self Injury.

The first two words, Non-Suicidal are an important distinction because self injury is often confused with a person desiring to attempt suicide^[1]. This confusion is understandable but Self-Injury is in fact not a desire to end one’s life, it can be quite the opposite. Self injury is often used as a means for one to feel in control, or to feel the pain physically that they can not process emotionally. Also, while the media may try to tell us that self injury is a female problem, studies do not support such a claim. Many studies report that males and females self injure at the same rate, and a few report a slight increase in the number of females over males, but not a significant one. Many who study self injury believe numbers to be skewed towards females because more females are treated for self injury, but this doesn’t mean it does not affect boys at the same rate^[2].

As stated before many who self injure do so by cutting their skin, and this is especially true of girls. However, one of the reasons boys go untreated is because people don’t always notice their form of self injury. Boys may cut, with razor blades, knives, or whatever is handy, but they also may choose other outlets, like burning, punching or hitting themselves against walls. The problem with these other outlets is that they may be easily confused with the normal rough and tumble life of boys. Cuts on arms need to be hidden, but bruises can be easily explained away^[3].

Adolescents’ lives are a mix of positive and negative emotions.

Youth who have been emotionally abandoned, or neglected, or abused live most of their lives on the negative side of the line that separates the two extremes. They are also at the mercy of their adolescent development, which is chaotic in an of itself. These young people who live lives filled with negative emotions are desperate for relief from the emotional pain they feel from abandonment, physical or emotional, neglect, betrayal or abuse. When a student stumbles on the idea of hurting themselves as a way of escaping from emotional pain or frustration, the initial reaction is usually one of relief.

The decision to begin self injuring starts to make more sense to outsiders when you understand what happens in the brain when one hurts oneself. When you stub your toe or cut your finger, you of course feel pain, and after the sensation of pain the brain releases endorphins that act as pain killers. Endorphins work in the same way that morphine acts as a pain killer, and just like morphine, can be addictive. Endorphins produce a feeling of euphoria which can relieve the emotional pain a youth experiences as well as provide some control over a life that may seem very out of control.

This is where youth get caught in the cycle of addiction that self injury can create.

When they have emotional pain they can’t handle, they might burn their leg, while this hurts the brain is producing endorphins that create a pleasant sensation for a while. However the space between the pleasant sensation and the guilt and shame that usually follows begins to creep closer and closer together. Some students might be able to go days in-between episodes, while others who have been using this as a coping mechanism for so long, may find that relief only lasts moments, and they have to escalate either the intensity in which they self injure, or the frequency^[4].

I mentioned the cycle of addiction. This is important to note that self injurious behavior is cyclical in nature. One experiences the cycle of emotional pain, so then he/she cuts, experiences euphoria, followed by shame and guilt which leads to more emotional pain. The chemically induced state of euphoria caused by the endorphins also wanes over time, as the body builds up a tolerance, much like an addict having to resort to more frequent, or harder drugs to get the same high^[5].

What can you, the terrified youth worker, do when you realize a student is self injuring?

First, I can not stress enough that you need to remain calm, any time a student tells you something he is watching to see what your reaction will be. Many who choose to participate in this behavior have been emotionally abandoned, and if they choose to trust you then they are trying to figure out if you will abandon them as well.

So while you are summoning all your energy trying not to freak out and feel totally unprepared remember something. This student asked for help, or is at least willing to entertain the idea of help. This is huge, and should be praised with as much enthusiasm as you can muster. Boys especially are rarely praised for seeking help, or for recognizing emotional needs, and you can be a huge confidence boost by assuring him that you are proud of him for asking for help and for being honest.

Honesty is going to play a huge part in the relationship you have with this student, so I suggest creating a place of honesty in exchange for a lack of judgement.

[bctt tweet=”Your student needs to know you won’t judge her for what she’s done, and may continue to do.” username=”ys_scoop”]

You can assure her that you won’t judge, but her part of the partnership needs to involve being honest. She needs to be honest about how she’s feeling, and the frequency of her instances of self injury. At the beginning of this journey you may be the only person she is willing to be honest with, and so you need to uphold that expectation of honesty, and return that gift with loving understanding.

I mentioned the journey you will take with this student, and I mean that in more than a metaphorical sense. If you begin a relationship with a student who self injures then you are walking a path with them, a path that may lead you through hell and back out again, so be prepared to enter into this relationship for the long haul. But luckily you don’t have to go through this alone.

You need to get a student who is self injuring more help than just talking with you.

Unless you have training in psychiatry or are a trained counselor you are going to need to enlist the help of a professional. The first step, however, is talking to his parents or guardians. please do not tell yourself that this is “no big deal” or “I’m sure he’ll stop on his own”. If a student has resorted to physical violence to his own body he is in need of real help and support from more than just you, and to get him professional help you will need to involve parents.

Involving parents in this is a terrifying prospect for any youth worker, and for your student. Even if the student really wants help and desires to stop her self destructive behavior, she may not understand that he will have to talk to her parents. Honestly, some of you may question if we even need to tell parents, and I assure you, as someone who works with young people and as a mother, we do.

