Self-harm: how to hear your troubled teen's cry for help
It took previous generations some time before they could accept that addiction and depression weren't simply character flaws but serious mental health issues. Next it was eating disorders that made people raise their eyebrows as they wonder, could this really be a sickness or are these people just attention-seeking neurotics? And then Karen Carpenter died and everyone began taking eating disorders more seriously. Nowadays, it is self-harming behaviour that many people find difficult to understand.
In my work as a psychotherapist, the bewildered parents of self-harming teenagers often ask me, "Why on earth are they doing it? Are they completely mad?" But if we consider that animals in captivity also engage in self-harm, we can begin to understand that this isn't some weird overblown and overindulged phenomenon but a method of coping that incredibly stressed young people turn to when they feel their mind is exploding.
Just like humans, anxiety and social isolation is the main reason why animals self-mutilate; stressed monkeys bite themselves, anxious parrots in captivity pull their feathers out, distressed dogs and cats over-lick themselves ... and many young people cut themselves, scratch themselves and hit themselves.
Dr Brian Houlihan, consultant child and adolescent psychiatrist, recently stated that the number of teenagers attending the emergency department of Dublin's Temple Street hospital for self-harming or threatening to self-harm had increased year on year for the last five years.
Every year in Ireland, approximately 12,000 individuals go so far as to end up in hospital as a consequence of deliberate self-harm.
Youth organisation Headstrong states that as many as one in five young people in Ireland reported that they had deliberately hurt themselves - and it is an infectious activity, as one of the most common factors in self-harming behaviour is having a friend who self-harms.
This behaviour is often very secretive, but with worrying statistics such as these emerging, you can rest assured that if you know lots of teenagers, then you probably know individuals who secretly self-harm.
Life is not simple for young people in Ireland today. Bullying has become so complicated that it would make your head spin - the unpopular awkward-looking girl gets voted as the best-looking girl in the class and everyone sniggers at the irony, and then the unpopular awkward-looking girl can't even begin to explain to her parents why this isn't a good thing but is in fact a veiled insult.
There is insidious usage of social media like Snapchat, where nasty teenagers can message their hapless victim that "Everyone hates you and wishes you'd die". It comes in on the child's phone and it vanishes as quickly, like a malevolent phantom.
However, it is not only bullying and peer pressure that leads teenagers to self-harm; family problems, exam pressure and body-image issues can also cause intense distress. In many ways, self-harming behaviour is a distorted version of self-soothing.
Whether it is running your hands through your hair, or touching your lips unconsciously, self-touch is often comforting. If the emotions are very intense, however, then the self-soothing behaviour can become compulsive and destructive. The act of physically hurting yourself just about distracts you from the monsters of your mind. It can reduce the intensity of your emotions and the physical pain can symbolise your emotional pain in a more definitive manner.
The problem is that the self-harming often needs to become more and more painful to get the required numbing of the mind. And that's when the knives come out. So, with the great back-to-school show under way, how are parents to help their teenagers? School is pretty much the centre of many young people's lives and if school is going well and the family is relatively happy, then life is often not too bad.
If school is a source of strain, however, then things can quickly fall apart. Parents can begin with asking open-ended questions such as, "Is school better or worse this year compared to this time last year?" or perhaps, "What do you like about school and what do you dislike?". The idea with these open-ended questions is not to find a solution - life just ain't that easy - but to start a conversation that might help the child to figure out how they feel. Because, if you cast your mind back to when you were a teenager, you might remember that you didn't really know what you were feeling; you weren't actually sure of anything.
Teenagers suffering the 'storm and stress' of adolescence are often attracted to grand gestures - they can't help taking themselves too seriously when they are beginning to become adults and they are trying to act all grown-up.
But whether your teenager reminds you of 'The Catcher in the Rye's' sullen Holden Caulfield or a more rebellious Amy Winehouse, when you handle your teenager, you will need to put on some emotional body armour. They might roll their eyes, be sarcastic, become hostile, shout, scream and bang a lot of doors.
But the difficult behaviour of a teenager is often a cry for help, and the level of pain that teenagers cause their parents can often be symbolic of the level of pain the child feels.
And if your teenager is lashing out at the world, at themselves or at you, then you can bet your bottom dollar that they are hurting inside - because, as the saying goes, 'hurt people hurt people'.
Stella O'Malley is the author of the book 'Cotton Wool Kids'