Self-Harm and Your Teen

If you are the parent of a teenager, we know you have spent the last sixteen or so years thinking about what it will be like to watch your child grow up. You likely imagined them doing well in school, playing a sport or an instrument, having wonderful friends, and someday going to college or having a job. This is a beautiful image. You have worked hard to get your teenager to the high school years, and you hoped for a smooth and easy transition. You never imagined getting to this point in time and watching your teen struggle so significantly. You especially never imagined that part of their journey into adulthood could include self-harm.

If your teenager is intentionally harming themselves, through cutting, burning, head-banging, or any other methods, we want you to know that there are support systems available to your teenager. This is a terrifying time for your teen and your family. That is understandable. We know you probably feel as though things are at your rock bottom, but things can get better from here. It is possible.

Why is my teen self-harming?

As a  parent whose child has turned to self-harm, you have probably wondered: “why my teenager is self-harming?” You have likely racked your brain to understand the reason behind this behavior and to explore the ways that you can provide support.

There are many reasons that young people choose to self-harm.

Often, they do so because everything is incredibly overwhelming, and they feel a loss of control in every other aspect of their lives. This feeling of no control is common for teenagers who may be experiencing trauma or dealing with bullying.

Choosing to self-harm, for many teenagers, is a way of gaining back that control that they feel they have lost as the result of trauma in their lives. In this situation, self-harm becomes a coping strategy and while it may not seem effective to you as a parent, it is offering them a way to cope, regardless of how maladaptive it may seem. Some research shows that the chemicals released during self-harming provide a short relief for intense emotions which then triggers a dependency on the self-harm to feel “normal”.

The common feelings that young people report associated with self-harm can be intense anger, sadness, anxiety or tension, and a feeling of self-hatred. If the young person feels as though they do not like themselves then engaging in self-harm theoretically wouldn’t bother them because, at that moment, they may not value their body.

Research suggests that self-harm isn’t inherently connected to suicide the way we might automatically think and serves primarily as a warning flag for a teenager that participates in it. If your child is self-harming it may not be linked to suicide ideation. They may just want to find a way to cope with their feelings and emotions.

While self-harm isn’t effective and it is harmful, it is an indicator that your child wants to live. They just might be having a hard time finding effective ways to live well.

There are many interventions that can be used effectively to reduce and altogether end your teenager’s time with self-harm and they can get that help if they attend therapy and get access to the right support and services. For example, teaching other coping strategies such as deep-breathing or journaling, is more effective at reducing the self-harming behavior in teenagers.

Another reason that the teenager may be self-harming is because they do not feel anything at all. This is a common report by young people – especially those that belong to vulnerable populations like the LGBT community. Often teenagers report feeling numb and so they choose to self-harm as a way of feeling something.

How do I know my teenager is practicing self-harm?

Often teenagers will hide their self-harming behaviors. It is understandable that they do not want to get caught self-harming if they are using this as a way to cope. They don’t want their only coping mechanism taken away from them. They also probably won’t want the scars or medical issues that could come from self-harming. These are things we need to teach them.

If they are self-harming you will likely notice scars on their body including their arms, legs, and stomachs. They may be red and raised or white and less transparent if they have been harming longer. If your child is unwilling to wear summer clothing and only want to cover their skin and are avoiding social activities where their skin might show, this could be a concerning sign of self-harm. If your child used to change clothes in front of you or in front of their friends in the locker room and are no longer will to, this could also be a warning sign.

Ask questions

If you notice your teenager is engaging in self-harm or you have suspicions that they might be, my suggestion is to ask questions. If your child is self-harming, they may be having difficulties at school, in their friendships, or are likely having symptoms of mental health distress. You should be asking your child about these life domains.

Ask them why they are engaging in self-harm and what it does for them. Instead of shaming your child for this behavior it is much more effective to try to understand it. You may need to ask questions from people in your child’s school as well. Reach out to their teachers and ask if there has been a change in your teenagers’ behavior or disposition. Be straightforward with your child. Ask them straight up if they are harming themselves. Typically, a teenager has a hard time avoiding answering questions if you are very straight forward with them.

