Self-harm

Understanding Self-harm

An adolescent who is harming themselves needs help, as this is a behaviour that rarely stops without intervention. As such, if your teen is harming themselves, it is important to speak to them as soon as possible. 

Self-harm Does not Mean Suicidal Thoughts

It is often a huge shock to learn that an adolescent is harming themselves, and frequently we associate this practice with the idea that the teen has suicidal thoughts and wants to end their life. However, self-harm and suicide attempts are completely different. Someone who is self-harming is above all looking for a way to relieve their pain and doesn’t intend to commit suicide, although these two issues can coexist. Generally, it is a way for the person to channel their distress, rather than a desire to end their life.

Harming the Outside to ‘Feel Better’ Inside

Self-harm is a self-inflicted physical injury that is done to physically manifest a psychological wound or trauma. Whether it is cutting, branding, burning the skin, or even nail picking, or hair pulling, this practice is an attempt to control uncontrollable suffering.

Harming the ‘outside’ temporarily relieves the pain they are feeling on the ‘inside’. When the adolescent is experiencing anxiety that seems insurmountable, they relieve it physically by self-harming. However, this relief is only temporary and is often replaced by feelings of shame and guilt, then the irrepressible desire to do it again recurs.

A Vicious Cycle

Most adolescents who resort to this practice are often living paradoxically. On the one hand, they want to stop harming themselves, but on the other, this method is how they relieve the pain they are feeling.

As a parent, it is important to consider self-harm as a generally addictive behaviour. As such, it is difficult for the adolescent to stop themselves.

It is a behaviour that can decrease and stop when the teen gets help quickly. However, self-harm practices can get worse, because to get the same relief as when they started, adolescents tend to self-harm more frequently and more deeply.

Signs that my Teen is Self-harming

The majority of adolescents who self-harm are fully aware of the fact that their loved ones may negatively judge them if they find out. They also often feel shame about this behaviour and generally dress to hide it.

Nevertheless, you may notice certain clues:

• Your teen is increasingly isolating themselves, withdrawing, and abandoning several of their activities.
• Your teen wears weather-inappropriate clothing (such as long-sleeve shirts or pants when it is hot out).
• They refuse to go swimming even though they loved it in the past.
• Discovering razor blades, scissors, or sharp objects in their room or other areas they frequent.
• Spending long periods alone in the bathroom or their bedroom.

Possible Reactions to Self-harm for Parents

Shock and Denial

As self-harm is often hidden, there is a strong chance that we’ll feel shocked when this behaviour is revealed, and we may be tempted to deny it exists. However, denying it also means denying your teen’s suffering, so it is important to take a step back from the situation to find help.

Anger, Frustration, and Disappointment

We can also feel anger and frustration when faced with a behaviour that we can’t control and that may seem irrational to us, as well as the fact that our adolescent lied to us about their injuries. Along with the anger, we may be disappointed that they resorted to these practices and the difficulty of stopping. In this case, it is often useful to remind ourselves that we can’t control the behaviour of others, even when it’s our child, and that trying to do so won’t improve the situation. It’s also possible that we may experience empathy or sadness when faced with our child’s reality.

Pity

Pitying an adolescent who is self-harming can be interpreted by them as condescending. As pity isn’t useful, and because it is impossible to carry all of the weight of your teen’s suffering for them, this attitude will not be helpful for them.

Guilt

Many parents feel guilty about their adolescent’s behaviour. We may think that we didn’t give them enough love or attention, or that we didn’t want to notice their behaviours sooner.

How to Help my Teen Who is Self-harming

• When talking about your concerns, it is often helpful to use ‘I’ statements rather than ‘you’ statements to address that the teen is hurting themselves. By speaking calmly and reassuringly, you can express the behaviours and the emotions you are experiencing, as well as your concerns.
• Validate their feelings. It is important to accept and validate what your teen is feeling, all while listening respectfully to their opinion, and, if applicable, discuss healthier ways to manage their distress. If your adolescent isn’t open to talking, it's important not to insist, stop and come back to it later. Self-harm is a very emotional topic and the fact that your teen has learned that their parents are aware can be a huge shock.
• Determine whether they are currently experiencing challenges. If they are, ask how you can help them overcome those challenges. In addition, you can also bring up your relationship and ask if they are experiencing frustrations related to that.
• Ask them if they have ideas about how to improve the relationship and ways that they can feel better understood. If you’re comfortable enough, you can also speak directly about the self-harm, by asking them to explain how they feel before and after they hurt themselves. If they refuse to talk, simply tell them that you understand and that you’re there for them, even though it might be uncomfortable. You can also check with them to see if they want you to approach them again or if you should wait until they bring it up with you instead.
• To bring up the topic of self-harm, it is ideal to choose a calm moment when your teen is available and ready to listen. You can use a two-person activity for this, or a private moment.
• Take the self-harming behaviour seriously and explain the options for getting help for the adolescent. Ask them what they think and what they prefer.
• For professional intervention to be as effective as possible, they need to commit to it, so it is preferable that the adolescent chooses the time and place once they begin to work with a professional.

Reactions to Avoid

The emotions experienced when discovering that our adolescent is self-harming can cause us to react spontaneously without thinking, rather than acting to help our teen, so try to avoid:

• Asking to see the injuries. Even though it might be tempting, asking the adolescent to see their injuries will not change the situation if we are certain that they are self-harming. We can ask if the injuries have been properly disinfected and if there are any signs of infection, but insisting on seeing them is not useful and runs the risk of upsetting everyone even more.
• Getting angry. We might be tempted to shout, lecture, belittle, or to seriously punish the adolescent to take back control of the situation. However, these measures will create a power relationship where everyone wants to win, which can harm the relationship of trust and communication between you and your teen.
• Trying to be in control. It is impossible to control the behaviours of others, even our own children. As such, we can’t force our adolescent to stop these practices. Instead, we can talk to them about how the situation makes us feel. When telling them that they need to get help, we are sending our adolescent the message that we are taking them seriously, which is very important in this type of situation.
• Getting rid of the objects used. This generally doesn’t improve the situation, as an adolescent who feels a strong desire to harm themselves will find other means of doing so. In addition, using the same tools may be part of a ritual for the teen, and trying to control these objects can cause a feeling of panic and trigger more serious consequences. Instead, try to get help, be open, and give them space as needed.