Self Harm and the Process of Healing
By Stephen C. Schultz
With three daughters of my own, it’s always a moving experience to see and listen to teen girls in therapy. I am often saddened by the emotional struggles that these girls have endured in their short life times.
Some are forced to deal with grown up problems way too early through experiences with abuse, trauma, substance use and even self harm. Many times these issues are complicated with symptoms of depression or anxiety. There is something troubling when a teenage girl has a hard time seeing a reason to live.
I recall in the early 1990’s, working at a psychiatric hospital as the admissions and marketing director. I was in my office one evening and got a call from a local therapist.
This therapist said;
“Hi Steve, I have a female teen, 18 years of age. We were working through some of her trauma when she asked to use the bathroom. She left my office and did not come back in to finish her session. I sent my receptionist in to check on her and she was in the stall cutting her arm with some type of sharp instrument. We think she still has the instrument in her hand, but she is dissociating and is keeping her hand clenched. There are numerous superficial cuts on her arm, but nothing requiring stitches. I would like to have the parents bring her right over.”
I mentioned that we would be ready when they arrived and then I notified the nurses on the mental health floor of the situation.
When they arrived, the parents had a shocked look of concern. They struggled with forced decorum through this heightened emotional situation. They obviously had suffered through family conflict and turmoil with their daughter previously, but this event had taken things to a whole new level. I took this young lady and her parent’s straight back to the nurses’ station to attend, first and foremost, to her arm.
I sat her at a table. She had a glazed look in her eyes and didn’t seem able to make eye contact. She was softly moaning and rocking back and forth in the chair. One of the nurses grabbed a wash cloth and started to clean the blood off her arm. The other nurse started prying her fist open to retrieve the sharp implement. Tanya, (I still remember her name) clenched her fist even tighter. The nurse then pried harder, softly encouraging her to let go of the sharp object. It was so small; I couldn’t see what she was holding. There was certainly something in her hand because blood started to ooze between her fingers.
I immediately grabbed another wash cloth and ran to the sink. I soaked it in hot water and brought it back to the table where the nurses were frantically trying to get her hand opened. I loosely wadded the wash cloth into a ball and said;
“Tanya…Tanya…I need you to hold this cloth in your other hand.”
I then placed the cloth in her other hand and curled her fingers around the cloth.
I then said;
“Tanya…Tanya…I need you to now squeeze the cloth as hard as you can. That’s it…squeeze harder…harder…that’s it, harder…harder!”
As Tanya began to squeeze the wash cloth with the warm water in it, she began to slowly loosen her grip on the sharp instrument. As she focused on the cloth, and the warm water running down her arm, the nurses were able to retrieve a small scalpel tip from her clenched hand. (Her father was a veterinarian and she had obtained one of his small scalpels.)
The nurses then got Tanya cleaned up and settled in a room. She was able to receive some medication to help her feel more comfortable. I went back to my office and finished my work as usual…just another “day at the office”.
While this is a somewhat extreme situation, for the girls that enter treatment in residential programs around the country, the stress and emotions preceding their stay are no less emotional. Parents are shocked and concerned that things have gotten to the point where they need to intervene in their daughter’s life.
Often, with boys acting out at home, parents are happy to get them out of the house. With girls, it’s a whole different dynamic. There is certainly frustration on the part of parents, but they also worry about what will happen to their “little girl” if they send her away!
Here are some links that provide some insight into what it is like for girls to be in treatment. You can read about it here and here and here. It has been my experience that when girls buckle down, get real, work hard on their emotional concerns and learn to trust their judgment and decision making, they leave treatment on top of the world with an attitude that they can accomplish anything they set their mind to!