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Speaker 1: Brought to you by the reinvented two thousand twelve camera.

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Speaker 1: It's ready. Are you welcome to Stuff Mom Never told you?

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Speaker 1: From how Stuff Works dot Com. Hello, and welcome to

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Speaker 1: the podcast. I'm Kristen and I'm Caroline, and today we

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Speaker 1: are talking about a very sensitive topic. UM. We've gotten

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Speaker 1: some request from listeners to cover this before, and I

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Speaker 1: also wanted to offer a trigger warning just to the

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Speaker 1: top of the podcast because it is a sensitive topic.

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Speaker 1: If we're not going to get graphic or gruesome, but

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Speaker 1: we are going to be talking about non suicidal self

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Speaker 1: injurious behavior and that's often better known as cutting or

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Speaker 1: self injury, self harm, self mutilation, paras suicide. So it

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Speaker 1: is one of the tougher topics to cover, but it's

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Speaker 1: something that isn't talked about that much, but it is

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Speaker 1: happening a lot, especially among adolescent populations. So we definitely

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Speaker 1: felt like it was worth, um, maybe having a potentially

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Speaker 1: uncomfortable conversation about a very real issue. Yeah. I was

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Speaker 1: really taken by the fact as Kristen and I were

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Speaker 1: doing research for this episode. I mean, every almost every

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Speaker 1: study you come across about this is dealing with the

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Speaker 1: age factor. Um, that it is so common among young people,

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Speaker 1: especially young people who are just hitting puberty, but it

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Speaker 1: does have the very real potential to carry over into

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Speaker 1: young adulthood and then adulthood. Yeah. And there are also

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Speaker 1: questions out there of whether or not UM self injury

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Speaker 1: and self mutilation is becoming more prevalent among younger populations,

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Speaker 1: which we will get to as well. But first off, UH,

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Speaker 1: let's just go ahead and offer a definition of what

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Speaker 1: we were talking about. This is coming from the Virginia

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Speaker 1: commiss Sin on Youth and they define non suicidal self

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Speaker 1: injurious behavior as deliberate indirect destruction or alteration of body

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Speaker 1: tissue without conscious suicidal intent, but resulting an injury severe

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Speaker 1: enough for tissue damage to occur. And that is an

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Speaker 1: important delineation to make. These are not suicide attempts. A

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Speaker 1: lot of times it's the opposite of a suicide attempt.

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Speaker 1: You're hurting yourself to feel better. Um. And the types

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Speaker 1: of behavior is involved um and this is coming from

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Speaker 1: the Mayo Clinic, might include severe scratching, cutting, burning, uh,

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Speaker 1: intentionally poisoning yourself, carving words or symbols onto your skin,

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Speaker 1: breaking bones, hitting yourself, punching, yourself, piercing the skin with

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Speaker 1: sharp objects, headbanging, biting, pulling out your hair, UM, interfering

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Speaker 1: with wound healing UM. Also one thing that is not

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Speaker 1: considered self harm behavior tattooing. UM. Yeah, things like piercing

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Speaker 1: and tattooing are not necessarily UH self harm behaviors unless

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Speaker 1: you are doing them for the sake of the pain

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Speaker 1: that comes with them UM. And the Mayo Clinic also

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Speaker 1: points out that it's this is typically a way to

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Speaker 1: cope with emotional pain. Kristen pointed out that a lot

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Speaker 1: of people are doing it to feel better in a way,

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Speaker 1: it just happens that it's a definite unhealthy way to

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Speaker 1: cope with any intense anger or frustration you're feeling. It's,

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Speaker 1: as one site pointed out, an external way to express

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Speaker 1: internal feelings. So who is practicing this? Who is intentionally

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Speaker 1: engaging in this kind of self harm? Um? The Virginia

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Speaker 1: Commission on Youth again UM says that n s I B,

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Speaker 1: which is the self injury behavior, occurs without regard for age, gender, ethnicity,

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Speaker 1: or socio economic status. But as we have mentioned already,

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Speaker 1: h younger populations are especially at risk, and especially younger girls.

