Millions of teenagers throughout the world intentionally and repeatedly bruise, cut, burn, mark, scratch or mutilate different parts of their own bodies. Since the wounds inflicted are not intended to be life-threatening they often do not require medical attention and are frequently dismissed as "accidental". Girls are more affected by this problem than boys with a ratio of about 5 girls to every boy involved in the act. It is thought that boys are more likely to hit out at others when frustrated whilst girls are more likely to internalize their frustrations.

However there appears to have been a dramatic increase in the number of teens of both sexes who engage in self harming behavior over the last ten years and family and friends are confused, angry and frightened by these acts. Adolescents who self-harm often experience tremendous tension and anxiety before the act, along with an intense preoccupation with injuring themselves. One of the worrying trends is that what often starts out as methods of displaying frustration becomes in effect a habit. They continue with the acts even though the stress and anxiety triggers have gone.

In fact many teens report that the impulse to injure is irresistible and and occurs almost subconsciously. The teenager may feel little or no pain as the cut, burn or scratch is inflicted. There can be feelings of gratification, relief, comfort, and even arousal after the act. Despite the fact that many teens seem locked into the behavior and feel helpless to stop, self-injurious behavior can be reduced and eventually extinguished.

A combination of individual and family therapy, self-help strategies, self-harm substitutes and medication can help individuals reclaim a healthy sense of control over their bodies. To simply sit back and state that they 'will grow out of it' is wrong with many teens continuing the habit well into adult life.

The most common form of self-injury is by cutting and slashing, generally to the arms although the upper legs and torso are also affected. Other forms of self harm include burning the skin, limb-hitting and bruising, head-banging, picking at wounds, peeling the skin, deep biting, severe skin scratching, nail and cuticle biting, pulling out hair, bone breaking, swallowing sharp objects and inserting sharp objects or toxic liquids into the body. Adolescents may use razorblades, scissors and knives to cut the skin, and cigarettes, lighters and matches to burn themselves. They can also take seemingly benign objects such as paper clips, pen caps, jewelry, fingernails and nail clippers, and turn them into self-harming tools. Having tattoos and piercings are not forms of self mutilation but rather forms of expression or rebellion.

Often, adolescents who hurt themselves may be engaging in other forms of self-destructive behavior, including reckless driving, shoplifting, sexual promiscuity or unprotected sex, substance abuse and eating-disordered behaviors. Anyone who engages in self-harm is desperately trying to cope with overwhelming feelings and thoughts. Self-inflicted violence is meant to soothe, alleviate anxiety, and increase a sense of power and control. Ironically, as the behavior escalates, it actually exacerbates feelings of dis-empowerment, alienation and helplessness.

To understand self harm you must first understand this self-harm is first and foremost a coping strategy. It manages overwhelming thoughts and feelings by short-circuiting them. Often, an individual’s behavior will be triggered by a simple life event. The event will create negative thoughts such as "I will always be a failure" and negative feelings such as rage or despair. Without the tools to handle these thoughts and feelings, tremendous tension and anxiety are produced. As the tension builds, the adolescent begins to dissociate or zone out, looking for an escape. Once the teen has dissociated, he or she is able to hurt the body without experiencing any real pain.

To treat an individual involved with self harm is a job best left to the professionals. It wise to seek out an expert in the field of self harm rather than a general therapist. Treatments include providing safer, alternative ways to communicate, self-soothe and cope. The use of journaling, art therapy, relaxation techniques, visualizations, cognitive re-framing and affect management are all recommended and useful.

Encouraging the teenager to write, draw, exercise and self-soothe before engaging in self-injurious behavior are more effective than demanding the immediate cessation of the behavior. In fact it is typical for a teen who has been confronted to immediately head off and harm themselves again.

In severe cases anti-depressants can dramatically reduce the negative feelings and cognitions associated with the cycle of self-harm. Anxiolytics prevent the escalation of panic and generalized anxiety, which decreases the need for dissociation and self-injury. Providing a pharmacological safety net may also allow adolescents to process painful trauma memories without becoming flooded or overwhelmed.

In conclusion, if your child is affected by these acts you must seek out professional help from a practitioner experienced in the field of self-harm. It is unwise to try and handle the matter in house. You should never be critical or demand the cessation of the practice as this may well aggravate the situation. Remain calm and provide as much care and support as possible. Whilst long term injuries are frequent, self harmer's are rarely out to do permanent damage and are generally not suicide risks in the normal sense. Deaths do occur but these are more in the form of accidental deaths. Seek medical intervention at the earliest sign of self harm - the earlier you can intervene, the better the long term prognosis.