Self-harm. Cutting. Self-injury. These are words that you may not be familiar with or have even heard of. Hopefully you do not have any experience with them.
Self-injury is any behavior that is done to intentionally hurt oneself. Nonsuicidal self-injury (NSSI) specifically describes the act of causing physical pain to yourself or damage to your body without intending to die from the behavior. NSSI is frequently used as a coping mechanism during times of intolerable distress when an individual does not have other, healthier ways of coping. NSSI can take a number of different forms, such as cutting or burning one’s skin, scratching, picking at scabs, head-banging, swallowing objects, cutting off circulation to a digit.
When people do find out what these words are and what they mean, it is difficult for many people to understand why a person would engage in this behavior to intentionally hurt themselves, or how that can be a way to feel better. Yet, self-harm is actually a common behavior amongst teens and young adults. Studies show that 15-21% of teens and 17-38% of college students have engaged in NSSI. So for parents, these words can be scary.
The majority of people say they engage in NSSI to make painful emotions, like sadness or shame, and negative thoughts go away. Other people hurt themselves when feeling numb and say things like “I wish I could just feel something.” Some want to make bad things stop, others want to punish themselves, and there are also people who want to let others in their life know how miserable they are. Most people say they cut or do other things to hurt themselves for more than one of these reasons.
Social media has likely played a large role in the increase in rates of self-harm. For some teens, they first engage in self-harm because they see others doing it and they want to fit in. Frighteningly, teens are posting images of themselves cutting or hurting themselves, and given the pressures to belong and have friends, teens copy the behavior, so they too can post pictures of themselves on social media in the hopes of being accepted. A search on Instagram results in millions of photos and posts about self-harm. Instagram has even had to post trigger warnings when you search for the word “cutting” because of the often-graphic nature of these posts.
Although it is upsetting that there are so many posts about self-harm on social media, social media outlets are trying to address this phenomenon. Knowing that young people use social media as a primary form of communication and entertainment, when you search for self-harm or related topics, not only does a warning appear, but so do crisis resources. Instagram asks if you are OK and want help, and Twitter serves a link connecting you to the Suicide Hotline. By simply clicking these links, a person is connected to a crisis service. Although social media may be a way for teens to seek out negative behaviors, social media is now becoming a way to easily get help. Having the numbers right at their fingertips makes it easy for young people to know that there is help and that there is another way to feel better instead of self-harming.
While an individual may find some of the support they need online, none of that can replace the support of a parent or loved one, so it is still important to know what is happening with your child and how to respond.
Here are some things you need to know about self-harm.
Self-harm can be addictive.
First, self-harm can become addictive. Someone may try it out once, and when they realize it helped make them feel better, they may be likely to do this again when upset and overwhelmed. Once this pattern starts, it can be difficult to resist the urge to harm unless there is a replacement behavior or therapeutic intervention.
Teens and young adults often fear getting caught, and will go to great lengths to cover up their behavior. Knowing what to look for and understand the signs of self-harming behavior can clue you in on whether someone you care about needs support. Warning signs or behaviors include:
- Wearing clothes inappropriate for the weather: long sleeves or pants in summer; refusal to wear a swim suit
- Blood stains on clothes or sheets
- Increased isolation (spending long periods of time in their bedroom or bathroom)
- Decrease in academic performance or less involvement in activities
- Finding hidden knives, razors, other sharp objects, matches, lighters, or rubber bands in their room or bathroom
- Increased desire to “fit in”
- Decrease in hygiene
NSSI is not suicidal behavior, but it is behavior to take seriously.
While technically your child may not be suicidal, accidental suicide from cutting too deeply, or other dangerous behaviors, is a big risk. Additionally, your child may be using NSSI as a coping mechanism for depression or anxiety and they deserve to feel better. If you suspect self-harm, talk to your child openly and honestly about your concerns in an empathetic and loving manner. You may be upset, but try not to be angry with your child. Instead, listen to what they have to say. Ask questions about what is going on that is making them want to hurt themselves, or how they feel before or after they engage in self-harm. These questions can help get to the reason they are hurting themselves, and also help to identify alternative coping strategies that work for them.
In addition to talking to your child, you may want to do the following:
- Try and find professional support for your child. It may be difficult to get your child to agree to therapy, but do your best. Let them know how much you care, and you want them to feel better. Dialectical Behavior Therapy (DBT) is the most commonly known research-supported treatment for NSSI, including in teens.
- Encourage your child to reach out to you or a friend when they have the urge to self-harm, or to find an alternative, healthy behavior. It can take time to learn an alternative coping skill, but with time, they will and can stop. Here is a list of alternatives to self-harm.
- Remove objects from the house that your child is using to self-harm.
- Try and encourage an “open door” policy in your house. Teens find comfort in their rooms and although they want and deserve privacy, until you know they are safe, it may be best to encourage them to be around the family or at least have their door open. You may start by asking (or requiring) them to come out of their room at least once a night to watch a show with the family, play a board game, or have a conversation.
Take time for yourself.
If you do suspect self-harm or learn that your child is injuring themselves, you may initially be in denial, or feel shock, guilt, or sadness; all of this is normal. Remember, this is not your fault as a parent, and you are not doing anything wrong. In fact, figuring it out means you are doing your job as a parent, and now you are going to make things better. Know that you matter, and it is important to also take care of yourself.
Remember, many people engaging in self-harm want to stop, but it is not easy to resist the urge once it becomes an addiction. Many teens start self-injuring because they have heard about someone else doing it and they think it is a “cool” thing to do, but once they start, they cannot stop.
If you’re worried about your teen or a loved one engaging in self-harm, either speak to your family physician or school counselor, or call a crisis hotline such as 1-800-273-8255 or text HELLO to 741741. You can also call Sheppard Pratt’s Therapy Referral Service at 410-938-5000 on weekdays between 8 a.m. and 4:30 p.m.
If your child is in immediate danger, call 911.
There is hope. Your child deserves to know that you are there for them and they can get better.