“My daughter has been taking handfuls of over-the-counter painkillers and has been cutting herself,” my friend blurted out to me as she and I were in the middle of our ski trip.
I instantly felt a rush of sadness, empathy, and concern. I immediately went right into my “doctor mode ” & began asking questions about her childhood. How frequently she cuts herself, her past and current relationships, her hobbies, and whether these intentional overdoses are linked to suicidal ideations.
“She never takes enough pills to have her stomach pumped; but she knows just how much Ibuprofen she needs to elicit a trip to the emergency room. Her therapist believes she is acting out because she felt that she was abandoned as a child. There has also been mention of borderline personality disorder. “
I immediately homed in on the mention of borderline personality. Individuals who have borderline personality disorder are 55-85% more likely to engage in self-harm behaviors.
Shedding light on self-harm behavior
I had a roommate in college who engaged in cutting, and I have seen this a lot in my adolescent patient population. But for whatever reason, cutting and other self-injury behaviors are not commonly discussed within the media, on college campuses, or in high school classrooms. Parents are shocked when they discover their son or daughter is engaging in these behaviors.
Approximately 14 percent of adolescents are estimated to engage in self-harm behaviors. Clinically referred to as non-suicidal self-injury; self-harm is the act of physically inflicting pain on oneself without the intention of dying. Cutting is the form of self-injury that is portrayed most often in the media .
Using physical pain to express emotions
Individuals will use sharp objects to carve into their skin (most commonly in the legs, arms, and stomach) to elicit feelings of physical pain as an unhealthy coping mechanism to relieve feelings of guilt, internal pain, shame, anxiety, and worthlessness. This physical pain induces a sense of calmness and relief and, for some, even a rush of euphoria. This instant gratification and sense of relief are quickly replaced by feelings of guilt and shame, perpetuating the vicious cycle of the urge to self-harm once again. In a sense, self-harm is similar to addiction.
This behavior can be fueled in part by drugs and alcohol ; which are also unhealthy coping mechanisms to numb internal pain. As a result, a substance use disorder can go hand-in-hand with self-harm behavior.
The link between suicide and self-injury
As a parent, watching your child engage in self-harm behavior can be one of the most gut-wrenching and frustrating experiences. Most parents do not understand why their child is drawn to this behavior. They worry that their child can be severely harmed from their physical injuries or, even worse, take their own lives.
Although self-harm behaviors can indeed result in complications such as nerve damage and wound infections, they do not always coincide with suicidal ideation. However, research shows that individuals who engage in self-harm behavior have an increased risk of suicidal ideations and suicidal attempts in the future.
According to an article in the journal PLOS ONE, “among those with a history of NSSI, 70% have attempted suicide at least once and 55% several times. The risk of death by suicide is highest during the first six months after an NSSI episode and tends to fall later on.”
Because of the increased risk for suicide attempts within this six-month window, individuals must seek professional treatment immediately to prevent suicidal ideations. Unfortunately, most individuals who engage in self-harm behaviors are teenagers and adolescents, and access to care for these age groups is quite difficult (50% do not seek help at all, and only 20% ask for medical treatment).
So how can you, as a parent, help your teenage or adolescent child who is struggling with self-injury behaviors?
Remain calm, stay connected with your son or daughter, and offer any support you can. It is important not to judge or place any blame . This can result in unwanted harmful feelings that can lead them to continue to engage in self-harm behaviors.
Educate yourself on self-harm behaviors and get yourself and your adolescent into therapy to discuss underlying triggers and treatment strategies. Self-harm behaviors may be related to low self-esteem, borderline personality disorder, eating disorders, past trauma, poor parental attachment, emotional neglect, or abandonment. Finding the right therapist can be a trial-and-error process, and it may take meeting with a few different therapists before you can find the right “fit.” Having a strong therapeutic alliance is the highest predictor of success rates for mental health and substance use disorders.
Remember, this is not your fault. Parents tend to blame themselves for anything that goes sideways with their child. Individuals with borderline personalities are more likely to engage in self-harm behavior; and these individuals can be very manipulative when it comes to interpersonal relationships, sometimes blaming the parents for what they are going through. Self-harm behavior, whether it goes hand in hand with borderline personality disorder or develops due to other underlying triggers, is not caused by one factor. There are usually multiple underlying reasons for this type of behavior in your son or daughter.
