Self-harm as a symptom of distress for young people in the U.S. has been on the rise over the past 20 years. Generally, girls are more likely to try self-harm, but this behavior is often more severe and persistent with boys. Self-harm can be associated with specific mental disorders (i.e. depression, anxiety, trauma, substance abuse, psychosis), but can also occur at times of sudden extreme distress.
It comes in many forms, the most common include scratching, cutting or burning skin. Some self-harm where marks are easily visible – but others use areas on the body hidden from sight. Many might “try” self-harm in moments of extreme distress, but don’t continue to engage in the activity. Others might find self-harm helps manage extreme emotions and the activity might become more consistent as a way to cope with distress for this much smaller group of adolescents.
It’s important to recognize self-harm is not equal to suicide. Oftentimes, a young person trying self-harm is doing it in an attempt to manage emotions, not die. There is, however, a link between chronic self-harm and suicidal thoughts/actions, so self-harming behavior should be addressed directly, seriously and compassionately.
If your child has or is engaging in self-harm, take a deep breath and consider if you need to talk first with another trusted adult (spouse, friend) regarding your emotional reaction to the news. Initial reactions might come off as scary or challenging to your child, and can make an open conversation more difficult.
Do your best to ask compassionately, but honestly, about how your child is feeling, especially if you’re going to address self-harm. Diving right into questions about when, where, why and how can put your child on the defensive, making trust more difficult to establish.
Expect your child to resist. You might allow them to move the time of the conversation, but not for days. Do your best to not pre-judge, and stay curious about how they’re doing emotionally.
Once you have a better sense of their emotional state, you can then begin to ask more directly about the self-harm. Your child may resist again, be prepared by staying calm. Resist arguing and making statements of certainty. If the scratch was self-harm, you’ll only manage to solidify the statement and get pushed further away from your goal of understanding and helping.
If you’re child agrees (not admits – this isn’t a police interrogation) self-harm might be linked to emotions, you can work to establish your desire to help with their emotional distress, not the self-harming.
This can be challenging as most parents want some type of assurance that the self-harm behavior will stop. Of course, a final plan must be put in place for a child to stop engaging in self-harm, but parents will harm their position if they make the entirety of the approach about halting a behavior. You can comment on the behavior without invalidating their distress.
Certainly, if your child is struggling with emotional distress and engaging in self-harm, you don’t want to help your child all by yourself. Locating a mental health professional will likely be the next step.
The good news is that intervention can be helpful. For some, psychotherapy is sufficient. For others, a combination of approaches that might include medication for an underlying disorder might help. There are no medications approved to treat the “symptom” of self-harm. The best way a parent can move their child onto a path of recovery and resilience is to be compassionate and seek to understand the underlying emotions that lead to the decision to engage in self-harm.
Resources for online version:
- Example dialogue for parents to use, including specific phrases and how to speak to your child about these issues is available in the longer version of this article online: https://www.texaschildrens.org/blog/self-harm-why-does-happen
- Psychiatry at Texas Children’s Hospital: https://www.texaschildrens.org/departments/psychiatry
- Psychology at Texas Children’s Hospital: https://www.texaschildrens.org/departments/psychology