Separation and attachment problems from early childhood reappear and manifest themselves during adolescence. For this reason, adolescence is almost like the final stage of becoming a healthy adult. The intensity of impulsivity, which causes these control problems, differs in each adolescent and varies depending on the attachment difficulties experienced in early childhood. Some adolescents experience this process extremely intensely and destructively.
In a study conducted at the University of Kansas, findings showed that 20 adolescents hospitalized for self-harm behaviors they could not control had not experienced a stable attachment process in their childhoods. At least 16 of these twenty adolescents were found to have been physically abused. Additionally, it was revealed that some had lost one of their parents. Some adolescents had also been subjected to sexual abuse by their families. These adolescents experience feelings of guilt, isolation from society, and abandonment. Compared to their peers, they feel much more helpless. The physical, sexual, and psychological trauma they have experienced affects them so severely that they suffer loss-of-control episodes influenced by the emotional and affective impact of the trauma. We can think of this process like a dizzy person trying desperately to cling to something to avoid falling. A dizzy individual feels the need to hold onto whatever is near to prevent collapse. Similarly, adolescents exposed to such abuse try to prevent their emotional collapse by harming themselves.
These self-harm behaviors include punching themselves, slapping themselves, or scratching themselves.
Isolation becomes an extremely overwhelming condition for them. They begin to feel as though they have no place in the world, and the sight of their own blood or bodily injury becomes their only sense of reality. The expression “Seeing blood calms me” may be understood as the psyche’s effort to cling to reality during a moment of dissociative rupture. If dissociation is a moment of psychological detachment, then self-harm may serve as a mechanism that prevents this detachment and reattaches the individual to reality. These explanations may sound unusual, but they reflect the lived reality of individuals whose psychic structures have not reached the necessary level of cohesion and adaptation.
The weaker the internal harmony, the more the individual will attempt countless methods—some shocking, unexpected, or incomprehensible—just to hold onto reality. This is because the internal mechanisms responsible for emotional balance and regulation have been damaged. Adolescence itself is a suffocating period even for well-adjusted youths. For adolescents who have been sexually or physically abused, the distress is layered upon the strain imposed by their violated bodies. Moreover, adolescence is a period in which the body matures sexually despite the adolescent's wishes. Therefore, adolescence is, in a sense, an invasion—an invasion of the body and the psychic structure. This means that for an adolescent already traumatized by past abuse, the changes of adolescence reawaken and intensify prior trauma, resulting in trauma layered upon trauma.
Particularly among female adolescents, the behavior of cutting themselves has been interpreted by some psychoanalysts as an unconscious attempt to identify with the mother’s menstrual bleeding. Unlike menstruation, however, self-inflicted bleeding allows the adolescent to control when the blood flows and when it stops. These are symbolic and unconscious interpretations. Regardless of whether these explanations apply, such adolescents attempt to regulate themselves—emotionally and in terms of impulse control—through primitive or more developed methods, fighting a literal struggle for psychological survival.
