Helping Teens Who Self-Harm

Most of us know that some teens cut. But cutting — using a sharp object like a razorblade, knife, or scissors to make marks, cuts, or scratches on one's own body — is just one form of self-injury. Teens who self-injure also might burn, scratch, or hit themselves; bang their head; pull their hair; pinch their skin; pierce their skin with needles or sharp objects; or insert objects under their skin.

It can be hard to understand why teens would hurt themselves on purpose. Learning that your own teen is doing it can leave you feeling shocked and upset — and not sure what to do or how to help.

Why Do Teens Self-Injure?

For most who do it, cutting or other self-harm is an attempt to interrupt strong emotions and pressures that seem impossible to tolerate. It can be related to broader emotional issues that need attention. Most of the time, it's not a suicide attempt.

Cutting affects many teens and preteens — even beyond those who self-injure. Many teens worry about a friend who cuts or face pressure from peers to try cutting as a daring thing to do.

In many cases, cutting and the emotions that go along with it are something teens struggle with alone. But because of growing awareness, more teens can get the help they need.

Parents can help teens who harm themselves — and the earlier, the better. Cutting and other self-injury can be habit-forming, and sadly, many people underestimate the risks of getting seriously sick or hurt that go along with it.

How Can Parents Help?

If your teen self-injures, there ways to help. By learning about it, coping with your own feelings, finding professional help, and just being there to love and believe in your teen, you'll provide the calm, steady support that they need.

Accept your own emotions. If you know or suspect that your teen is self-harming, it's natural to feel a whole range of emotions. You might feel shocked, angry, sad, disappointed, confused, or scared. You might feel hurt that your teen didn't come to you for help or feel guilty that you didn't know about it. All of these emotions are completely understandable. But it's not your fault, and it's not your teen's fault.

Take time to identify your own feelings and find a way to express them. This might mean having a good cry, talking with a friend, or going for a walk to let off steam or quietly reflect. If you feel overwhelmed, talking with a therapist can help you sort things through and gain some perspective so that you can provide the support your teen needs.

Learn all you can about it. Find out all you can about self-injury, why teens do it, and what can help them stop. Some teens cut because of peer pressure — and once they start, they can't easily stop. Other teens feel pressure to be perfect and struggle to accept failures or mistakes. And still others contend with powerful moods like anger, sadness, worthlessness, and despair that feel hard to control or too heavy to bear. Self-harm is sometimes the result of trauma and painful experiences that no one knows about.

It can hurt to think that your child might experience any of these feelings. As difficult as it is, try to keep in mind that exploring what pressures prompt your teen to self-injure is a necessary step toward healing.

Communication Is Key

Talk to your child. It can be hard to talk about such a painful topic. You may not know what you're going to say. That's OK. What you say won't be nearly as important as how you say it. To open the conversation, you might simply say that you know about the cutting or other self-harm, and then convey your concern, love, and your willingness to help your child stop.

It will probably be hard for your teen to talk about it too. They might feel embarrassed or ashamed, or worried about how you'll react or what the consequences might be. You can help ease these worries by asking questions and listening to what your teen has to say without reacting with punishment, scolding, or lectures. Try to avoid judgment or reacting with fear or disgust, and instead try to respond with a compassionate, supportive stance when possible.

Let your teen know that self-harm is often related to painful experiences or intense pressures, and ask what difficult issues your teen may be facing. Your teen might not be ready to talk about it or even know why they do it. Even if that's the case, explain that you want to understand and find ways to help.

Don't be surprised if your teen resists your efforts to talk about it. They might deny that they do it, get angry or upset, cry, yell, or storm off. A teen might clam up or say that you just don't understand. If something like this happens, try to stay calm and patient. Don't give up — find another time to communicate and try again.

Find professional help. It's important to get help from a qualified mental health professional who can help you understand why your teen self-harms, and also help your teen heal old hurts and develop new coping skills.

Therapy can allow teens to tell their stories, put their difficult experiences into words, and learn skills to deal with stresses that are part of life. Therapy also can help identify any underlying mental health condition that needs evaluation and treatment. For many teens, cutting or other self-injury is a clue to depression or bipolar (mood) problems, unresolved grief, compulsive behaviors, or struggles with perfectionism.

It's important to find a therapist your teen can feel open and comfortable with. If you need help finding someone, your doctor or a school counselor might be able to provide guidance.

Staying Positive

Offer encouragement and support. While your teen is getting professional help, stay involved in the process as much as possible. Ask the therapist to guide you in how to talk with and support your teen. And ask your teen how you can best help.

For example, it may help to:

• Let your teen know you'll be there to talk to when feelings are painful or troubles seem too hard to bear.
• Help your teen create a plan for what to do instead of self-harming when pressures get strong.
• Encourage your teen to talk about everyday experiences and put feelings, needs, disappointments, successes, and opinions into words.
• Be there to listen, comfort, and help your teen think of solutions to problems and offer support when troubles arise.
• Spend time together doing something fun, relaxing, or just hanging out. You might take a walk, go for a drive, share a snack, or run some errands.
• Focus on positives. While it helps to talk about troubles, avoid dwelling on them. Make sure what's good about life gets airtime, too.

Set a good example. Be aware that you can influence how your child responds to stress and pressure by setting a good example. Notice how you manage your own emotions and deal with everyday frustrations, stress, and pressure. Notice whether you tend to put others down, or are self-critical or quick to anger. Consider making changes in any patterns you wouldn't want your teen to imitate.

Be patient and be hopeful. Finding out that your teen is self-harming may be the beginning of a long process. It can take time to stop — and sometimes a teen doesn't want to stop or isn't ready to make the changes it involves.

To stop cutting or another type of self-injury takes motivation and determination. It also takes self-awareness and practicing new skills to manage pressures and emotional distress. These things can take time and often require professional help.

As a parent, you might need to be patient. With the proper guidance, love, and support, know that your teen can stop and can learn healthy ways to cope.