MArta is 15 years old, her parents have been tormenting her since her school performance took a nosedive, her brother annoys her relentlessly. She can’t take it anymore, of them, of everyone. She locks herself in the bathroom, to finally be alone, but there too mum and dad start knocking: “Martaaaa, what are you up to, why don’t you come out?”. A nightmare. But she found a solution. And she shows it, via cell phone, to a friend of hers: a thin, shallow scar. Only when she got it – with little pain – did she feel relaxed, at peace. It’s a shame that no one noticed this act of self-harm. He’ll try again, who knows, maybe something might happen.
Marta’s story is told in the first of the three podcasts A vocal from the future that accompany the book Just one, well done, by Stefano Vicari, in collaboration with Scuola Holden and Erickson editions. The book and the podcast are the first release, dedicated to self-harm, of an editorial series on youth distress, Read between the lines.
Marta, as well as Simone and Angela, protagonists of the other two stories, have nothing in common except the dangerous habit of cutting themselves. An unfortunately very widespread and growing phenomenon: according to data from the Child Neuropsychiatry of the Bambin Gesù hospital in Rome, Self-harming behavior (or self-cutting) has increased by 75 percent in the last 10 years in children between the ages of 9 and 17. In most cases, fortunately, those who use the razor blade do not want to end it. It’s called non-suicidal self-harm, but it’s scary just the same.
A teenager alone with her suffering. Self-harm is one of the possible risks. Getty Images.
Self-harm: the boom after Covid
It is now clear that teenagers are in bad shape. The discomfort was already there before, the Covid isolation lit the fuse. According to the Istituto Superiore di Sanità, suicide is the second cause of death among adolescents, after road accidents. “Depression – and not infectious diseases – is the main cause of absence from school” says Stefano Vicari, head of child neuropsychiatry at the Bambin Gesù hospital in Rome, and editor of the series. «Three-quarters of mental illnesses begin before the age of 18and out of 1000 treated by paediatricians, at least 100 have a mental disorder.”
Impressive data, to which are added those of a research on emergency room visits by under 18s in 9 Italian hospitals which Benedetto Vitiello, professor of child neuropsychiatry at the University of Turin, explains to us: «In 2021, after the reduction of the Covid period, there was an explosion, with a + 50 percent of accesses for psychiatric problems.The first three causes: suicide attempts, agitation and aggression, anorexia nervosa.”
Nonsuicidal self-harm typically does not lead to emergency hospitalization. But that doesn’t mean it should be underestimated. On the contrary. Meanwhile, due to the very young age of those who practice it: «13-14 years, then around 17 the phenomenon attenuates, and between 20-25 it disappears» adds Vitiello. But above all because it is the symptom of great emotional suffering. Behind every cut there is a unique experience that must be understood and cared for, according to his times. Other disorders often appear – sleep or eating disorders, mood swings, difficulty managing anger or frustration – which add to self-harm and complicate the view.
«The good news is that people generally recover» explains Vicari. «But every boy – and especially girl, because it is a predominantly female phenomenon – must follow a personalized path. When a teenager full of cuts arrives in the emergency room, I have to ask myself: is she someone who imitates videos on Tik Tok? Do you have structured depression? What is the family context?”.
The body is a blackboard
There is also another question to ask: why, among the many ways of harming oneself, choose to violate the body, and a young body, with scars that remain? “Sometimes, it’s an attempt to feel” clarifies Elisa Fazzi, president of the Sinpia (Italian Society of Child and Adolescent Neuropsychiatry). «Kids who suffer from the feeling of emptiness, from the silence of the houses, who don’t know who they are, when they cut themselves they feel emotions that make them exist».
Others, underlines Vitiello, «they do it to relax. They have such internal suffering that when they feel pain they release tension, obtaining an anesthetic effect. The problem is that, since these moments serve to calm the anguish, they become dependent on it. They have to keep cutting themselves, more and more, more and more often, hoping that with the escalation it doesn’t get out of hand. Someone confesses: “Doctor, when the blood comes out I feel better”. Still others do it by imitation, to be accepted by their peers in the group and show off their photos on social media.
