If you have a tween or teen at home, more than likely you’ve heard the news about the Disney Star, Demi Lovato. People magazine reported that this young 14 year- old star has been battling with cutting (a form of self-mutilation) for some time. They also reported that she recently attacked one of the dancers on her show. It seems surprising coming from young girl that “appears” to have it all. She is a talented young lady with a magnetic TV personality and most likely, financially set for the rest of her life.
Why would she do that? What would cause anyone to intentionally mutilate? While, I do not have enough history on this teen star to understand what lead to her incorporating a behavior of this severity, I can speak to the consistent commonalities that I have experienced in working with Teen girls challenged by the desire to hurt themselves.
An understanding of Bryan Post’s Stress Model highlights some potential causes, outlines a process of moving forward, and focuses on healing and eliminating the behavior. He states, “All behavior arises from a state of stress, in between the stress and the behavior is the presence of a primary emotion, Love or Fear. It is through the expression and processing of the emotion that you calm the stress and diminish the behavior.”
Her story will always begin with past traumatic experiences that have been unaddressed or not addressed in a way that will produce the level of healing needed. Sometimes that traumatic experience is even buried in the unconscious memory. Whatever, her story these significant events will dictate and determine the way in which she views the world around her. She is therefore extremely sensitive to any stressors within her environment and her brain is unable to determine the difference between what is a threat what is not a threat. This perception creates a reality that appears unsafe, scary and hopeless. In addition, we are armed with a lot of research proving that today’s teen is more stressed out than ever before. This is due to hormonal and cultural changes as well as societal demands.
Essentially, cutting becomes her voice screaming “I am terrified, stressed out and it hurts”. It is her means of fixing it herself when she is unable or incapable of connecting with someone to express and process her fear and achieve a sense of calm and well-being. This is also her brains method of survival. She moves from freeze into flight. Louann Brizendine, MD, explains in her book, The Female Brain, when females become stressed and the chemical cortisol is released thereby blocking her brains ability to produce oxytocin (anti-stress hormone) response. Without the brain’s production of the oxytocin hormone and dopamine, the motivation and/or ability to seek calm and engage in an intimate relationship to assist her in becoming calm is not possible.
But why the cutting? There is a payoff. The payoff is the “reason” we continue a potentially negative or harmful behavior despite the risks. The risk of losing her career is a steep consequence, so the payoff has to be far greater than the risk. From the outside, when we don’t have an understanding, it may seem that her behavior was far too risky and not worth the trouble it could cause. The payoff is rooted in meeting a deeper need; a need to survive. It is important to recognize as humans our cellular system is driven to be in relationship and community as a means to survive. It is when we feel stressed that we move into the survival response of freeze, fight and flight. Without the presence of stress, oxytocin is produced and we move into community.
Louann Brizendine, MD, also explains that at puberty a teen girl’s increase in estrogen produces and amps up dopamine (a chemical that produces an effect like that of heroin) and Oxytocin (bonding hormone). These chemicals combined will reduce stress and create biological comfort for her when she can connect. Examples of this are girls playing with one another’s hair, gossiping and going to the bathroom in groups of 3 or more.
Here is the first key; Are you ready…. when estrogen and progesterone climb during puberty she will become ultra sensitive to the stress and the pain caused by the cortisol produced within her brain. In the place of being highly stressed she will start looking for ways to calm and soothe!
She is driven to escape from the emotional pain that most girls describe as, “feeling like I’m gonna die.” Her experience of hurt, pain and fear is overwhelming and all encompassing. Thus, the payoff is instantaneous.
Here is the second key; The first time she tries cutting or any other self-mutative behavior, her brain will release a chemical surge of endorphins. Endorphins are our body’s natural opiate providing a feeling of going away or leaving the body. It feels good to leave your body when it hurts so bad. The internal feeling validates and adheres to the brains desire to survive through fleeing.
For me, this explains why cutting is highly prevalent among teen girls with early life trauma. It was described in the article about Demi Lovato that she had lost two important friendships as well as had broken up with her boyfriend prior to the latest cutting episode. The threat of a lost relationship and any conflict will induce extreme fear in all teen girls however, the threat or loss of a relationship for girls with a history of physical and/or emotional abandonment is equal to death. This teen with trauma does not have the ability to produce the levels of oxytocin necessary to seek relationship(s) for the necessary comfort. Therefore, when she cuts the endorphins produce the calm she desperately needs.
