Understanding & Helping Teenagers Who Self-Harm
Self-harm is a difficult, but important topic.
As parents and adults who care about teenagers, we need to educate ourselves so that we can help the kids we love.
There is often a misconception around non suicidal self injury (NSSI) that it is always associated with suicidal behavior. Although self-harm and suicidal behavior can occur simultaneously in the same person, it is not always the case.
Most people who self-harm use the behavior to relieve negative feelings, increase positive emotions and relieve or eliminate the overwhelming ones. NSSI is often impulsive and the thoughts to self-harm often happen within an hour of the behavior.
Download our resource: 27 Tips for Managing Self-Harming Behaviors
There's no one single or simple cause that leads someone to self-harm.
In general, self-harm may be related to poor coping skills. It is usually the result of an inability to deal in healthy ways with psychological pain. The teenager has a hard time managing, expressing or understanding their emotions.
The mix of emotions that trigger self-harm is complex. For instance, there may be feelings of worthlessness, loneliness, panic, anger, guilt, rejection, self-hatred or confused sexuality.
That is a lot for anyone to deal with, especially teenagers who are going through so many changes.
A teenager who uses self-harm might be trying to . . .
Manage or reduce severe distress or anxiety and get relief
Distract themselves from difficult emotions through physical pain
Feel a sense of control over their body, feelings, or life situations
Feel something, anything, even if it's physical pain
Express internal feelings in an external way
Communicate depression or distressing feelings to the outside world
Punish themselves for perceived faults
Deal with difficulties in personal relationships
Make a statement of helplessness, hopelessness or worthlessness
Self-harm usually occurs in private and is done in a controlled or ritualistic manner that often leaves a pattern on the skin.
Some examples of self-harm include:
Cutting (cuts or severe scratches with a sharp object)
Scratching
Burning (with lit matches, cigarettes or heated, sharp objects such as knives)
Carving words or symbols on the skin
Self-hitting, punching or head banging
Piercing the skin with sharp objects
Inserting objects under the skin
Most frequently, the arms, legs, and front of the torso are the targets of self-harm, but any area of the body may be used. Teenagers who self-harm may use more than one method to harm themselves.
Becoming upset can trigger an urge to self-harm. Many teenagers self-harm only a few times and then stop. But for others, self-harm can become a long-term, repetitive behavior that usually follows a pattern.
It usually starts with a negative thought that leads to building tension, an urge to act and then actually self-harming. This is followed by a feeling of relief, then shame, which can be quite intense.
After a teen harms themselves and a parent or adult finds out, it is important to evaluate the gravity of the crisis to determine the best plan of action
Assessment includes inquiring and asking direct questions about thoughts of suicide
Whether or not they have a plan or idea of how they would do it, how frequently and intensely they feel suicidal (rating scales are helpful), do they have the means to follow through with a plan and do they have a history of self-harming and/or suicide attempts.
Most people who self-harm are teenagers and young adults, although those in other age groups also use this negative coping skill. Self-harm often starts in the preteen or early teen years, when emotions are more intense and teens face increasing peer pressure, loneliness, and conflicts with parents or other authority figures.
Certain factors that may increase the risk of self-harm, include:
Having friends who self-harm. Teens who have friends who intentionally harm themselves are more likely to begin self-harming.
Difficult life circumstances. Some people who injure themselves were neglected, sexually, physically or emotionally abused, or experienced other traumatic events. They may have grown up or still be in an unstable family environment. Young people questioning their personal identity or sexuality are also at risk. Some teens who self-harm are socially isolated.
Mental health issues. Teens who self-harm are more likely to be highly self-critical and be poor problem-solvers. In addition, self-harm is commonly associated with certain mental health disorders, such as borderline personality disorder, severe depression, anxiety, post-traumatic stress disorder and even eating disorders.
Alcohol or drug use. Teens who harm themselves often do so while under the influence of alcohol or recreational drugs.
These situations are often complicated by:
Worsening feelings of shame, guilt and low self-esteem
Infection, either from wounds or from sharing tools
Permanent scars or disfigurement
Severe, possibly fatal injury
Worsening of underlying issues and disorders, if not properly treated
Getting help is hard, scary and vulnerable.
It takes a lot of courage to be honest about the struggles and seek help.
Download our resource: 27 Tips for Managing Self-Harming Behaviors
Teens often fear being viewed as “weird”, “abnormal”, “crazy” or “sick” by others. They might also be afraid of being punished by parents or caregivers for lacking the ability to control their emotions, manage impulsive behaviors and causing the family additional stress.
It is important to get help and create a strong support system around young people who struggle with self-harm
Counseling for the teen and possibly the family is a good start. Parents often need help as well, because this is a distressing and confusing time for everyone.
Get in touch with us today and find out how counseling can help your teenager and your family.
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