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Is this a form of self injury?

Thread starter #1
I haven't had experience with self injury, and I never heard about it manifesting this way, so I wanted to see if anyone had any insights about this. I have a friend who has a 15 year old teen who is "accident prone." He's already broken 4 bones in his body at different times. His "accidents" always occur when she has a major project at work. Within a few days of him hearing about her plans, he gets into an accident that is so serious, it leaves him with a broken bone. Examples of his accidents are falling after climbing a tree, riding his bike in the street and getting hit by a car, etc. It never seems intentional as cutting is. But he fits in with characteristics of self injury disorder that I read about online: he's impulsive, has trouble coping with strong emotions, has a high pain threshold, has interpersonal conflicts with his narcissistic father who he has to stay with when his mom starts a project (it gets really intense). Also, it seems to me that if he has an objective, it is to elicit guilt to get attention and care from his mom, which was also online as something a self injuring person does. Most recently, she even cancelled her work plans to care for him. She feels really guilty when she has to focus on work, and her son's injuries heightens her emotions and guilt a lot. But in doing that, is she possibly feeding into his unconscious motives? She's nervous because she needs to work as her ex hasn't had a job in a while and does not give her any financial support.
 
#2
For me it is hard to tell if this is something he is doing on purpose. Sometimes bad things happen at inconvenient times. But, it does seem odd that it relates to her being busy at work. Sounds like a complicated home life for everyone. I can understand why she would be nervous. Reminds me of many years ago when I knew someone who was changing working hours and their child became very anxious and very ill and the working hours had to be put on hold. Only to change again and then the child ended up in the hospital. The child was later diagnosed with separation anxiety. And, the family had to make adjustments to make the child feel safe and continued with the work changes. Hope they can work things out so everyone can be safe.
 

grit

MyPTSD Pro
#3
I am not familiar with self-harm but reading what you wrote and sitting on my high chair (from this vantage point of view), I think this child has maybe some dependency and abandonment issues and the anxiety may be manifesting as accident or unconscious injury to the body. I could be wrong of course as I have no more information than what is written here. I wonder though if the child get satisfaction out of the injuries or surprised and annoyed as everybody else around them?
It is tough call.
 

enough

MyPTSD Pro
#4
I can relate a bit. I was accused of having a "death wish" as a teen but in reality it was more like a total disconnect between action and consequence, and thats pretty common when the frontal lobes havent fully developed. I was pretty damn sure that accidents happened to other people and having survived a broken neck and collarbone. ruptured liver etc. by age 15 I was more or less "pre-disastered, giving me super human abilities when working on construction sights or with cattle and horses and hogs.
Personally I wouldn't be overly concerned about the timing of the events, but very concerned about what you call a high pain threshold.
This kid is headed for a long hospital stay or worse and needs guidance to get him to 18-20. It is going to be a tough row to hoe, ecpecially with parents coming and going. I wish him luck, he can have all the luck I didn't quite use up.
 
#5
His "accidents" always occur when she has a major project at work. Within a few days of him hearing about her plans, he gets into an accident that is so serious, it leaves him with a broken bone
interpersonal conflicts with his narcissistic father who he has to stay with when his mom starts a project (it gets really intense).
Can't really say one way or the other regarding the accidents being intentional or self harm, however another question may be is the behaviour possibly related to the father also, in addition to/instead of the mother? Is it mother - project - injury? Or is it mother - project - father - injury?

Is either parent noticing a pattern of behaviour? Is either parent concerned? Is there mental health concern or diagnosed mental illness in any of these family members? Is anyone in therapy?
 
#6
Self harm disorder? I very much doubt it.

Horses & zebras. When you hear hoofbeats? Think of the most common causes FIRST.

Every time he goes to live with his dad? He ends up beat up from the street up. >>> So what’s more likely? Boys will be boys, his dad is abusing him & attempting to cover it up with normal teenage-boy mishaps, or the kid is enacting a deceitful and dangerous plot to manipulate his mother in connection with a rare brain disorder?