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Speaker 1: Some of the risk factors, A lot of it has

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Speaker 1: to do with age. Most of those who self injure

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Speaker 1: our teams. Other risk factors are life issues or substance abuse.

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Speaker 1: So if you have this this toxic combination of a

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Speaker 1: of a troubled teen who's dealing with life issues, maybe

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Speaker 1: this team was abused or neglected, maybe they are self

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Speaker 1: injuring under the influence. That is someone that would definitely

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Speaker 1: need professional help, right. UM, So, just to put some

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Speaker 1: numbers around this. According to a November two thousand eleven

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Speaker 1: study published in The Lancet and this was reported on

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Speaker 1: by ABC News one in twelve teens engages in self

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Speaker 1: harm or self mutilation. UM and community samples have found

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Speaker 1: a range of prevalence rates. It can be hard to

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Speaker 1: uh to sort of extrapolate one community sample across the

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Speaker 1: entire population, but it branches between four and its high

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Speaker 1: at thirty eight per cent. And that's coming from the

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Speaker 1: Cornell Research Program on Self Injurious Behavior, which was something

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Speaker 1: that will be aiding often throughout this podcast. UM and

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Speaker 1: even further studies among high school populations in the US

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Speaker 1: and Canada specifically will typically find the range between thirteen,

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Speaker 1: which is a very large population to and it does. Yeah,

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Speaker 1: it does depend on age, UH, and it also depends

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Speaker 1: on self reporting, because if people aren't coming forward with

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Speaker 1: their injuries or their mental and emotional issues, how are

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Speaker 1: you supposed to find these kids. There were some studies

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Speaker 1: that were done at schools, so that's a more general

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Speaker 1: broad population to sample from. Um. Dr Moran, who who

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Speaker 1: did the study, said that the window of vulnerability for

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Speaker 1: this experience of self harm appears to open at around puberty.

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Speaker 1: And the writer of the article calls it a perfect

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Speaker 1: storm of surging hormones, immature brains, and unfamiliar emotions. So

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Speaker 1: these are kids who are having a lot of trouble

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Speaker 1: dealing with their own emotions and expressing them to people

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Speaker 1: around them. Yeah, the the window that this usually will

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Speaker 1: start as between twelve and fifteen years old, but an

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Speaker 1: early onset around the age of seven is not that

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Speaker 1: uncommon either. And we talked about girls being at higher

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Speaker 1: risk of this as well. UM That study from the

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Speaker 1: Lancet again UH followed kids for fifteen years, starting at

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Speaker 1: ages fourteen and fifteen, and in every stage when the

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Speaker 1: researchers would go back and check in, more girls reported

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Speaker 1: self harm than boys and then again, uh. In juneteen

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Speaker 1: thousand eleven, there was a study published the Journal Pediatrics

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Speaker 1: which found that ninth grade girls in that fourteen fifteen

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Speaker 1: year old range, ninth grade girls were three times more

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Speaker 1: likely to be engaging in self harm compared to ninth

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Speaker 1: grade boys. And to get a picture, that Lancet study

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Speaker 1: describes that teens at particular risk are quote on a

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Speaker 1: fast track to adulthood, those kids who are at the

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Speaker 1: margins of school, who are engaged in early sexual activities,

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Speaker 1: who are using alcohol and drugs at a young age,

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Speaker 1: and they're also familial risk factors involved. And researchers are

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Speaker 1: wondering whether there is a genetic component to this, because

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Speaker 1: they found that relatives of individuals who have engaged in

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Speaker 1: self mutilation are three times more likely to engage in

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Speaker 1: the same behavior, and so they're wondering if there's something

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Speaker 1: in the genes prompting this impulsive, depressive behavior. Um And

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Speaker 1: it's also been linked to things like family violence, family

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Speaker 1: alcohol abuse, childhood separation and loss, physical abuse, and childhood

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Speaker 1: sexual abuse. Right, yeah, there's a link. This is a

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Speaker 1: two thousand eight Journal of Consulting Clinical Psychology study that

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Speaker 1: pointed out a link between childhood sexual abuse and self harm,

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Speaker 1: but a two thousand eight analysis in the British Journal

