Advice On Coping With Teens’ Risky Behavior

FALMOUTH- A mother has dinner alone with her teenage daughter. It is warm outside, but her daughter is wearing a long sweater that covers every inch of skin from her neck to the tips of her fingers. The girl has even cut holes in the sleeves to put her thumbs through, so no part of her arms is visible.
They talk about friends and school and the election and college, but they do not talk about what is really happening. They do not talk about the razor blade cuts across the daughter’s shoulder.
The cuts are not a suicide attempt or a way to get attention.
The cuts are a way of taking control of her life.
When she feels too much, she cuts. When she feels nothing, she cuts. 
Her arm is a measuring stick of pain, frustration, helplessness. The scars that grow there are her history of trauma.
Why does she do that?
This was one of the questions raised at last night’s Understanding Risky Behaviors in Adolescents talk at Highfield Hall. Catherine Thomas, LICSW, the director of the Cape and Islands Emergency Services/Crisis Team, and Philip A. Dingmann, MD, who specializes in adolescent behavior, discussed dangerous teenage risk-taking that includes cutting, stealing, eating disorders, substance abuse, and self-strangulation.
The presentation, sponsored by Falmouth Public Schools and VIPS, was one of several talks in the “Parent Connection Series,” which is designed to address issues facing students.
Risk-taking is a normal part of growing up, said Ms. Thomas and Dr. Dingmann, and in most cases is healthy. The problems arise when teenagers take risk-taking behavior to dangerous degrees.
Cutting was just one of the examples of risk-taking behavior mentioned, but it resonated strongly with a small group of mothers who stayed afterward to discuss their children and how to talk about the scars under the sweater.
Joanne M. Leonard of Middleborough, who is the mother of two children who have struggled with dangerous risk-taking behavior, said in her experience the best way to talk is in the car.
Something about not looking each other in the eyes, with the radio playing, and traveling to a destination, she said, makes it a lot easier to talk to her teens.
“They are usually much more open,” she said. But talking with a teenager about risk-taking behavior can be shocking, especially when the answers start coming.
She recommended that parents talk about these issues “when you’re ready and you really have to be open and honest and not afraid of the answer. You have to be prepared.”
Cutting, or self-mutilation, mostly affects young women, Ms. Thomas said. Ninety percent of those who cut are female, and that cutting is not usually a suicide attempt.
Women who resort to self-mutilation often hide cuts on their arms and legs, stomachs or under their clothes. There is an overwhelming sense of shame associated with the practice, and for that reason, it can be extremely difficult for them to talk about it.
Family and friends often assume it is attention seeking behavior, but Ms. Thomas advised that the behavior should always be taken seriously.
Ms. Thomas explained that feelings of being overwhelmed, and an inability to cope can be a trigger to self-injury, and that the act of cutting releases chemicals into the brain that result in the person feeling relieved, in control, and calm.
The young person’s brain does not fully develop until age 25, explained Ms. Thomas, and the last part of the brain to develop is the prefrontal cortex, which governs risk-taking behavior.
Young men often take risks that are much easier to see but can be even more destructive. Dr. Dingmann explained  that boys are more likely to make a drastic decision and be the victim of impulsiveness.
One disturbing trend discussed last night that often affects boys is self-strangulation. Sometimes called the choking game, scarfing, or the blackout game, self-strangulation is increasing in teens.
The goal of self-strangulation is to reach a brief euphoric state caused by starving the brain of oxygen. Oftentimes this game is learned at parties, and boys continue the practice on their own.
Thirteen-year-old boys made up 86.6 percent of the fatalities from self-strangulation from 1995 to 2007. Warning signs parents should be aware of are mentions of the game, bloodshot eyes, marks on the neck, frequent severe headaches, disorientation following time alone, and ropes, scarves, and belts tied to bedroom furniture or found knotted elsewhere.
Jennifer Ross, one of the group of mothers and director of the Parent Information Network, a parent support program in Middleborough, said she has both a boy and a girl, and they both require very different strategies to discuss these risk-taking behaviors.
“You have to be delicate,” she said, and never ever pull up a sleeve to look for cuts. That is a violation of the teen’s privacy, she said. One way to bring up dangerous risk-taking behavior is to ask a pediatrician to examine the child for signs of self-harm.
Ms. Leonard agreed that sometimes the best strategy is to have someone else in your life, like a trusted aunt or friend, ask the difficult questions. She said, “It’s okay to have someone else saving your child’s life.”
Future talks include teasing, bullying and cyber-bullying on October 21; teenage substance abuse on November 13; Internet safety on December 2; children’s temperaments on December 3; and ADHD on December 10. To learn more about these future presentations, call VIPS at 508-548-1621, or go to [email protected].