If you are the parent or guardian of a young individual that you think (or know) is engaging in self-harm, be aware that this behavior is more common than you may have thought. You may be wondering why they are making the choice to hurt themselves. And you certainly must be wondering what you can do to support them.

According to a study that surveyed over 40 countries, approximately 17% of individuals will self-harm at some point during their lifetime. This is especially common during adolescence, with the average age of the first occurrence at 13 years old.

Signs of self-injury include:

• Scars, especially on the arms or legs
• Isolation
• Keeping sharp objects
• The presence of multiple bandages
• Wearing inappropriate clothing for the weather.

Risk Factors:

There are certain risk factors that may make your child or teenager more vulnerable to self-harm. They include:

• Mental health issues such as depression, anxiety, eating disorders and/or personality disorders
• Substance use or abuse
• Low self-esteem
• Having family members or friends that engage in self-injurious behavior
• Stressful life events such as traumatic experiences, unstable familial relationships, or uncertainty regarding sexual orientation/identity.

Gay and bisexual individuals seem to be especially at risk; one study suggests that close to 50% of females identifying as bisexual self-harm.

How To Support Your Child:

Although you may feel frustrated or angry with your child for engaging in self-injury, a compassionate and understanding reaction is an important step to supporting your child during this difficult time.

It is best to ask your child open-ended questions, in a non-judgmental manner, about what they are feeling and what is causing the behavior. Assure them that you are there to provide emotional support at all times.

You may also talk with your child to form a list of alternative coping strategies. These may include talking to a family member or friend, or practicing techniques that provide a release similar to self-harm. Examples of the latter include:

• Exercise
• Taking a cold shower or bath
• Rubbing an ice cube on their body where they want to self-harm,
• Screaming into a pillow

Encouraging your child to seek help from a mental health professional who deals with this may be another very important way to support your child.

Treatment:

Professional treatment for self-injurious behavior can be very successful. The most common forms of treatment for self-harm are psychotherapy and/or medication.

A few different types of psychotherapy are recommended including Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), and family therapy. The goal of treatment is to help the individual to restructure maladaptive thought processes that lead to inappropriate behaviors, as well as learning more positive coping mechanisms and to better deal with unpleasant emotions.

Family therapy may also be useful, especially if there is a stressful situation going on at home, in order to develop better communication skills and understanding of presenting problems.

Finally…

Finding out that your child is engaging in self-injurious behavior can be extremely alarming and upsetting. However, with information and tools, such as coping strategies and communication techniques, you will have a better understanding of what they are going through and how you can help.

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Resources:

There are many resources available that can help you to help your child. Search online for reputable sources of information and referrals.

Here are a few suggestions to get you started:

• The Cornell Research Program on Self-Injury and Recovery http://www.selfinjury.bctr.cornell.edu/perch/resources/distraction-techniques-pm-2.pdf
• National Alliance on Mental Health (NAMI) https://www.nami.org/About-Mental-Illness/Common-with-Mental-Illness/Self-harm
• Mental Health America (MHA) https://www.mhanational.org/conditions/self-injury-cutting-self-harm-or-self-mutilation

Suggestion for further reading:

Hollander, M. Helping Teens Who Cut, Second Edition: Using DBT Skills to End Self-Injury. The Guilford Press, 2017.