[bctt tweet=”Parents can be the greatest asset in the care of their child.” username=”ys_scoop”]

And they will need to be involved in the professional counseling process, especially if family problems are at the root of what causes a student to self injure.

One way you can aid in the painful process of informing parents about a students self injurious behavior is by giving him options so he feels in control of his situation, remembering the out of control cycle addiction has created. You can offer to tell his parents for him, or be present with him while he tells them, or to help him write a letter that they can read while you both sit in the room. Being present with a student when he tells his parents is crucial, because you provide a much needed buffer in a time of high stress for a family. Parents will be less likely to fly off the handle with you in the room, and even if they do, your student knows you are with him through it all.

While you are planning how to tell parents, remember you can give the student some time to think this over. Unless a student has hurt herself to the point where she needs medical attention, she is not in immediate danger, and telling parents does not need to happen immediately. I wouldn’t wait longer than 48 hours to tell parents about the self injury, but you can give her some time to adjust to what is about to happen. Please do not react to the news of self injury by immediately forcing a student to tell her parents, without any time to adjust. This will not create a relationship of trust, which is paramount in dealing with a student who is scared her life is about to change and she won’t be able to handle it.

After parents have been told, be prepared to provide sources of professional help for the family.

If you haven’t put together a resource list of therapists, social workers, support groups, christian counselors, or books already, then start putting one together now. I highly suggest owning a copy of Marv Penner’s Hope and Healing for Kids Who Cut as a resource for you, your student and the family as the book has advice for all parties involved in self injury. If you start with an online search for professionals look for counselors who have listed self-injury or self-harm as a specialty, and ones who work with teenagers. You can also call some other youth pastors, school counselors, or social workers in the area and ask who they would recommend as a referral for a student who self injures. Not all therapists are prepared to deal with this type of behavior form a teenager, so research done ahead of time will relieve some of the stress for the family. Another great organization for you to look into would be S.A.F.E alternatives, which stands for Self Abuse Finally Ends.

Please don’t think your job is done when your student and his family start getting professional help.

If he trusted you, you may be the person he continues to trust. Counselors probably won’t be someone he can talk on days when he doesn’t have an appointment, but you are someone who can be available to him when he feels out of control. Be sure to maintain boundaries for your own health, teenagers who have been abandoned are known for pushing boundaries, by calling at all hours, or showing up at homes unannounced. Be sure to let them know that they can call if there is an emergency, but that there are times when you are available and times when you need to see to your health, this not only demonstrates appropriate boundaries but shows that adults need to care for their own mental health and it is ok to tell people what you need to be healthy.

[bctt tweet=”Your presence in the lives of students who self injure in your ministry is invaluable.” username=”ys_scoop”]

Youth who are caught in a cycle of self injury need adults in their lives to walk with them through a time so scary and stressful that it can seem overwhelming to both you and him. I challenge you to keep walking with them, though the fear, anxiety, failure, and success that await you on the road ahead. Remember you can not save anyone, that’s not your job, but you can continually minister students by your persistence and presence while you point them to the one who saves.

Resources

Penner, Marv Hope and Healing for Kids who Cut, Grand Rapids, 2008 Zondervan

Rettner, Rachel “Why do teens hurt themselves” Sept 12, 2010 http://www.livescience.com/11043-teens-hurt-science-injury.html Accessed 4/20/2015

http://www.selfinjury.bctr.cornell.edu/about-self-injury.html#tab2 The Cornell Research Program on Self Injury

http://www.apa.org/pubs/books/4317183.aspx Overview of the book Understanding Nonsuicidal Self Injury: Origins Assessment and Treatment Accessed 4/20/2015

Frequently Asked Questions about Self Harm https://self-injury.net/information-recovery/frequently-asked-questions

S.A.F.E. Alternatives www.selfinjury.com

^[1] http://www.apa.org/pubs/books/4317183.aspx Overview of the book Understanding Nonsuicidal Self Injury: Origins Assessment and Treatment Accessed 4/20/2015

^[2] http://www.selfinjury.bctr.cornell.edu/about-self-injury.html#tab2 The Cornell Research Program on Self Injury

^[3] Rettner, Rachel “Why do teens hurt themselves” Sept 12, 2010 http://www.livescience.com/11043-teens-hurt-science-injury.html Accessed 4/20/2015

^[4] Penner, Marv Hope and Healing for Kids who Cut, Grand Rapids, 2008 Zondervan

^[5]Rettner, Rachel “Why do teens hurt themselves” Sept 12, 2010 http://www.livescience.com/11043-teens-hurt-science-injury.html Accessed 4/20/2015

Fleming and Colleen Mills. HTTP://WWW.VARK-LEARN.COM/DOCUMENTS/NOT_ANOTHER_INVENTORY.PDF

Sara Galyon is the Episcopal Youth Community Director for St Matthew’s Episcopal Church in Madison, AL. She has been working with youth in some capacity for 15 years, and has an MA in Youth Ministry from Memphis Theological Seminary. She is a wife to a fellow youth minister, mom to two boys and two dogs, and underfunded world traveler.

Website: weedsandnerfdarts.com Twitter: allthenerfdarts