Be patient. Treatment takes time, and underlying triggers must be treated before recovery. There are no medications or magic potions that can make this behavior go away. Therapy may take weeks to months before there is any improvement. The ultimate goal is for your child to find healthy coping mechanisms . To deal with their internal triggers and stop engaging in self-harm behaviors; however, the immediate goal is to keep your child safe and out of harm’s way.
March is Self-Injury Awareness Month. It is dedicated to educating the public and raising awareness about self-harm while supporting those who are affected by it.
Other times, I look at my scars and see something else. A girl who was trying to cope with something horrible that she should never have had to live through . My scars show pain and suffering, but they also show my will to survive. They’re part of my history that’ll always be there.
Even if children and teens don’t appear to be following the coronavirus news carefully, it is likely that they are absorbing the information and stress from adults. They are hearing about it from friends and making their own inferences about what it all means. Rather than leave this education up to siblings, the media, or friends, you play an important role in helping children and teens better understand what’s happening and help them manage their own related worries or anxiety.
The World Health Organization officially declared coronavirus a pandemic. Health experts predict that the virus and its impact on our communities are just beginning. We can help our kids manage their stress and emotions as they live through this pandemic. Here are some tips for different age groups that can help:
Talking about the virus to children in Early Childhood
Even though babies and toddlers may not know what is going on, they may pick up a parent’s worry and anxiety with their “sixth sense.”
Try to stay calm around babies and toddlers.
Maintain normal routines as much as possible. Routines are reassuring for babies.
Shield babies and toddlers from media coverage as much as possible.
Look for non-verbal signs that your toddler may be anxious. This might include being scared to go outside or to daycare, extra weepy, clingy, or irritable. Provide extra reassurance and time together.
Take the lead from your toddler. Don’t talk about it unless they show signs of distress or ask questions.
Talking about the virus to Preschoolers
Preschoolers may be more tuned in to what is happening. They may have questions about germs, doctors, and even death.
Safety is a primary concern for this age group. Reassure them that adults are in charge and working to keep people safe, healthy, and secure.
Preschoolers are also concerned about the health of parents, relatives, and friends. Reassure them that everyone is doing what they can to stay healthy and take care of others. Remind them that they can stay healthy by washing hands and make hand-washing fun with songs.
Preschoolers are not always able to distinguish fantasy and reality. Limit media exposure.
Look for non-verbal signs that your preschooler may be anxious. This might include being scared to go to preschool, extra weepy, clingy, or irritable.
Bedtimes are very important. Stories, books, and tuck-ins are crucial.
Try to maintain your children’s normal routines and rituals when possible. If school, daycare or events are canceled, try to create and stick to other routines when you can.
Give them lots of hugs and physical reassurance and limit media coverage.
Take the lead from your preschooler. Don’t insist on talking about it a lot unless they show signs of distress or ask questions.
Talking to Elementary School children
School-age children will be more aware of what is going on. They have probably had discussions at school and with friends.
Talk to your elementary age children. Explain what happened while reassuring them that you and your child’s teachers will do everything to keep them healthy and safe.
Children this age are also concerned about their own health, as well as that of family and friends. For example, they may have heard that kids aren’t impacted by coronavirus but that older people are, triggering fears about grandparents. They may be worried about money if they know adults are off of work. Try to spend extra time together. This will provide extra reassurance.
Don’t be surprised if they are more irritable and touchy. Be extra patient.
Limit media coverage.
Try to continue normal home routines, especially at bedtime. If routines are disrupted due to school or after school activity closures, explain that this is part of the precautions grown-ups are taking to prevent people from getting sick. It doesn’t mean that all of their teachers and friends are sick.
If fear persists, point out all the things adults are doing to help and to prevent the virus from spreading. Children like to be helpful and feel like they can do something from hand washing to writing letters to nursing homes.
Ask them if they have any questions. If they do, stick to the facts and tell them what you know without exaggerating or overreacting.
Talking to Middle School Children about the Virus
Children this age will be very aware of what is going on. They have probably seen news coverage and discussed the virus at school or with friends.
Talk to your middle school children and answer any questions. This will help you determine how much they know and may help you correct any misinformation they might have.
Seek out positive media. Watch, read, and share stories about ways people are responding to the virus in collaborative ways to keep communities safe.
