Family Matters

For Teens Who Cut, Going Online Can Sometimes Help

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Not sure how to birth a baby or change a diaper? Check YouTube; it’s likely that the compiler of videos galore has got a tutorial for you. But in addition to helpful how-to footage, the site is also a magnet for harmful activities, like self-mutilation. Those videos are the focus of a new study published in the journal Pediatrics that seeks to draw attention to the phenomenon of kids inspiring other kids to hurt their bodies.

When Canadian researchers plugged the terms “self-injury” and “self-harm” into YouTube’s search engine, 5,000 videos popped up. They selected the 100 most-viewed videos. Wonder who in the world would watch explicit images of someone hurting herself?

Apparently lots of people. Viewers clicked on the videos in question more than 2 million times and designated them as a “favorite” more than 12,000 times. (More on Gallery: Self-Injury in Japan)

Up to a quarter of teens and young adults intentionally hurt themselves by self-cutting or burning; the medical term for such behavior is nonsuicidal self-injury, or NSSI, which refers to intentionally injuring oneself with no intention of committing suicide.

Many of the videos chronicle personal timelines — “I started self-injuring when I was 14,” a video might begin — while others present statistics about NSSI. The information conveyed in the videos was pretty evenly split between the factual or educational and hopeless stories of woe. Nearly all the videos contained images of self-injury; 28% of the videos that featured a person actually included in-action footage. More than half the videos contained no warning about graphic, violent content. (More on How to Find the Best Drug Treatment for Teens: A Guide for Parents)

Experts worry that the prevalence of NSSI videos may encourage “normalization” of self-injury. With so many videos out there, they’re concerned that teens who view the videos could leave with the impression that self-injury is typical teen behavior. The positive comments that accompany many of the videos could lend credence to the behavior. Likewise, a vulnerable teen might interpret the encouraging comments as a green light for NSSI.

“Some of the more hopeless messages and graphic descriptions of self-injury can reinforce it or in some cases trigger it, especially in those people who actively search out self-injury on YouTube,” says Stephen Lewis, a study co-author and assistant professor at the University of Guelph in Ontario, Canada.

But others aren’t as concerned about the insidious effects of cutting videos. Marilee Strong, author of A Bright Red Scream: Self-Mutilation and the Language of Pain, thinks it’s unfortunate that some videos glorify self-injury. “But I don’t think it’s really a problem in the sense that a lot of teens are going to see that and want to do that,” says Strong, who spoke with hundreds of cutters for her book, which was updated last year. “Maybe they would stumble upon it and try to find out if it works. But I don’t see a lot of kids all of a sudden cutting because it seems cool or because there are videos on the Internet.” (More on Time.comThe Protective Effect of Family Acceptance for Gay Teens)

YouTube contacted the researchers and requested the URLs of the videos they’d studied; the website has since flagged many of the videos for mature content and removed others.  But even if all 100 were taken down — and not all 100 were — what about the other 49,900?

“It speaks to a much larger issue,” says Lewis. “In many ways, the Internet represents a novel medium to try to reach out to these young people and offer messages that could help them overcome self-injury.”

Also, as Strong found, the Internet has helped many cutters find online support. “It’s been a huge resource for people who have this secret shame that drives them to cut,” she says. “To be able to reach out to other people and have virtual support groups has been a tremendous healing tool.” (More on A Glimmer of Hope in a Bad-News Survey About Bullying)

Links to resources and helpful websites embedded within a string of video-related comments could also be useful, particularly because — as is typical of the Internet — some of the information shared on videos may not be accurate. Here, Lewis offers some insight into the world of self-injury:

Q: Why do people intentionally hurt themselves?

A: People self-injure in order to cope with difficult emotional experiences — lots of sadness, stress, anxiety. Usually self-injury is a marker or sign that something is not going very well for a young person.

Q: How does it help them cope?

A: A lot of people do report it provides temporary relief from negative emotions. But what happens is it becomes repetitive, and it’s used as a negative coping strategy.

Q: Do girls engage in self-injury more than boys?

A: It was previously believed that by far more females self-injured than males. However, more recent research suggests that males self-injure as well, and many studies report no sex differences in rates of self-injury.

Q: It’s called NSSI — non-suicidal self-injury. People who self-injure don’t want to kill themselves?

A: Based on research, we can distinguish self-injury from suicide. It’s about the intent behind the act itself. Many people are adamant this is not about suicide. It’s about dealing or coping with negative emotions.

Q: Are people who self-injure just seeking attention?

A: It’s a myth that it’s about getting attention because many young people don’t want to tell anyone about it.

Q: What might treatment involve?

A: We try to foster more adaptive coping strategies for when those negative emotions arise — different types of distraction techniques, physical exercise or just talking to someone when the urge arises. It’s important to help a young person identify what triggers the urge to self-injure.