Part 2: Adolescents Self Harm and Social Media

by Tony Martin, MSW Intern

In this two-part series, we explore the subject of adolescent self-harm and how social media may serve as both a risk factor for this behavior and a form of social support. The aim of these posts is to offer research-based information on a topic that can be very emotional. TRIGGER WARNING: Some of this might be hard to read—especially if you love someone currently engaging in self-harm. Knowledge is power. Better understanding self-harm and its relationship with social media, can empower you to provide more unconditional support. Part I provides an overview of self-harm behavior while Part II explores how to relate to someone who self-harms and the relationship with social media.

PART 2

The graphic nature of non-suicidal self-injury (NSSI) behaviors often causes emotional distress among parents and guardians. When this happens, and it inevitably will, it’s important to keep your questions and comments focused on your child’s underlying pain, rather than pre-occupied with the nature of the physical acts. You may want to exert more control over a teen who self-harms, but this may limit their willingness to open up about what’s really bothering them. 

Angry initial reactions are often a form of deflecting responsibility or perhaps projecting blame that we might be feeling. Be mindful not to minimize or mis-appropriate self-harm behavior. Facing the fact that someone we love is hurting themselves is a really difficult place to be. NSSI is a very serious matter. Minimizing, projecting or misdirecting attention can alienate our loved ones and create barriers to getting them the support and treatment they need.

Therapists who work with families of adolescents who self-harm report hearing things like, “my kid is crazy, why else would they hurt themselves,” “they’re just doing it for attention,” or “they’re doing it to get back at me.” Emotional reactivity, no matter how relatable, distracts time and energy from the healing process. When processing challenging emotions with someone who self-injures, try to stay with your own feelings and use “I” statements. Be mindful of the impulse to fix the problem. Something as complex as NSSI won’t be undone with advice, or punishment. If what your child is doing doesn’t make sense to you, see this as an invitation to find out more. Curiosity is more productive than fear and anger.

Teens often describe self-harm as a last resort in dealing with feelings of loneliness, isolation, and disconnection. Studies show that adolescents who report feeling disconnected are at a higher risk of self-harm behavior. Many teens, particular those with introverted personalities, rely on social media to cope with feelings of social isolation. Though how much time kids spend online is often used as a scapegoat for unwelcome behavior.

Studies show that social media is associated with both positive and negative mental health outcomes. 

There is an ongoing debate about whether teens’ use of social media is more of a risk factor for adolescent NSSI or can it serve as an important social support and protective factor. As an alternative to the challenges of the real world, social media can make it easy to communicate with peers and meet the need for social connectedness. Most research looking at the relationship between adolescent NSSI and social media focuses on frequency of social media use without considering the psycho-social-emotional benefits that adolescents often form with online communities. Adolescents who self-harm have found therapeutic benefit from online social interactions. But the research on social media and NSSI is inconclusive.  

One study found the quality and consistency of peer relationships was associated with adolescents who engaged in self-harm behavior and then stopped. Another study found that teens who spent more time on Instagram, Snapchat, and WhatsApp over a three-week period reported lower levels of self-esteem than adolescents who spent less time.  On the other side of the coin, studies have shown that depressive symptoms and suicide-related indicators got worse with adolescents who spent more than four hours a day online. It seems that some digital experiences may have the potential to contribute to positive outcomes while others may be very problematic.

It can be challenging to know how best to support adolescents who self-harm.

We often turn to punishment and take away devices. This may not always be the best course of action. In some situations, it definitely is the best thing to do. The hard part is figuring out if social media is a support or a risk. One way to consider the relationship between NSSI and social media is that when a teen is on social media to start or deepen social connection this could lead to positive mental health outcomes.  Problematic social media use shows up when adolescents are online avoiding and/or dissociating from difficult emotions. If after using social media a teen feels more distressed or their self-esteem takes a hit, this might be time for a break, as this could add to the risk of NSSI. 

Adolescents increasingly get social needs met online. Jumping to conclusions, shaming, or forcing young people to give up their devices “cold turkey” could exasperate self-harm behavior rather than alleviate it. Even if you are convinced of problematic social media use, weening adolescents off their devices is probably the best approach. 

There is also a dark side of social media. There are sites and chat rooms where disinformation about self-harm runs rampant. There are even sites which taunt and encourage young people to engage in self-harm behavior.  There is a difference between positive social connectedness and content which recklessly promotes NSSI. Some content may turn out to be relatively harmless or even supportive, but that same content could prove to be dangerous to more vulnerable teens. 

We need to continually reflect on the risk-reward equation of social media. For many of us, this means putting aside personal experiences and underlying bias about how best to use, or not use, technology. Mental health providers have an ethical responsibility to educate themselves about NSSI and its relationship to social media. A lack of knowledge can lead to misdiagnosis or mistakenly attributing suicide intent to an adolescent who has no such desires. Misdiagnosis can lead to inappropriate treatment and stigmatization which can make a situation worse. 

One study found that over 50% of adults with a history of NSSI never received any mental health treatment for their behavior. When parents and caretakers do their homework and are able to put aside personal feelings, this empowers young people to seek help. Empathy and understanding are important in addressing underlying needs of adolescents who engage in NSSI. This can only begin when we move beyond fear and defensiveness, creating more positive emotional experiences, something teens who self-harm typically don’t experience in connection with their behavior. 

There is no standard treatment for adolescent NSSI behavior. Preferred therapy includes a combination of support, assessment, family involvement, and individual therapy. Evidence-based treatments with success targeting NSSI include cognitive behavioral therapy, dialectical behavioral therapy, mentalization-based treatment for adolescents, developmental group therapy, and emotion regulation group therapy. Most of these focus on the connection between a teen’s thoughts and feelings and how they relate to their behavior.  Group therapy models and those which involve family members may improve outcomes. One important part of therapy is teaching adolescents more effective, non-avoidant emotion regulation skills. A combination of mindfulness and self-compassion have been found to be important emotion regulation strategies.

At best, conflicting information about social media use and NSSI behavior creates confusion over whether to limit a child’s use of social media or not. At worst, it could facilitate well-intended but misguided decisions to remove protective factors for self-harm. Getting comfortable with being uncomfortable, being okay with not having all the answers, and never underestimating the seriousness of NSSI are important takeaways. Being open to the possibility virtual connectedness could be helping to keep your child safe, while remaining vigilant against algorithms that might populate your child’s feed with determinantal content is a difficult job to undertake, but one that could prove an important step in healing.

If you or someone you know is struggling or in crisis, help is available. Call or text 988 or chat 988lifeline.org

Read Part 1 Here.

 

Meet the Author

Tony Martin (he/him) earned a Bachelor of Science in Psychology from the University of Richmond and is currently in his final semester of UNCW’s Master of Social Work program. Tony will be facilitating a LGBTQ+ teen meditation group every Monday this winter here at Stillpoint. Tony has practiced mindfulness meditation since 2014 and received training in Mindfulness Based Stress Reduction (MBSR). He has sat several long silent mediation retreats including one for 6-weeks! He is passionate about supporting the LGBTQ+ community. Tony moved to Wilmington from Oakland, CA with his husband Jeff and their rescue pup Mandy. Tony & Jeff have one son in college.