Psychologist Terri Bacow offers actionable advice, along with talking points, to help your family navigate this sensitive situation.
If you've discovered that your child has been self-harming, you're likely experiencing a flood of emotions about their safety and well-being, as well as a ton of questions about how you should handle the situation. According to research provided by Mental Health America (MHA), up to 4% of American adults engage in nonsuicidal self-injury, with rates markedly higher among adolescents — 15% of teens report some form of self-injury, and that rate skyrockets up to 35% among college students. LGBTQIA+ youth are four times more likely to self-harm than their cisgender, heterosexual peers.
The fact that it’s alarmingly common for kids and teens to self-harm only heightens the gravitas parents feel upon discovering their own child engaging in this type of behavior. So, what should you do (and not do) if you find your family in that situation? How should you respond? Scary Mommy asked a mental health expert for insight.
What is self-harm?
"Self-harming behaviors include anything a person does to hurt themselves," explains Terri Bacow, Ph.D., New York-based psychologist and author of Goodbye Anxiety. The term is typically used interchangeably with self-injury, self-mutilation, or self-abuse. "These behaviors tend to include cutting, burning, or pinching one's skin or banging one's head against the wall." Other forms of self-injury include: scratching at skin to the point of drawing blood, punching (either oneself or other objects), infecting oneself, inserting objects into body openings, drinking harmful agents (like bleach or detergent), and breaking bones purposefully.
Skin cutting is the most common form of self-harm, at 70-90% of cases, while head banging or hitting is 21-44% and skin burning at 15-35%. Most people who engage in these behaviors have more than one method of self-harm.
"Typically, people engage in these behaviors in private," says Bacow. "Self-harm can occur for many reasons, and the most common one is that the individual is trying to seek relief from intense negative emotions and numb emotional pain."
What are the signs of self-harm in children?
Keep in these signs are not always direct indications that your child is self-harming, but it is behavior you should note in case you are worried.
- Cuts, bruises, or burns are unexplained around the wrists, arms, and thighs.
- An increased habit of wearing long sleeves or clothing that covers in even hot weather.
- An apprehension to get changed in front of others.
- A significant change in eating habits that ranges from either over to under-eating.
- A compulsive need to exercise.
Does self-harm mean your child is suicidal?
Bacow notes that most forms of self-harm fall under the umbrella of nonsuicidal self-injury (NSSI), which means they do not indicate a suicide attempt. Research shows that NSSI behaviors are most common among adolescents and young adults, typically beginning around age 13 or 14. And while self-harming doesn't necessarily mean your child is in imminent danger or having active suicidal thoughts, studies have shown a markedly high correlation between NSSI and suicide attempts. In fact, 70% of adolescents engaging in NSSI reported a lifetime suicide attempt, and 55% reported multiple attempts, according to a 2006 study.
What should you do if you discover self-harming?
First, you'll want to tend to any acute injuries and seek immediate medical attention if necessary, notes Bacow. "Parents should immediately attend to wounds/injuries, seek medical attention if needed, and remove any items the child used to harm themselves (i.e., discard razors, hide knives, lock up cabinets where the harmful objects can be found). Parents should then immediately seek professional care for their child. This would involve contacting your child's therapist or psychiatrist or calling your pediatrician to get an immediate referral to a therapist or psychiatric care provider."
Bacow emphasizes that any evidence of self-harming should be treated professionally, "ideally a psychologist or psychiatrist, and ideally someone who practices an approach called dialectical behavioral therapy (DBT). DBT is the gold standard treatment for addressing self-harm in children and adolescents. This skills-based form of therapy teaches coping mechanisms for promoting emotion regulation, including alternatives to self-harm," such as distraction, movement, guided meditation, and the like.
No matter how scary the situation might seem to you as a parent, staying calm and approaching your child in a gentle, shame-free manner is of utmost importance. As for what you can say to them, Bacow recommends something like: "I am so sorry to see you going through this, and I am worried about you and want to keep you safe. I am going to find you an expert to talk to who will help you, and I am here to support you in any way I can." Anger, aggression, or frustration isn't the way to get through to your child, who is clearly struggling in a significant way.
"Parents should interpret these behaviors as the child struggling with emotional pain, such as anxiety, depression, trauma, intense negative emotions," says Bacow. "The child likely does not truly wish to hurt themselves, but rather seek relief — in some cases, rather than pain, self-harm can bring a sense of relief and calm. Rather than self-harming, parents can encourage the child to come to them when they are intensely upset to talk it out, or engage in an alternative coping strategy such as distraction. But quite honestly, self-harm is an area where a parent should absolutely not go at it alone and should seek expert guidance from a therapist."
She adds, "Self-harm may simply be a child's attempt at emotion regulation, but either way, should be taken very seriously. Self-harm is a signal that a child is really suffering and is trying to escape feelings of intense emotional pain. Parents and caregivers should take all means to prevent the self-harm from happening again and ask the child if they are having any thoughts of [suicide] — though a risk assessment is best done by a professional, which is why parents should seek professional help immediately."
What resources are there for worried parents?
Aside from reaching out to your child’s doctor or school for local resources, here are some links that might be helpful:
- American Psychological Association’s Find a Psychologist tool
- Asian Mental Health Collective’s therapist directory
- Association of Black Psychologists’ Find a Psychologist tool
- National Alliance on Mental Illness Helplines and Support Tools
- National Queer and Trans Therapists of Color Network
- Inclusive Therapists
No matter what’s going on, you (and your child) don’t have to go it alone.
If you or someone you know is considering self-harm or experiencing suicidal thoughts, call the National Suicide Prevention Hotline at 1-800-273-8255 or text HOME to the Crisis Text Line at 741741.
Terri Bacow, Ph.D., New York-based psychologist and author of Goodbye Anxiety
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