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Speaker 1: of Psychology found the link between the two to be

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Speaker 1: pretty weak and could have more to do with the

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Speaker 1: two being correlated with the same psychiatric risk factors. Right,

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Speaker 1: we're broadly it's UM, like you've touched on before, UH,

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Speaker 1: issues with not being able to to process and express

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Speaker 1: emotions UM. For instance, there is a very strong correlation

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Speaker 1: with borderline personality disorder, and a lot of times the

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Speaker 1: therapy that's involved UM with self harm is teaching UM

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Speaker 1: people how to how to deal in a healthy way

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Speaker 1: with negative and depressive emotions. Right. And you know, Kristen

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Speaker 1: touched on that genetic link, and it isn't proven. It

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Speaker 1: is something that they are looking into because of just

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Speaker 1: the way these conditions develop. UM patients diagnosed with borderline

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Speaker 1: personality disorder often grow up in environments where emotional expression

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Speaker 1: goes unrecognized or is punished. So, like I said earlier,

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Speaker 1: you know kids who are having trouble expressing their emotions

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Speaker 1: and dealing with them. And this two thousand ten UH

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Speaker 1: studying the Journal of Nervous and Mental Disease points out

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Speaker 1: that invalidating childhood environment put youth at risk for non

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Speaker 1: suicidal self injurious behavior. So these things are definitely overlapping.

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Speaker 1: Whether there's a definite genetic link, we're not sure yet. Yeah,

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Speaker 1: there might be. Probably is an interaction between the nature

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Speaker 1: and nurture there because it's often accompanied with anxiety disorders,

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Speaker 1: depression oppositional defiant disorder UM. And then when when it

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Speaker 1: comes down to the actual self harm behaviors, while UM

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Speaker 1: girls are more likely to engage in it, the specific

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Speaker 1: behaviors UM are different a lot of times between boys

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Speaker 1: and girls, which might be one of the reasons why UH.

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Speaker 1: The statistics indicate that that girls it might actually be

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Speaker 1: artificially inflated in a way UM because according to the

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Speaker 1: Journal Pediatrics that June two eleven study that I referenced earlier,

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Speaker 1: UM girls are more likely to report cutting and carving behavior,

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Speaker 1: whereas boys reported hitting themselves more often and UM. Because

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Speaker 1: of that, it might not be UM as a parent

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Speaker 1: that self harm is going on. And not only is

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Speaker 1: the behavior itself different, but the motives are different. Two

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Speaker 1: thousand five study in Psychiatric Times found that females who

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Speaker 1: self harm are more likely than males to explain it

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Speaker 1: by saying that they wanted to punish themselves. They're also

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Speaker 1: more likely to say that they were trying to get

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Speaker 1: relief from a terrible state of mind. And so they

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Speaker 1: point out the depression and anxiety are much more noticeably

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Speaker 1: associated with girls, whereas males have typically received far less

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Speaker 1: attention for this. Yeah and um, when it comes to

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Speaker 1: how this behavior starts, um, you know, we've we've ticked

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Speaker 1: off all of these risk factors, but sometimes it's also

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Speaker 1: something that seems to a behavior that happens without almost

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Speaker 1: without someone even meaning to um over. At Exo Jane

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Speaker 1: blogger S. E. Smith talks about her experience as um

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Speaker 1: a cutter and as she's I should say, used to

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Speaker 1: be a cutter. Um. She said, I started cutting largely

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Speaker 1: by accident. I have trouble remembering what the catalyst was,

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Speaker 1: but there was a moment when I realized that there

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Speaker 1: was something, one thing in my life that I could control.

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Speaker 1: I could creep off into the corners and darkness and

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Speaker 1: master something in my environment. It started quietly, and it

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Speaker 1: got bigger and bigger over time, as these things often do.

