Comment On: “One in 12 teenagers self harm, study finds”

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One in 12 teenagers self harm, study finds – Yahoo! News.

Just a quick comment on the above article by Kate Kelland. I was stunned to hear that one in 12 teenagers engage in self-harm behavior, such as “cutting, burning or taking life-threatening risks” (quoting the article). As a psychotherapist working with teens, self-harm behavior was one of the toughest ones I had to deal with. George Patton (the lead researcher for the study profiled) stated: “[S]elf-harming represents a way of dealing with [the emotions that hit during adolescence].” The article quotes Paul Moran (another researcher in the area of teen self-harm behavior) when he tells us that “a combination of hormonal changes during puberty, brain changes in the mid-teens with the final development of the pre-frontal cortex—the brain area associated with planning, personality expression and moderating behaviour—and environmental factors such as peer pressure, emotional difficulties and family tensions appeared to be key factors [contributing to self-harm behavior].”

There’s a bit of a silver lining to this story. The article states: “By the time [study] participants reached young adulthood … rates of self-harm dropped dramatically so that by age 29, less than 1 percent of participants reported deliberately doing something they knew would hurt or endanger themselves.”

The above tends to point out that for many teens, adolescence represents a precarious transition period. Although the article suggests that many factors contribute to this precariousness, I’d like to focus in on the one I feel to be most important—“the final development of the pre-frontal cortex—the brain area associated with planning, personality expression and moderating behavior” (quoting the article from above).

In my post of November 15th, 2011, I mention a fascinating book by the neurologist Elkhonon Goldberg entitled The New Executive Brain: Frontal Lobes in a Complex World (2009, Oxford University Press). I’ll be summarizing Goldberg’s book in a future post. By way of a preview, allow me to mention an amazing observation by Goldberg. Goldberg suggests that as the frontal lobes “come online” (to use a computer metaphor) during adolescence they will appear to the mid-brain (or thalamic) regions of the brain as, for lack of a better frame, “ghostly spirits.” (As an aside, Goldberg talks about how these ghostly spirits do not go away in cases of schizophrenia.) I cannot help but think that one reason teens engage in self-harm behavior is to deal with these ghostly spirits. Maybe when teens take on a Goth look and lifestyle (or embrace vampire-inspired movies), it is an attempt to match outer and inner experiences. Carried to an extreme, self-harm behavior may be framed as trying to make the ghostly spirits associated with frontal lobe development go away. Fortunately for most teens, the ghostly spirits of natural frontal lobe development subside as the mid-brain to upper-brain connections become strong and robust. But Kelland issues this warning when she quotes self-harm researcher Keith Hawton thus: “[P]revious studies have shown that self-harmers who come into hospital during their teenage and young adult years are 100 times more likely than the general population to commit suicide.”

So, what’s going on that our society is dropping the ball as far as helping teens deal with the ghostly spirits of natural frontal lobe development? I would suggest that in earlier times initiation rites of passage were designed specifically to help teens deal with frontal lobe ghostly spirits by encouraging strong and robust mid-brain to upper-brain connections. SImply put, our modern society lacks these initiation rites and processes (the Bar Mitzvah and Bat Mitzvah being the lone exceptions I can think of). I’m pulling this in part from the work of Father Richard Rohr, O.F.M., as well as Joseph Campbell. I would also go so far as to suggest that the well-crafted fairy tales of days past were also designed to help kids/teens develop strong and robust mid-brain to upper-brain connections. I’m pulling this in large part from Bruno Bettelheim’s seminal 1975 book The Uses of Enchantment: The Meaning and Importance of Fairy Tales, and the extensive work of Clarissa Pinkola Estés (of Women Who Run With the Wolves fame). I hate to say it but it is entirely possible that the Disneyfication of modern fairy tales has had the unfortunate side effect of greatly reducing the ability of fairy tales to develop strong and robust mid-brain to upper-brain connections. Here’s one more possible reason why these connections are not being built.

