Young People and Self Harm

In Grief by Nathan ToLeave a Comment

As you know, it can be particularly tough to figure out an ideal response for teenagers and self-harming behaviours.

By honouring the emotional experience of the teen while offering more constructive solutions, this video outlines my team’s research on this urgent issue, and proposes an innovative solution: a graphic novel that can connect with teens and spark transformation and healing for positive social change.

This video outlines my team’s research on this urgent issue, and propose how graphic novels could be tools of transformation and healing.

IDEO/Acumen project on Human-Centred Design and Design-Thinking

*Dr. Nathan To: Slide deck design, video & sound editing, content, research, narrative.
*Team Collaborators: Lee C (Research, Interviews, Narrative), Candace Y (Prototype graphic design)





  • CHALLENGEHow might we create empowering spaces for young people engaging in self-harm, and enable them to find help?



Research Backgrounder:

  • 1 in 5 females + 1 in 7 males every YEAR U.S. stats on self-harm injuries: self-harm-statistics-and-facts/ engage in SELF-INJURY
  • That’s… 1 in 4 hospitalizations among youth age 10 to 17 2013-2014 Canadian statistics on intentional self-harm injuries: Canadian Institute for Health Information (CIHI):

See also: 1, 324 hospitalizations (in 2009-2010) 2,500 hospitalizations (in 2013-2014)

Self-harm describes a range of behaviours, including:

  • Cutting your own flesh
  • Severely scratching your skin
  • Burning or scalding yourself
  • Punching things or throwing your body against walls and hard objects
  • Hitting yourself or banging your head
  • sticking objects into skin
  • intentionally preventing wounds from healing
  • swallowing poison, toxic substances or inappropriate objects

We Focus on the topic of:




  • ONLINE + COMMUNITIES ➜ Tumblr ➜ Instagram

Role of Peer Pressure:

  • Young people cut to “fit in”
  • Past research suggested self-harm occurs in physical isolation. THIS HAS CHANGED.






1. Young people see their cuts as battle scars, a source of pride among those who cut. (INSIGHT THEME 1)

  • Young people cut to make connections with others.
  • There is a tight-knit group online of young people who self- harm. Some are recovering, many are still active.
  • Cutting can involve Peer Pressure
    • e.g. in an effort to fit in with a social group, young people may experiment with cutting when they see their friends doing it
  • Cutting can be addictive. Young people who cut cannot help themselves.

2.Cutting triggers a biochemical reaction in the brain. (INSIGHT THEME 2)

  • Serotonin, Dopamine & Endorphins interact… Cutting feels Soothing, even Rewarding. so People who cut get some hormone-rush and feel soothed from cutting.
  • The “soothing” experienced by those who cut differs with each individual.
  • Cutting can be experienced differently: as numbing or feeling more alive.
  • Thus, cutting can feel rewarding, reinforcing & addictive for those in emotional pain.

3. Young people cut to cope with overwhelming emotions. (INSIGHT THEME 3)

  • A goal of cutting is to deal with emotional pain. e.g. Sadness, depression, anger, trauma, bad memories
  • Thus, Cutting is a way to help with emotional regulation
  • “We can’t just take away someone’s coping strategy without replacing it with something else”
  • They need support to find alternate ways of coping / emotional regulation Can’t just tell those who cut to stop.
  • “Telling young people to go ‘COLD TURKEY’ will not work.”
  • Emotional pain is made worse when young people shame & blame themselves for cutting
  • More support & public understanding is needed.
  • Stigmatizing those who cut reinforces the shaming cycle.


  • These are brain neurotransmitters.
  • Sometimes called the “happy chemicals”.
  • Serotonin: mood related. associated with feelings of pride & significance.
  • Low amounts mean higher impulsivity
  • Dopamine: associated with the good feeling of achieving rewards. Addictive.
  • Endorphins: brings euphoric feelings that mask pain. e.g. runner’s high[1]



  • How might we reward young people differently– so that they feel the same amount of pride without harming themselves?
  • How might we help break the cycle of biochemical reward & reinforcement in people who cut?
  • How might we direct people to alternate ways of coping when they are overwhelmed and feel compelled to cut?

