Psychologist: Increase in school violence possibly linked to self-harm

During the pandemic, counselling psychologist Sule Joseph noticed “a marked increase” in the reporting of children using “maladaptive coping strategies” such as self-harming.

“There are positive coping mechanisms like exercise, meditation, art and so on, but you can have negative ways of coping with stressful situations, like smoking or drinking excessively, taking pills, extreme risky sexual behaviours and the like. Like self-harm, you find some activity that gives you some immediacy in terms of relief or distraction from the stress in the short term.”

Specialising in child and family therapy, Joseph compared it to having a dirty bedroom. For some, the easiest way to deal with it, or not deal with it, would be to sleep. But when the person wakes up, when the drugs, sex or pain stops, the bedroom would still be dirty.

All maladaptive mechanisms worsen over time because as the body adapts to whatever the person is continually doing to it, the less it works and the more extreme the act has to be to get the same feeling. As a result, if they do not deal with the root of the problem, some people fall into addiction. Unintentional suicide can also be an extreme side effect of self-harm.

He said self-harm presents differently with each individual but, in general, females tend to physically hurt themselves while males put themselves in risky situations with a high possibility of pain or injury.

Self-harming in girls is easier to identify because it is mostly physical. But because of the way it manifests in boys – picking fights they would probably lose or generally putting themselves in risky or high adrenaline situations – people tend to dismiss it as "boys being boys," or that they are looking for attention.

“We may have a situation, I can’t say with 100 per cent certainty, where the increase in violence in schools could have something to do with self-harm and children putting themselves in situations to treat with the anxieties and issues they feel coming out of the pandemic.”

He said there is little to no national statistical information on the matter but, in his experience, self-harm is more prevalent in females and high-performing students. However, it depends on many factors including people’s life experiences, stress tolerance, personalities, support systems and more.

Possibly, an empathetic person, or a person with an A type personality – competitiveness, impatient, likes to be in control, base their self-worth on external achievement – could be more susceptible. Or if a person had to deal with stressful situations or disappointment at an early age, they may be better equipped to deal with other life stresses.

But there are no hard and fast rules, as people self-harm in a way that makes them feel most comfortable. It could include pulling hairs from their scalp, eyebrows, eyelashes, or pubic area, cutting, burning, alcohol and drug misuse, disordered eating when they do not have a diagnosable eating disorder, self-destructive behaviour and more.

“Research has shown us that parts of the brain that respond to life stresses and so on, also respond to pain. When we self-inflict pain, it lights up that region where we have the stress or anxiety. The way the body responds to that specific pain is to release endorphins. So it hurts at first, but then may feel good after a while.”

Joseph said people may think about what method they use but they do not really give their actions significant thought. He likens those who self-harm to someone who is drowning and who would do anything for a breath of air to survive.

“The only thing they could think about is air. All you are thinking about in that moment is your next breath, so they are going to start reaching for anything that could give them one breath. In that moment it’s purely about survival.

“How can you be in your right mind if you’re drowning? You can’t think about anything other than surviving. Self-harm is an attempt to get a breath. If it means hurting themselves so they can feel better so they can breathe, then that’s what they do.”

He added that it could be dangerous for untrained people, especially children, to try to help those who self-harm. Just as someone who is drowning and panicking could pull the person trying to help underwater, an untrained person who wants to help could start experimenting as well.

Children could also be introduced to self-harming if there is a hidden culture of it in schools, through the internet via challenges and fads or people advising others on how to “feel better” through self-harm, or they could hurt themselves accidentally and like the feeling.

He stressed that self-harming usually does not go away by itself. Rather, it may evolve into more emotional self-harm as the person grows older if the issue causing the problem is not addressed.

For example, someone may have cut themselves when they were young but, as they grew older, they could find themselves continually choosing partners who were abusive in some way.

Joseph explained that counselling equips people with the tools to help them face their reality and solve the problems they attempt to avoid. And so, seeing the increase in frequency of clients with self-harm ideation, he became concerned, spoke to two senior psychologists and they decided to do something about it.

They facilitated a one-day Understanding Self-Harm workshop on May 6 at UWI's Faculty of Medical Sciences Amphitheatre. In the morning, they treated with children, helping them understand their feelings and giving them tools to deal with their issues. In the afternoon they focused on adults as they need to be able to identify self-harm and deal with it before it goes too far.

He hopes to host similar workshops in Tobago and in south Trinidad soon, but that will depend on sponsors and other forms of assistance.