Your child begins wearing long sleeves all the time, even in the summer. You find bloody tissues in the trashcan. And then, the pediatrician tells you about the scars he found on your child’s arms.

What is more frightening as a parent than learning your child is deliberately hurting themselves?

You probably feel helpless. Many people jump to trying to control in the face of so much fear.  Some common thoughts are, “Does my child want to die?” “Are they being ‘dramatic’?” “How do I get them to stop?” “I’m a bad parent.”

You are not alone. In fact, rates of self-harm, or non-suicidal self-injury (NSSI), tripled in the past ten years for adolescent girls. One in four adolescent girls reports self-harming.

This does need to be addressed, and only half of those who self-harm actually get treatment for it. Yet, those who self-harm are fifty times more likely to attempt suicide. This behavior is indicative of much deeper emotional issues that can be resolved.

So what do you do to help your child who is doing something that sounds so frightening and foreign?

First Steps

Here are some helpful suggestions for how to respond to finding out that your child is self-harming.

1. Confront Your Child’s Behavior In Love

Approach your child with love, concern, and curiosity. Remember that your child is not his or her behavior. Their behavior is likely coming from a place of deep emotional pain. When you have had some time to process finding out about their self-harm and are in a place of calm yourself, confront your child’s behavior directly. Be curious, not judgmental. If they feel they are being shamed, they likely will shut down. Instead, you could approach them saying, “Honey, I know you’ve been self-harming. I love you so much and it hurts me to know that you must be hurting. Could you tell me what you’ve been feeling that’s been leading you to cut? I want to help you get the help you need.”

Your child may not be ready to talk to you about it. That is normal. Sometimes, self-harming comes from difficulty communicating directly, which leads a person to communicate through their behaviors. So, don’t expect for them to become a master at expressing their emotions. If they do express the way they feel, validate their emotions (and not the action).

 If your child tells you they feel sad or depressed, validate the emotion by saying something like “I hear how sad you are. You must really be in pain if it feels like the way to get through it is to harm yourself.”

2. Create Physical Safety

Make sure that your child is safe. This means having them assessed by a doctor or therapist for risk of suicide, mental health issues, and abuse.

Partnering with your child, remove their means of self-harm from their room to create physical safety. This behavior shows them you are concerned, taking them seriously, and are with them. [Note: You can’t remove everything. If someone wants to self-harm, they will find a way to do it. The ultimate goal is for your child alternate ways of coping in therapy — not just not cutting.]

3. Create Emotional Safety

Create a safe place where your teen can talk to you about their emotions. A “safe place” would be one where a child feels their emotions are heard and understood. When you are in a place of such confusion and fear, it is important for you as the parent to use your own coping skills to remain calm and have perspective.

Self-harming does NOT mean your child is suicidal and it does NOT mean your child is just attention-seeking. If you overreact, your child will likely shut down further, retreat, and increase the self-harm. If you dismiss the self-harm behavior as merely attention-seeking, the behavior may escalate, or you could miss crucial information that could gravely hurt your child.

Ultimately, to have a safe and secure relationship, your child needs to feel and know that you are accessible to them when they need you, responsive to their emotions, and engaged in helping them meet their needs.

4. Help Them Connect with A Therapist

Your teen likely needs to feel a sense of control, so forcing them to see a therapist could make them rebel. Instead, encourage them research and “try out” a few licensed therapists until they connect with one.

Dialectical Behavior Therapy (DBT) is the “gold standard” for treating self-harming behaviors. DBT is a type of therapy that teaches how to regulate emotions by using coping skills and mindfulness. DBT was originally created to treat women who were suicidal and self-harming. Research has now proven that DBT is also highly effective in treating anxiety, depression, PTSD, eating disorders, and substance abuse.

Don’t know where to look to find a therapist that your child will be comfortable opening up to? PsychologyToday.com can be a great resource to find therapists. Also, please feel free to reach out to me to help you find a trusted professional in your area.

For more information on DBT and self-harm: https://behavioraltech.org/

Be on the lookout for my next post on the reasons for self-harm.

Sources:

reeman, Kimberly R., et al. “Outpatient Dialectical Behavior Therapy for Adolescents Engaged in Deliberate Self-Harm: Conceptual and Methodological Considerations.” Advances in Pediatrics., U.S. National Library of Medicine, 1 Apr. 2016, www.ncbi.nlm.nih.gov/pmc/articles/PMC4789287/

Klonsky, E D. “The Functions of Deliberate Self Injury.” Advances inPediatrics., U.S. National Library of Medicine, Mar. 2007.

Monto, et al. “Nonsuicidal Self-Injury…”, American Journal of Public Health 108, no. 8 (August 1, 2018): pp. 1042-1048.

Valentine, S E, et al. “The Use of Dialectical Behavior Therapy Skills….” Advances in Pediatrics., U.S. National Library of Medicine, Jan. 2015.