Boys will be boys.

The vast majority of teenage boys are hurtling themselves through space at terrifying speeds, in the most dangerous circumstance, with little to no care for their own safety, nor heed to the consequence of their actions. That ANY of them survive to adulthood is something of a minor miracle.

That it’s only happening at his dad’s house, when mom has a work project on? Speaks less to what his mom is doing, than what his dad is doing. Which doesn’t mean it’s nefarious, in any way at all. (Neither neglectful nor abusive). Men tend to be far more relaxed about personal safety & use of personal time; whilst women tend to hover, & be more structured. Men tend towards natural consequences, whilst women tend towards directed consequence. Neither is inherently right/wrong. They’re just different. Which doesn’t mean you don’t get helicopter-dads and relaxed moms. You do. But most of the time if a kid asks if they can climb a tree? A dad will say “Go for it!” or “Why the heck are you asking me? If you want to climb a tree, climb a tree!” whilst a Mom will remind the kid it’s dangerous and to be careful, or why not come do this over here, instead? Or freaks the hell out if not consulted about jumping off the barn roof into the hay (or whatever today’s harebrained scheme is/was). // Regardless of whether classic gender-roles are in play, or not? Most parents argue, quite a lot, over different safety standards for their kids at different ages. It’s incrediably rare that both parents are exactly on the same page about what’s allowed. Even more rare if those parents are divorced.

Add in that it’s a different environment, with different rules, and different expectations, and different challenges, and very possibly different people (other boys to compete against, or girls to show off for) and it doesn’t even have to be related one bit to parenting style. Just a totally normal teenage boy, doing teenage boy things.

Now... if it’s not actually happening AT dad’s, but just after he hears about having to go stay somewhere he doesn’t want to? That’s probably more related to blowing off steam. Being pissed off so taking bigger risks, with even less thought/care as to what happens next. Again, though, that’s super normal teenage boy behavior.
 
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enough

MyPTSD Pro
#7
That ANY of them survive to adulthood is something of a minor miracle.
I work with guys. the break table is usually just mindless chatter trying to make each other laugh. Sometime its about knucklehead shit our kids have done, and then it's "Sherman, set the wayback machine to 1973" and we all tell tales of stupid stuff we somehow survived.
Been that way everywhere I ever worked with guys that were comfortable with each other. We are all pretty much hammerheads and it is a MAJOR miracle that we survived, got girls to even talk to us, and reproduced.
 
Thread starter #8
Thanks for everyone's replies. I was confused by this situation and I'm getting confirmation that it's not that clear cut. @enough and @Friday, I think you both make a good case, especially given the details that I provided. But can I say that I have a very strong intuition that there is a pattern to his "accidents" rather than it being a case of just boys being boys. To add to the details, my friend doesn't have big projects often. Her regular duties keep her busy, but she can pretty much always have dinner with him on her days (her ex only takes their son every other weekend). She has a big project only once or twice a year when she has to rely on her ex to care for her son almost full time (usually for a few weeks). What are the chances that he always breaks his bones within days of her beginning such projects? I think 3 times, he broke his bones after he was already at his dad's. But the last time, he broke his bone while he was still with her, a few days before he knew he was going to stay with his dad for a few weeks. All the times happened in the last four years while he was hanging out with friends. There were witnesses, ambulance rides, etc. So I'm almost 100% sure that none of the times was due to his dad (at least directly). His dad is more covert narcissist than sadistic (though my dad was a sadistic narcissist!), yells a lot, but has never gotten physical. The father definitely plays a role in this, but my main concern is how my friend just gets completely depressed about his getting hurt - she has never made the connection explicitly, so it's more like this unconscious guilt she has that is already there and completely amped up with the emotions surrounding her son's "pain" and "terror" at being in the hospital, getting surgery, etc. I think she secretly blames herself. If it is a pattern, I'm also afraid for her son who might get himself into a dangerous situation that could cause lasting harm. Plus, he just needs a better way of dealing with his emotions. But again, maybe I'm reading too much into this.
 

joeylittle

Administrator
#9
Non-Suicidal Self-Injury Disorder is a fairly new diagnosis. It's an attempt to recognize that self-harming is something adolescents are particularly susceptible to, and that they may demonstrate those behaviors without having any other mental health disorder.