The more difficult aspect of this solidified behavior is that the stage for an addiction has been set. Bryan Post, called this a new understanding of self-mutilation. He defines an addiction as, “an external attempt to sooth an internal feeling”. When the internal dysregulation (being stressed) feels so profound and she is unable to express or process the emotion she uses this as a means to make it better. I categorize it in a group with a few other behaviors, associated with teen girls as, “I’ll fix it myself behaviors”. These survival mechanisms are always an attempt to find their power and their voice in a world they perceive as terrifying and disempowering.
Please allow me to clarify this again because I believe it is truly very powerful. If she feels as if she is going to die and her brains natural defense, “survival” is the only way she can keep herself alive, then yes this payoff will far exceed any consequence that she may
receive. The payoff from the chemical rush can become a conditioned response to stress which in turn becomes an addictive behavior. To survive she moves into flight by going away to a safe place, far and deep inside herself. This is truly her only option when her brain cannot produce the dopamine and oxytocin necessary to release her from the pain she feels from the cortisol/stress.
If I truly understand this I can respond in a manner that will address what is beneath the behavior and move toward healing. This is often difficult when we know she is about to cut. In that moment, seek to stop or fix the behavior. The issue inherent within our reaction is the escalation of more stress and fear amongst the already existing state of stress and fear. Remember, “All behavior arises from a state of stress”. The first question I receive from parents is, “do you expect me just to let her hurt herself”. The answer of course is no. I teach parents to influence the behavior, minimize the stress and build a stronger relationship.
Here is the third key; Our brains learn to produce oxytocin and dopamine through the safe connections and bonding that we experience in our early lives. When stress and trauma is present in females their brains do not build the appropriate pathways for long term trusting relationships. Neuroscientists will say that when neurons fire together they wire together. Meaning this can create the pathways necessary for the production of oxytocin and dopamine. Relationship and connection prompts the firing in the brain.
Here is what makes the difference and creates healing. It is also a good idea to have a professional open to this modality guide you in the process. We cannot control another person’s behavior even if they are our child. The only time we will seek to control someone else is when we are scared. A primary example with cutting, is “She is practicing to commit suicide”.
Here is the forth key; The first thing we need to do…BREATHE. Breathing gets oxygen into your brain allowing access to clear thinking and oxytocin production. If you react and rush to grab the object out of her hand, the increased stress will ensure that the cut will go longer and deeper. You have created more stress and fear. I believe it is also noteworthy to mention that it is impossible to pull everything away from someone looking to cut or to watch them at every moment. She will find something.
We need to seek to influence her behavior. Remember, a safe relationship causes the neurons to fire and wire making the production of dopamine and oxytocin (anti-stress hormone) possible. When she becomes connected she can then find her voice, express and process her pain. Therefore the relationship is the pathway she needs for the stress release and calm. There is biological comfort that is created through this process.
I recently advised a mom to tell her daughter before she cut “I really hate that for you but I understand if that’s what you need to do”. Her daughter’s response was not to cut, even though she felt frustrated about it. Every cell in our body desires and needs relationship. Thus our intentions are always seeking to align and connect with others.
On the flip side if we over power (pull it out of her hand), shame (what’s wrong with you) or blame (can’t you see that you’re hurting those that love you) or lecture (this isn’t healthy and…..). It will cause her to feel victimized and she will see you as the perpetrator. Teens will often tell me, “No one understands me or No one cares.” While this is often not true, it is valid because it is how they feel. These dynamics in any relationship will create the feeling of separation and stress.
To maintain the relationship, you can try an alternative. If she is about to cut you can say (this should be reinforced when she is also calm), “I see you are really hurting, I’d like the opportunity to make it better and then if you still feel the need to cut you can”. Depending on the teen you can either sit down and shift into holding her or asking about how she is feeling. For most teens, initially, you may need to walk away because it will reduce the threat/stress that you are going to take away her cutting utensil. If this is the case be sure you say, “I’ll be sitting on the couch when you are ready”. If she comes to you prior of after cutting validate and encourage her feelings, listen without judgment and stay away from your own agenda. This will make it safe for her to come to you in the future.
Again, teens will cut because she doesn’t feel as if she has the voice to express and process her feelings. She truly needs to feel as if you can feel her and her pain. If we are feeling scared, angry or frustrated and act as if we are coming from a calm loving place it will feel incongruent and create more stress. Therefore, the absolute only way you can be effective is if you are truly calm inside (BREATH) and speaking/acting from the heart. When you are there, she will feel understood, she will open up emotionally to express and process her pain. This is where the healing lays.
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Helene Timpone, LCSW is an internationally recognized Therapist, Speaker and Coach. She is mostly known for expertise and success with preteen and teen girls. Please feel free to contact her with thoughts, comments and questions related to services. EMAIL: firstname.lastname@example.org.