We came up with a lot of exciting, innovative ideas…




  • It will create an engaging, visual and emotionally stimulating way of reaching young persons engaging in self- harm.
  • They are “cool”, accessible & also relatively less expensive to produce (e.g. compared to our more tech-focused solutions)
  • Distribution can involve local libraries, schools, community centres, & both independent & mainstream book outlets
  • Graphic novels can be accessed regardless of whether young people self-harm or not.
  • This wide appeal prevents young people from seeing themselves as a “problem”.

“The person is not the problem. The problem is the problem.” -Michael White, Narrative Psychotherapist

Thus, this wide appeal helps reduce the stigma of persons engaging self-harm, preventing cycles of self- shame.



  • A graphic novel: …adapted from Real Stories …based on actual experiences of real people who have struggled with self-harm in the past or present.
  • Developed in collaboration with: …writers who have close knowledge of self-harm issues. …clinical professionals, social science researchers, educators & other key experts on self-harm.

It’s called F . M. L .

  • FML is real and raw
  • FML is the sentiment driving despair and hopelessness, and the compulsion to self-harm
  • FML can and will be turned on its head, showing our audience that there is redemption and hope

The Proposal: FML the graphic novel

  • a seven part series each part, a stand-alone piece, is anchored on a unique character
  • each part explores the lives and struggles of each character
  • all the characters share one thing in common – a history of self harm and a way out of their own personal hell

Sample story:

  • The world contemporary suburban wasteland where teen girls deal with a lethal combination of ennui and abuse
  • Amy’s story opens with blood and gore, and a paramedic rescue – then the story takes us back to how she got here. and the redemption that saves her.
  • amy comes from a middle class suburban household
  • her dad is irish, her mom is chinese jamaican
  • she is bullied constantly by other kids who don’t get her mix.
  • she develops symptoms of social anxiety and depression.
  • she becomes reclusive, retreating in a world of online games and anime
  • she starts to hurt herself, first with a pin prick. but it doesn’t stop there.


  • Amy, 15 – Mixed and weird C H A R A C T E R 1
  • Graphic Novel Cover: contains Information included for people who need help

Brief Cover Page copy: “If you are, or know anyone who currently engages in self-harm, please urge them to call: 1-800-Alt-Cut


People said…:

“It’s cool. I don’t cut, but this will help me understand why other people in my school do it. And maybe I can pass this along to them.” – teenage girl

“Many people enjoy reading graphic novels and they can speak to people in different ways. This mode also caters to those of varying degrees of reading abilities so can target a wider audience. In this way the message can be delivered which is better than a flyer or only textual format that might overwhelm people…it will also help those who are creating the graphic novel to cope and reflect on what happened in their lives and bring meaning to their experience; thereby, serving multiple people.” -Dr. D.M. Law, Assistant Professor, WLU Youth & Children’s Studies & Psychology

In future iterations:

  • We will tell different stories about characters that…
  • …may not fit a stereotypical teen subculture. We will tell their unique, personal story.
  • We will also tell inclusive stories…….stories that embrace cultural diversity & sexual diversity.
  • Unique backgrounds. Unique contexts.
  • Shared struggles. Shared emotions.
  • and Different definitions of three, powerful letters.

F . M. L .

What Does it really stand for?


Team Health DX Members: Lee Chapman, Nathan M. To, Candice Yee

For more details or collaborations, please contact us. Look forward to hearing from you. Primary Contact: Nathan To, CCC PhD Research Consultant/Counsellor


This presentation was originally created for the IDEO/Acumen “Human-Centred Design” course on NovoEd. ➜ Presentation template by SlidesCarnival ➜ Photographs by Death to the Stock Photo (license)


-Special thanks to all the people who made and released these awesome resources for free:

➜ Animation graphics & thumbnail of “FML – Amy’s Story” by Candice Yee

➜ Presentation template by SlidesCarnival

➜ Photographs by Death to the Stock Photo (license)

[1] Sources:



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