Help guide your child’s worry into things they can do – like learning more about how to prevent the spread of the virus including washing hands and getting enough sleep.
Talking to teens in High School
High school students have probably had conversations with their peers and teachers. They might have fears about what the virus will mean for their own health, schooling, schedule or safety.
Questions about health, the economy, and public policy are all legitimate issues for this age group. It is important to discuss these topics with them if they are interested.
Acknowledge any worry, anxiety or fear they have and remind them that these feelings are normal.
Help guide your teen’s worry into things they can do – like learning more about how to prevent the spread of the virus including washing hands, getting lots of sleep, or making concrete plans of what you will do if work or school schedules are disrupted.
Some teens may want to block out the whole thing. It may appear that they do not care. This might be masking real worries. Ask questions and be ready to listen.
Some teens may make jokes. Humor can be a way to help them cope, but discourage them from using humor as the only way to talk about the virus.
Stick to the facts in your conversations and talk to your teens about what they see on TV or read online. Point them towards reliable sources of information like the CDC website.
Talk through the difference between going online to get informed versus media over-use that can fuel anxiety. Enforce a tech curfew at night and encourage them to take media breaks.
Talk about how events like this can surface harmful stereotypes and discrimination against certain people and populations. In this case, talk about the importance of disrupting anti-Asian and xenophobic sentiment in coverage of and response to the coronavirus.
Don’t use your teen to process your own anxiety. Reach out to other adults to process your fears about the virus or the economic disruptions that it is causing.
If you follow my work, then you know that, although I’m completely addicted to my cell phone and to Facebook (there, I said it), I’m extremely concerned about modern technologies such as social media and the effects that such technologies are having on our world.
As an evolutionary psychologist, or as someone who looks at questions of human behavior in terms of principles of evolution, I’m particularly concerned about what we call evolutionary mismatch as it relates to social media. Evolutionary mismatch exists when something in the modern environment of an organism is mismatched from the ancestral conditions that surrounded the evolution of that organism.
In so many ways, social media platforms, such as Instagram, Snapchat, and Facebook, are mismatched from the kinds of communication platforms that existed for the lion’s share of human evolutionary history. For more than 99% of our evolutionary history, face-to-face communication with individuals whom you knew well was pretty much it. Social media has changed all that—and, as you’ll see below, not necessarily for the better.
Using this evolutionary mismatch framework, the list below focuses on adverse consequences of cellphone technology and social media in our modern worlds.
10 Ways That Life Is Now Worse Because of Social Media
People can be nasty behind screens. When our identities are downplayed or hidden, there is less motivation to be kind to others. And all the research in the field of social psychology on this point is clear: When people are deindividuated, they are way more likely to be nasty to others (see Zimbardo, 2007). Modern-day social media includes more deindividuated communication than has ever existed in the history of the human species.
Social media creates unhealthy social echo chambers. The westernized world is more polarized than ever these days. This is not just lip service—solid research on political polarization has shown that this is truly the case. Things are getting more polarized with time (see Motyl, 2018). Social media fuels this. If you identify as liberal, you likely belong to a broad array of liberal-focused Facebook groups that provide extraordinary levels of social validation for your beliefs. And if you consider yourself conservative, you likely belong to a host of social media groups that validate and amplify your beliefs. Social media has the capacity to create large-scale echo chambers, adding, unwittingly, to the growing political polarization that is tearing our world apart as I type.
Social media is not for the impulsive at heart. Think about all the impulsive tweets or social media posts that have led people to get into all kinds of hot water. In 2018, Rosanne Barr put out a highly questionable (and impulsive) middle-of-the-night tweet that got her into such hot water that her TV series got canceled. And if you follow the news, you know that this is not an isolated incident. Indeed, these days people are regularly getting into hot water—at work, with family, with friends—as a result of impulsive social media behavior. Under ancestral conditions, people were not able to broadcast any thought they had at any time to the entire world. Things on this front have changed. And not necessarily for the better.
Infidelity rates have increased due to social media. While cellphones may help us communicate and share more regularly with our romantic partners, and, thus, may have some relationship benefits, current research shows that social media is playing a huge role in increasing the prevalence of infidelity, which is made increasingly easier and more tempting than ever thanks to social media. For an eye-opening expose of this issue, check out this report put out by the National Marriage Project (summarized in this article in The National Review by the study authors Betsy VanDenBerghe, Jeffrey P. Dew, and W. Bradford Wilcox). From an evolutionary perspective, infidelity is a major threat to the welfare of any intimate relationship (see Guitar et al., 2016). And social media platforms and cell-phone technology have increased this threat to relationships everywhere—significantly.