Previously, self-harming behaviors were primarily identified as symptoms of other diagnoses - depression, OCD, a few personality disorders, bipolar spectrum, autism spectrum...etc.
His "accidents" always occur when she has a major project at work. Within a few days of him hearing about her plans, he gets into an accident that is so serious, it leaves him with a broken bone.
Bone breaking isn't the most common form, but it is considered within the self-injury spectrum. However - the part I bolded doesn't quite conform; it would be more common for the self-injury to occur "in the heat of the moment", as it were - so immediately upon experiencing an emotional stressor, as opposed to a few days later.

That's the biggest indicator that - if there is a mental health issue going on - it's probably something else. Or, it's not something that rises to the level of 'disorder', it's certainly something worth talking with him more about - especially since the subsequent hospitalization/treatment is distressing to him.

He could just be adventuring, in which case he could (perhaps) start applying better judgement. Or, he's for some reason doing it on purpose. Adolescents are very, very difficult to diagnose, and my advice would be to tread carefully, in your role as friend. Sounds like the kid could probably use someone to talk to - but the wrong therapist/psychologist can make things worse. Research, getting recommendations for talented clinicians specializing in adolescents...possibly family therapy, even, just to open up lines of communication+trust between mom and son. Also sounds like he's caught in the middle of a messy divorce - it could be that getting some help w/that would resolve other things.

Also, it seems to me that if he has an objective, it is to elicit guilt to get attention and care from his mom, which was also online as something a self injuring person does.
Yes, it very well could be in order to get mom's focus. But, the impulse could be driven by unresolved stuff around the divorce, rather than a mental illness presenting itself...It's tricky, because if mom starts to treat son like he's (perhaps) got some mental health issues, that will only add to son feeling more alienated - first from dad, then from mom.

If there's a family history of depression, bipolar, schizophrenia - like a solid history, not a guess-timated one - that can provide some more context. But my not-a-doctor, totally just giving my opinion take is: the kid is feeling the impact of his parent's problems, and best support mom can give would be to work on her own guilt+get help building a stronger relationship with kid, one where he can talk with her about how he's feeling instead of (possibly) signaling his distress through reckless behavior.
 
Thread starter #10
Thanks so much, @joeylittle. That was a very helpful post.

on-Suicidal Self-Injury Disorder is a fairly new diagnosis. I
I didn't realize it was a new diagnosis. I just read about it online. I read that it is not a mental illness per se, but as you say, was seen as a feature of more primary mental illness. I read that it was a coping disorder.

Previously, self-harming behaviors were primarily identified as symptoms of other diagnoses - depression, OCD, a few personality disorders, bipolar spectrum, autism spectrum...etc.
Her son has anxiety and adhd, but she also did take him to get evaluated because my friend's ex's mom is bipolar and her ex was obsessing that their son might have gotten that gene. But the psychiatrist said that he did not have any diagnosable mental illness.

the part I bolded doesn't quite conform; it would be more common for the self-injury to occur "in the heat of the moment"
This one sticks with me as well. I was reading online that self-injury is a way of coping with intense emotions. But that is not what is going on here. This is exactly why I was wondering at first if it could be Baron Munchausen syndrome. In that syndrome, one desperately wants sympathy and attention, but their methods are more calculated rather than reactive. Labels aside, they both are driven to acquire attention and care even if it means inducing physical suffering. And by using physical ailments, it is a roundabout, but therefore safer way to get the attention - it's a lot easier to ask for attention for that broken bone rather than risk asking for attention from busy, distracted parents who might continue to ignore you. In the case of my friend's son, whenever he gets injured, she cancels everything and runs to his side and only leaves it with a lot of emotion and guilt (and later gifts). In my friend's son's case, his "accidents" are opportunistic. He is usually impulsive, but on those occasions of injury he will take unprecedented, surprising risks that are pretty dramatic. For example, veering into traffic with his bike when he's never done that before. He'll later say 'that really taught me to be careful on my bike.' But is that a mistake a 15 year old would make? In the days leading up to that accident though, I could see him becoming agitated. So I know emotions were on the burner if not on the surface. Again, my intuition tells me that there is an unmistakable pattern even if it doesn't quite fit any paradigms.

