News from SCA October 2016
The Truth About Self-Injury by Jodi Top

For over ten years now, I have specialized in the mental health area of self-injury. My clients come from all over the metro area and even other states, because finding proper treatment for these hurting souls is very difficult. I want to dispel a destructive myth – the myth that these young people are using a negative behavior to attract attention.

Psychologically speaking, I wish this were the case. Attention-seeking behaviors are rather simple to treat clinically. But the child who cuts is usually lost in a highly complex set of circumstances including family systems and social systems, leaving the child with unmet needs and deep pain. Self-injurers require support and change in all areas of their lives, not the least of which is their mental health.

Let's be clear: self-injury is always a sign of a mental health issue. ALWAYS. I have not, in ten years, had a client come to me because they were actively trying to get attention. Rather, they were discovered. Those who cut, hide. They hide cuts (not always well), they hide pain, they hide need, they hide the deep shame that possesses them, and they hide the fear that they are crazy.

What is even more frightening is that they so very often hide secrets. In her book, A Bright Red Scream, author Marilee Strong looks at cutting from an investigational point of view. In the fourth chapter she reports the following:

“As nearly every study of chronic self-injurers indicates, 50-90% of those studied report being sexually victimized as children.” P.64

There is no room to casually dismiss the child who is cutting; he or she is silently carrying profound levels of pain. But they are amazing kids: high academic achievers, cheerleaders, athletes, leaders in their peer groups and church groups, gifted with compassion superpowers! They see others' pain and prioritize it over their own, including the adults around them.

They see the world’s suffering and haven’t been jaded by it yet; they still think they can help. They are often poor at boundaries, meeting the needs of others and never saying "no." They believe the adults around them are unavailable. It may be just their perception or their desire to protect already stressed-out adults. But sometimes there truly are no adults they can count on. Self-injurers are the strongest kind of survivor.

I hope you find this convicting. There is no better place to live into the call of Isaiah 61:1, “The Spirit of the Sovereign Lord is upon me, because the Lord has anointed me to proclaim good news to the poor. He has sent me to bind up the brokenhearted, to proclaim freedom for the captives and release from darkness for the prisoners.”

In conclusion, my hope is that houses of faith will be places of refuge, where hurting teens know there are those who will touch scars with kindness and compassion. Where they will be told “I know just who to ask and how to help.” My prayer is that shame would no longer keep hidden what needs to be brought to light. Please, my friends, if you need help, ask for it. Read books, call me, call someone, someone who knows how to treat pain with love and hope.

Jodi Top, LCSW
Clinical staff member, Southwest Counseling Associates

Questions and Answers

What can a pastor or member of clergy do when faced with a teen who is self-injuring?

Always respond out of the deepest wells of grace, kindness and compassion. Self-injury is about managing deep emotional and psychological pain. Listen to the child without trying to change or challenge their story. Don’t be afraid. There are people who can help in significant ways. You may never have faced pain like this before, but Jesus knows every pain, and you know him.

Be thankful out loud that they have considered sharing part of their story with you. It’s okay to tell them that. If you are brave and if it’s appropriate, ask if you can see the cuts or scars. When it is appropriate, you may, without a word, help to dispel the shame attached to cutting by touching the scars. Simple statements go a long way – like, “I’m so sorry you have so much pain. I’d like to help.”

Once I am listening to a person who self-inures, what resources can I access to help me minister more effectively?

First of all, let me just say that if this is a common thing with your youth, I am fully willing to do an in-depth training for your staff. Second, there are great books to educate, share and learn from. As quoted in the article, the book A Bright Red Scream by Marilee Strong is a fantastic journalistic approach to the subject. It includes interviews and research. Skin Game by Caroline Kettlewell, and Cut by Patricia McCormick are short fiction stories that are easily read in a couple sittings. They will put you in the mind of the self-injuring teen. If you want an instruction manual of sorts, Cutting by Steven Levenkron is my absolute go-to.

And when facing parents who are scared and confused, Hope and Healing for Kids Who Cut by Marv Penner is great and mirrors some of the more clinical information in the Levenkron book. Finally, if you want a visual portrayal of the pain and chaos, I recommend the 2003 film, Thirteen. It shows the swirling emotions and lack of skills that characterize many of the kids who get lost in the world of self-injury. Please, always feel free to call with a question or for a referral.

Jodi Top, LCSW

Jodi is a graduate of the University of Denver's Graduate School of Social Work. She completed an undergraduate degree in social work at Dordt College in Sioux Center, Iowa. She has been practicing social work for over 13 years and is a Licensed Clinical Social Worker in the state of Colorado.

Jodi specializes in the treatment of adolescents for issues including substance use, delinquency, depression, self-harm, and general teenage angst. In addition, Jodi is experienced in family issues, mood and anxiety disorders and women's issues. Jodi works with groups as well as individuals, couples and families.

Jodi has facilitated prayer events locally, nationally, and in several other countries. She has a passion to help others better understand prayer and how it works both personally and corporately. Jodi has held a leadership position in her church for over eight years, and is currently serving as an elder in her church.


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