Self-harming, punishing yourself for feeling anger

Alice: I need to tell you that I did it again...

She looks straight in my eyes waiting for my reaction, I do understand immediately what she's talking about.

Therapist: What happened? What caused it?

Alice: Nothing, I don't know...I just wanted to

Therapist: Tell me how the day went before you came to it.

Alice: I went to school, nothing new...then got home, my father called then I went to bed.

Therapist: what did your father say?

Alice: He wanted to know how school was going, with my grades etc. I didn't want to talk to him, he never cares..hadn't called me in 3 months and now he calls to ask about my school grades.

Therapist: You got angry then..what happened during and after the phone call?

Alice: (raise her voice) Nothing! I replied with yes and no, he got angry because I don't make any effort to have a relationship with him. Then my mother got angry because he is trying and I am not helping him!

Therapist: So it is your fault that your father is not present in your life, you shouldn't be angry with him for this and you should also help him with his effort to make up for it. Do you think this is right?

Alice: (crying) no!

Therapist: so you went into your room and cut yourself to release the anger on yourself. Does it sounds right to you?

Alice: no its not.. but it is exactly what happened.

This is an example of what I hear continuously in my daily practice with teenagers, they get punished for feeling. Especially unpleasant emotions, especially emotions directed to parents. They were taught to punish themselves when they get mistreated, they don't recognize anymore when it is right or wrong to get angry. this leads to an incredible amount of guilt that can only be released via self-harm.

Compassion and psycho-education, a bond in which they can feel safe in feeling is what prevents and stops the behavior. Recognize and honor their scars, inside and out is what has proved to be the best approach in this kind of situations.

Pain has to be honored, pain has to be seen, felt and recognized before it could be let go.