I just started a book by Ronald Dworkin, M.D., Ph.D., entitled Artificial Happiness—The Dark Side of the New Happiness Class (2006, Carrol & Graf Publishers). Dworkin talks about how the medical community (without malice of forethought) has created a class of artificially happy people by using such things as antidepressants, extreme exercise, and even far-out forms of alternative medicine. Dr. Dworkin finds this Happy American trend alarming. Consider this quote by Dworkin:

My concern may seem alarmist, considering that the United States has forty years experience with Artificial Happiness without Happy Americans proving to be especially troublesome or dangerous. Yet for most of those forty years Artificial Happiness has been an adult phenomenon. Only recently have doctors induced Artificial Happiness in younger people in great numbers, especially with antidepressants. Adults under the influence of Artificial Happiness seem to retain enough of a conscience [which tends to be an upper-brain phenomenon] to be respectful and law-abiding. They can reach back into a past when they lived without Artificial Happiness and be guided by the voice of that [natural] past. Their consciences are fully developed by the time they try Artificial Happiness, which somehow steels them against the worst effects of the experience. Children by [developmental] definition do not have this past. Their consciences are not fully formed; if anything Artificial Happiness interferes with their formation.

In essence, Dworkin is suggesting that we are seeing the first generation of kids (and young adults) who have known nothing but Artificial Happiness. I know that Dr. Dworkin points mainly toward psychotropic drugs, extreme exercise, and far out alternative medicine as paths toward Artificial Happiness, but I would go even further and also include the self-esteem movement (which came on the scene at about the same time as antidepressants—circa the late 1960s – early 1970s). I don’t wish to be an alarmist but it would seem that Dworkin is describing an actual generation of children who might fit well within the 1980s horror movie Children of the Corn. Here’s how Dr. Dworkin describes this emerging Children of the Corn generation:

These Happy Americans know happiness independent of life. For this reason, they can’t be controlled through conventional threats to their happiness. Life neither  moves them nor threatens them. Totally self-contained organisms, they don’t need kindness when they’re feeling down; therefore, they don’t know what kindness is [which would include secure attachment]. They need nothing from others and get nothing in return. Although the prospect is mere speculation at this point, a society composed of such people would be a nightmare.

Yeow! What I find interesting is that the article by Kelland doesn’t mention widespread use of antidepressants and other psychotropic drugs with kids (like Ritalin and Adderall) as a possible factor contributing to self-harm behavior. As a psychotherapist I was told that many forms of self-harm behavior are actually about kids wanting to feel anything that approaches life, to feel their body, to feel love, to simply feel. So, is it possible that we can frame self-harm behavior in this light: expressing a desire to not live in a dead world, a world filled with Artificial Happiness and Artificially Happy Americans? Here’s how Dr. Dworkin describes the situation:

Albeit painful, unhappiness is vital to the development of a health conscience, for unhappiness teaches a child what it means to feel dissatisfied with oneself, to feel ashamed, to acknowledge that one has made a mess of things, and to hear for the first time the inner voice within [e.g., Freud’s ego bridging mid- and upper-brain regions] that points the way to proper living. Happy Children are relieved of this unhappiness at the very moment they need to feel it, assimilate it, and learn from it [again, the purpose of initiation rites of passage].

We are left with a daunting challenge: how do we help kids and teens deal with the ghostly spirits of normal frontal lobe development and, in the process, help them develop strong and robust mid-brain to upper-brain connections? With both initiation rites of passage and fairy tales essentially gone, where do we turn? With mentoring relationships on the wan, where do we turn? With doctors eager to write another prescription for Ritalin or Adderall, where do we turn? With self-esteem being preached on almost every street corner (along with its message of “feel no unhappiness”), where do we turn? Honestly, I have no idea. I guess I’ll finish Dr. Dworkin’s book and hope that he offers up some solutions. What about you my BLT readers? Where do you turn? What solutions do you have? Or are both Dr. Dworkin and I being a couple of whiny alarmists? (Lest you think that Dworkin is a lone voice, see Ernest Keen’s Chemicals for the Mind—Psychopharmacology and Human Consciousness (2000, Praeger).)

On a personal note, I feel lucky because I’m part of the crossover, baby boom generation, a generation that has one foot in the natural happiness world, and one in the Artificial Happiness world. But as Dworkin points out, that early natural happiness experience provides a certain level of psychological protection against becoming engulfed by the penumbral world of Artificial Happiness. But what about the kids who know nothing else, who have been raised on a steady diet of psychotropic drugs, self-esteem, Disney films, and the Internet? As Dr. Dworkin puts it, “[A] society composed of such people would be a nightmare.” Are we today living that nightmare? Is this now the night of the living dead?