Q&A: Addressing self harm in college student population


March is dedicated to self-harm awareness, or non-suicidal self-injury, a behavior that is particularly common among college students. The Mercury spoke with Regina Ybarra, a professor who has done research on self-injurious behavior among college students, and Jenna Temkin, head of the Student Counseling Center to explore the issue.

Q: Can you start by giving a definition of what self-harm is?

A: Self-harm is defined as any behavior that seeks to cause injury on the body…without suicidal intent. So, you can have all kinds of different self-harm behaviors. Most of the time, people are most familiar with cutting. But you can have biting…there is sometimes rubbing things on the skin to scratch, so sometimes like glass or sandpaper and things like that. I mean, it can go all the way to breaking your own bones, punching yourself, more severe damage.

Q: Do you have any ideas as to why self-harm is so common in this age group?

A: So, some of the research that I have done in the past, when we looked at self-harm… [showed] people who self-harm multiple times, tend to show some sort of change in their experience. And this might be feelings of relief, too: ‘I felt numb before, but I was feeling something.’ And for a lot of people, numbness can be kind of a disturbing thing. And so physical pain kind of breaks through that.

Other people sometimes feel relief because they experience a lot of psychological pain and a lot of things that they don’t have a lot of control over. And if I cause physical damage to myself, that’s something I’m in control of. And it’s something tangible…that’s easier to deal with than the psychological pain that they might be feeling.

Q: What kind of treatments might you pursue with a client who self-harms?

A: You can’t just address the self-harm, you have to address what’s causing it. What’s the pain? It might be loneliness, it might be depression, it might be anxiety, all kinds of different things it could be. So first of all, figuring out what is driving that.

And secondly, it’s really important to give people tools to know what to do…one of the things that we would do is… brainstorm different strategies. I’d have my clients sometimes list five strategies [that] are going to be their go-tos, in that order…For most people who have been self-harming for a long time, self-harm is on that list. It’s hard to get them to agree right off the bat to say, oh no, I’m definitely not going to. So, we would start with an agreement—you’re going to try all these other things first, before you get to [self-harm].

Dr. Jenna Temkin

Q: One study found that 17 percent of college students have self-harmed at one point. Could you tell me about how often the SCC sees students for this issue?

A: I don’t have the specific data to share — I’m thinking about confidentiality, you have to hold that too. But what I can share is that it’s a very common issue that we do see here. And it can range from someone trying it out one time, to someone that’s maybe been engaging in it since before they even came to college…And again, we know in our understanding of self-harm and self-injury that it serves a lot of functions. It oftentimes can be connected to someone’s emotional state. And so, it makes a lot of sense that again during college, during a really stressful period of time, we can see that as a coping mechanism.

Q: Could you talk a little bit about treatment options for people who self-harm? What about the services we have at the Counseling Center?

A: So, all of the services at the Student Counseling Center are, number one, free, and they’re also confidential…So, you know, if someone is presenting to us with self-injury without the intent to follow through with taking their life, it is not a reason we’d have to break confidentiality.

…We do offer brief individual counseling. We have incredible workshops and groups programming that gives students actual tangible skills to deal with anxiety, depression, relationship issues, so we have a lot of services. And then if someone needs something beyond that, if someone is needing just to see someone more consistently, or for longer-term counseling, we also help students get referred out to the community. And another service we have actually that could be connected and useful is of course psychiatry, so medication.

Q: Is there anything else you want the student body to know about self-harm or mental health?

A: I think the notion of reaching out. Reach out to us; reach out to a friend. You know, individuals…oftentimes can feel like they’re the only ones, or feel damaged, or like they’re failing at something because of mental health struggles, and in fact, as we know now more and more, they’re very widespread. It’s very normal to have these type of struggles, and so we just want people to reach out. Again, whether it be to a friend at first or a professor, whoever it might be, certainly reach out to us to get some help and to get some coping skills.