9Mon

For parents: What to do if your teen is cutting (Part 1)

borderline-cutting-depression“I told my daughter that he couldn’t go out and next think I know she’s yelling at me: “If you don’t let me go out with my boyfriend I’m going to cut.”

“I was cleaning my kid’s bed and then I saw a cutting kit, it was the first time I realized that she was cutting.”

Are any of these situations familiar to you? Are any of your friends or relatives dealing with a situation like this? If so, this is a post for you.

According to a study published in the British Medical Journal in 2002, approximately 13 percent of British 15- and 16-year-olds engage in self-injury behaviors such as cutting. When working with teenagers this is a problem we encounter more often than not. Parents who discover that their teen is cutting experience a broad range of emotions such as anger, guilt, shame, fear, hopelessness… and quickly blame themselves for the teen’s behavior or blame the teen directly. Parents also spend hours trying to figure out what to do next. Some of them go into searching for help on the internet, others decide to talk to a friend or the school psychologist, or the pediatrician but unfortunately despite the world of information we’re exposed to, parents still get lost and don’t have access to “effective help.”

This post is dedicated to those parents that simply “don’t know where to start and what to do when they find out their teen is cutting.”

1st. Thing to do: Breath, breath, and breath again.

2nd. Stomp your feet on the floor or press your feet really hard against the floor as if you are dropping an anchor and you’re locking your body in that particular position.

3rd. Notice the quality of the experience you maybe going through. If possible, grab a piece of paper and honestly answer the following questions:

What am I feeling right now?
What am I scared will happen now?
What am I thinking right now?
What do I feel like doing in this precise moment?

For example, Jessica went back to her home on a Monday morning after dropping her kids at school. While cleaning the bedrooms, found a pencil sharpener on the floor with blood as well as the sheets in the bed had blood stains. She desperately searched for any other clue or prove that Olivia is cutting and discovered tissue paper with blood in the trash can; she also found a small knife in the drawers.  She quickly put her knees on the floor, cried, blamed herself and noticed the thoughts “it’s all my fault; I shouldn’t have ever get divorced; what if Olivia never stops cutting? Does she hate life? Does she hate me? Is she upset? Jessica also acknowledged that her worst fear is that Olivia will attempt suicide without her knowing anything or being able to help.

4th. Notice the natural impulses you maybe having:  Do you feel like screaming at your teen? Are you blaming yourself? Are you blaming your partner? Do you feel like calling your kid’s school and talking to the teacher? Are you telling yourself that your teen is manipulating or trying to controlling you? Once again, write down all other urges you maybe having right now… let’s put all on the paper. Whatever you feel like doing right now, do the best you can to pause and pause again.

6th. Stomp your feet against the floor really really hard, and anchor yourself again in this moment.

7th. Get ready to talk to your teen! Prepare yourself for talking about the cutting or other self-injury behavior with your teen in the most effective way possible. If possible grab a piece of paper and write a script for it; we highly recommend a specific format such as:

(a) Describe the situation, specifically the facts, (b) I think, (c) I feel, (d) I want …

Continuing with Jessica’s example, her assertive script looks something like:

– Today, Monday morning I was cleaning your bedroom and found a pencil sharpener covered with blood; I also found blood in the sheets in your bed and tissue paper covered with blood in the trash in your bedroom. I realized you are cutting and I feel concerned and worried about it. I want us to talk about it with a professional who can help us.

Notice that in the above statement there is one word accusation, judgement or blaming to the teen. Once again, it’s all about describing what you found, how you felt, and making a request.

Now that you have a script ready to go, let’s take a look at the non-verbal communication variables: are you looking down, are you rolling your eyes, are you screaming?   It’s helpful if you record yourself or rehearse in front of a mirror before talking to your teen so you can see these other variables, as well and modify them before hand.

8th. Be prepare to deal with your teen’s response.

When you talk to your teen, it’s quite likely he/she may have all types of responses: agreeing with you and acknowledging the cutting behavior, denying it, or getting upset; these are the most common reactions we witnessed. Because as parent you have a sense of how your teen may respond, it’s helpful to visualize what’s the worst response your teen could give you? Do the best to notice how your mind may predict the future over and over; it’s natural if your mind is predicting the “worst case scenario.” What’s really the worst response you could receive? For a couple of moments bring that image to your mind, do the best you can to really notice all detail of it, like your teen’s tone of voice, body language, hand gestures, words he/she may use…then, write down those potential responses.

Here is what to do, whether your teen denies it or argues back to you: in a soft and firm tone of voice you say a short and sweet sentence that has two parts: validating statement + assertive statement. Validating statement simply refers to any statement that notices your teen reactions, emotions and struggle in that precise moment, even though you may not agree with it.” A validating statement sounds like “I see this is hard; I can see how upsetting this is to you; I understand that hearing this is a lot right now. Assertive statement is simply reiterating your request from your assertive script: “… and I still want us to get help with a professional.”

Now, here is the deal again: your teen may argue, scream back at you, or tell you that this is not true. Notice what’s your reactive responses in that moment: Are you arguing back? Do you feel like proving you’re right and your teen is wrong? After naming and noticing these responses, do the best you can to not engage on them and simply go back to say your magical sentence: validating + assertive statement, over and over. If your teen continues to argue with you, let him/her know that you will ask for professional help, and you will wait until he/she is ready to talk about it,  then remove yourself physically.

9. Talk to your teen!

Now that you’re prepared to talk to your teen, do it. If your teen is open he/she may tell you about how long has the cutting being happening, when he/she  does it. Notice if your internal reactions while having this conversation, are you getting upset, do you feel like you want all the responses at once? It’s natural to have all those reactions and trying to “solve” this right away. Pause again, and remember that your task is “to search for professional help.”

10th What if you didn’t talk to your teen?

If  you find yourself there maybe there is a part of you that is still is hesitant to do it. Do the best you can to notice what makes you hesitant about taking this step: are you afraid of your teen’s response? Are you afraid of not knowing what to do? Are you holding the belief that “nothing will happen if I talk to him/her?” Can you write down all those potential obstacles that showed up for you and answer yourself this question: What are the short and long term consequences of me not talking to my teen today about the cutting and/or self-injury behavior?

Our next post will be about how to find the right therapy and therapist for your teen so you don’t waste time and financial resources in an ineffective treatment.