The body then becomes a blackboard on which to express one’s suffering, the one that cannot be said verbally. «For adolescents today it is an individual communication tool», claims Leonardo Mendolicchio, psychotherapist, head of the eating disorders departments of the Auxologico Institute, who has recently published Fragile. Our children, betrayed generation (Solferino). «When parents were the same age, however, collective, political and social battles were waged through the body».
Self-harm and signals to adults
And if it is true that invisible points are often chosen for the cuts – the groin, the thighs – it is also true that children try to communicate their discomfort to adults, and send signals. However, they are not always accepted.
In another story by Just one, well doneThe protagonist Simone drips a few drops of blood on the math test he turns in the next day. The teacher doesn’t notice, perhaps she mistakes them for ink stains. Simone continues to cut himself, photograph himself, post, gaining many followers. Summer arrives, she covers her forearms with cotton bandages and no one says a word. As long as he himself takes matters into his own hands. He “forgets” the PC in the kitchen, with his profile open and the photos of his cuts in plain sight, and goes to take a shower. The mother enters the house, discovers everything and, crazy with pain, tries to break down the bathroom door.
Faced with a discovery like this, a parent’s reactions can be very varied: if Simone’s mother screams in terror, there are those who downplay it and think it will soon pass. «A classic way to defend oneself» comments Mendolicchio. «A parent finds it difficult to accept self-harm, and so he protects himself from feelings of guilt. But even showing anguish is wrong, because if the teenager feels like he’s in a corner, he shuts himself away. You need a calm approach, showing that you want to understand, looking for a communication channel.” The road will be long, full of obstacles. You have to stay clear and keep anxiety at bay.
A point of contact
«Dads and moms should control the worry, don’t judge and try to understand what message the son or daughter wants to send with self-harm” suggests Elisa Fazzi. «The first step must certainly be listening and reasoning together, analyzing the events that precede or follow the impulse to cut. Don’t settle for one answer because often the real one, which explains everything, comes later, between the lines. And try to contrast those moments with something beautiful to do together. Then you will have to contact a specialist who will start a program – with psychotherapy and possibly targeted drugs – in the medium or long term. She doesn’t leave in a week. Parents must learn to mediate the request for help for their child and for themselves.”
Early diagnosis of self-harm is essential, so be careful not to underestimate the signs, such as «changes in lifestyle and mood. A boy who did well at school and slept regularly, if he has a significant change in habits or results, he should be kept under an eye » advises Vicari.
A difficult task for today’s “fragile” adults, as Mendolicchio defines them in the book, “who struggle to support their educational role alone, often in families of three”. A fragility evident in the eyes of the children, who see their parents as unreliable, as well as absent, and feel betrayed. Nevertheless, this very weakness not only must not distance oneself but can be the point of contact between generations, «because it is an element that brings us closer to our children, overcoming every barrier. If they see how we manage our emotional fragilities, they can manage theirs” claims the psychotherapist. “If we admit mistakes and show that we don’t want to repeat them, we send a positive and concrete message. If we understand that mistakes are part of our lives, we will support them when they make them. Fragility is an opportunity for mutual understanding.”
Have you decided that fragility is a condemnation? By changing perspective, fragilities become sisters of possibilities. Possibility to grow, to make mistakes, to feel human. Possibility to truly embrace and understand those who feel and experience the same things, in a new idea of empathy, which transforms weaknesses into great opportunities.
It happens that anxiety holds our hand when we open our eyes, when we walk, when we go to sleep. It happens that he tells us that we are wrong, that we will never accomplish anything, that we will always and in any case be less than others. It happens, above all, that it prevents us from giving a specific answer to those who ask us why we feel bad. It often happens that we don’t know it, that we don’t find a precise reason, yet we know his pain well.
iO Donna © ALL RIGHTS RESERVED