Teresa Sánchez, psychologist: "There is an alarming growth in both self-harm and suicidal practices among adolescents"

All signs point in the same direction: suicidal behavior in adolescents has skyrocketed.

From the worst-case scenario —completed suicides in children under 15 years of age have gone from seven in 2020, to 14 in 2021 and to 22 last year — to ideations of death, which in clinical jargon is known as non-suicidal self-harm : deliberate acts to injure the body, but which,

, are not an autolytic attempt, but a harmful way of dealing with an emotional situation.

Everything is going up.

According to the FAD Foundation barometer, young people who declare having suffered mental health problems very frequently was close to 16% in 2021 (in 2017 it was 6.2%).

At the Anar Foundation, requests for help for self-harm multiplied by 56 in 13 years (from 57 cases in 2009 to 3,200 in 2021).

And another study by the Generalitat de Catalunya estimated that 27% of the total number of Catalan adolescents had ever harmed themselves.

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In an eloquent conference during the National Congress on Child and Adolescent Mental Health, held last week in Salamanca, Teresa Sánchez, dean of the Faculty of Psychology at the Pontifical University of Salamanca, described as "alarming" the number of "adolescents who are starting out in parasuicidal activities or behaviors that end up being declared autolytic”.

Without holding back, Sánchez (Zarza-Capilla, Badajoz, 62 years old) x-rayed the complexity of the phenomenon and the weight that social contagion can have on the mental health problems of young people.

"You can suspect that there is some social contagion because there is not so much modesty to tell it," she said.

The psychologist attended EL PAÍS after that busy presentation with the title "gimmicky", she acknowledged.

It was titled

.

“I always like to give a plastic image and even that we can, synesthetically, hear with our eyes or see with our ears.

It is a scream that the person is emitting with the blood, with the burn, with the bodily damage that is inflicted.

It is a way of shouting that does not go through the vocal cords, ”she justified.

Ask.

When did this phenomenon begin to become visible or occur more?

Answer.

We never know if, really, mental health problems are greater now than before or if they are confessed more than before.

The fear of being treated as freaks has been lost and the truth is that now they are more diagnosed and, being more visible, we tend to think that a new phenomenon is taking place.

That is why there is some questioning as to whether there is an effect of social contagion or of hyper-visibility or hyper-diagnosis.

Q.

What do you think?

R.

I think there is an overdiagnosis, but not only with this subject, but with practically all of them, because society is more permissive and mental illnesses are coming out of the closet.

There is a certain Me Too movement, the “it happens to me too”, taking a step forward.

Social contagion has to do with the fact that there is greater social tolerance and less invisibility.

Q.

But the fact that there is an overdiagnosis is negative, it means that people who do not have that are diagnosed.

R.

Overdiagnosis is always negative, but many times it is induced by social modism.

I don't think it applies to self-harm, but it does apply to other disorders.

In the 18th century, vampirism was completely normal, but does it mean that there was more vampirism then than now?

No. It was a pathology dragged by the cultural movement itself that believed in werewolves and the Draculas of the day.

There are social waves of certain diagnoses and, although I don't think this happens with self-harm, we do live in an era of overtreatment and there are many more cases than the real ones of a lot of pathologies

Q.

What is meant by self-harm?

R.

There are self-injuries that are rituals, such as, for example, in some African populations stretching the lip, or modal self-injuries, such as tattoos.

But we exclude those.

What ends up qualifying as clinical self-injury is deliberate self-injury without suicidal intent, although many times, the practice of self-injury is a predictor that that person is going to carry out a suicidal act later, especially if it has been prolonged more than seven years.

Q.

What is the ultimate goal of people who self-harm?

A.

Above all, they seek a release of negative emotions, such as anguish, anxiety or anger, which they cannot channel outwards.

But there are also states of intense displeasure, of suffering, of mental pain that they don't know how to understand and they have to do something to get rid of that demon of discomfort that they have inside.

Usually, it is a search to get rid of that negative, evil part that they feel they have.

And of reintegration: by doing this, I feel myself again, I am not dissociated.