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Speaker 1: And that is such a good point that she makes,

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Speaker 1: UM because according to research out of Cornell University. Among

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Speaker 1: respondents in a Too College study, one in five students

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Speaker 1: who had engaged in self harm indicated that they had

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Speaker 1: hurt themselves more than they intended to. It's like, once

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Speaker 1: it starts, it becomes an addictive cycle. And we should

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Speaker 1: point out that not all of these experiences do become addictive. Um,

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Speaker 1: if you have borderline personality disorder, a lot of times

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Speaker 1: it will continue to get worse and or carry over

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Speaker 1: her as you get older. But according to psychiatrist Nile,

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Speaker 1: boys of these self injury cases do resolve on their

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Speaker 1: own as the boys and girls get older. Yeah, and

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Speaker 1: a lot of times that that window is within about

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Speaker 1: five years. And I'm also referencing that Lancet study. Uh,

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Speaker 1: they noticed that the proportion of the participants who reported

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Speaker 1: self injury declined with age. But at the same time,

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Speaker 1: obviously we can't brush this off and say, well, yeah,

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Speaker 1: just just let it go. This will resolve on its own. Um.

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Speaker 1: For instance, this is also the third most common form

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Speaker 1: of adolescent suicide, and behaviors may crop up again even

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Speaker 1: if it goes away for a while. That's one thing

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Speaker 1: that se Smith over at Exo Jane talks about. She

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Speaker 1: says that you know, she has not cut herself in

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Speaker 1: a very long time, but she would be lying if

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Speaker 1: she said she never thought about it. And it's scared

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Speaker 1: that at some point it might happen again because it

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Speaker 1: does become such a strong coping mechanism a lot of times.

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Speaker 1: And there's also the potential danger that comes along with

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Speaker 1: UM infection and infection that could possibly lead to unintentional death.

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Speaker 1: And one other potential complication for this really is worsening

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Speaker 1: feelings of guilt or shame UM. A lot of people

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Speaker 1: who have reported their self injury talk about how it

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Speaker 1: is a coping mechanism there it brings relief UM, but

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Speaker 1: it's usually followed by feelings of guilt or shame, and

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Speaker 1: so there is this link to suicide. This Cornell study

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Speaker 1: that Krista mentioned earlier site studies that show people who

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Speaker 1: engage in this behavior are nine times more likely to

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Speaker 1: report suicide attempts and seven times more likely to report

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Speaker 1: a suicide gesture YEAH and UM. And in addition to

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Speaker 1: these concerns about the underlying roots of the behavior, such

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Speaker 1: as psychological issues or prior trauma or inability to cope

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Speaker 1: UM with emotions UM Researchers are also concerned with how

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Speaker 1: this behavior might be spreading as well. UM there's concerned

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Speaker 1: that it has a contagious effect among peer groups, especially

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Speaker 1: because it tends to affect UM younger groups that we

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Speaker 1: talked as, we've talked about that twelve or fifteen year

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Speaker 1: old window, and there have been UM studies examining whether

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Speaker 1: or not it's something that actually spreads by kids talking

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Speaker 1: about it, it being something that that they do as

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Speaker 1: almost together. I mean, obviously it's a private thing, but

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Speaker 1: as a still a form of bonding. Yeah, I mean

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Speaker 1: we've talked about and this isn't exactly the same thing,

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Speaker 1: but we've talked about on the podcast before, like if

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Speaker 1: your social group is doing something whatever, that's something is

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Speaker 1: it normalizes the behavior in your mind. So if a

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Speaker 1: couple of people you know at school or doing this,

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Speaker 1: it might seem more normal, you might be more willing

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Speaker 1: to experiment with it. And clinicians have also been concerned

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Speaker 1: over the rise of like self harm videos that are

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Speaker 1: on YouTube UM and also talking about it on social media.