Respond appropriately to self-harm

If your child does report they are self-harming, how you respond is very important. It is important you do not shame or further distress your child by responding in a highly emotional way. Of course, it is normal to want to say things such as: “why the hell would you do this to your body?” but that reaction is not effective. This is shaming and often makes them feel guilty along with sadness or remorse for their actions.

You should stay as calm as you are able to and listen without judging your teenager. This will promote them communicating honestly with you and being open about how they feel and why they are self-harming. We suggest you ask questions such as: “can you tell me why you feel the need to do this?”. These kinds of open-ended questions will promote them to answer fully and openly instead of simply saying “yes” or “no”.

As mentioned above, you should avoid being highly emotional. Crying in front of your child may seem like the right thing to do because you want to express to them your own sadness, but it will take over their own feelings. Your child’s emotions need to be front and center and you have to take a back step as a parent so that they can process their feelings without having the feelings of their parents interrupt their own processing. It can be helpful as a parent to seek your own therapy and support out so that you too have an appropriate place to address your sadness or feelings about your child’s self-harm. It simply should be away from your child for the most part.

What to do if your teen is practicing self-harm?

If you learn that your child is self-harming and you have already explored questions you may have with them about it, it is best to start planning with the child right away.

I suggest that you offer your child mental health supports immediately. Getting your teen enrolled in therapy will be very helpful. The therapist can explore the reasons that your teenager is harming and start to develop more appropriate coping skills such as deep breathing, mindfulness, journaling, exercise, and more.

As your child learns these skills, ask them about it so that you can help them implement them at home. For example, you could do a family meditation time together. Some of the therapy modalities that can be helpful are Cognitive Behavioral Therapy (CBT) and Dialectical Behavioral Therapy (DBT).

CBT focuses on learning about your teen’s thoughts and attempts to change them as a way of changing their behavior. It will recognize distressing thoughts and negative thinking patterns and focus on replacing those patterns with healthier patterns.

DBT focuses on changing behaviors as a way of changing your teen’s thoughts about themselves. DBT is heavily skills-based and will focus on teaching your teen more effective coping skills and will spend less time analyzing thought processes and patterns. CBT is more of a traditional psychotherapy approach to treatment. DBT will offer a significant amount of skill learning and practice.

In both therapy programs, your teen will have homework to work through each week with the goal of obviously reducing self-harm to no occasions and providing an overall better quality of life. It may also be helpful to engage your child in family therapy during this time. Not only will your teen benefit but your entire family unit will benefit from learning and growing together.

You should also try to get your child seen by a physician to ensure they do not have any infections from self-harm if they are cutting or burning their skin as well as to have the Physician teach them about the impact of the harm such as seriously injuring their body or accidental death.

Together you and your teen can develop a coping plan for at home and at school including reducing access to any items they can use to self-harm, setting up a system for them to communicate with you and for you to offer support when they feel an urge to harm, and even a crisis plan if their desire to harm becomes too strong. Common crisis supports include texting or calling local crisis lines.

If your teenager is unable to stop their reliance on self-harm despite extensive therapy and home supports, inpatient residential treatment may be the right option for your child. They would admit to a residential facility where they would reside and have access to trained professionals 24/7. This would include doctors, nurses, therapists, and psychiatrists. They would engage in daily and weekly individual and group therapy sessions. Ongoing skills support is provided to families as well to ensure the teenager discharges and is able to carry their new skills back to the home.

If your teen is self-harming, there are likely many different things going on with them that are resulting in this dangerous behavior. There is still hope for your child. They can get access to the right supports to ensure recovery and health and safety. This may be outpatient support or inpatient support but it will lead to your child living a much happier and healthier life. Reach out to support immediately if you learn that your teenager is engaging in self-harm and know that you are not alone in this journey.

If your teenager is dealing with self-harm, know that you have options for treatment. Hillcrest is here and our dedicated staff knows how hard it can be to heal from trauma and recovering from self-harm. Reach out today to find out how we can help!