Also sounds like he's caught in the middle of a messy divorce - it could be that getting some help w/that would resolve other things.
This is definitely true. Neither parent is really great at talking to the child, and he does have some worrying behaviors. Let's just say that he definitely engages in screaming matches with his dad and he gets into trouble a lot. But my friend has a lot of blind spots. She sees his bravado as confidence and thinks he is ultimately fine. In my mind, my friend can't open up the floodgates of seeing his problems, so she sees him through rosy glasses.

the kid is feeling the impact of his parent's problems, and best support mom can give would be to work on her own guilt+get help building a stronger relationship with kid, one where he can talk with her about how he's feeling instead of (possibly) signaling his distress through reckless behavior.
I think that is exactly what her son needs. I'm totally hearing you in your caution against rushing to judgment, giving any particular advice, and even if he did need help, making sure to find the right kind of help. It's a weird situation because even if my suspicions were true, there is no direct way of addressing it. So I just watch my friend about once a year go through hell, while a part of me wonders if all of the suffering on both of their parts is really necessary.

@Invisible Fire , I feel like your story is similar to the dynamics that I'm speaking of.
 
#11
years ago a medication I was on made me accident prone. In a short period of time I was at the ER for accidents. One day I accidentally ran a drill bit through me hand. That ER visit they thought about admitting me to the psych ward thinking I was doing things intentionally to hurt myself. I had to convince them it truly was just an accident and I was accident prone. Antibiotics then discharged.

I haven't had experience with self injury, and I never heard about it manifesting this way, so I wanted to see if anyone had any insights about this. I have a friend who has a 15 year old teen who is "accident prone." He's already broken 4 bones in his body at different times. His "accidents" always occur when she has a major project at work. Within a few days of him hearing about her plans, he gets into an accident that is so serious, it leaves him with a broken bone. Examples of his accidents are falling after climbing a tree, riding his bike in the street and getting hit by a car, etc. It never seems intentional as cutting is. But he fits in with characteristics of self injury disorder that I read about online: he's impulsive, has trouble coping with strong emotions, has a high pain threshold, has interpersonal conflicts with his narcissistic father who he has to stay with when his mom starts a project (it gets really intense). Also, it seems to me that if he has an objective, it is to elicit guilt to get attention and care from his mom, which was also online as something a self injuring person does. Most recently, she even cancelled her work plans to care for him. She feels really guilty when she has to focus on work, and her son's injuries heightens her emotions and guilt a lot. But in doing that, is she possibly feeding into his unconscious motives? She's nervous because she needs to work as her ex hasn't had a job in a while and does not give her any financial support.
 
#12
Caveat - Totally possible that the accidents really are accidents & this kid is just a reckless teenager with NO big bad underlying cause as well, of course!

In response to the post itself - It may or may not be self injury, but that does not sound like the real issue here.
2nding the recommendation to ensure the KID gets an adult to talk to about what's going on with him. It may not even have to be a shrink; an adult the knows and thinks decently of is a good free first try. Anyone like that in this family's world?
I had some similar patterns as a teenager, and addressing the sucktastic parts of life and having someone to help me figure out how to dig out of them thru resilience and planning would have been a godsend.

I did not do what I did "at" my parents' careers or at them personally, I was overwhelmed and thought nothing would ever change. And still I was supposed to do all the normal school stuff, be nice, etc, in spite of some longstanding active trashfires that could no longer be ignored, and only got bigger by the day. That's just not realistic.