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Speaker 1: It's just it's in UM there our conversation more often

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Speaker 1: than it used to be in getting that attention in

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Speaker 1: a negative way might be compelling more kids to to

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Speaker 1: do this as a cry for help. Right, But a

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Speaker 1: lot of people will point out a lot of people

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Speaker 1: who have gone through this will point out that, yes,

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Speaker 1: a lot of people say that, well, that's just a

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Speaker 1: cry for help. She needs therapy, she wants attention from

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Speaker 1: her parents. But there is a large portion of this

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Speaker 1: population who say, you know, I was going off into

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Speaker 1: you know, my bedroom and doing this like I didn't

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Speaker 1: want anybody to know about it. This was for me

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Speaker 1: to feel better, and so I guess you know, it's

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Speaker 1: obviously unique to to everybody, but it definitely isn't necessarily

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Speaker 1: a cry for help or a cry for attention. Right,

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Speaker 1: but nevertheless, us, what do you do when you, um,

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Speaker 1: you know, if you if you discover that a friend

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Speaker 1: is hurting themselves on purpose, well you shouldn't keep it

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Speaker 1: to yourself, no, no, um, that's you should try to

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Speaker 1: talk to your friend if possible, but be non judgmental

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Speaker 1: and non threatening about it. You know, don't get up

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Speaker 1: in anybody's face who might be in a fragile condition

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Speaker 1: and be like, you know, you really need to cut

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Speaker 1: this out. This is really bad for you. You have

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Speaker 1: to try to be sympathetic to your friend and let

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Speaker 1: them know that you're very concerned for their safety. Right,

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Speaker 1: And one thing that you could do to help them

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Speaker 1: is UM help them seek out resources, therapists, helpful adults,

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Speaker 1: someone who could help resolve this kind of behavior. And

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Speaker 1: they're also organizations out there such as Safe Alternatives which

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Speaker 1: stands for Self Abused Finally ends, which you can find

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Speaker 1: its Self Injury dot com UM and there there's also

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Speaker 1: the Self Injury Foundation Mental Health America, and also, as

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Speaker 1: we've referenced before, the Cornell Restart Program on self injurious Behavior,

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Speaker 1: which is more takes more of a clinical approach, but

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Speaker 1: it still has a lot of information for what to

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Speaker 1: do and how to cope or if you are finding

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Speaker 1: yourself doing this, uh, you know, seek out the resources.

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Speaker 1: There is a lot out there and a lot of

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Speaker 1: ways to cope. And UM. One thing we haven't talked

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Speaker 1: about much is treatment for it. There is no medication

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Speaker 1: that's just going to take this behavior way. Sometimes antidepressants

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Speaker 1: will be prescribed probably if there if the doctor finds

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Speaker 1: out that there is um anxiety or clinical depression going

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Speaker 1: on with that, But a lot of it revolves around psychotherapy,

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Speaker 1: right because Oftentimes there are those underlying um conditions that

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Speaker 1: people are dealing with. It might have driven them in

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Speaker 1: the first place to experimenting with this behavior. So, you know,

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Speaker 1: going to psychotherapy to learn healthier coping mechanisms, learn how

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Speaker 1: to communicate and express emotions, basically undo all of those

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Speaker 1: well not undo, but try to get to the root

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Speaker 1: of all of those behaviors that you started in the

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Speaker 1: first place. You know, why, why are you having trouble

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Speaker 1: expressing emotions or why do you feel like you need

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Speaker 1: this release right? And that's actually how um Se Smith,

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Speaker 1: the blogger that we referenced, was able to stop that behavior,

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Speaker 1: was that she finally got to a point she knew

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Speaker 1: that some people knew what was going on, and no

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Speaker 1: one ever said anything to her, and um what she

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Speaker 1: wishes that someone had, But she finally got to a

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Speaker 1: point where she had to talk to a therapist. And

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Speaker 1: gradually it's establishes accountability as well of setting up like

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Speaker 1: signpost in a way of saying, Okay, we don't engage

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Speaker 1: in this for a week, don't you know, almost weaning

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Speaker 1: yourself off of this behavior and learning how to channel

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Speaker 1: that all of that emotional energy into something healthier and

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Speaker 1: safer exactly. So I feel like in a way we've

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Speaker 1: only thrown out tons of statistics, but it is such

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Speaker 1: a complex behavior. UM. You know, I hope that we

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Speaker 1: were able to offer an overview of of what it

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Speaker 1: is and also um a word of hope out there

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Speaker 1: for people who might be dealing with us or know

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Speaker 1: people who are dealing with us, that there is hope

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Speaker 1: for recovery and treatments out there to help people get

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Speaker 1: better and not and not hurt themselves. So, if you

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Speaker 1: would like to write to us about um cutting, self mutilation,

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Speaker 1: self harm, uh, we would love to hear from you. Mom.

