Help...My Child is Self-Harming! What Does it Mean? What Can I Do?

This is probably one of the most common issues I deal with when talking to parents. I’ve seen a dramatic increase in self-harming behaviors (cutting, burning, scratching, bruising, etc.) in adolescents over the past 10 years, and most parents (understandably so!) have no idea how to handle this. When I ask kids how they wish their parents would handle finding out about their self-harming behaviors, 99.9999% of them say, “I wish they wouldn’t freak out.” In their adolescent brains, I’m sure it actually does seem that simple, but their adolescent brains don’t allow them the capacity to fully understand the storm of horror, fear, concern, sadness, hurt, anger, confusion, etc. that their behavior triggers in the people who have loved and cared for them since before they were born.

Some of the reasons kids self-harm include Self-Soothing, Externalizing Emotional Pain, Attention-Seeking, and Self-Loathing. Let’s look at these in more depth:

Self-Soothing. In people who have experienced trauma, self-harming behaviors actually induce a sense of calm by activating endogenous opioid receptors in our brains. If your child has a history of trauma (something they experienced as threatening to themselves or someone else, living in chronic stress and/or instability, neglect, etc.), when they self-harm they are basically getting high and feeling like they might feel if they just ingested heroin or morphine. People without trauma only experience pain and are less likely to repeat the behaviors, but the relief self-harming provides for people with trauma history can become a highly addictive sensation and one that they are likely to repeat any time they need relief and soothing.

Externalizing Emotional Pain. Many people who self-harm describe self-harm as a way to find relief from emotional distress by making the pain tangible. When they cut or burn themselves, they are creating a visible and palpable source of pain that they describe as feeling easier to manage than something intangible like sadness, anger, or worry. This serves both as a distraction from the emotional pain and a way to make it seem more real and manageable. Self-harming can also be a way to feel something for people who feel chronically “numb.”

Attention-Seeking. This is one of the most common reasons most people looking in from the outside tend to believe that people engage in self-harm. It is definitely a legitimate reason, but, in my experience, not as common as many people think. The rise of social media has made the attention-seeking aspect of cutting more prominent, however, and it has also made it more of a “social contagion” phenomenon than it was in the past.

Self-Loathing. Sometimes people engage in self-harm as a way to express hatred toward themselves and/or their bodies. Usually this is done spontaneously in moments of frustration and humiliation, and it also aligns closely with body dysmorphia (an intense dislike for certain aspects of one’s body).

This list is not exhaustive, and people will often self-harm for more than one reason. For example, “Alex” may experiment with cutting because his friends are doing it, and then continue because it provides a powerful and addictive way to self-soothe. Similarly, “Jessica” may begin burning her thighs because she believes she is fat, and she may continue because she gets attention from friends and others for it. Identifying the reason(s) your child is self-harming can give you great insight into how to handle it. Unfortunately, getting to the reason can often be quite challenging for a number of reasons.

In my experience, most parents do, indeed, “freak out” when they first find out that their children are self-harming. This is very human and very normal. Read that again…this is a very human and very normal response! Finding out that your child is self-harming activates a number of alarming thoughts and feelings, and it also activates your primal response to protect your child. Parents in all species are wired to go into protection mode when their offspring are injured, so of course you’re going to feel “freaked out” when you see cuts or burns or bruises on your child’s body.

The key to effectively vs ineffectively handling your child’s self-harming behaviors is what you do after your initial response. Some parents run to their rooms and cry, some parents scream at their kids, some parents call the crisis line, some parents ground their kids…all very normal and appropriate behaviors when you’re having big feelings and wanting to protect your child, AND, they are not the most effective ways to handle the situation. In moving forward, your objectives are to get information and try to prevent the behaviors from happening again, but you won’t be able to achieve either of these if you are dysregulated and/or if your child feels shamed and becomes defensive and secretive. To be effective in the long-term, your number one priority in the short-term needs to be to regulate yourself, and this usually involves taking some space away from your child (after reassuring them that you love them and need to take some time to work through your feelings so you don’t freak out).

Once you are feeling more calm and centered, the most effective way to approach your child is with validation and curiosity. I want to be clear that validation does NOT mean you agree with what your child did—it simply means that you show them that you are trying to understand their experience (i.e., “I’m not sure why you did that, but I’m guessing that you might have been feeling really desperate about something. Can you help me understand more about it?”). Your child may say, “I don’t know,” and that may be true. One way you can help explore the “why” is to offer options of different emotions your child might have been feeling at the time they self-harmed (sad, worried, hurt, scared, angry, numb, bored, disappointed, etc.). Sometimes kids have a hard time connecting with and generating emotions on their own, and they more easily connect with a menu of options.

Once you know a little bit more about how your child was feeling, you can explore what your child was needing (soothing, relief, attention, expression, etc.). From there, you can brainstorm with your child other ways to meet the needs the next time those feelings and needs arise. It’s also important to let your child know that you’re available to talk the next time they have an urge to self-harm and/or the next time they self-harm. Remember, this can be an addictive behavior for some kids, and the likelihood of relapse is fairly high, which can be a terrifying thought as someone who loves and wants to protect your child. If your child knows you are going to meet any of their urges or relapses with love and support, however, instead of punishment and shame, they will be much more likely to be open with you in future instances and will be less likely to follow through with urges.

You can also collaborate with your child to find out how they would like you to support them (i.e., checking in regularly to ask about “sobriety”/urges, connecting them with a therapist, holding them accountable by doing regular body checks, not talking about it unless they bring it up, etc.). It is also important to make sure your child doesn’t have easy access to means of self-harm, and you can work together to get rid of blades, sharp objects, lighters, etc. that may be triggering for them. If your child is interested, you can also help them find an app to track their sobriety from self-harm (some kids are very motivated by this kind of thing and others are not).

If your child is not open to talking to you about their experience and not interested in collaborating with you in any way (a very typical scenario), it may help to get your child connected with a professional (licensed therapist, school counselor, physician, etc). It will also be helpful to hide or remove any means of self-harm. Even if your child is shut down, you can still let them know how much you love them and want to understand and help, and eventually they may open up to you.

Often parents assume that their child’s self-harming behavior is an indication that their child is suicidal. This is usually not the case, and research has shown that self-harm is usually not done as a suicidal gesture. Research has also shown, though, that kids who self-harm are more likely to have suicidal thoughts, but not necessarily suicidal behavior. That being said, it is important to understand that most people have occasional suicidal thoughts, and if your child is having suicidal thoughts it can be helpful to try to understand more about the nature of those thoughts. You can validate the experience of wanting to escape due to not wanting to feel the way they are feeling, and then ask things like, “When you have those thoughts do they stay stuck in your mind for a while or do they leave quickly?”, “Do you think about how you would kill yourself?”, and “How likely is it that you think you would actually act on those thoughts?”. If your child is having the thoughts regularly and they get stuck in their mind, they have a specific plan about what they would do, and/or they say they would likely act on the thoughts, please call a mental health professional or your local crisis line and get your child evaluated. More often, though, kids will say that they have occasional fleeting thoughts and maybe they have thought about a general idea of how they would do it, but they would never do it for a number of reasons.

In summary, if this is an issue you are dealing with, please know that you are not alone, and please know that it is very normal and appropriate to feel a number of big feelings about your child’s behavior, and that there are a number of reasons kids self-harm. Find ways to regulate your feelings so that conversations with your child can be as effective and productive as possible, and please contact a professional if you or your child need extra support.