Social media makes bullying easier. The literature on how social media has affected bullying is staggering. In a recent study of this issue conducted by the Pew Research Center, a large majority of U.S. teens have reported that they have, at some point or another, been the victims of cyberbullying. Given the ease with which people can put thoughts and ideas out there using social media, putting this technology in the hands of teenagers seems, when you think about it, concerning at the very least. Unfortunately, cyberbullying often leads to issues of emotional and mental health and has, in multiple cases, played a substantial role in suicides (such as the case of 13-year-old Ryan Halligan of Essex Junction. VT, who was repeatedly and incessantly sent homophobic messages by other teens via social media).
Social media creates permanent records—of just about everything. Under ancestral conditions, you could learn from your mistakes and simply move on. These days, mistakes are often recorded. In fact, just about everything seems to be recorded these days—and then blasted out on social media. When a fight breaks out in a school these days, witnesses famously bust out their phones and start streaming the action instead of helping out. And these videos then become permanent records of ugly situations that would be hard enough to forget and move past in the first place. Modern technologies give new meaning to the phrase “there is no escaping your past.”
Cellphones are truly addicting. Think about the number of psychological reinforcers found on social media. People can make social connections. They can corm romantic or even sexual relationships. They can receive excessive and instant praise and validation for all sorts of things. And more. It’s no wonder that research on the topic of cellphone addiction essentially shows that we’re pretty much all crackheads when it comes to our cellphones and social media (see Shoukat, 2019).
The natural world is suddenly less interesting than the virtual world is. When our kids were younger, my wife and I would try to take them out hiking with some regularity. They weren’t always into it. Kids aren’t as into nature these days as they used to be, and for understandable reasons. The virtual worlds found on cellphones and on other devices is simply dazzling in terms of reinforcing stimuli. And this is too bad because all the research on nature experiences suggests that being in nature is a foundational and necessary part of the human experience (see Wilson, 1984).
Social estrangements are made too easy on social media. Recent research from our lab has found that social estrangements, which exist when people define someone else as persona non grata (or “dead to them”), wreak havoc on people’s emotional and social worlds (see Geher et al., 2019). Simply, the more estrangements someone reports having, the more social and emotional difficulties that person is likely to encounter. Social media seems to be a breeding ground for social estrangements. All platforms have various ways to “hide,” “unfriend,” “unfollow,” and “block” others. Interestingly, these features are regularly used by mature adults, as well as teens. Just as social media makes all kinds of social interactions more accessible, the cutoff is now a more accessible option than has ever been the case. On one hand, it’s probably good to cut toxic people out of one’s life. But on the other hand, social media is likely increasing the degree to which people are exercising this option, perhaps leading people to, on average, have more estrangements than would have been the case years ago.
People can deceive in the domain of mating like never before. Social media has had ubiquitous effects in the realm of mating. And in this realm, where self-presentation is foundational, deception and exaggeration are more possible than has ever been the case. Under ancestral conditions, people met potential mates in-person, seeing them as they actually are and listening to spontaneous and largely unprepared introductions. These days, you can find the best photo of yourself that has ever been taken. And then use some filter from Snapchat to make yourself look even better. You can write your introduction for your dating profile over a number of days, editing it carefully and asking for input from friends. And, well heck, you can downright lie about yourself to make yourself appear as better than you actually are (and yes, this has been known to happen!). While self-enhancing self-presentation has probably always been an issue in the mating domain for humans, modern-day social media and related technologies bring the ability to deceive in a mating context to an entirely new level.
Bottom line: While social media technologies have led to all kinds of positive outcomes, such as families being reunited or friends coming together to build prosocial organizations across geographical boundaries, when it comes to the effects on our modern worlds, social media has a dark side—a very dark side. In short, social media has the capacity to bring out the worst in humans, such as bullying, betrayal, hate, and estrangement. And more.
When it comes to technological evolution, there seems to be only one direction. There truly is no stopping “progress.” Hopefully, as we move forward into this new world, people take the time to understand our evolved nature and, along the way, develop methods to ameliorate the adverse effects of social media on the human experience.