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Self-esteem Information > Self-Abuse more likely among teens with low self-esteem, anxiety

Experts warn parents to watch for signs

 Belinda was 13 when she first took a blade to her skin. They were just shallow cuts, but they were signs of a deeper pain.

 She barely remembers now why she first cut herself. Family problems? Stress at school? New boyfriend? She just remembers feeling extreme anger, sadness and worry from which there seemed to be no escape.

 There's a weird sense of calmness in it, that it makes you actually feel something, said Belinda, who asked that her real name not be used. It's a distraction.

 Eventually, she attempted suicide, and while in the hospital she received counseling that helped her overcome self-injuring.

Every once in a while, the thought would come back to do it, but I learned to do something else instead,¨ she said.

 Like Belinda, many Valley teenagers, some suffering from anxiety, depression or the effects of abuse, cut or injure themselves. They do it for the emotional release, for stress relief, for respite from painfully low self-esteem. They do it because they see few other options, said Leticia Nering, a McAllen psychotherapist.

 They have a lot of inner pain, and don't have the coping skills to deal with it, said Nering, who has worked with several self-injurers in her practice.

 According to the National Mental Health Association, approximately 1 percent of the population self-injures, with a higher number of females than males engaging in the behavior.

 Dean McKay, an assistant professor of psychology at Fordham University in The Bronx, N.Y., puts the number of self-injurers at higher than 1 percent.

 There are probably a lot of people who do it who are unwilling to report it, said McKay, who has written articles on the subject. We're certainly hearing more about it. I don't know if that's because it's on the rise or if it's just commented on more.

 Because most people never report self-injuring, and teenagers who self-injure often go to great lengths to hide it, it's hard to know how many Valley teens are cutting or hurting themselves, Nering said.

 They often hide it under long sleeves. They won't go to the emergency room, for example, she said. Some parents might just see it as part of the teenage years, so they might not take it seriously. But it's definitely not healthy.

 At Valley Baptist Medical Center-Harlingen, about 25 teenagers come in each month who have cut or hurt themselves, but usually these seem to be actual suicide attempts rather than self-injury, said Sherry Russo, director of emergency and trauma services.

 Sometimes in this setting it's hard to get a true answer, Russo said. We try to stabilize them.  Why it happens, whether it's a suicide attempt or not, is determined by screeners and specialists.

 Some of the teenagers have scars that are from self-inflicted wounds, Russo said.

 Maricela Medrano, a social worker for Women Together, which offers counseling and assistance for victims of sexual assault and domestic violence, said she sees about two self-injurers a month. Many of them have disclosed that they've been cutting themselves for years.

 Medrano said that parents often don't realize that the child might need help, and so never seek treatment.

 A lot of times parents think it's a fad or a body decoration, she said. Also, the obvious (cuts) are superficial the child can easily say the cat scratched me or a friend scratched me.

 McKay said that the behavior eventually can become compulsive  an automatic response to stress or pain.

It's a way of distracting the self by external-oriented activity, he said. The reaction (from cutting) allows you not to experience inner pain.

 Teenagers who self-abuse often have symptoms of depression or anxiety disorders like obsessive-compulsive disorder, McKay said. Children who have been abused might self-injure as a result of post-traumatic stress disorder, he said.

 Medrano said that abused teens might self-injure during or after an abuse flashback to relieve the pain of the memory. They might also injure themselves to express self-hatred.

A lot of times they feel they are worthless, don't feel they are loved, Medrano said of abuse victims. They try to scar themselves to make themselves look ugly. They're feeling guilty for disclosing the abuse, the family is divided. There's a lot of pain there.

 Martha Martinez, a school counselor in Raymondville, said she has seen several children in school who self-injure.

 It's a significant number, and it goes undetected, said Martinez, who also is director of family violence services at the Family Crisis Center in Harlingen.

 To break the pattern of self-injury, teenagers need to learn a healthier outlet for their feelings, counselor Nering said. She advocates talk therapy.

 It's pretty amazing what can happen when they talk about the pain, Nering said. It's relieved.

 She also suggests that parents help their children who self-injure find healthy friendships, extracurricular activities and pastimes that will offer distraction, support and a creative outlet.

 Medrano encourages her clients to write down their feelings in a journal, and Martinez urges them to scribble on paper if necessary to stop self-abusing.

 Above all, Medrano said, parents need to be willing to seek help for a child who is self-injuring.

 It's still something we don't want to talk about, like sexual abuse, she said. But the community needs to be more aware, and parents need to know about it so they can assist their children.

Signs of Self-Abuse

Wearing long-sleeve shirts and long pants, even when it¡¦s hot outside

Reluctance to go to pool or beach

Extreme withdrawal

Obvious cuts or scratches on wrists, stomach, legs

Low self-esteem

Difficulty handling feelings

Relationship problems

Poor functioning at school or home

Sources: Dean McKay, assistant professor of psychology, Fordham University; National Mental Health Association



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