Luckily I had a handful of adults around (mostly teachers & a few friends' parents since we didn't have a lot of family friends I meshed with) whose opinions I gave a damn about & that kept highish expectations. Somehow they carved out some time & actually talked to me about how things looked from my limited kid's perspective. Some of those were "well, you definitely f*cked that up; let's figure out together how to prevent that next time since I know you can knock this outta the park" talks where I was getting suspended or kicked out of something, not just warm fuzzy after-school-special mentor type talks building stuff in the garage or tossing a ball around for enrichment.

I did end up also working with a therapist but these non-family, non-therapy adults taking me seriously and treating me like a potentially reasonable proto-adult was a huge positive factor.

Those chats got me thinking about what the future might hold if I wanted to try and change things & what I could try & do to pave the road. The notion of being a proactive agent in my own life and not just having life happen to you was a very big, positive turning point. So was realizing that adults also bumble thru things and don't always know...but that healthy ones KNOW that and are prepared to push on with a new approach if option 1 fails. And that failing once at one thing doesn't mean you are doomed to nonstop failure at everything and totally worthless.

And someone should help mom and kid come up with a plan for what he'll do, where he'll stay that doesn't require him to stay with the dad. At 15, the kid should definitely be an active participant in whatever plans are hatched about his life. Mom probably could use help managing her own stress & guiding a teenager to adulthood but that's been suggested already so i am leaving that alone.

This is a teenager, not a toddler, and I didn't see any descriptions here of autonomy/appropriate reponsibility for him. If the mom's projects are during the regular workday and she comes home at nights could son "watch" himself on a conditional basis? Especially if there's a low-level easy-success responsibility he could take on (plan or make dinner? some chores? pet care? does he work at all, or want to?) to add accountability and structure. If they have a neighbor or family friend close by that SON thinks even a little highly of and mom trusts, that person could check in on son now and then if mom has doubts. Mom & son have dinner or whatever and maybe start seeing each other more as people than "grownup" and "child" stock roles. And son is not flapping in the breeze totally unsupervised or forced to stay with the dad. The responsibilities let the kid rack up real achievements and build realistic competence and (hopefully) confidence in his personal effectiveness.

Obviously this would be nerve wracking for the mom at first and it's possible that the kid would turn out not to be up to watching himself, but it sounds like he hasn't been offered the option. If son still isn't able to keep his bones intact, then look at other possibilities. The unspoken expectation that you're too fragile and incompetent to take care of yourself is something kids/people notice and it can become a self fulfilling prophecy.

If the issue is that the kid's life sucks in some fundamental ways, and the suck requires fixes he isn't empowered to enact single handedly, that is going to require the ones who CAN fix the suck to do so. A teenager cannot fix a War of the Divorced Parents, parents' money issues, narcissistic dad, etc. They can still feel the stress of it and some will assume guilt or feel responsibility nonetheless. I still have problems differentiating what "feels" like my responsibility from what really is or is not my responsibility & I'm freakin' 40.

If the accident-prone kid was instead an adult with a spine in a healthy situation, he more likely would have spoken up or looked at productive options he could take and had the fire addressed, but a kid doesn't likely know WHAT their options really are. And a kid absorbing problems for/between their adults? Not likely to ask even if they do know it's an option. Whether the poorly-timed accidents are due to wanting attention or to being driven to distraction BY the impending situation mom's project may cause for son, son needs some realistic ways to improve his own situation.

Not just running my mouth: I have also been on the grown-up-family-friend side of this with a friend's tween and teen and been an interested adult for them when mom at her limit with everything. Not always the most comfortable, fun, or convenient but it was the right thing to do. Her older kid also absolutely blossomed when he got his first job because all of a sudden people were counting on him.

(Note: I hope none of this comes across as mean, disrespectful, or dismissive of the family or the OP or any other poster. I know everyone's experience and circumstances are different and I also know I can get heated when the subject of labeling kids comes up, and a lot of things that are normal for teenagers are also listed as symptoms of lots of things.)
 
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