Emotions in Teens: “We have observed instances of self-harm”

“This is the school psychologist at your daughter’s school”, the voice mail said.  It went on: “I wanted to bring to your attention that your daughter’s coach and the athletic director has brought it to my attention that they observed instances of self-harm with your daughter.”

“Self-harm”, self-harm.  It rhymed with “arm” and I could visually see my daughter’s forearm, that I had noticed weeks ago, slashed with cut marks from the wrist all the way up to the elbow crease.

Yes, we had observed the same, and we had discussed it with her a few weeks back.  Such a tough subject to even raise, but so obviously important to address.  It’s not something you ignore; it’s not something you hope will just go away.  We had noticed it, as well as other clues and cues, which she admitted to leaving behind for us to see: bloodied tissues stuffed into a bag on her windowsill, a small box containing a few blades, and then – in the same bag – a bottle of ibuprofen.

Recently, I caught up with an old colleague, a widower and single dad to 3 teenage girls.  When I asked how the girls were, his second update was: “by now, they’ve all cut themselves.  Their teachers and coaches say they see it all the time in girls their ages.  They even did it before their mom passed.”
He seemed nonchalant about it, very matter-of-fact.  Really?  All the girls engage in this behavior?  It is more the norm than the anomaly?

Whether common or uncommon, it is serious.  My partner and I tried to talk to our daughter about this behavior immediately.  But, what do we ask?  “Dear, what’s wrong?”  And, what do we say?  “You know we are always here for you.”  And also: “Why?”

Our girl had a hard time putting words to her feelings.  There were more tears than complete sentences.  She seemed dark and a bit confused.  She seemed flustered and upset.  She seemed upset that we couldn’t easily translate her feelings into words for her.  We let her know we wanted to help: help her identify her feelings, help her untangle the feelings, help her pinpoint “what’s wrong” and maybe even help her find ways to maybe even fix what felt “wrong”.  “Could we help you do that?”  She agreed.  Yes, she wanted to feel better.  Yes, she wanted to lift this heavy load.  Yes, she wanted the dark to become light.

We offered to start by asking her doctor for resources.  She had her annual physical coming up, and she would have the chance to have one-on-one time with her doctor.  To be sure, pediatricians to teenagers would have suggestions for resources for young people who grapple with these feelings.  She sounded open to broaching the topic with her doctor.
She also had a school counselor/psychologist she could talk to.  We are lucky to be one of the few schools in our district with a full-time school psychologist on campus.  Being on the more shy side, we weren’t sure whether she would initiate reaching out to the school counselor/psychologist.  Should we insist that she did?

It turns out that she didn’t have to.  Soon after, this instance, our daughter brought home paperwork for us to sign, authorizing her to miss limited class time, as necessary, for her to meet the school psychologist.  Part of ones treatment is owning it for oneself.  And, so, in addition to her individual therapy, we also enlisted in family therapy at a local public agency offering services for up to 3 months on a sliding scale basis.  We had found that very few private practices were accepting new clients, and none within our insurance network could accommodate us, so we were so grateful for this agency that was suggested to us by the school.  Our time at family therapy elevated new ways to communicate and hear one another’s concerns, and we also came up with strategies to better connect moving forward.  It built great foundation for us as we worked our way through the teen years, together.

I wrote all of the above almost four years ago, to the day, when our first daughter was a freshman in high school.  We did not see it as a blessing then, but we do now.  I am ever grateful for the incident, that gave us time to pause, reflect, and work together.  As I re-read and finally post this, our second-born is now a freshman in high school.  Although these two are very different individuals, there are certain points in our life cycles that are common.  This reflection point seems to be one of them.  I have a feeling I’ll have more to share on this before too long.  

Thank you for reading.