They also seek emotional self-regulation.

Self-harm stops the person's discomfort, but if they continue, they lead to suicide.

Q.

What is the link with suicide?

A.

Self-harm is a temporary solution to a chronic problem, while suicide is the permanent solution to a problem that is sometimes temporary.

When there are problems that have a long-term discomfort, self-injury places them, slows them down;

but it is a temporary solution.

In the short term, the discomfort and anxiety that the person who performs self-injurious practices has stops with the self-injury, but if this continues and continues, it will eventually lead to suicide.

Q.

What is the current picture of self-harm?

R.

There is an alarming growth, both in this and in suicidal practices.

I, walking through a park, have heard flirting, playing with language, like "I'm going to commit suicide."

There is a frivolization, a trivialization of suicidal behavior in some adolescents because dying is possible.

We have gone from a youthful perception of invulnerability to a vision of why not die.

Because if I decide my death, I am the master of my death: it's like you have a bomb and you remove the ring when you want, not when biology or nature wants it.

It is a feeling of power and control.

Q.

Why is this happening now, with this generation?

R.

I believe that this generation, more than any other, is a collector of sensations and is very fond of exceeding limits, trying, experimenting, not conforming to any social prescription.

And I am not saying that they are the only causes because then, of course, there is hopelessness, desolation and adolescents have many things, but they often lack their parents or reference figures who are there as a point of connection, as a point of relationship.

There is a trivialization of suicidal behavior in some adolescents”

Q.

And the pandemic?

Because it seems that everything has crystallized as a result of the health crisis.

R.

From the pandemic we have come out with what we have entered accentuated.

If a person, before the pandemic, had an introspective capacity and certain mental work skills with problems, well, during the pandemic, they have not felt so bad.

The problem is that when your resources are always in the outside world and consist of doing things like going to the gym, meeting friends, going to bars... when they block all of that, you have no choice but to be left alone with your own resources. .

And in that forced return to themselves, when they have no mental resources, they have been left dismantled.

Q.

He said that they scream with their blood instead of with their throats.

Do they yell for help?

Is it a wake up call?

R.

One of the motivations is this: to modify aspects of the outside world, to become visible, to demand attention... But this is not necessarily the case either.

Sometimes the war is with themselves, not with the outside world.

Sometimes the cry is expressive, evacuatory rather than communicative.

Q.

How do you have to interpret what is happening?

To what extent can fashion influence these dynamics?

R.

It can influence, but I would not encrypt everything in relation to fashion.

It can influence because there are trends that are publicized, that are reinforced in networks, and that can have an intra-group reinforcement, even if it is only virtual.

Sometimes the reinforcement comes from social media or from watching other people do it too.

And with this reinforcement you have to count, but not alone.

In fact, self-harm is a rather solitary act, what happens is that the person who self-harms knows that they are not unique, that in their same class or school there are other people who do it too.

Q.

What are the risk factors?

R.

Girls have more ballots and another risk factor is, for example, having at the same time an eating disorder, having a terrible social image and above all, having a high level of family conflict with people who should act as figures of containment.

I would also say [that the early adulthood of adolescents is a risk factor]: children who become adults before the time, who feel that they are burdened, socially or familially, with a social, work, economic or academic responsibility, are people that they are going to feel very stressed and self-injury can be seen as a way to evacuate everything.

Q.

What are the warning signs?

R.

The way of dressing, for example, is concealing, you will avoid bathing in public or showing your arms and legs.

There will be many excuses for not showing your own body.

The wounds are not always due to cuts, although

, which is the most common, will produce blood and stains.

Another sign is being locked in the locked bathroom for a long time or that there are many spikes in behavior, such as very loud explosive reactions.

Q.

How is it resolved?

R.

I am very much in favor of models based on mentalization: as the ability to mentalize your own moods increases and to put your mind to that chaotic thing that escapes you and that you do not control, it improves.

Because of the compulsive part that self-injury may have, there is pharmacological help that can help to achieve improvement, but therapeutic intervention is key.

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