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Speaker 1: Stuff at Discovery dot com is where you can send

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Speaker 1: your letters. If you're looking for advice or resources, we

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Speaker 1: will do our best to point you in the right direction. UM. Again,

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Speaker 1: I recommend heading over to self injury dot com. UM.

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Speaker 1: It seems like that's a uh good go to if

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Speaker 1: you're looking for more information on this kind of behavior. Uh.

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Speaker 1: And in the meantime, we do have a couple of

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Speaker 1: listener letters to share and this is both in relation

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Speaker 1: to our episode on clothing donations. And this first one

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Speaker 1: comes from Karen and she works at a domestic violence

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Speaker 1: shelter and then they take in a lot of clothing donations.

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Speaker 1: But she talks about how a lot of times they

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Speaker 1: can't keep much of many of the clothes that are

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Speaker 1: donated because they are in such poor conditions. So she

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Speaker 1: offers a few tips for listeners who are planning on

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Speaker 1: donating items. Tip one, when collecting items to give to donate,

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Speaker 1: stop and put yourself in the recipient's position. Ask yourself

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Speaker 1: if the item would be something you would enjoy if

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Speaker 1: you were in their shoes. Tip to call her, email

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Speaker 1: the charity and ask them if they need the items.

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Speaker 1: You can also ask if there is a local thrift

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Speaker 1: store that they partner with where you can donate it,

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Speaker 1: and do this before you go drop off your items

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Speaker 1: so you don't lug things around. It will of view

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Speaker 1: you and the agency time. That's also a great time

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Speaker 1: to ask if there's anything needed on their wish list.

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Speaker 1: Those items can be small and toothbrushes or shampoo and

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Speaker 1: make a big impact. And Chip three, do not be

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Speaker 1: offended if a charity won't take the item. There typically

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Speaker 1: are so many factors and accepting donations. If you're still

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Speaker 1: looking for a good home for an item and you

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Speaker 1: live in the US give to one one a call.

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Speaker 1: It's a toll free number like one or four one

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Speaker 1: one that connects people who need help or want to help.

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Speaker 1: So thanks for those suggestions, Karen. Okay, this one's from Cali,

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Speaker 1: also about our donated clothing episode, and she has two

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Speaker 1: suggestions for people. She says. One is an organization called

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Speaker 1: Dress for Success, which receives professional clothing and gives it

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Speaker 1: to low income women looking for work. Each Dress for

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Speaker 1: Success client receives one suit when she has a job

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Speaker 1: interview and can return for a second suit or separates

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Speaker 1: when she finds work. Participants also receive help in the

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Speaker 1: job search process to prepare for interviews and develop their resumes.

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Speaker 1: Another organization and is called ever After, which is a

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Speaker 1: nonprofit that provides young women with new and gently used

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Speaker 1: formal gowns, shoes, and accessories to be warned to their

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Speaker 1: high school prom. Guests are pre selected by their high

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Speaker 1: school guidance counselors based on financial need, and the items

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Speaker 1: they choose are theirs to keep forever free of charge,

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Speaker 1: and she provides two websites. First is for Dress for Success,

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Speaker 1: which is Dress for Success dot org. The second is

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Speaker 1: ever After gowns dot org. So thanks for that info, Kelly. Yeah,

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Speaker 1: and thanks to everyone who has written in mom Stuff

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Speaker 1: at Discovery dot com is where you can send your letters.

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Speaker 1: You can also find us on Facebook, leave us to

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Speaker 1: comment or message there, and you can follow us on

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Speaker 1: Twitter at mom Stuff Podcast. And if you'd like to

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Speaker 1: feed your brain during the week, you can head over

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Speaker 1: to our website, it's how stuff works dot com for

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Speaker 1: more on this and thousands of other topics. Is it

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Speaker 1: how stuff works dot com brought to you by the

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Speaker 1: reinvented two thousand twelve Camry. It's ready, are you